We are frequently faced with patients who require reversal of anticoagulation due to hemorrhage or an emergent procedure. This has grown rather complicated, due to the emergence of numerous new anticoagulants and reversal agents. Furthermore, new evidence is emerging regarding the reversal of old agents (e.g. the PATCH trial regarding platelet transfusion in patients on aspirin).
by Howard Greller In the late 1880’s, University of Hamburg Professor Ludwig von schlechte Schalentiere was convicted for the shocking and untimely deaths of tens of his fellow Hamburgers. Proclaiming his innocence until his death in prison, he would never live to see his name cleared. What led to the suspected poisoning deaths of so […]
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 […]