Critical Concepts

buddy I am with you x.com/critconcepts...

I had two minds to write a letter to the editor on the obvious physiologic error, but ran out of motivation

This week on the podcast, Jon-Emile Kenny on fluid resuscitation and his wireless doppler device for predicting responsiveness

icuscenarios.com/episode-93-f...

#medsky #emimcc

Prophylaxis is growing on me. Nothing worse than withdrawal developing in someone admitted to the ICU for another reason

We explore the rare but scary phenomena of propofol infusion syndrome (PRIS) and propylene glycol toxicity, with our favorite toxicologist Jerry Snow.

icuscenarios.com/episode-92-p...

#emimcc #medsky

Because like all peripherals, they can fail

We demo a simulated goals of care conversation on this week's episode at icuscenarios.com/episode-91-a...

#medsky #emimcc

But like amio, I think many times, after a day or two the need has passed. Much of our RVR is transient

same as amio

hard to hurt anyone with a dose or two

Agree somewhat, but should acknowledge the dosing issue, as these folks were on a high dose range. Not sure if it’s generalizable to a low dose strategy.

My mind became a little more open when I rechristened this method as “asking someone to Google it for you,” which is more or less what I would have done otherwise, and I already understand the pros and cons of that well.

Subdissociative dosing at most for pain. Stay way out of a partial dissociation range

How does a town get a cervical collar named after it

Had a great time chatting with you guys about residual NMB and reversal strategies in the ICU! Thanks so much for the conversation and for highlighting this topic.

#emimcc #medsky #pharmsky

I am both

I guess it would make sense for the two systems to behave similarly, but I could just as easily see the opposite being true

But what of the venous side?

ACCRAC Podcast Anesthesia and Critical Care Reviews and Commentary

I joined the ACCRAC podcast to discuss one of my favorite topics: physiologic methods to determine the best PEEP. Check it out if you're into that! accrac.com/episode-314-...

#emimcc #medsky

#medsky peoples: alpha agonists cause more venoconstriction than vasopressin. Agree/disagree?

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The great @sarajpharmd.bsky.social tells us how to use sugammadex in the ICU, why we should, and how many of our patients may have occult residual paralysis. #medsky #emimcc icuscenarios.com/episode-90-s...

Then you gotta hold it like a mountain climber until the wire’s in

epic case 🤯

man trying to eat a better diet asks ChatGPT how to eliminate chloride, it advises him to use *bromide* instead

he buys NaBromide from the internet

develops bromism (with psychosis)

key diagnostic clue = negative anion gap!

(more on low anion gap emcrit.org/ibcc/agma/#l...) #EMIMCC

This week on the show, Leeah Sloan gives us the straight scoop on the new CHEST critical care APP certification program.

icuscenarios.com/lightning-ro...

#medsky #emimcc

I need one of those graphic T shirts Facebook keeps trying to sell me with an image of a grizzly doing curls. Caption: “Weight bear”

#medsky

Interesting. Thanks!

For pancreatitis?

Looking to subscribe to the Academy? To celebrate our 1-year anniversary, we're running a sale for the month of August: use the code AUG25 for 20% off all new subscriptions. Check it out!

#medsky #emimcc

Always associated this with gluconate. Chloride too?

From our new lesson in the SICU program: Abdominal emergencies and damage control surgery

Available at icu101.com

#medsky #emimcc

not common but it’s there. I’m thinking about patients on 4-6 liters O2 baseline, etc - doesnt take much to precipitate ICU admit

man openevidence is good

I have usually assumed nobody is really getting critically ill from the latter, but I admit I don't have proof of that. There must be some data on it somewhere. (Or maybe not... hard to diagnose these.)