When you think of "toast," you think of sliced bread browned by radiant heat. When I think of "toast," I think of the Trial of Org 10172 in Acute Stroke Treatment. We are not the same.

Every Monday I get to play my favorite game in the ICU: Pneumatic Tube Hide and Seek! This is where ICU staff hide (hoard) the tubes all weekend so I can find them first thing Monday morning. Anyone else play this game?

We all know that ICU patients are at risk of 🌊 FLUID OVERLOAD 🌊 which increases morbidity AND mortality. While it is a good first step to limit all “maintenance” fluids, do not forget to account for all IV intake! Keep reading for a discussion on IV fluid intake in the ICU. 👇

This week in the ICU I d/c’d inappropriate antibiotics, caught and fixed med errors, and optimized sedation drips to facilitate faster vent weaning But the thing I’m most proud of is tracking down a pen so a ventilated patient could better communicate with his family #PharmICU

Question: Are there any vaccines that have been tested in a randomized controlled trial? Answer: Yes, yes, a thousand times yes! See the linked spreadsheet below as well as a list of all the different vaccine targets that I could find on "quick" review! docs.google.com/spreadsheets...

I'm kind of a big deal. #PharmICU

mo problems.

Friends don't let friends put nonsensical allergies in their medical records!

How I imagine very joint commission surveyor

Thank you to those who participated! The correct answer is “SUBQ”! ✅ Per the ISMP, “SC” can be mistaken as “SL” (sublingual), “SQ” as “5 every,” and the “q” in “sub q” as “every.” ❌ Best practice: use “SUBQ” (all uppercase, no spaces) or just write out “subcutaneously.” 👍

Per the ISMP, which is the BEST practice for abbreviating the word “subcutaneous(ly)”? 🤔 Answer below and I’ll follow up with the answer in 24 hours! 👇🙏 A. SC B. SQ C. sub q D. SUBQ

Had a great time at #ACCPAM25! Back to the real world now but I left with new motivation for my work thanks to so many wonderful, inspiring people. 🙏 Minneapolis, MN ➡️ Jackson, TN

When a physician changes all my recommendations I carefully crafted and ordered

ANOTHER @BradSpellberg shoutout! What else can you expect when a clinical session is titled “‘Myth-Conceptions’: Debunking Common Myths in Infectious Diseases” #ACCPAM25

Shorter is Better gets a shoutout at #ACCPAM25 @bradspellberg.bsky.social

Standing room only! #ACCPAM25

Okay Minneapolis, I wasn’t familiar with your game! #ACCPAM25

Flying out to a conference today! My presence is already putting people on alert. 😤💪 As in, I set off the body scanner alarm at the airport and had to get a full-body pat down. 🤦‍♂️

We ALL know dexmedetomidine (Precedex) and propofol (Diprivan) are preferred over benzodiazepines in ICU patients requiring sedation (shoutout PADIS guidelines). BUT (as there are exceptions to every rule) here are some situations to "consider" BZDs. 🧐 Keep reading below! 👇

Only 10 days until the 2025 ACCP Annual Meeting in Minneapolis! Who else is going to be there? 🙋‍♂️ Bonus points if you can share some touristy things to do/places to eat… 🙏

An ICU rounds convo… Me: Can we reduce duration of ABX to 7 days? Them: Isn’t 10-14 more appropriate for gram (-) bacteremia? Me: Per the BALANCE trial, a 7-day course of ABX was non-inferior to 14 days. Them: Is this in guidelines yet? Me: … What would YOUR response be??

Name that drug!

How many of us working in the ICU use the term "stress dose steroids" daily but are unsure where the term comes from? For me, I learned how to order hydrocortisone well before I understood “why” these doses were used. Read below for a quick thread on stress dose steroids! 1/8

Sorry albumin, ICU pharmacists ACTUALLY reduce mortality 🤓👏💊 journals.lww.com/ccmjournal/f...

“So, pharmacists can also work in hospitals.”

Anyone have a good article on natural versus vaccine-induced immunity? Thanks! 🙏

When is the answer to “which vasopressor should we use?” NOT norepinephrine? 🤔 Share your answers below! 👇

The plight of the non-physician AKA Debating whether a problem with the patient is big enough to contact the physician or if that will just get you yelled at

Submit your @sccmcriticalcare.bsky.social abstracts before midnight tonight!

“Patient has been advised against continued alcoholism.” 👏👏👏 No notes, job well done!

The only Fantastic Four (Ts) that matters: Thrombocytopenia Timing Thrombosis oTher causes

We need a head-to-head double-blinded RCT of cane sugar versus high fructose corn syrup to put this debate to rest

Waiting for (Doctor) Godot

How the mighty have fallen

A lot to process here

To all the new attendings: you got this! Trust your training, but also know you will continue to learn and get better every day. More importantly, ask your pharmacists lots of questions!

To your knowledge/per your hospital policy, what are the max volumes for IM and SUBQ injections?

Just because an antibiotic “covers” an organism doesn’t mean it COVERS that organism

The Pitt taught me I can get away with anything in the hospital as long as I say I learned it from a case report published in the New England Journal of Medicine

The real reason I take a day off from the ICU is to remind the intensivists how bad they have it without a pharmacist

“Did I order that DNR on the wrong patient?”

Pharmacist typing a kinetics note that no one will ever read

Pro tip for new residents/hospital employees: use the mirror domes Repost to save a life/embarrassment

My super power is speedily identifying pop song titles for the acoustic guitar covers playing in my coffee shop

Guidelines love to suggest and consider

The unrivaled hubris of thinking you can solve all health problems by removing artificial food dyes

"Joint commission can arrive any day at this point."

Me: Pt on Merrem and Flagyl. Can we d/c Flagyl to avoid dual-anaerobic coverage with Merrem? Hospitalist: No pt is worsening at this point deescalating ABX would be inappropriate Me: Please just let me cook