Antimicrobial dosing and kill characteristics

A topic much loved by the CICM Fellowship examiners… and with good reason, it is important stuff! there is no point giving antibiotics if they don’t kill bacteria – getting the dosing and timing right is essential.

Spontaneous breathing and mechanical ventilation

Eventually, every mechanically ventilated ICU patient that survives needs to start breathing for themselves. However, timing is everything and there are pros and cons to spontaneous breathing during mechanical ventilation. How can we ensure it is safe?

Therapeutic Drug Monitoring

Which drugs should you do it for and when? Therapeutic Drug Monitoring is probably under utilized in critically ill patients and is especially important for antibiotics and transplant immunosuppression.

Trismus and restricted mouth opening

Trismus can be scary for the patient and for the treating physician. This page emphasizes the differential diagnosis, complications, and treatment from the viewpoint of critical care and airway management.

Urine drug screen

The bane of the clinical toxicologist… Urine drug screens rarely change the management of acute toxicological cases and have numerous limitations. These include variations in the drugs assayed, false positives and negatives, and prolonged detection times. Perhaps their biggest limitation is a lack of awareness of their limitations by doctors…