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 * The most immediate benefit of APRV is to help restore lungs to FRC (functional residual capacity). While this can be achieved with PEEP, most people don’t use enough PEEP. APRV proves a...

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 * Rehabilitation psychology is a specialty of clinical psychology that generally partners with patients who have acute illness...

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 held a variety of leadership positions. Find us on Patreon here! Buy your merch here!

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 merch here! Takeaway lessons * ATC, originally called “electronic extubation,” is meant to normalize or eliminate...

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 * A quick kidney and bladder ultrasound to rule out urinary obstruction is appropriate for most...

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 * Data is light, but perhaps 1% of cardiac arrests have some form of...

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!

Photo by Tim Webb 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 * Most kidney transplants will end up on a calcineurin inhibitor like tacrolimus (or...

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 * ICU Liberation.org * ICU Delirium * ICU Rehab Network

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 * Edentulous (toothless) patients are usually easier to intubate, but harder to mask ventilate. Heavy beards are harder to...

Arterial lines are resuscitative tools.