Critical Care Scenarios

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"

The second part of our overview of interventional radiology with Dr. Bobby Chiong, board-certified interventional radiologist and chair of radiology at SBH Health System, with a focused look at some common IR procedures, namely abscess drainage and GI bleeding. Listen to part 1 here. Takeaway lessons Common goals would be INR <2.0, platelets >50k. If … Continue reading "Episode 17: Interventional radiology with Bobby Chiong (part 2)"

An overview of interventional radiology with Dr. Bobby Chiong, board-certified interventional radiologist and chair of radiology at SBH Health System, with a focused look at what IR’s all about, coordination between care teams, vascular access, and troubleshooting. Takeaway lessons Interventional radiologists can’t do everything, but they potentially can do almost anything, and you usually won’t … Continue reading "Episode 16: Interventional radiology with Bobby Chiong (part 1)"

Quick takes on common controversies in the ICU, with Bryan and Brandon: Stress ulcer prophylaxis: drug selection, candidates, and when to discontinue Stress dose steroids: candidates, dosing, lab tests, and weaning Titrating PEEP: considering the disease process, PEEP/FiO2 tables, driving pressure trials, and pragmatic approaches

A detailed look at cirrhosis and acute-on-chronic liver failure as we typically see it in the ICU, with Dr. Elliott Tapper, gastroenterologist and transplant hepatologist, and director of the cirrhosis program at the University of Michigan in Ann Arbor. Takeaway lessons When treating liver patients, think infection, infection, infection—and understand that with good care and … Continue reading "Episode 15: Liver failure with Elliott Tapper"

Delve into the intricacies of managing intracerebral hemorrhage and the emotional challenges faced by caregivers. Discover the complexities of communicating prognosis and treatment plans to families. Learn about vital neurological assessments and the nuances of tracheostomy decisions in neuro recovery. Explore how emotional factors can impact critical care decisions while emphasizing the need for realistic expectations. The discussion highlights the importance of multidisciplinary collaboration and effective family communication throughout the recovery process.

Dive into the urgent world of neurocritical care, where the challenges of managing acute ischemic strokes are unraveled. Discover the vital role of the Glasgow Coma Scale and CT scans in assessing brain injuries. Learn about the intricate evaluation of intubated patients and the importance of family input for understanding a patient's history. Explore the evaluation and management of intracerebral hemorrhage, highlighting critical decisions in neurosurgery and monitoring strategies for elevated intracranial pressure.

Join Tyler Christifulli, a flight physician and paramedic known for his expertise in pre-hospital medicine, and Sam Ireland, a fellow flight doctor and educator, as they tackle high-stakes scenarios in air transport. They dive into managing critical cases like GI bleeding and arrhythmias while navigating the challenges of providing care in a helicopter. From using the Lucas device for CPR to coordinating seamless patient transfers, Tyler and Sam emphasize effective communication and decision-making under pressure. Their insights highlight the urgency and complexity of flight medicine.