Episodes
We talk about diagnosis, treatment, and subsequent care of the patient with bacterial meningitis, with Emory neurointensivist Casey Albin, MD (@caseyalbin).
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Takeaway lessons
* Many septic patients have altered mental status, but suspicion should be raised for CNS infection when there is also: headache, photophobia, vomiting, or any possibility of seizure...
Published 11/13/24
We chat with Nick Ghionni, pulm/crit attending at MedStar Baltimore Hospital, about identifying and combating cognitive biases in our clinical decision-making.
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Published 10/30/24
We discuss the practical barriers to implementing the A-F ICU liberation bundle, with Kali Dayton, ACNP-BC (@daytonicu), host of the Walking Home from the ICU podcast, and consultant to ICUs working on these issues.
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Published 10/16/24
We chat with Noelia Bischoff, recently off orientation in the medical ICU at Johns Hopkins as a nurse practitioner, about the transition from her role as a bedside ICU nurse.
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Published 10/02/24
We discuss transfusion reactions, risks, and management, including infection, consent, TRALI, TACO, and hemolytic reactions—with Dr. Joe Chaffin (@bloodbankguy), the “Blood Bank Guy” and transfusion medicine specialist.
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Takeaway lessons
* The risk of transfusion-related infection (HIV, hepatitis B, and hepatitis C) is around 1 in 3 million.
* Acute hemolytic...
Published 09/18/24
Experts in critical care share their approach to post-intubation sedation.
Contributors:
* Jason Wieland
* Casey Albin
* Jace Mullen
* Kali Dayton
* Nick Ghionni
* Emily Fridenmaker
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Published 09/04/24
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.
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Takeaway lessons
* RV echo starts with evaluating three things: size, squeeze, and septal kinetics.
* Size should be 2/3 the LV
* Squeeze can be assessed in a variety of...
Published 08/21/24
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.
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Published 08/07/24
We share our grand new project, the Intensive Care Academy, an online, video-based, subscriber-only educational platform. Check it out at icu101.com!
Published 07/31/24
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).
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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...
Published 07/24/24
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.
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Published 07/10/24
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.
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Takeaway lessons
* Rehabilitation psychology is a specialty of clinical psychology that generally partners with patients who have acute illness...
Published 06/26/24
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.
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Published 06/12/24
Responsible self-directed learning occurs in a zone between comfort and novelty.
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Published 06/05/24
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.
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Takeaway lessons
* ATC, originally called “electronic extubation,” is meant to normalize or eliminate...
Published 05/29/24
Brandon summarizes his recent publication describing best practices for performing POCUS. Read the paper open access at POCUS Journal.
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Published 05/22/24
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!
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Published 05/10/24
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.
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Published 05/08/24
The difference between people and institutions.
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Published 05/01/24
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.
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Takeaway lessons
* A quick kidney and bladder ultrasound to rule out urinary obstruction is appropriate for most...
Published 04/24/24
The nuts and bolts of how we produce the show.
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Published 04/17/24
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.
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Published 04/10/24
When do patients deaths bother us?
Published 04/03/24
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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...
Published 03/27/24