Kat Chester, PharmD, BCCCP, FNCS

We do more than rise and shine ☀️ We caffeinate and intubate! Thank you #SESCCM for the new, blue coffee machine! ☕️☕️☕️
#critcaremonth
#SCCM

Today's the day to turn your ICU blue! 💙 Show off your blue scrubs, decorations, treats, and all the other ways you're celebrating today using #critcaremonth
#SCCM

💫 Practical advice for intraventricular meds (Part 5):
Flush with PF saline? Sure. But what if it’s not compatible with your drug, like amphotericin B? Simple—just flush with the CSF you definitely took out before giving the drug (right?). Who needs saline when you got the good stuff? Problem solved

💫 Practical advice for intraventricular meds (Part 4):
🐌 How slow can you go? Administer drug slowly over a couple minutes. Drug should be prepared in smallest size syringe 💉 that can hold the drug volume—>helps provider better control the admin rate = less pressure and gentler administration

1/9
🤔 Why doesn't an elevated BUN lead to extreme thirst? If increased serum osmolarity compels us to seek water, uremia should be a significant driver of this craving.

And yet, it isn't.

Let's examine why.

We need in-house free VPA levels everywhere, STAT for our SE pts. With total levels, what you see 👀 is NOT what you get 👺📈

💫 Practical advice for interventricular Meds (Part 3):
Volume of CSF removed prior to administration = drug volume. In the cranial vault, small volumes can have big impact especially when ICPs are of concern. In this case, every drop really does count 💧⚖️💧

#neurocrit #pharmsky

Neurocritical Care Society Podcast: HOT TOPICS: The PROPHY-VAP Study In this episode of Hot Topics, Dr. Nicholas Morris interviews a professor of anesthesia and intensive care at the University of Poitiers, to explore the groundbreaking PROPHY-VAP trial published in ...

Intrigued by the PROPHY-VAP trial? Don’t miss this interview with author Claire Dahyot-Fizelier, MD, Ph.D. Great insights including this key takeaway: it’s not a blanket approach—consider inclusion/exclusion criteria for application in practice. Tune in for the full conversation! bit.ly/4eYuwUs

⬆️ ICP means avoiding central catheterization of internal jugular due to ⬇️ venous return, right?

Wrong, according to work by my colleagues! @emoryneurocrit.bsky.social

"Contrary to classic teaching ... IJ CVC placement was not associated with increased ICP"

pubmed.ncbi.nlm.nih.gov/39592540/

💫 Part 2:
Best to keep intraventricular meds < 2-3 mL/dose, ideally. Preservatives? No thanks! 👎 They can cause ADEs in the 🧠 Some are probably safer than others, but until we get better data, the rule of thumb is to avoid them in intraventricular meds and use preservative-free flush 💦

Yes! 👍

💫 Practical advice for intraventricular meds (Part 1):
🔎 Determine the volume of the EVD lumen, from med access site to catheter tip. That’s your flush volume. It’s like a small chaser (usually 2-3 mL) to ensure the entire dose goes in smoothly. 💉🧠
#Pharmsky #Pharm2Table #neurocrit

📣 🛑 Don’t combine these two drugs! More VPA levels & higher doses won’t solve the issue. It’s often easier to choose a different antibiotic than adjust a patient’s AED regimen, which may need EEG—hard to get in resource-limited settings. Neuro, ID, & Pharm must collaborate. #IDsky #Pharmsky #Medsky

Thanksgiving is a cranial nerve celebration! 🦃🧠 #neurosky

CN I: Smell the turkey
CN Il: See the feast
CN III, IV, VI: Keep eyes on the pie
CN V: Chew the stuffing
CN VII & IX: Taste the flavors
CN VIII: Hear the laughter
CN X: Digest it all
CN XI: Lift the turkey platter
CN XII: Toast your thanks

I’m so jealous 😟 🎁

Cardiovascular Surgery / ECMO Critical Care Pharmacist | Mayo Clinic | Rochester, Minnesota Mayo Clinic is hiring for Cardiovascular Surgery / ECMO Critical Care Pharmacist . Rochester, Minnesota · Apply on HealtheCareers.com

‼️🫀 Looking for a CV surgery/ECMO pharmacist job? Check out this opportunity at Mayo Clinic

💊 Work with some rockstar pharmacists
📖 Lots of research opportunities
👩‍⚕️ Collaborative multidisciplinary environment

❓Feel free to message me with questions!

www.healthecareers.com/job/Cardiova...

I’m thankful for the glymphatic system that launders my brain each night. Time for a deep clean! Good night 😴

Dachshund wearing a prescription bottle costume saying “doxycontin: take 1-5 photos hourly as needed for puppy fever. Pet as directed. May cause serotonin syndrome”

The drug we all need: doxycontin

Any PGY1 Pharmacy residents on here?

💎💎💎
Grady’s Neurology Pharmacy Residency program isn’t just about learning—it’s about growing your expertise in a specialty few others get to master 🦄
💎💎💎
#Pharmsky
#NeuroPharm #PharmacyResidency

#NeuroCriticalCare enthusiasts be sure to add this to your feeds!

Pin it to the top of your profile and you can choose to scroll only #NeuroCritCare content at any time!

@vasisht.md @caseyalbin.bsky.social
@soojinpark.bsky.social
@ajwpharm.bsky.social

bsky.app/profile/did:...

Can we use direct thrombin inhibitors or GPIIbIIIa inhibitors with thrombolytics for AIS? Dr. Morgan Daniel walks us through the literature

First up on #NCSPharmJC: Medina Halimanovic, PharmD, PGY2 CC resident an IU Health is presenting the TRACE III trial on TNK up to 24 hours after AIS with LVO without thrombectomy

@neurocritical.bsky.social

✨Starting soon! ✨
Log in to learn and support our Grady PGY2 Neurology Resident, Morgan Daniel, PharmD

Join us for the @neurocritical.bsky.social November Pharmacy Journal Club TOMORROW, 11/22 at 2pm EST! DM me for Zoom information or find it on the NCS Pharmacy Connect page.

Two excellent articles on AIS care - TRACE III and MOST - will be presented!

#NCSPharmJC

Writing a letter of reference for someone? Or (gasp) drafting for someone who’s writing for you?

If you haven’t seen this graphic on avoiding gender bias, read it. Ref letters are broadly biased in both major and seemingly tiny ways. The bias is avoidable once you’re aware.