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 critical analysis of the fallacy of time-to-intervention studies and their impact on clinical practice.

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 medication delivery in dysphagic patients, the potential benefits and limitations of sublingual dosing, and the need for further research to optimize this promising method.

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 various types of ICH are covered, along with a deep dive into the evidence behind alteplase use in acute ischemic stroke, including major trials like NINDS, ECASS-III, and IST-3—highlighting the evidence, controversies, and evolving practice considerations.

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 and rocuronium, are discussed in terms of their benefits, contraindications, and side effects. The episode also highlights the critical role of the emergency department pharmacist in ensuring safe and effective RSI, including medication selection and managing challenges such as drug shortages.