Critical Care Scenarios

We talk the nitty-gritty of assessing the right heart using echocardiography, with our friend Matt Siuba (@msiuba), intensivist at the Cleveland Clinic and master of zentensivism. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessons

We explore the fascinating world of artificial intelligence and its role in medicine, with Nawar Shara (@NawarShara), PhD, Chief of Research Data Science at Medstar Health Research Institute and cofounding director of the AI Collab between Medstar and Georgetown. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here!

We share our grand new project, the Intensive Care Academy, an online, video-based, subscriber-only educational platform. Check it out at icu101.com!

We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr. Rory Spiegel (@EMnerd_), emergency physician and intensivist at MedStar Washington Hospital Center (and EMNerd at Emcrit). Find us on Patreon here! Buy your merch here! Takeaway lessons

We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital. Find us on Patreon here! Buy your merch here!

We discuss the field of rehabilitation psychology, and how it can help patients with persistent critical illness, with Dr. Megan Hosey (@DrMeganHoseyPhD), clinical psychologist and assistant professor at Johns Hopkins School of Medicine, where she practices in the medical ICU. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources

We explore the profession of respiratory therapy in the US, including their role and training and how to optimize our clinical relationships, with Keith Lamb (@kdlamb1), RRT, RRT-ACCS, FAARC, FCCM. Keith is an RT at the University of Virginia in Charlottesville, working clinically in neuro/surgical/trauma critical care, who has been active in research and has … <a href="https://icuscenarios.com/lightning-rounds-41-respiratory-therapy-with-keith-lamb/" class="more-link">Continue reading<span class="screen-reader-text"> "Lightning rounds 41: Respiratory therapy with Keith Lamb"</span></a>

Responsible self-directed learning occurs in a zone between comfort and novelty. Find us on Patreon here! Buy your merch here!

We discuss the principles and application of automatic tube compensation (ATC) on modern ventilators, with its creator Ben Fabry. Dr. Fabry is a professor and chair of biophysics at University of Erlangen-Nuremberg, originally trained as an electrical engineer, who originally developed ATC as part of his PhD program. Find us on Patreon here! Buy your … <a href="https://icuscenarios.com/episode-74-automatic-tube-compensation-with-ben-fabry/" class="more-link">Continue reading<span class="screen-reader-text"> "Episode 75: Automatic tube compensation, with Ben Fabry"</span></a>

Brandon summarizes his recent publication describing best practices for performing POCUS. Read the paper open access at POCUS Journal. Find us on Patreon here! Buy your merch here!

Our collaboration with Sarah Lorenzini of the Rapid Response RN podcast, discussing a case and general principles for diagnosing and managing obstructive shock. Check out the other episodes on shock in the Nurses’ Podcrawl 2024! Find us on Patreon here! Buy your merch here!

We chat about pulmonary/critical care medicine fellowship with recent graduate Nicholas Ghionni (@pulmtoilet), a first-year attending at the MedStar Baltimore Hospital system. He completed PCCM fellowship at MedStar Washington Hospital Center where he also served as chief fellow. Find us on Patreon here! Buy your merch here!

The difference between people and institutions. Find us on Patreon here! Buy your merch here!

We discuss the role of point-of-care ultrasound in evaluating the patient with kidney injury and assessing volume status, with Abhilash Koratala (@nephroP), nephrologist, Director of Clinical Imaging for Nephrology at the Medical College of Wisconsin, and champion of nephrology-focused ultrasound. Find us on Patreon here! Buy your merch here! Takeaway lessons References Episode 4 with … <a href="https://icuscenarios.com/episode-73-pocus-for-nephrology-with-abhilash-koratala/" class="more-link">Continue reading<span class="screen-reader-text"> "Episode 73: POCUS for nephrology, with Abhilash Koratala"</span></a>

The nuts and bolts of how we produce the show. Find us on Patreon here! Buy your merch here!

We explore critical care transport medicine from both a clinical and career perspective, including helicopters (HEMS), fixed wing jet, and ground ambulance transports, with Jace Mullen, flight paramedic and airway educator out of Denver. Find us on Patreon here! Buy your merch here!

When do patients deaths bother us?

Find us on Patreon here! Buy your merch here! We discuss the phenomenon of CPR-induced consciousness (i.e. patients demonstrating awakeness during resuscitation) with Jack Howard, Intensive Care Paramedic at Ambulance Victoria in the northern suburbs of Melbourne, Australia, and first author on a recent literature review and Delphi-derived expert guideline on CPRIC management. Takeaway lessons … <a href="https://icuscenarios.com/episode-72-cpr-induced-consciousness-with-jack-howard/" class="more-link">Continue reading<span class="screen-reader-text"> "Episode 72: CPR-induced consciousness with Jack Howard"</span></a>

Should you use volume or pressure control ventilation? Find us on Patreon here! Buy your merch here!

We talk about working in critical care APP leadership positions, with Jason Wieland, PA, Lead Pulmonary & Critical Care APP at WakeMed Health System in Raleigh, NC. Find us on Patreon here! Buy your merch here!

You poked through the deep wall of a vessel. Now what? Find us on Patreon here! Buy your merch here!

We discuss the medications typically used after organ transplant, their impact on critical illness, and how to manage them when these patients show up sick—with Olivia Philippart, transplant clinical pharmacist specializing in liver and kidney transplant at University of Kentucky HealthCare. Find us on Patreon here! Buy your merch here! Takeaway lessons References From: Fishman … <a href="https://icuscenarios.com/episode-71-transplant-medications-with-olivia-philippart/" class="more-link">Continue reading<span class="screen-reader-text"> "Episode 71: Transplant medications with Olivia Philippart"</span></a>

How I make patients poop. Find us on Patreon here! Buy your merch here!

A roundup of opinions from attendees at SCCM’s 2024 Critical Care Congress in Phoenix on strategies for rescuing the patient stuck in a loop of deep sedation and agitation. Thanks to Pat Posa, Martha Roberts, Juliana Barr, Kelly Drumright, and Ben Lassow for their input. Resources

How to document your ultrasound findings. Find us on Patreon here! Buy your merch here!

We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr. Jed Wolpaw, anesthesiologist and intensivist from Johns Hopkins, anesthesiology residency program director, and host of the ACCRAC podcast. Find us on Patreon here! Buy your merch here! Takeaway lessons References

Arterial lines are resuscitative tools.

Bedside nurses and providers (physicians, PAs, NPs) tend to see the world differently, much of it driven by their training and the systems they work within. We chat about reconciling this and how to best function as a team.

In general, medical decisions that avoid error are better than those that optimize care.

We discuss head and neck surgery with Dr. Alexandra Kejner, otolaryngologist at the Medical University of South Carolina specializing in transoral robotic surgery, reconstructive surgery including microvascular free tissue transfer, salivary neoplasms, and sialoendoscopic procedures. Find us on Patreon here! Buy your merch here! Takeaway lessons References

The core disorders of critical care are mostly syndromes, not diseases. What should this mean to us?

Discussing the new 2023 AAN/AAP/CNS/SCCM Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline, with the joint first authors: Dr. Ariane Lewis, neurointensivist, professor of neurology and neurosurgery at NYU Langone, director of neurocritical care, and chair of the Langone ethics committee, and Dr. Matthew Kirschen, pediatric neurointensivist and associate director of pediatric … <a href="https://icuscenarios.com/lightning-rounds-35-brain-death-updates-with-ariane-lewis-and-matthew-kirschen/" class="more-link">Continue reading<span class="screen-reader-text"> "Lightning rounds #35: Brain death updates, with Ariane Lewis and Matthew Kirschen"</span></a>

If you produce academic work, use the research to produce multiple products. Once is a waste.

We learn about liver transplant with Dr. Meera Gupta, transplant surgeon at the University of Kentucky Healthcare Transplant Center, and surgical director of the Kidney and Pancreas Transplant Program. We discuss eligibility, triage, the peri-operative course, and important post-op complications. Find us on Patreon here! Buy your merch here! Takeaway lessons

Explaining the ultimate expression of prognosis: Morbidity = (Severity x Duration)/Reversibility

When should you…

Which site should you select for your central line placement? A discussion of some considerations.

We learn about pancreaticoduodenectomy (the Whipple) with Michael Cavnar (@DrMikeCavnar), surgical oncologist at University of Kentucky, with a fellowship in Complex General Surgical Oncology from Sloan Kettering. He specializes in GI surgical oncology (liver, pancreas, stomach, etc), with ongoing research in GI stromal tumors and hepatic artery infusion pump chemotherapy. Find us on Patreon here! … <a href="https://icuscenarios.com/episode-67-whipples-with-michael-cavnar/" class="more-link">Continue reading<span class="screen-reader-text"> "Episode 67: Whipples with Michael Cavnar"</span></a>

A review of the physiological and practical reasons to position patients with ARDS in the prone position.

We chat with Janelle Bludorn (@JanelleRBlu), former emergency medicine PA, Assistant Professor and Academic Coordinator at the Duke PA program, about transitioning from clinical work into teaching and academia. Find us on Patreon here! Buy your merch here! Resources

The value of being curious about practice differences, not judgmental.

We explore aortic dissection with Travis Hughes, vascular surgery fellow from the University of Kentucky, including classification, medical management, and nuances of the surgical perspective. Find us on Patreon here! Buy your merch here! Takeaway lessons

What are the ways that patients fail breathing trials, and what can they tell us about how to optimize them for next time?

We chat with Leon Chen about his work setting up infrastructure for clinical POCUS at Memorial Sloan Kettering. Leon is an Adult/Gerontology Acute Care Nurse Practitioner in the ICU, Clinical Program Manager of Research and Simulated Learning, and an Associate Professor at Columbia University School of Nursing. Find us on Patreon here! Buy your merch … <a href="https://icuscenarios.com/lightning-rounds-30-creating-a-pocus-system-with-leon-chen/" class="more-link">Continue reading<span class="screen-reader-text"> "Lightning rounds #32: Creating a POCUS system with Leon Chen"</span></a>

A brief discussion of the stuff in your pockets as you practice medicine.

We discuss the nuts and bolts of urinary infection with an obstructing stone with Ashley Winter (@AshleyGWinter), board certified urologist with a fellowship in male and female sexual medicine, and chief medical officer of Odela Health. Find us on Patreon here! Buy your merch here! Takeaway lessons

From the Critical Concepts blog, thoughts on our personal biases and lack of humility when contemplating end-of-life decision making.

Bryan and Brandon chat about holding down jobs, conflict resolution and interpersonal skills, and how to protect yourself as an employee.

When are patient outcomes your fault?

We explore the cutting edge practice of point-of-care ultrasound of the brain, including optic nerve sheath measurement, transcranial doppler, assessing midline shift, and more, with Aarti Sarwal, neurologist and neurointensivist, director of the neurocritical care unit at Wake Forest, and director of their neurovascular lab and ultrasound courses. Find us on Patreon here! Buy your … <a href="https://icuscenarios.com/episode-64-neurologic-pocus-with-aarti-sarwal/" class="more-link">Continue reading<span class="screen-reader-text"> "Episode 64: Neurologic POCUS with Aarti Sarwal"</span></a>