PulmCrit (EMCrit)

When treating anaphylaxis, epinephrine is generally given via an intramuscular (IM) route.  This is well established to be effective and life-saving.  One advantage of IM administration is immediate use (without requiring intravenous access), including by patient auto-injection.  IM epinephrine is doubtless the best approach for patient self-treatment, for first responders, and for immediate treatment in […]

Tumor lysis syndrome isn’t encountered very often in critical care, but we will see the most extreme extent of this illness.  Within the last decade, rasburicase has been a game-changer here.  Understanding some basic physiology will guide the optimal diagnosis and treatment of tumor lysis syndrome in the post-rasburicase era. The IBCC chapter is located […]

There is currently an outbreak of vaping associated pulmonary injury spanning several states, which is under intense investigation by the Centers for Disease Control.  We will certainly be learning more about this in the coming weeks to months. However, for now, how should we manage patients who present in respiratory distress following vaping?  This chapter […]

Magnesium might be the darling ion of critical care.  It has an interesting array of therapeutic applications ranging from asthma to Torsade de Pointes to preeclampsia.  This pair of chapters discusses the evaluation of both hypomagnesemia and hypermagnesemia. IBCC chapter on hypomagnesemia is located here. IBCC chapter on hypermagnesemia is located here. The podcast & comments […]

How much fluid can safely be removed from a pleural effusion during a thoracentesis? Much has been written about this, but solid evidence remains elusive.