Pharmacy - Emergency Medicine Deep Dive Podcast
Pharmacy - Emergency Medicine Deep Dive Podcast delivers high-impact, high-yield clinical pearls in emergency medicine, with a focus on pharmacotherapy and EM critical care. Each episode explores real-world cases, unpacks emerging research, and breaks down the latest evidence to support confident, informed decisions at the bedside. Notebook LM AI cuts down the time spent on manual scripting and narration, making episode production more efficient while maintaining expert insight and timely, practical knowledge. If you’re into meds, mechanisms, and critical decision-making, this is for you!
Episodes
Code Blue: The Impact of Emergency Pharmacists on Resuscitation Outcomes
When a cardiac arrest or trauma activation is called, most people think of physicians, nurses, and respiratory therapists. But what role does the emergency medicine pharmacist play when every second counts? In this episode, we explore the growing evidence behind pharmacists on resuscitation teams, from improving ACLS guideline adherence and reducing medication errors to helping deliver life-saving
Antithrombotic Resumption After Intracranial Hemorrhage
Restarting blood thinners after an intracranial hemorrhage is one of the most challenging decisions in neurology and stroke care. Restart too early and the risk of recurrent bleeding rises. Wait too long and patients may be left vulnerable to stroke or other thromboembolic complications. In this episode, we break down the latest evidence on when to resume antiplatelet and anticoagulant therapy, wh
Norepinephrine as the Preferred Vasopressor After Cardiac Arrest
Your patient has a pulse again, but will your vasopressor choice determine whether they keep it? In this episode, we tackle one of the most common yet underappreciated decisions in post-cardiac arrest care: epinephrine or norepinephrine for post-ROSC hypotension. We break down the physiology of the stunned myocardium, explore why epinephrine may increase the risk of recurrent cardiac arrest, and e
Prolonged Beta-Lactam Infusion Strategies in Sepsis: A Deeper Dive
Sepsis demands timely, effective antimicrobial therapy, but does how we administer beta-lactam antibiotics matter? In this episode, we take a deeper dive into the growing evidence behind prolonged beta-lactam infusion strategies and explore why recent guidelines now recommend extended or continuous infusions for many patients with sepsis and septic shock. We unpack the pharmacokinetic and pharmaco
Ketamine During OAT Initiation: Can It Help in the Fentanyl Era?
Ketamine is best known for its roles in analgesia, sedation, and depression, but could it also help patients navigate the most challenging phase of opioid agonist therapy initiation in the fentanyl era? In this episode, we explore the emerging science behind ketamine as an adjunctive treatment for opioid withdrawal and OAT initiation, including its potential effects on NMDA receptors, opioid toler
Time Is Blood: Why Early TXA Saves Lives in Trauma
In this episode, we explore the race against time in trauma care and why every minute matters when treating life-threatening bleeding. Drawing on evidence from major clinical trials and meta-analyses, we examine how tranexamic acid (TXA) can dramatically improve survival when administered as early as possible after injury. You'll learn why the greatest benefits occur within the first hour, why
Blood Pressure Management in Acute Intracerebral Hemorrhage
How low should you go when lowering blood pressure in acute intracerebral hemorrhage, and can treating too aggressively actually cause harm? In this episode, we explore the pathophysiology of ICH, including why spontaneous hemorrhage lacks a true ischemic penumbra and how perihematomal benign oligemia supports the safety of blood pressure reduction. We review the landmark INTERACT-2 and ATACH-II t
Clinical Management of Toxicological Seizures
In toxicology-induced status epilepticus, the clock starts ticking the moment first-line benzodiazepines fail. In this episode, we dive into the evolving evidence behind second-line therapies for benzodiazepine-refractory seizures, exploring why phenobarbital remains the best-supported option based on pharmacologic principles and animal data, while propofol emerges as a powerful rescue therapy in
Tenecteplase vs Alteplase: The Evolving Standard for Ischemic Stroke
Stroke thrombolysis is rapidly evolving and tenecteplase is emerging as one of the most exciting developments in acute ischemic stroke care. In this episode, we explore how a simple change from a one-hour infusion to a single IV bolus could transform stroke treatment workflows, improve transfer logistics, and potentially enhance early reperfusion in some patients. We unpack the science behind tene
Pharmacological Priorities in Emergency Upper Gastrointestinal Bleeding
In this episode, we dive into the evolving evidence behind proton pump inhibitors (PPIs) in the management of nonvariceal upper gastrointestinal bleeding. While PPIs have long been considered standard early therapy, emerging data challenge whether starting treatment before endoscopy meaningfully improves major clinical outcomes such as mortality, surgery, or overall rebleeding rates. We explore ho
Is Ondansetron Really Dangerous? A Deep Dive into the Data
Ondansetron is a widely used antiemetic, but concerns have long circulated about its potential to prolong the QT interval and trigger dangerous arrhythmias like torsades de pointes. In this episode, we explore what the evidence actually shows, drawing on large-scale research including a review of over 32,000 surgical patients and a meta-analysis of 170 clinical trials. The data consistently sugges
Safety of Co-administering Olanzapine and Benzodiazepines for Acute Agitation
In this episode, we unpack the long-standing controversy around combining IM olanzapine with benzodiazepines like lorazepam in the management of acute agitation. While warnings from regulators such as the U.S. Food and Drug Administration have historically discouraged this pairing due to concerns about respiratory depression, we take a closer look at the data behind those risks. Emerging evidence
Corticosteroids in Severe Pneumonia: The CAPE COD Debate
In this episode, we break down the landmark CAPE COD trial and what it means for treating severe community-acquired pneumonia. Discover how early hydrocortisone use can significantly reduce mortality and the need for mechanical ventilation in critically ill patients, and why that is reshaping clinical practice. We also explore contrasting evidence from other studies, fueling an ongoing debate abou
Hypertonic Saline and Furosemide in Acute Heart Failure Management
What if a simple shift in how we use fluids and diuretics could transform outcomes in acute heart failure? In this episode, we explore the emerging strategy of combining hypertonic saline with high dose furosemide and why it is gaining attention in acute decompensated heart failure care. We break down how this approach can enhance fluid removal, improve kidney function, and even reduce mortality a
CCM 2026 Surviving Sepsis Campaign Guidelines: Precision Pharmacotherapy Unpacked
Sepsis care is entering a new era, as the 2026 CCM Surviving Sepsis Guidelines shift practice away from “throw everything at it” toward precision pharmacotherapy, giving the right drugs at the right dose and stopping unnecessary ones early. In this episode, we break down the strongest recommendations, from extended-infusion β-lactams that optimize antibiotic exposure to permissive hypotension stra
Essential Clinical Pearls for DOAC Therapy
Choosing the right DOAC is not just about preventing clots, it is about maximizing safety for every patient. In this episode, we unpack the latest evidence on direct oral anticoagulants, including the practice changing COBRRA trial comparing apixaban and rivaroxaban. Discover why similar effectiveness can come with very different bleeding risks, and how that should shape your prescribing decisions
Critical Care Antibiotic Pharmacokinetics and Dosing Strategies
What happens to antibiotics when the body is in crisis? In this episode, we dive into the fascinating and often unpredictable pharmacokinetic changes that occur in critically ill patients and why these shifts make precise antibiotic dosing essential. We explore how conditions such as sepsis and aggressive fluid resuscitation can dramatically alter drug distribution and clearance, especially for hy
Ketamine for Rapid Control of Excited Delirium
When a patient arrives in the emergency department in a state of extreme agitation or excited delirium, every second counts. In this episode, we explore the growing use of ketamine as a rapid intervention to control dangerous psychomotor agitation when traditional sedatives may act too slowly. Research shows ketamine can achieve adequate sedation far faster than medications like haloperidol, loraz
ACLS Medications 2025: What the AHA Guidelines Really Say
In this episode, we unpack the 2025 ACLS medication updates from the American Heart Association and what they mean for real-world cardiac arrest care. Epinephrine remains the standard for improving short-term survival, but evidence is still limited when it comes to long-term neurological outcomes. Alternative vasopressors and high-dose strategies show no clear advantage and routine use of calcium,
Still Febrile: When Ongoing Fevers Don’t Mean Treatment Failure
The fever persists but does that mean treatment is failing? Not necessarily. In this episode we unpack why ongoing fevers do not automatically signal the need to escalate antibiotics. Instead, smart stewardship focuses on the bigger picture including hemodynamic stability, improving organ function, and microbiologic data that reveal the true course of infection. You will learn how to interpret per
When Medications Fail: Can Keto Stop Seizures?
Drug resistant status epilepticus and seizures are some of the highest stakes emergencies in the ED. In this episode, we explore the ketogenic diet as an emerging strategy for patients who continue seizing despite standard therapy. We highlight how quickly seizure control can be achieved, why early initiation in critically ill patients is gaining attention, and how this therapy is starting to infl
Ketamine and Second-Line Agents in Status Epilepticus Management
Status epilepticus is a true neurologic emergency where every minute matters. In this episode, we review modern emergency management strategies, starting with benzodiazepines as first line therapy and examining why traditional second line agents like levetiracetam often fall short in rapidly stopping seizures. We explore growing evidence supporting the early use of ketamine, highlighting its abili
From Rate to Rhythm: Why Early Treatment Changes Atrial Fibrillation Outcomes
Rate control has long been the default strategy for atrial fibrillation, reserving rhythm control primarily for symptom management. In this episode, we examine the EAST-AFNET 4 trial and the evidence supporting early rhythm control as a means to reduce stroke and cardiovascular death in patients diagnosed within the past year. We discuss how timely initiation of anti arrhythmic therapy or catheter
When Heart Failure Improves...What Comes Next?
Heart failure looks better on paper but is it really gone? In this episode, we explore the landmark TRED HF trial and why a recovered ejection fraction in dilated cardiomyopathy often represents remission rather than cure. Nearly 40% of patients relapsed within six months of stopping therapy, and that risk rose to 65% over five years, sometimes even after medications were restarted at lower doses.
Ketamine as a Neuroprotective Agent Following Cardiac Arrest
In this episode, we explore the potential of ketamine as a neuroprotective therapy for patients recovering from cardiac arrest. Brain injury after arrest often follows a “two-hit” process of ischemia and reperfusion, triggering toxic chemical cascades that damage neurons. As an NMDA receptor antagonist, ketamine may interrupt these pathways and help preserve cognitive function. While animal studie
Medetomidine: Clinical Realities of a New Illicit Drug Toxidrome
This episode explores the emergence of medetomidine, a powerful veterinary sedative, now appearing in the illicit opioid supply and rapidly replacing xylazine across various regions of the United States and Canada. Clinicians are reporting a severe and unfamiliar withdrawal syndrome marked by extreme hypertension, rapid heart rate, and persistent vomiting, often requiring ICU care and resisting st
Rethinking Rate Versus Rhythm Control in Atrial Fibrillation
When managing atrial fibrillation, clinicians face a pivotal choice...control the heart rate or restore normal rhythm. In this episode, we explore emerging evidence showing that for patients with long standing atrial fibrillation, neither strategy clearly outperforms the other in overall cardiovascular outcomes. However, timing changes everything. For patients diagnosed within the past year, early
The RSI Trial: Ketamine Versus Etomidate
In this episode, we dive into the RSI Trial, a groundbreaking study comparing ketamine and etomidate for rapid sequence intubation in critically ill adults. While the trial found no difference in 28-day mortality between the two drugs, it revealed that ketamine was linked to more episodes of cardiovascular collapse, largely due to increased vasopressor use. We unpack the clinical debate around thi
Sodium Content in Common ED Antibiotics: A Hidden Risk in CHF
When patients arrive with acute decompensated heart failure, IV antibiotics are often started “just in case.” But what if that precaution is doing more harm than good? In this episode, we break down new research showing that unnecessary IV antibiotics, packed with extra fluid and surprising amounts of sodium, can worsen outcomes, extend hospital stays, and even increase readmissions. We explore wh
Lithium Toxicity, Interactions, and SILENT Syndrome
Dive into the complex world of lithium management as we explore how the drug is processed in the body, how common medications affect its levels, and the risks of chronic exposure. We unpack SILENT syndrome, a serious form of long term neurotoxicity, and challenge conventional wisdom around dialysis for lithium toxicity. Discover why careful monitoring and hydration may be safer than rapid interven
The Imperfections of Creatinine Clearance in Drug Dosing
Renal drug dosing is more complex than most clinicians expect. This episode examines why common creatinine based measures such as creatinine clearance and estimated glomerular filtration rate can be misleading, from the biological limitations of creatinine to the risks of applying the wrong calculation to the wrong medication. These inaccuracies can have real clinical consequences, particularly fo
Rethinking Beta-Blockers After MI
In this episode, we explore the growing debate around the role of beta blockers after myocardial infarction, especially for patients who have a preserved or only mildly reduced ejection fraction. Recent studies have challenged the long standing assumption that all post MI patients benefit equally, suggesting that while beta blockers remain essential for those with reduced heart function, their adv
Optimizing Piperacillin-Tazobactam Dosing for Pseudomonas
In this episode, we dive into the evolving strategies for treating Pseudomonas aeruginosa infections with piperacillin-tazobactam (PTZ). Challenging the conventional high-dose approach of 4.5g IV every six hours, recent evidence and Monte Carlo simulations suggest that more isn’t always better. For most strains with MICs ≤8 mg/L, the standard 3.375g IV Q6H is usually sufficient, while higher MIC i
Drug Protein Binding and Clinical Implications
In this episode, we dive into the critical role of drug protein binding in pharmacokinetics and why it matters for patient care. Only the unbound, or free, fraction of a drug is pharmacologically active...available for distribution, metabolism, and elimination. We explore how highly protein-bound drugs, often bound to albumin, act as reservoirs, influencing drug half-life and distribution. Changes
Rocketamine vs. Keturonium: Managing Rapid Sequence Intubation
In this episode, we dive into a critical and controversial aspect of rapid sequence intubation (RSI)...the optimal order of administering rocuronium, a paralytic, and ketamine, a sedative. We explore recent research, including a Monte Carlo analysis that quantifies the risk of anesthetic awareness when rocuronium is given before ketamine, highlighting the chilling possibility of patients being par
Anticoagulation in Chronic Kidney Disease
Managing anticoagulation in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) is a complex clinical challenge. In this episode, we explore the delicate balance between preventing venous thromboembolism (VTE) and minimizing bleeding risks in this vulnerable population. We discuss the evolving role of direct oral anticoagulants (DOACs), including the limited and often con
SQuID Protocol in Mild-Moderate DKA
What if treating diabetic ketoacidosis didn’t always require IV drips, ICU beds, or long hospital stays? In this episode, we explore the SQuID protocol, a cutting-edge approach that uses subcutaneous insulin for mild to moderate DKA. Evidence shows it can safely resolve DKA, speed up recovery, and free up critical hospital resources...all while keeping outcomes comparable to traditional treatment.
Rapid Antiseizure Medication Administration
When every second counts, speed matters. But how fast is too fast when it comes to giving intravenous antiseizure medications? In this episode, we dive into the latest research on rapid administration of lacosamide, levetiracetam, and valproate. From intravenous push to piggyback infusions, we break down what the data says about safety, side effects, and real-world efficiency. Join us as we explor
Warfarin and Antibiotic Interactions
Dive into the world of pharmacology as we explore how warfarin interacts with antibiotics at a molecular level. This episode highlights the crucial role of CYP2C9 metabolism in regulating S-warfarin and explains why certain antibiotics, like metronidazole and fluconazole, can significantly impact INR levels. We also unpack the challenge of separating true drug-drug interactions from infection-driv
Tranexamic Acid Unpacked: Evidence vs. Expectations
Tranexamic acid (TXA) has been hailed as a game-changer in bleeding management...but does the evidence really support its widespread use? In this episode, we dive into the research behind TXA across multiple clinical settings: trauma, surgery, postpartum hemorrhage, GI bleeds, intracranial hemorrhage, and more. We explore landmark trials like CRASH-2 and CRASH-3, discuss why small positive studies
Tranexamic Acid: The 90-Minute Trauma Window?
In this episode, we dive into a groundbreaking exploratory analysis from the Annals of Emergency Medicine examining the PATCH-Trauma trial. Researchers investigated the optimal timing for administering tranexamic acid (TXA) to patients with severe trauma, challenging the long-standing 3-hour window established by the CRASH-2 trial. The findings are striking...giving TXA within 90 minutes of injury
BRASH Syndrome
BRASH syndrome is more than the sum of its parts. In this episode, we unpack this complex clinical entity defined by bradycardia, renal failure, AV node blocker use, shock, and hyperkalemia...and explore how these factors create a dangerous, self-perpetuating cycle. You’ll learn how to distinguish BRASH from isolated hyperkalemia or AV blocker toxicity, understand the synergistic physiology behind
Sliding Scale Furosemide for CHF
In this episode, we explore an innovative approach to managing congestive heart failure (CHF) in the Emergency Department: the use of a patient-directed, weight-based sliding scale furosemide plan. This strategy empowers patients to adjust their diuretic dose based on daily weight changes, aiming to improve self-management, reduce ED visits, and prevent hospital admissions. We also examine the rol
Pharmacotherapy for Insomnia
What exactly qualifies as insomnia...and how does it differ from the occasional restless night? In this episode, we unpack the clinical definition of insomnia and demystify key sleep science terms like sleep latency, total sleep time, and sleep efficiency. We explore the far-reaching impacts of chronic insomnia on both physical and mental health, before guiding you through evidence-based treatment
Anticoagulation in Cirrhosis
Patients with hepatic cirrhosis are uniquely at risk for both bleeding and clotting, making anticoagulation decisions complex. In this episode, we explore how cirrhosis alters coagulation, the pros and cons of LMWH, warfarin, and DOACs, and why INR isn’t a reliable guide. We also discuss the challenges of managing anticoagulation around procedures and how to individualize therapy in the face of li
Gabapentin vs. Pregabalin for Chronic Neuropathic Pain
In this episode, we dive into the clinical nuances of using gabapentin and pregabalin for chronic neuropathic pain. Join us as we unpack the evolving approach to gabapentinoid prescribing, including key pharmacologic differences, practical dose limitations, and when to consider switching therapies. Learn why doses of gabapentin above 1800 mg/day may not provide added benefit...and how pregabalin’s
Antiemetics Uncovered: Side Effects, Interactions, and Clinical Pearls
In this episode, we explore how a targeted approach to neurotransmitters such as serotonin, dopamine, and acetylcholine, can optimize antiemetic therapy. We break down key safety concerns for commonly used agents, including QT prolongation with ondansetron, extrapyramidal effects from metoclopramide and phenothiazines, and anticholinergic risks with diphenhydramine. Tune in for practical tips to b
Status Epilepticus Treatment Approach
In today’s episode, we explore the updated approach to managing status epilepticus. We walk through a practical, stepwise treatment strategy starting with benzodiazepines, followed by ketamine, and then anti-epileptics like levetiracetam and lacosamide. We also cover recommended intubation and general anesthetic choices for refractory cases, emphasizing the importance of early airway management. S
Aspirin for Venous Thromboembolism Prophylaxis in Orthopedic Trauma
In this episode, we dive into the PREVENT CLOT trial, which compared aspirin to low-molecular-weight heparin (LMWH) for thromboprophylaxis in orthopedic trauma. While the study found aspirin to be noninferior in preventing all-cause mortality, some clinicians raise concerns about its limited generalizability. We break down the findings, the controversy, and what it all means for real-world practic
IV Push Antibiotics in the Emergency Department
In this episode, we dive into the evolving practice of administering intravenous (IV) push antibiotics, a method gaining traction across emergency departments and outpatient antimicrobial programs. Prompted in part by IV fluid shortages during natural disasters, healthcare providers have increasingly embraced IV push for its speed, efficiency, and potential to reduce hospital stays. We explore wha
Rapid Buprenorphine Induction with Low-Dose Naloxone
In this episode, we explore a groundbreaking case report introducing a novel approach to buprenorphine induction for patients with Opioid Use Disorder, especially those using fentanyl. Learn how low-dose intravenous naloxone is used to safely trigger moderate withdrawal, allowing for immediate buprenorphine initiation and dramatically shortening the induction timeline. Tune in to hear how this pro
Anticoagulant and Antiplatelet Reversal
This episode covers practical, evidence-informed strategies for reversing anticoagulant and antiplatelet medications in critical bleeding scenarios, including intracerebral hemorrhage. We review reversal protocols for warfarin, dabigatran, and Factor Xa inhibitors, and discuss the roles of PCC, FFP, DDAVP, and tranexamic acid. Key pitfalls in reversal therapy are examined, along with guidance on t
Liver Assessment and Drug Impact
In this episode, we break down how to assess liver injury and understand its impact on drug therapy. We explore the difference between liver enzymes and true liver function tests, why normal labs can be misleading in cirrhosis, and how impaired hepatic metabolism affects drug efficacy and toxicity. Tune in for practical insights on adjusting medications safely in patients with liver dysfunction.
Toxicology Key Principles
This episode takes a deep dive into the fundamentals of medication overdose management in hospital and critical care settings. We explore the four key pillars of treatment: supportive care, antidotes, decontamination, and enhanced elimination...highlighting why supportive care often makes the greatest impact. You’ll also learn key clinical pearls and considerations to guide decision-making and nav
Pharmacists and Emergency Code Response
This episode highlights the vital role of emergency pharmacists during high-stakes resuscitations such as cardiac arrests and trauma codes. We explore how their involvement improves patient outcomes by reducing medication errors, ensuring accurate dosing, and contributing to rapid clinical decision-making. Backed by research, we also discuss the importance of targeted training programs that go bey
Diuretic Resistance in Congestive Heart Failure
In this episode, we dive into the complex issue of diuretic resistance in congestive heart failure (CHF), focusing especially on loop diuretics. We break down how these medications work, why they sometimes stop working, and the physiological mechanisms behind resistance including post-diuretic sodium retention, the braking phenomenon, and cardiorenal syndrome. You'll also hear about evidence-based
Levetiracetam Dosing for Refractory Status Epilepticus
In this episode, we explore the role of levetiracetam (LEV) dosing in the management of benzodiazepine-refractory status epilepticus (BRSE), a life-threatening neurologic emergency. We review recent evidence comparing lower (<30 mg/kg) versus higher (≥30 mg/kg) weight-based LEV loading doses. The findings suggest that higher doses are more effective in terminating seizures and are linked to imp
Phenobarbital for Alcohol Withdrawal
In this episode, we examine phenobarbital monotherapy as an emerging approach to managing alcohol withdrawal syndrome. We discuss the advantages of phenobarbital over traditional benzodiazepine-based regimens, including more predictable pharmacokinetics, a wider therapeutic index, and broader neurological effects. Topics include accurate diagnosis, the benefits of phenobarbital’s long half-life fo
ActionADE Unpacked
In this episode, we explore ActionADE—a web-based application designed to prevent repeat adverse drug events (ADEs), a major cause of emergency room visits in Canada. We discuss how the platform improves communication across healthcare settings by standardizing ADE documentation and sharing it through connected electronic systems. Learn how pharmacists and clinicians are using ActionADE to make sa
Acute GI Bleeding
In this episode, we explore evidence-based pharmacological treatments for severe gastrointestinal bleeding, drawing from Cochrane systematic reviews. Topics include the use of antibiotic prophylaxis in cirrhotic patients to prevent infections and reduce mortality, the impact of proton pump inhibitors (PPIs) started before endoscopy on patient outcomes, and the effectiveness of somatostatin analogu
Advanced Trauma Life Support
In this episode, we focus on Advanced Trauma Life Support (ATLS) principles, with a special emphasis on the role of tranexamic acid (TXA) in trauma care. We review key clinical trials, including CRASH-2 and CRASH-3, discussing their findings, methodologies, and ongoing debates about TXA’s efficacy and safety in major trauma and traumatic brain injury. Additionally, we cover important trauma manage
Hyponatremia
In this episode, we explore hyponatremia, a common yet complex electrolyte disorder in hospitalized adults. We discuss causes, diagnostic approaches, and treatment strategies, including the DDAVP clamp-bolus technique for precise sodium correction. We also review recent evidence showing that more rapid correction of severe hyponatremia may be associated with reduced mortality and shorter hospital
Status Epilepticus
In this episode, we explore the urgent management of convulsive status epilepticus, focusing on the efficacy and safety of anticonvulsant medications. We review first-line benzodiazepine therapy and examine second-line options—including fosphenytoin, phenytoin, levetiracetam, and valproate—with insights from the ESETT trial showing similar effectiveness among them. We also discuss the emerging rol
ACLS_ Algorithms and Pharmacology for Cardiac Resuscitation
In this episode, we dive into the latest updates on medications used in Advanced Cardiovascular Life Support (ACLS), focusing on epinephrine, amiodarone, lidocaine, vasopressin, and esmolol. We also discuss the VSE protocol (vasopressin, steroids, and epinephrine), highlighting its potential to improve ROSC outcomes. Additionally, we review changes in timing, dosing, and clinical indications, alon
Diabetic Crises: DKA and HHS
In this episode, we provide a thorough overview of Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS), two critical diabetic emergencies. Drawing from the EMCrit Project’s expert content, we cover key topics including diagnosis, pathophysiology, and practical management strategies such as fluid resuscitation, electrolyte replacement, and insulin therapy. We also address complex
Sepsis, Shock, and Adrenal Insufficiency
In this episode, we dive into the latest evidence-based guidelines for managing sepsis and septic shock from the Surviving Sepsis Campaign 2021. Topics include fluid therapy, vasopressor use, and long-term patient outcomes. We also discuss insights from the EMCrit Project, an independent platform providing practical, cutting-edge perspectives on timely intervention in sepsis care, including a crit
Sublingual Levodopa
In this episode, we explore an innovative approach to managing Parkinson’s symptoms in patients with swallowing difficulties. Hear the story of an 85-year-old man with Lewy body dementia who experienced rapid symptom relief through sublingual administration of crushed levodopa/carbidopa—a practical alternative when traditional oral or rectal routes aren’t feasible. We discuss the challenges of med
Acute Stroke
This episode explores key aspects of managing cerebrovascular events, with a focus on intracranial hemorrhage (ICH) and ischemic stroke. We review clinical trials investigating optimal blood pressure targets in acute ICH, and discuss best practices for managing subarachnoid hemorrhage (SAH), including blood pressure control and seizure prophylaxis. Guidelines for reversing antithrombotic agents in
Rapid Sequence Intubation
This episode provides a comprehensive overview of Rapid-Sequence Intubation (RSI), a vital procedure for securing a patient’s airway. It explores the pharmacology, pharmacokinetics, and safety of medications used in RSI, focusing on pretreatment, induction, and paralysis. Key sedative induction agents such as etomidate, ketamine, and propofol, along with neuromuscular blockers like succinylcholine
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