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.
Untreated pain, anxiety, and agitation have both short- and long-term consequences for our critically ill patients. More importantly, it is well-known that patients remember...
Critically ill patients receiving mechanical ventilation require analgesia and sedation. At present, propofol remains the most widely used sedative for intubated/ventilated patients. Recent trials...
Emergency medicine, critical care, and resuscitationists often use the Shock Index to identify patients with increased mortality. The Shock Index is calculated by dividing...