Critical Care Scenarios

We explore the controversial area of using hypertonic saline to support hemodynamics, protect the kidneys, and facilitate diuresis in the critically ill patient. Our guest is Dr. Sean Barnett, hypertonic aficionado and nephrologist with a focus in critical care. Takeaway lessons The furosemide stress test in the shocked patient is a useful means to assess … Continue reading "Episode 51: Resuscitating and deresuscitating with hypertonic saline, with Sean Barnett"

Ruminations on nursing post-nominals, understated wealth, and how it’s easiest to not show your power when you already plenty of it.

Continuing the discussion from last Lightning Rounds about presenting at conferences, Brandon and Bryan chat about writing for peer-reviewed journals: why, how, and the process from choosing co-authors to choosing journals to navigating the submission.

How do PAs and other APPs compare with physicians in the clinical context?

We look at the rib fracture patient requiring ICU admission, including a discussion of surgical repair, with Dr. Ron Barbosa (@rbarbosa91), Portland trauma surgeon and SICU director at Legacy Emmanual Medical Center. Takeaway lessons Algorithms and protocols for admitting disposition exist but are generally poorly predictive. ICU admission in rib fracture patients is still most … Continue reading "Episode 50: Rib fractures and surgical plating with Ron Barbosa"

Brandon and Bryan chat about academic presentations… how to prepare and submit them, selecting the right venue, giving a good talk, and the elephant in the room: why to do it at all.

How the arc of disease peaks and falls, and how the curve of our care should match it to avoid under- or over-treatment.

We discuss invasive aspergillosis, with a focus on when to consider and how to make this difficult diagnosis in the general ICU population—with Dr. Shmuel Shoham (@ShohamTxID), Associate Professor of Medicine at Johns Hopkins, transplant infectious disease physician, and an extensively published expert in invasive fungal infections as well as host of the Transplant ID … Continue reading "Episode 49: Invasive pulmonary aspergillosis with Shmuel Shoham"

Time is always a factor in the ICU, but some time matters more than other time.