Introduction with a clinical question A young woman is transferred to the ICU from an outside hospital due to severely depressed mental status, thought due to intoxication. You evaluate her intracranial pressure using ocular ultrasonography. Evaluation of the optic disc diameter in both eyes and in both orientations yields four measurements: 5.5 mm and 6.0 […]
The ideal suction tool for intubations is debatable, but it seems clear that the Yankauer is a poor choice. Persistent use of the Yankauer suction catheter for airway management represents a profession-wide failure in our ability to manage large-volume regurgitation.
The ketamine-tolerant patient presents a quandary to clinicians who aren’t familiar with this phenomenon. The first time I encountered this, I was baffled and aborted the procedure after giving 200 mg ketamine. Eventually I realized that the drug isn’t “failing” to work, but rather we are failing to administer a sufficiently high dose.
Effective, rapid peer review allows for the creation of a new series of posts. These posts will cover material which isn’t supported by much evidence nor experience. In the past, I wouldn’t have felt comfortable posting this material to the blog.
As with many uncommon situations that are unique to critical illness, we cannot always rely on specialist consultation. Critical care practitioners must develop a firm grasp of this diagnosis. This post will explore some diagnostic conundrums in brain death diagnosis. The radionuclide flow scan is emphasized because it is the most commonly used tool to sort out difficult cases.