Presentation for ICU team

[Cocogirl]

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Hello,

I am a pharmacy practice resident currently on rotation in a Trauma ICU and will need to do a presentation for the medical ICU team before the end of the rotation. Was wondering if anyone has any ideas of good topics that would be of interest to medical residents as they have left it pretty open for me to pick and I'm pretty clueless?

Thanks!

 

[PharmDMBA]

Coco,
I am a 4th year on Neurosurgery ICU and I have presented some interesting cases so far this month. How about the differential diagnosis between SIADH and Cerebral Salt Wasting and the treatment for each. Or perhaps Identification and treatment of Sick Euthyroid in critically ill patients. Or how about, intraventricular administration of TPA for Intraventricular hemorrhage. I currently have a patient with hypothyroidism and hyperthermia secondary to hypothalamic dysregulation due to increased intracerebral pressure following a subarachnoid hemorrhage with bilateral ventricular involvment with an etiology of MoyaMoya disease. Moya Moya is a rare disease everywhere but Japan involving arterial stenosis of the circle of willis.

Good Luck with your presentation

 

[PharmD2MD]

I was an ICU pharmacist before I decided to go to med school. Don't discuss differential diagnosis crap. It's not your role. They go to med school for that. Their attendings will beat that to death. However, most of them don't know much about drug therapy. That's your role. The biggest areas I saw pharmacists making an impact was sedation, antibiotic selection/dosing, and prophylactic measures (stress ulcer/DVT/VAP). A review of sedation guidelines is usually good. Or, you could talk about antibiotic selection for some infections in the ICU. Preop antibiotic guidelines are good for surgery residents- they are important, but rarely followed. Heparin induced thrombocytopenia is a good topic. Steroids in septic patients is another. TPN's/nutrition if the docs order it, if the dietitians handle that stuff at your hospital then I would leave that alone. Intensive insulin therapy...I could go on. The point is that the medical residents will find your knowledge of drugs more useful than you going out on limb and discussing stuff that's not really in your purview.

 

[WVUPharm2007]

Use of Coreg in treatment of hyperthermia in ecstasy overdose. That's a fun one.

 

[ZpackSux]

Treatment option for MRSA / VRE... discuss vanco, zyvox, cubicin, tygacil
Treatment option for Non-Albican Candida with Echinocandins.

Sedation options in mechanically ventillated patients, Propofol, midazolam, lorazepam..

 

[sdn1977]

Since you're in trauma...I'd recommend some of what others have said...

review sedation for mechanically ventilated pts

review tx options when faced with DIC

review antibiotic choices when faced with different sources of infection - surgical vs penetrating wounds vs pneumonias

review interesting kinetic issues you've been exposed to - aminoglycosides which have been difficult to dose because of renal function or Vds which are not what they seem

review heparin/LMWH for dvt prophylaxis

review tx of OD's if your ICU tx OD's - ie APAP, narcotic, ETOH...what drugs are used to tx & how their dosing changes as the acute toxicity resolves & you are faced with whatever organ damage results.

What have you observed which has either been of interest to you or has been an issue with pharmacy & ICU?

 

[Cocogirl]

Thanks for all the responses guys! 🙂

A lot of food for thought....I'll prob need some time to digest!