Critical Care Scenarios

How to manage the intubated critically ill patient while keeping them awake, non-delirious, and mobile, with Dr. Dale Needham, FCPA, MD, PhD. Dr. Needham is a Professor of Pulmonary and Critical Care Medicine as well as Physical Medicine and Rehabilitation at the Johns Hopkins University. He is also director of their Outcomes After Critical Illness … Continue reading "Episode 26: ICU sedation, mobility, and delirium with Dale Needham"

Initial workup, fluid management, renal replacement, and other subtleties of caring for the critically ill patient with rhabdomyolysis. Takeaway lessons Rhabdomyolysis is defined by elevated levels of creatinine kinase and/or myoglobin in the serum secondary to skeletal muscle breakdown with release of cellular contents. Common causes are crush or compartment syndrome, prolonged downtime on hard … Continue reading "Episode 25: Rhabdomyolysis"

The COVID-19 pandemic will hopefully wind down this year. What happens next with these patients? A powerful discussion with Eve Leckie (@browofjustice), RN, CCRN, formerly of the CVCC at Dartmouth-Hitchcock and now disabled after contracting COVID. Learn about their acute course of illness, the challenges of navigating the healthcare system with this new disease, and … Continue reading "Special episode: Surviving COVID-19 with Eve Leckie"

Scene management, logistics, and stabilization of a blunt trauma patient in the Australian outback with Dr. Minh Le Cong (@ketaminh), rural GP and retrieval physician for the Royal Flying Doctor Service and host of the PHARM podcast. Takeaway lessons If there is reasonable suspicion of the presence of a pneumothorax (of any size), have a … Continue reading "Episode 24: Rural retrieval medicine with Minh Le Cong"

Best practices in care of the critically ill patient with COVID-19 pneumonia are not known at this time. However, practical lessons from the ground are filtering in from those who have seen many of these patients, and Dr. Nicole King—critical care anesthesiologist, ECMO-ologist at the University of Cincinnati, and alumnus of the New York City … Continue reading "Episode 23: COVID-19 pneumonia with Nicole King"

The discussion starts with protocols for managing subarachnoid hemorrhage, emphasizing symptoms and risk factors. A detailed case study highlights the importance of blood pressure management in severe headaches and shock. Listeners learn about the urgency of CT angiograms to locate bleeding sources. The analysis of CT images offers visual indicators for diagnosis. The chat also dives into grading systems like Hunt and Hess for better patient outcomes. Lastly, managing complications like cerebral vasospasm is crucial for preventing neurological damage.

A patient with multiple abdominal gunshot wounds, resuscitated before and after damage control surgery by the legendary Scott Weingart (@emcrit): emergency physician, surgical intensivist by way of Shock Trauma in Baltimore, director of an emergency critical care program, and longtime innovator in medical education and FOAM via the EMCrit podcast and blog. Our 1st anniversary … Continue reading "Episode 21: Trauma resuscitation with Scott Weingart"

Kris Ramilo, a Cardiothoracic ICU nurse practitioner at the University of Washington, teams up with Brendan Riordan, a cardiothoracic ICU PA, to delve into the intricacies of post-operative care following CABG. They discuss vital management strategies, including pain relief and the importance of timely extubation. The duo emphasizes recognizing and addressing cardiac complications like tamponade, and the crucial role of Advanced Practice Providers during emergencies. Their insights on patient monitoring and teamwork in high-stress scenarios are particularly noteworthy.

A few rapid-fire cases from the emergency department, with Dr. Seth Trueger (@mdaware), emergency physician at Northwestern University and digital media editor for JAMA Network Open. [Sorry for the shotty audio quality in this one!–eds.] Takeaway lessons Many decisions in the ED are less about what to do, and more about when to do it. … Continue reading "Episode 19: Emergency medicine with Seth Trueger"

A look at oncology-related emergencies in the ICU, with Leon Chen (@CCMNP), NYC nurse practitioner specializing in oncology critical care. Takeaway lessons Extremely elevated leukocyte count should always raise suspicion for a “liquid tumor” such as leukemia. The principal acute complication is leukostasis from poor flow, potentially causing hyperviscosity issues such as stroke, MI, pulmonary … Continue reading "Episode 18: Oncologic emergencies with Leon Chen"