Critical Care Time 52. Listener Mailbag #2
Jun 30, 2025
This episode dives into your burning questions and insights from the world of critical care. The hosts tackle the safety of awake intubation, balancing patient comfort with procedure risks. They explore the management of critical medication under high-stress conditions, stressing the need for careful drug handling. Listener feedback shines a light on the role of Advanced Practice Providers, along with antibiotic selection and community dynamics in healthcare. Plus, enjoy some fun anecdotes and myths about coffee along the way!
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Episode notes
Paralytics After Awake Intubation
- Use paralytics as a safety margin after awake intubation to prevent tube displacement or coughing.
- Avoid deeper sedation only if cords are perfectly topicalized and patient is moderately sedated.
Angiotensin II Use in Mixed Shock
- Angiotensin II is not typically used in pure cardiogenic shock but may help in mixed shock cases.
- Emerging literature suggests safety and hemodynamic improvements with AT2 in cardiogenic shock adjunctively.
Fentolamine for Vasopressor Extravasation
- For vasopressor extravasation, inject fentolamine locally at the site to reverse vasoconstriction.
- Avoid systemic administration as it should not affect blood pressure significantly.
In this special Q&A episode, Nick and Cyrus read your comments, tackle your toughest clinical questions, and share how your insights have sent them diving back into PubMed, Reddit, and beyond. Whether you’re commuting, charting, or on break in the ICU, this episode is packed with practical pearls, literature deep-dives, and the human stories that make critical care so rewarding. Thank you for helping us learn and grow—let’s jump right in!