Acute mental status changes after the ingestion of alcohol or other substances are a common presentation to the ED. Those with severe obtundation may require intubation for airway protection while the substance metabolizes. In fact, more than 20,000 patients are intubated each year in the United States for acute poisoning or intoxication. Notwithstanding, intubation and mechanical ventilation are not benign procedures. In this podcast we discuss the recently published NICO Trial, that evaluated a strategy of withholding intubation in patients with coma due to acute poisoning.
Etomidate and ketamine are frequently used for RSI in critically ill patients. Recent articles have raised concern about an increased incidence of post-intubation hypotension...
Hyponatremia is one of the most common electrolyte disorders encountered in emergency medicine and critical care. Patients with hyponatremic encephalopathy represent a severe form...
Current international guidelines recommend TTM for adult patients with ROSC from OHCA who remain comatose or unable to follow verbal commands. However, the overall...