This week is nurses' week and I have an episode on why you should become a nurse during these times. I hope you enjoy this week's episode. 

I hope you get valuable information from this episode and don't forget to subscribe to the podcast, leave a review on wherever you listen to your podcasts, save this episode for future references, and share this valuable information with other fellow clinicians to build a strong community of informed providers.

JR

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We all have been in that situation where we need to replace potassium but after several doses, the potassium level seems to not go up. This might be because many patients with hypokalemia have hypomagnesemia as well.

This is because the ROMK channels, which control potassium secretion, are inhibited by magnesium. Therefore, we need to replace the magnesium before replacing the potassium.

I hope you get valuable information from this episode and don't forget to subscribe to the podcast, leave a review on wherever you listen to your podcasts, save this episode for future references, and share this valuable information with other fellow clinicians to build a strong community of informed providers.

JR

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Midazolam (Versed) is a benzodiazepine, hypnotic, anesthetic used in the critical care setting to promote sedation while patients are in mechanical ventilation.

Acts at the level of the limbic, thalamic, and hypothalamic regions of the CNS. Produces CNS depression leading to sedation, hypnosis, relaxation, and anticonvulsant activity. It binds to the gamma-aminobutyric acid (GABA)-benzodiazepine receptor complex.

Patients can develop tolerance to it, Versed has been associated with ICU delirium and it is related to respiratory depression.

Its reversal agent is Flumazenil (Romazicon).

I hope you get valuable information from this episode and don't forget to subscribe to the podcast, leave a review on wherever your podcast provider is, share, and save this episode for future references.

JR

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Septic shock is a medical emergency that is caused by a systemic infection in the body. This infection leads to a response by the immune system of releasing cytokines which leads to a cytokine storm. Subsequently, this action causes an increase in capillary permeability which makes blood vessels leak or shift fluid from the intravascular space. This causes lower systemic vascular resistance and hypotension.

It is important to recognize the symptoms of septic shock and act as fast as possible to prevent the death of the patient.

The Society of Critical Care Medicine created the Surviving Sepsis Campaign which has resources on sepsis and septic shock. One of these resources is the 1--Hr bundle which indicates the following: Measure the lactate levels of patients going through septic shock, obtain blood cultures BEFORE administering IV antibiotics, administer broad-spectrum IV antibiotics, initiate rapid IVF resuscitation by administering 30 mL/kg crystalloid for hypotension or lactate ≥ 4 mmol/L, start vasopressors if hypotension persists during or after fluid resuscitation and maintain a MAP >65 ( Levophed is 1st line of choice).

You can learn about septic shock, sepsis, and the 1-hr bundle on the Society of Critical Care Medicine website at https://www.sccm.org/SurvivingSepsisCampaign/Home