Team Welcome back. Zach here for med geeks. So after two weeks of gathering the survey results,

the majority of you want to keep doing what we're doing. Same format, working through a case,

and you want each topic done in one podcast.

So that's our plan. However, I will throw in reviewing topics systematically as an option

because that wasn't too far behind from what we're doing now with regards to the percentages.

As for topics, the majority you wanted to continue emergency medicine and critical care,

so let's jump right in. So one of the most common issues I face and majority of people

face in the ER and ICU and even on the floors is patients who have pain, anxiety, agitation, and delirium, and sometimes all the above.

So let's say you have a 75-year-old female with a past medical history of mild dementia,

chronic back pain with

redecolopathy. She had a motor vehicle accident when she was

younger, so she's on opiates as well as neuropathic pain

medications as an outpatient. Has a history of CAD status-post cabbage, heart failure

reduce the F, and end-stage renal disease

on hemodialysis Monday, Wednesday, Friday.

Was brought up to the ICU for septic shock due to UTI requiring pressers,

acute decompensated heart failure due to the infection,

and acute on chronic renal failure from the infection.

She was intubated and lined up in the

emergency room. So let's hit the pause button and step into the shoes of the

patient for a second. They're in a foreign place with foreign people poking and prodding them with various different noises in the background.

There's a 7.5 millimeter plastic tube in their throat that doesn't feel good.

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