PulmCrit (EMCrit)

Anticholinergic intoxication has been a moving target recently, with a resurgence in the popularity of physostigmine.  The thoughtful administration of physostigmine has much to offer these patients, but it must be provided within the context of a systematic approach. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on […]

Neuroleptic malignant syndrome is rare, but this will be encountered in the ICU.  Particularly with the rising utilization of antipsychotics for a variety of indications (e.g., emesis, agitation), we should be cognizant of this entity.  Another relevent cause of NMS is abrupt withdrawal of Parkinson’s medications (e.g., due to NPO status). The IBCC chapter is […]

The critical care community has long been plagued by a series of antiquated, overbearing guidelines created by the Surviving Sepsis Campaign (SSC).  The campaign was originally sponsored by Eli Lilly and Edwards Life Sciences, as a commercial marketing campaign.  The backbone of the original guidelines was a single center trial by Rivers, which has failed […]

Local Anesthetic Systemic Toxicity (LAST) is fortunately extremely rare.  However, with the ongoing expansion of nerve blocks and lidocaine infusions in a variety of different contexts, this is likely to be seen more often over time.  Prompt recognition and antidotal therapy are essential. The IBCC chapter is located 👉 here. The podcast & comments are […]

Calcium channel blocker poisoning is one of the most formidable intoxications encountered critical care.  As for most topics in toxicology, there is no level-I evidence regarding this.  This chapter explores treatment options for beta blocker and calcium channel blocker poisoning, with the admitted limitation that it’s impossible to know which treatments are optimal and in […]