Critical Care Scenarios

Philippe Rola, intensivist, master of the VEXUS scan, and founder of the Hospitalist and Resuscitationist conference, shares his recent model of four hemodynamic interfaces to describe the entire circulatory system. Register for the H&R conference (May 22-23 2025) here with the discount code provided in the show. (No, we’re not sponsored, just a cool event.) … Continue reading "Lightning rounds 51: Hemodynamic interfaces with Philippe Rola"

In this enlightening discussion, Heidi Engel, a physical therapist at UCF Submedical Center, delves into innovative strategies for mobilizing sedated ICU patients. She confronts the psychological and physical hurdles in patient recovery, emphasizing alignment with their experiences. The conversation shifts to pediatric ICU liberation, highlighting tailored sedation and mobility strategies. Engel also critiques traditional sedation practices, advocating for approaches that keep patients awake and mobile to enhance recovery outcomes.

Matt Siuba, an intensivist renowned for his expertise in right heart catheterization, shares his insights on the intricate art of placing pulmonary artery catheters. He highlights common pitfalls and essential techniques, offering practical tips to boost confidence for novice practitioners. The discussion covers the importance of proper positioning, communication within the medical team, and the role of ultrasound in ensuring accuracy. Listeners will gain valuable strategies for overcoming challenges in critical care settings.

In this discussion, Dr. Nicholas Chrimes, a consultant anesthesiologist and co-founder of the Safe Airway Society, delves into the innovative Vortex approach to airway management. He emphasizes the need for flexibility and strategic decision-making in critical situations, moving away from rigid algorithms. The concept of 'priming for neck rescue' is explored, along with the importance of clear communication during emergencies. Dr. Chrimes also highlights the value of visual tools for better decision-making and the significance of teamwork in effectively navigating challenging airway scenarios.

Vinciya Pandian, an Associate Dean at Penn State and a seasoned tracheostomy nurse practitioner, shares her wealth of knowledge. She discusses the critical factors in evaluating tracheostomy candidates, including medical history and physical assessments. Pandian highlights the importance of pre-procedural communication with patients and families to ensure informed consent. The conversation dives into various techniques for tracheostomy placement and the management of potential complications, offering listeners invaluable insights into best practices in critical care.

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Join Dr. Sergio Navarrete, an expert in transplant anesthesia, as he navigates the complex world of acute liver failure management. He dives into the critical assessment of liver function, highlighting the balance of supportive care and the importance of hemodynamic optimization. Discover the evolving role of N-acetylcysteine and the challenges of cerebral edema linked to ammonia levels. Dr. Navarrete emphasizes the intricacies of coagulopathy and the vital considerations for timely liver transplantation, showcasing his depth of knowledge in this high-stakes field.

Join Scott Weingart, an emergency medicine ace and the mind behind the Emcrit blog, as he dives into the intricacies of cardiac arrest management. He emphasizes the importance of specialized leadership and effective team dynamics for better survival rates. Discover advanced techniques for vascular access and the evolving debate between manual versus mechanical CPR. Weingart also highlights the critical decisions that come into play during resuscitation, advocating for tailored strategies that improve patient outcomes. A must-listen for anyone in critical care!

In this discussion, Thomas Piraino, a respiratory therapist and expert in airway management, delves into the nuances of airway closure during mechanical ventilation. He highlights the challenges posed by this phenomenon in critical care, especially in conditions like ARDS. Topics like the significance of optimizing PEEP levels, the intricacies of volume-controlled ventilation, and the analysis of ventilator waveforms are covered. Thomas also emphasizes the importance of using collaborative approaches for effective airway management and improving patient outcomes.

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