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! Buy your merch here! Takeaway lessons * The Whipple involves an...

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 * Harvard Macy Institute * Duke Ahead * UNC Center for Faculty Excellence * PAEA Jobs board * NONPF Jobs board

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 * Type B dissections do not involve the heart or coronaries, but Type A vs B nomenclature is falling out of favor versus more anatomically specific labeling; this system helps characterize the gray area between...

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 here! References * Leon’s recent paper: Point-of-care Ultrasound (POCUS) Program for Critical Care Nurse...

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 * A patient with UTI (or even just undifferentiated sepsis) and a non-trivial ureteral stone generally needs decompression of the affected kidney, whether or not there...

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 merch here! References Anatomy Literature and...

Dealing with the good and bad aspects of tissue mobility during percutaneous procedures.

We chat with friend of the podcast Matt Siuba (@msiuba), Mr. Zentensivist, to share our distinct perspectives on the relationship between APPs (PAs or NPs) and the intensivists we work alongside.

The dilemma of lung-protective ventilation in patients with strong spontaneous breathing.

We dive into when to initiate renal replacement therapy, the modalities, settings, and physics involved, troubleshooting problems, and more, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky. Find us on Patreon here! Buy your merch here! Takeaway lessons * One of the better indications for early dialysis in the ICU patient is to control volume, which in an oliguric patient you know is likely to keep...

5 things you pretty much must be doing if you want to be excellent at critical care. See also on the blog: The ten laws of critical care Practicing medicine like an adult

Bluejacket_headshotDownload We chat with Callie Tennyson, DNP, ACNP-BC, AACC, CHSE, assistant professor from the Duke University School of Nursing, about the use of the internet and social media for medical education: trends, challenges, and principles for doing it right.

The value of performing chart checks to see how your patients are doing after your care.

Bryan puts Brandon through the paces, discussing the nuts and bolts of managing a code. Find us on Patreon here! Buy your merch here! Takeaway lessons * Managing a room is less about asserting authority and more about leading by example. Cardiac arrest is a great microcosm and litmus test for your team dynamics for all resuscitation. * Consider arterial lines early. IOs are usually fine for other access; central lines are rarely essential early. *...

The importance of using an app to keep notes and establish a second, more reliable medical memory.

We chat about why people get burned out in medicine, how to weigh the pros and cons of our work, and the right perspective on job satisfaction.

A brief overview and call to arms around the key concepts of ICU liberation.