{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"The Critical Debrief","title":"Ask Pramod Pilot: Sedative Drug Overdose","html":"<iframe width=\"100%\" height=\"180\" frameborder=\"no\" scrolling=\"no\" seamless src=\"https://share.transistor.fm/e/5f215b83\"></iframe>","width":"100%","height":180,"duration":1392,"description":"🎞️ Episode Synopsis (AI)\nShreyas launches Ask Pramod, a new series under The Critical Debrief in which we walk through Pramod's research and discuss clinical application. In this first episode we discuss sedative drug overdose and evaluate if there are features of the early clinical assessment that can reliably predict the outcome?\nKeen to learn more from Pramod?  Pre-order his new book \"Clinical Examination in Critical Care Medicine\" - a gamechanger for teaching clinical assessment skills in the critical care disciplines!  All proceeds go to our emergency medicine education charity Network Five Emergency Medicine!\n\n⏱️ Episode Timestamps\n00:00 — Disclaimer and intro\n00:28 — Welcome — introducing the Ask Pramod series\n00:50 — The paper: why the question, the cohort, and the findings\n05:51 — Interpreting the pH 7.20 threshold\n08:49 — The NICO trial, the six-hour observation strategy, and Australian practice\n16:38 — At the bedside: airway mechanics, blood gases and drug factors\n20:51 — Next steps, and sign-off\n📚 References & Resources (in order of discussion)\nChandru P, Schriber K, Brasted HBF, Butler E, Gunja N (2026) — Risk Factors Associated with Deterioration in Sedative Drug Overdose. Journal of Medical Toxicology. 2026;22(2):296–304.\n🔗 doi.org/10.1007/s13181-026-01120-0\n⏱️ ~00:50\nThe paper under discussion. Retrospective cohort of 374 patients referred to a district toxicology service with suspected sedative overdose, November 2022 – November 2023. Common agents: benzodiazepines 32.1%, opioids 29.1%, GHB 20.6%. In-hospital complications 35.8%, ICU admission 17.9%, intubation 13.6%. ICU admission independently associated with lower venous pH and non-benzodiazepine GABA-ergic ingestion (adjusted OR 3.35, p = 0.04); in-hospital complications with opioid ingestion (adjusted OR 3.81, p < 0.001) and lower GCS. Modelled probability of intubation rose from 8% at pH 7.35 to 66% at pH 7.20. PMID 41792544.\n\nAgency for Clinical Innovation, Emergency Care Institute — The...","thumbnail_url":"https://img.transistorcdn.com/XAa3w6Ucjy6OY0zjtAeOSINROOD7gD76js6SllSVRqg/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS8wNTI4/ZDY0YzQ1NzIwODc0/MzU0MGZiNzM5MmFj/YzRkNi5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}