CONTENTS Overview Pharmacodynamics Pharmacokinetics Diagnostics & doses Clinical evolution Treatment Activated Charcoal Whole bowel irrigation Neurotoxicity management Cardiotoxicity management Podcast Questions & discussion Pitfalls Bupropion is increasingly used for several indications (depression, tobacco cessation, and ADHD). Unfortunately, it is also a uniquely dangerous and increasingly common source of intoxication (especially the extended-release formulations). For example, […]
Search Results for: airway
Typical bacterial pneumonias
CONTENTS Streptococcus pneumoniae (pneumococcus) Streptococcus pyogenes (Group A strep) Staphylococcus aureus (MSSA & MRSA) Haemophilus influenzae Moraxella catarrhalis Pseudomonas aeruginosa Klebsiella pneumoniae Other related topics: Rhodococcus equi Questions & discussion abbreviations used in the pulmonary section: 3 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid […]
EMDOCS.net hosted me on Ask Me Anything
EMDOCS.net brought me on for an AMA session
Situation Awareness in Resuscitation by Mike Lauria
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PulmCrit hot take: VAP prophylaxis (PROPHY-VAP trial)
background: ANTHARTIC trial Prophylaxis against VAP (ventilator-associated pneumonia) is already supported by a few studies in the literature, perhaps most notably the ANTHARTIC trial. That was a multicenter RCT evaluating 48 hours of therapy with amoxicillin/clavulanate for patients intubated following cardiac arrest. Antibiotic therapy reduced early-onset VAP, with a trend towards more ventilator-free days (further […]
Management of COVID-19 patients admitted to stepdown or ICU
CONTENTS Rapid Reference 🚀 Initial tests to guide management Chest CT findings Organ support Cardiovascular Respiratory Noninvasive respiratory support Invasive mechanical ventilation Infectious disease – antibiotics Renal Hematology Neurology Immunomodulation Steroid Tocilizumab Baricitinib Tofacitinib Things that don’t work Remdesivir Convalescent plasma Questions & Discussion References checklist for COVID admission to ICU/stepdown ✅ Review medication list […]
EMCrit 371 – Iodinated Contrast Issues: Part 2 – Contrast Reactions
Continuing on our contrast issues theme…
ICU care post craniotomy
CONTENTS General approach to neuroworsening after cranial surgery General postoperative management considerations Hemodynamics Seizure prophylaxis Analgesia & sedation Nausea and vomiting Fever Sodium abnormalities DVT prophylaxis General complications Intracranial hemorrhage Cerebral infarction Seizure Cerebral edema CSF leak Hydrocephalus Infectious complications Tension pneumocephalus Selected procedures Decompressive craniectomy Posterior fossa surgery Pituitary resection Carotid endarterectomy or stenting […]
PulmCrit: ARDS vs. pseudoARDS – Failure of the Berlin definition.
Did this woman have ARDS? According to the Berlin Definition shown below, she had moderately severe ARDS while on conventional low tidal-volume ventilation (P/F ratio of 166). However, she didn’t meet the definition of ARDS while she was APRV, a few hours earlier (P/F ratio 475). Her overall clinical course with prompt recovery and weaning off oxygen is inconsistent with the natural history of ARDS.
Brain Death
CONTENTS Brain death basics Clinical presentation of brain death Clinical context Clinical findings in brain death Spinal reflexes Diagnosis of brain death (1) Initial suspicion (2) Evaluate for confounders Excluding drug intoxication (3) Dedicated neurologic examination (4) Apnea test (5) Confirmatory test PRN If brain death is confirmed: Immediate next steps Supportive care prior to […]
EMCrit RACC Lit Review – January 2024
All the lit goodness for Jan 2024
Acute exacerbation of interstitial lung disease (AE-ILD)
CONTENTS Definition and background Clinical presentation Differential diagnosis Investigation History Physical examination Laboratory studies CT scan Bronchoscopy Treatment Medical therapy D/c potential pneumotoxins Antibiotics Immunosuppressive therapy Diuresis & volume management Antifibrotic therapy Respiratory support Noninvasive respiratory support Invasive mechanical ventilation Lung transplantation Prognosis Questions & discussion abbreviations used in the pulmonary section: AE-ILD: Acute exacerbation […]
Pulmonary arteriovenous malformations (PAVMs) & other rare pulmonary vascular disorders
CONTENTS Basics Epidemiology Symptoms Radiology of PAVMs Diagnosis of HHT (hereditary hemorrhagic telangiectasia) Management Management of PAVMs Management of HHT (hereditary hemorrhagic telangiectasia) Other rare pulmonary vascular disorders: Pulmonary artery aneurysms & pseudoaneurysms Pulmonary vein thrombosis/occlusion Platypnea-orthodeoxia syndrome Questions & discussion abbreviations used in the pulmonary section: 8 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute […]
PulmCrit- New guidelines simplify ICU nutrition
Introduction to nutritional dogma Everyone has strong opinions about food. We all feel that we have some special, intuitive understanding of nutrition. Nonsense. Such intuitions have historically created a wide array of dogma regarding nutrition, complicating matters immensely. Fortunately, the 2016 SCCM/ASPEN guidelines have stripped away much of the nonsense involved in nutritional support. This […]
COVID 19 Complete Chapter
CONTENTS Basic biology Infection control Transmission Personal protective equipment (PPE) Diagnosis Signs & symptoms Labs Imaging CXR & CT scan Lung ultrasonography General approach to imaging Bronchoscopy Diagnostic approach for admitted patients Treatment: General protocols ED patients getting admitted to the hospital Inpatient management of hypoxemic, non-intubated patients Intubated patients Treatment: Specific anti-viral & immunosuppressive […]
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