BCCCP case studies
BCCCP · Put your knowledge to work in context.
The Board Certified Critical Care Pharmacist (BCCCP) credential is a specialty certification for pharmacists who practice in intensive care units, cardiac care units, neuro-ICUs, burn units, and other high-acuity settings. It signals that a pharmacist can independently manage drug therapy for critically ill patients - patients whose physiology changes hour to hour and whose medication decisions carry immediate, life-threatening consequences. The BCCCP case studies are 5 cases and about 3,375 words.
1Hypotension After Inferior STEMI: The Preload-Dependent Right Ventricle
A 63-year-old man is admitted to the cardiac ICU after primary PCI of an occluded right coronary artery for an inferior STEMI. In the emergency department he received aspirin 325 mg, ticagrelor 180 mg, a nitroglycerin infusion at 40 mcg/min, morphine 4 mg IV, and metoprolol tartrate 25 mg PO.
644 words, about 3 min2Status Asthmaticus on the Ventilator: Breath Stacking and Shock
A 28-year-old woman (height 165 cm, 68 kg) with a history of asthma is intubated in the ED after failing high-flow oxygen and continuous nebulizers. Six hours later in the ICU: BP 88/50 mmHg, HR 128 bpm, SpO2 89%, peak pressures 48 cmH2O, plateau pressure 34 cmH2O, measured intrinsic PEEP 12 cmH2O.
695 words, about 3 min3Septic Shock With a Dubious Penicillin Allergy and a Prior ESBL
A 71-year-old woman (82 kg) is admitted with ascending cholangitis and septic shock. BP 84/48 mmHg on norepinephrine 0.15 mcg/kg/min, HR 122 bpm, lactate 4.2 mmol/L, urine output 0.3 mL/kg/h.
710 words, about 4 min4Intracerebral Hemorrhage on Apixaban: Reversal, Blood Pressure, and Restart
A 74-year-old man with atrial fibrillation (CHA2DS2-VASc 5) taking apixaban 5 mg twice daily for 3 years is brought in after sudden headache and left-sided weakness. Last apixaban dose was 8 hours ago.
664 words, about 3 min5Salicylate Toxicity: Acid-Base Interpretation and the Decision to Dialyze
A 19-year-old woman is brought in 10 hours after an intentional ingestion of approximately 40 g of immediate-release aspirin. She has vomited repeatedly, complains of ringing in her ears, and is now drowsy and confused.
662 words, about 3 min