0 Introduction: Selecting the best balanced crystalloid 0 About six months ago, Genius General Hospital added Normosol to its formulary. For those of you not familiar with Normosol, it is produced by Hospira and is essentially a generic version of Plasmalyte by Baxter (table below). Although most evidence has been obtained with Plasmalyte, this is […]
Search Results for: acid base
EMCrit 85 – A Confirmation of Prejudices: Chloride and Pressure Poisoning
In this Hurricane Sandy episode of the EMCrit podcast, I talk about the confirmation of two of my clinical prejudices.
EMCrit 242 – ED Nephrology with Joel Topf aka KidneyBoy
ED Nephrology with the Kidney Boy, Joel Topf
You Don’t Understand the Osm Gap – Guest Post by Rory Spiegel
Think you understand the Osm Gap–you don’t
Salicylate intoxication
CONTENTS Rapid Reference 🚀 Diagnosis Epidemiology Signs & symptoms General laboratory abnormalities Salicylate level Treatment Airway management & decontamination Delirium & dysglycemia Alkalinization Volume resuscitation Hemodialysis Lab monitoring When to stop Podcast Questions & discussion Pitfalls Salicylate intoxication checklist ✅ Labs & targets (cycle q2hr until resolution) 📖 Glucose: Target >80-100 mg/dL if altered mental […]
PulmCrit: pH-guided fluid resuscitation & BICAR-ICU
The use of bicarbonate is a source of eternal disagreement. Bicarbonate has a shameful history of being abused in situations where it’s unhelpful (e.g. cardiac arrest). This has impugned its reputation, giving it an aura of ignorance and failure. Consequently, bicarbonate is underutilized in some situations where it might actually help.
EMCrit 369 – Iodinated Contrast Issues: Part 1 – Is Contrast-Induced Nephropathy (CIN) a Thing in Patients with Tenuous Renal Function
Do you still need to worry about contrast in patients with tenuous renal function?
Table of Contents
SYSTEMS Cardiology Endocrinology Gastroenterology Hematology & Oncology Infectious diseases Nephrology Neurology Obstetrics Pulmonology Rheumatology Toxicology & Temperature Overview: Guide to supportive care in critical illness Medication reconciliation in the ICU About this book How to create your own IBCC smartphone app 📲 General Approaches to problems Cardiac arrest 🔜 Chest pain Hypertensive emergency SCAPE (Sympathetic […]
Respiratory alkalosis (hypocapnia)
CONTENTS How important is hypocapnia? Definition & diagnosis Clinical features Causes of hypocapnia Evaluation Consequences of hypocapnia Management Podcast Questions & discussion Pitfalls Hypocapnia is the most common acid-base disorder among critically ill patients.(12097540) This shouldn’t be surprising, since hypocapnia may be caused by almost any pulmonary disease, pain/anxiety, or sepsis – exceedingly common conditions […]
PulmCrit Table of Contents (TOC)
TOPICS airway & procedures cardiology endocrinology gastroenterology hematology/oncology infectious diseases nephrology neurology pulmonology rheumatology toxicology methodology & miscellaneous Airway pharmacology Medication sequence: rocketamine vs. keturonium Ketamine-tolerant patient Catastrophic complications, ROC vs. SUX Arterial lines: wrist versus the groin? Cricothyrotomy in asphyxial cardiac arrest Difficult airway communication via allergy list Drowned airway Large-bore suction strategies & […]
EMCrit 309 – Critically Ill Diabetic Ketoacidosis (DKA)
Critically Ill diabetic ketoacidosis is usually a bit of a misnomer
CC Nerd-The Case of the Neutral Documents
A brief editorial aside: Both Josh and Scott have commented on the BICAR-ICU Trial in previous posts, each presenting well thought out erudite analyses. I recommend reading/listening to them. EMCrit: Acid Base Episode 7 PulmCrit: pH-guided fluid resuscitation & BICAR-ICU The overwhelming need for euboxia has inspired a multitude of therapeutic endeavors, including the use of […]
Metabolic alkalosis
CONTENTS Diagnosis Symptoms Causes Investigation Treatment When to treat? Multimodal therapy Hydrochloric acid Podcast Questions & discussion Pitfalls Metabolic alkalosis may be diagnosed in two situations (red arrows above): (1) If the serum bicarbonate is elevated (>28 mM), this alone reveals a metabolic alkalosis. (2) If the anion gap is elevated but the reduction in […]
Blood gas measurements in DKA: Are we searching for a unicorn?
Routinely obtaining an ABG or VBG is widely recommended, for example in both American and British guidelines. Why? Is this helping our patients, or is it something that we do out of a sense of habit or obligation?
Non-anion-gap metabolic acidosis (NAGMA)
CONTENTS Diagnosis Causes Investigation History Laboratory workup for RTA (renal tubular acidosis) Type IV RTA Treatment Podcast Questions & discussion Other topics Urine anion gap (UAG) Pitfalls The diagnosis of NAGMA may be made in one of two ways: (red arrows above) Patient has normal anion gap with metabolic acidosis (bicarbonate < 22 mM). Patient […]
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