Very good guide! One thing I would note is that LR is not actually contraindicated in lactic acidosis, as the sodium lactate in LR does not actually affect lactic acid levels.

Usually our ICU providers usually grab for bicarb infusions in those cases, but that has been helpful to know on occasion.

I guess you don't have to actually run an agency in order to wreck it.

Of course he isn't aware. He's too busy firing actual medical experts to be bothered by little things like whether he's engaging in welfare fraud.

Seriously, I never liked the song, but I "fondly" remember the Christmas I worked retail at Walmart. Kept count one day. They played some version of "Sleigh Ride" no fewer than 11 times.

Granted, I think their only other options were "Baby It's Cold Outside" and "All I Want for Christmas Is You"

Geez, that's hardcore 😬 Definitely not the 1% you want to be a part of!

Ugh, that's lame.

Since the main advantage to administration in those units would be telemetry monitoring, maybe monograph data slowing low QTc effects would carry weight?

Idk. Blessedly haven't had to fight with P&T before, so I can't do much more than empathize 🤗

Dude, that is awful! Yeah, I'd definitely prefer to sacrifice an off-day than deal with that. Hope you were able to get back to 100% eventually 🥺

From my memory, olanzapine isn't associated with much in the way of QTc effects, and the biggest risk of IV dosing is somnolence, orthostatic hypotension, and falls.

On the night shift, we're usually giving it because we *want* the Pt asleep, so those AEs are a little less concerning.

It's not restricted at my hospital afaik, although I feel like I see it more IM than IV (although that may be because I see our Geri-Psych patients getting it most often, and they usually don't have IV access).

Sorry for the necrobump :)

Hate to hear you've had to deal with it multiple times 😟

Every booster I've gotten, the symptoms shut off like a faucet at 36 hours. I can't imagine the infection is anywhere near that polite.

Huh, that's an idea. I've been Moderna since dose #1, which from my (antiquated) literature review was associated with worse AEs. Wouldn't even have thought about Nova.

That's about what I've expected, since a simple bad cold will just about bury me for a week.

Most of the folks I know IRL who have gotten both shot and the virus had very mild cases, so they're better data points for vaccine efficacy than relative severity lol