Episodes
We were actively trying to fill your life with non-covid things... but we just had to talk about these big new things. Come take a listen of aerosol transmission, why Remdesivir just doesn't work in the real world, why not to make the same mistake with the -mab du jour, and a few other tid bits.
Published 12/04/20
In this episode, we cover that daily issue: Is this a VAP? Come take listen to level up beyond leukocytosis, inflammation, consolidation, worsening oxygenation and positive cultures.
Viva la Piptazo - Linezolid/Vanco diad.
Published 12/01/20
In this episode, we cover another great white whale in critical care: Hemophagocytic LymphoHistiocytosis (HLH). When your macrophages turn into paceman and start chomping your own cells, you're in trouble. Com listen about genetic predisposition to unchecked immune response, and a conversation around immunomodulation.
Published 11/28/20
In this episode we cover the big picture view of ileus, gastroparesis and colonic pseudo-obstruction. Come take a listen so summarize these issues you will encounter on the daily.
Published 11/16/20
In this episode, we cover the DVT of the Brain... Cerebral Venous Thrombosis. Lace up your shoes, start washing those dishes, do whatever you need to do while we remind you about presentation, workup and most of all, treatment. As 1% of all strokes and the most common cause of stroke in young patients, you'll want to know this one cold.
Published 10/23/20
In this episode we cover the often overlooked topic of glycemic control in the ICU. What blood sugar should we be targeting? Is that hyperglycaemia a stress response? Insulin resistance? Iatrogenic? All of the above. Come listen to our discussion, and Josh's attempt at clearing up a confused evidence base.
Published 10/19/20
We've reached a milestone, 100 episodes! In this podcast, we cover ICU level thiamine deficiency, not just your white-whale of Wernicke encephalopathy. Come take a listen for dosing, clinical features and complications.
Published 10/16/20
In this episode, we cover the approach to the not-so-rare cause of ICU level pancreatitis: hypertriglyceridemia. Come take a listen for nuances around insulin management, and second thoughts around using heparin and plasmapheresis.
Published 10/13/20
In this episode we simplify the approach to covering your invasive fungal infections in critically unwell patients.
Yeast vs Mold vs Endemic Mycoses
Azoles vs Echinocandins vs Amphotericin
Published 09/14/20
Its the rare occasion you go one complete day without treating Nausea and vomiting in the ICU. In this episode, we cover the ddx you can't miss, and the multiple receptors to target in your patients.
Published 09/12/20
In this episode, we cover the essentials of analgesia for your critically ill patients. Spoiler alert, multimodal approaches are the way to go. If your MAR only has opiates on it, there may be a problem.
Come listen for a new twist on the ladder approach, all things ketamine / precedes and lidocaine... with much much more.
Published 08/28/20
In this episode we cover the widely use, but poorly supported inhaled pulmonary vasodilators:
-Oxygen
-Nitroglycerin / Nitric Oxide
-Epoprostenol
-Milrinone
Published 08/08/20
In this episode, we cover the more sinister twin of DKA... HONK aka HHS (Hyperosmolar Hyperglycemic State).
Come listen to how not to blow up your patients brain in the tug-of-war between glucose and sodium.
Published 08/06/20
In this episode we cover Guillain-Barre Syndrome. Everything from presentation, to why you should stop checking negative inspiratory pressure and just stick with FVC. Read the post then come take a listen.
Published 07/28/20
In this episode we cover one of the most fatal and moribund conditions we see regularly, Intracranial hemorrhage.
Etiology, diagnosis and treatment (of course we spend time on BP goals).
Published 07/23/20
In this episode we cover Catastrophic Antiphospholipid Syndrome. A very rare and often missed diagnosis. Come take a listen to brush up on high risk patient population, clinical diagnosis, labs, steroids / anticoagulation and more treatment options.
Published 07/22/20
In this episode we talk about fever... fever in the ICU... ICU acquired fever. It is not all VTE or VAPS, Chole or CLABSI. We cover a thoughtful approach to not just sending pan culture, and adding piptazo-vanco.
Published 07/18/20
In this episode, we cover the sasquatch of ICU derived fever: catheter associated urinary track infection. Farkas is on the fence whether it is clinically relevent:
Come listen for those pearls: IDSA diagnostic criteria. Treatment coverage. Purple bag syndrome, and more!
Published 07/10/20
In this episode we cover a major cause of mortality for our sickle cell patients: Acute Chest Syndrome. This is a very serious entity you must keep a low clinical threshold for working up and treating.
Diagnosis
Pain Control, Volume Resuscitation
Antimicrobials
Exchange transfusions and more
Published 07/08/20
In this episode, we cover the rare but life threatening Epiglottitis.
Highlights:
Presentation not as you learned in medical school
Vast majority do not need intubation, but for those that due it can be catastrophic
Nasolaryngoscopy, Steroids, broad spectrum antibiotics and early airway plans are the way to go
Published 07/02/20
In this episode, we cover ICU level Pneumocystic Jirovicii Pneumonia (previously known as Pneumocystic Carinii Pneumonia).
Suggested approach:
HIV +(ve) vs HIV -(ve)
Invasive vs Non invasive diagnostic strategy
Treatment w. Septra vs other line therapies
Published 06/29/20
In this episode, we cover the lesser of evil stridor aetiologies: Vocal cord dysfunction, a.k.a paradoxical vocal cord motion, a.k.a Paradoxical Vocal Fold Movement. Read the post, then listen to review approach, diagnostic modalities (fibre-optic visualization, CT scan to rule out other entities) and treatment.
Published 06/22/20
In this episode we cover that not so friendly-Fingi: Aspergillus
Come get acquinted with the two forms: angioinvasive (think neutropenia) vs bronchoinvasive (the not so immunosuppressed). Don't forget to add this to your Ddx for nosocomial post-influenza & COVID-19.
Published 06/15/20
In this episode we cover the often overlooked entity that is re-feeding syndrome.
High Risk populations
Signs & Symptoms
Insulin mediated edema, and more
Published 06/08/20
In this episode, we cover the presentation, clinical signs / symptoms and workup of takotsubo cardiomyopathy. Come take a listen so you'll never miss that octopus-trap of a clinical confounder, with juicy pearls around LVOT obstruction.
Published 06/01/20