Critical Care Scenarios

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"

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

Join Dr. Elliott Tapper, a leading gastroenterologist and transplant hepatologist from the University of Michigan, as he dives into the complexities of liver failure. He emphasizes the importance of infection management in cirrhotic patients and unpacks the intricacies of lab result interpretation. The discussion navigates the delicate balance in treating hepatic encephalopathy and the critical role of multidisciplinary collaboration. Tune in for insights on managing spontaneous bacterial peritonitis and prognosis discussions with families in critical situations.