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Yes. I think your answer is wrong.

Well -- the relevance is that we're talking about measuring the partial pressure of CO2 in the exhaled gas. In my model, there's little reason it should not equal the arterial partial pressure. In yours it should be much lower.

Eh... I think I have to disagree with this, guys. COPD patients who "retain" don't have an elevated pCO2 because it's not diffusing into their alveoli. It's elevated because they can't exhale it from their alveoli. CO2 diffuses briskly, but is exhaled slowly, so it quickly forms an equilibrium...

Works fine. The only time I think it's a poor choice is when patient factors (such as dyssynchrony) create inconsistent compliance; this tends to confuse the vent and result in weird volumes. Or when you really want to tightly control all of your variables, and -- let's say -- directly control...

I guess I can't speak to all of the older models, but I don't think it's possible to have pressure control without a variable flow. Here's why: the basic premise of pressure control is that you reach a target pressure and then hold it for a set time. (At least, by convention this is how it...

I would say it manipulates inspiratory pressure to reach target volume. All pressure control manipulates flow (to reach the target pressure); variable flow based upon patient demand is a hallmark of pressure modes.

If you're thinking that the higher you get, the more people agree, I have some sad news for you.

This is an interesting thought! It does make sense that mean airway pressure should be the respiratory parameter most closely associated with intracranial pressure. Usually in the ICU we can directly follow the latter to see the effects of vent changes, but it's reasonable to do it empirically...

Hard to say as we pretty much always have the CT. If he were truly unresponsive with a blown pupil after the initial event I suppose I would consider an empiric slug of hyperosmolar therapy. Not sure what you mean about using pressure control. I would say to intubate in the field if you're...

It's relevant because opioids don't do us any more favors than they do you. (Plus we have plenty of postsurgical/post-trauma folks who are basically your patients anyway.) They slow vent weaning, decrease mobility, worsen pulmonary toilet, slow gut motility, etc. Less is better, but at least in...

Interesting stuff. How much juice do you get out of the clonidine? The parallel for us is presumably dexmedetomidine, but while I know they say it's an analgesic, I've never found it to be all that potent for pain. Are hemodynamics limiting? Assume it's just one part of a larger puzzle, of...

So what are you using intraop for analgesia? Nothing?

Interesting -- but don't opioids also "prevent" wind-up and hyperalgesia to a certain extent? May be more a matter of timing (early/pretreatment) versus agent?

No expert in this area. I certainly do think that there is probably a faster onset of analgesia with IV forms, and this can be relevant/useful. Especially, of course, in those who can't take PO. The immediate post-surgical period being both, that is where I have seen the best utility for a dose...

Not to be Boring Brandon, but I feel obliged to point out that IV ketorolac is not all that much better than oral NSAIDs (like the ibuprofen in your cabinet), and IV acetaminophen is not better than oral acetaminophen. They're just available for those who can't take pills. Which I bet most of...

Venous samples are reliably a few points off, if the meter is calibrated for capillary samples. A lot of meters can be set for either. Capillary samples can be off by much more than that in the critically ill, so I personally believe in using venous (or arterial) samples when possible, even in a...

Kidding. Paper dictionaries are getting rare these days. I think using an iPad might void the warranty.

A what?

I mean, a few days ago popped my own ganglion cyst with a needle, but I wouldn't go try it on a patient. (Incidentally: swabbed with alcohol.) Bit of a different standard. The only person who's gonna yell at you for doing dumb stuff to yourself is your mom.

People do indeed get cellulitis and the like from scrapes and lacerations. This is a bit of a weird discussion. Are we in a dystopian future without alcohol swabs? Are we bored enough that we're curious how much Zen-like minimalism our care can embody? Lots of the stuff we do has relatively...