Background: Vent withdrawal (VW) is a procedure offered when an intubated patient fails to demonstrate meaningful recovery, the patient is not likely to survive given the extent or burden of underlying medical conditions, or patient’s best anticipated outcome from ongoing ventilator support is inconsistent with patient’s known or presumed wishes. Comfort of the patient after [...]

Background: Acute alcohol withdrawal syndrome (AWS) is a common complication in hospitalized patients, but its occurrence and severity is difficult to predict based on clinical indicators alone. Phosphatidylethanol (PEth) is an abnormal phospholipid incorporated into erythrocyte lipid bilayers in proportion to levels of alcohol exposure, with a half-life of 5 to 10 days. We sought [...]

Background: Health care proxies (HCP), decision-making surrogates and involved family members often struggle with indecision when offered the option of went withdrawal (VW) for a patient who is intubated. A VW is a procedure offered when an intubated patient fails to demonstrate meaningful recovery or the patient is not likely to survive given the extent [...]

Case Presentation: A 65 yo male with insulin-dependent diabetes, chronic kidney disease, and bipolar disorder was referred to hospital due to a rising creatinine level and decreased urine output. Home medications included furosemide, insulin, amlodipine, aspirin, quetiapine, lamotrigine and clonazepam. Patient was diagnosed with acute renal failure with serum BUN/creatinine 125 mg/dL / 6.25 mg/dL [...]

Case Presentation: Loperamide is an over-the counter anti-motility opioid agonist considered to be specific to the intestinal µ receptor, safe for non-prescription use, and to have low abuse potential. However, several cases of fatal cardiac arrhythmias have been reported.1 38-year-old male without prior cardiovascular history, presented to a rural hospital with pre-syncope and lightheadedness. He [...]