Critical Care Scenarios

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.

Tyler Christifulli, a flight paramedic and co-founder of FOAMfrat, alongside seasoned paramedic Sam Ireland, tackle the high-pressure world of flight medicine. They vividly share their experiences managing complex cases during interfacility transfers, including airway management and cardiac arrests. Listeners gain insights into the nuances of diabetic ketoacidosis care, evaluating lab results mid-transport, and the intricacies of bicarbonate administration. The duo emphasizes teamwork and split-second decision-making in critical care scenarios.

A restless patient experiences a series of dyssynchrony events during mechanical ventilation. Come see how Bryan wades through it all, and allow us to offer an academic, yet practical approach to this sometimes-confusing subject. Case files Takeaway lessons Start with ABCs and stabilizing the patient, then put on your thinking cap and try to optimize … Continue reading "Episode 10: Ventilator dyssynchrony"

The book Buy the new textbook (Bryan edited, Brandon authored a chapter) here or on Amazon: Concepts in Surgical Critical Care, First Edition ed. Bryan Boling, DNP, ACNP; Kevin Hatton, MD, FCCM; Tonja Hartjes, DNP, ACNP-BC, CCRN, FAANP The podcast The second piece of our in-depth look at the management of right heart failure, with … Continue reading "Episode 9: Right heart failure and the SAVIOR protocol with Habib Srour (part 2)"

The book Buy the new textbook (Bryan edited, Brandon authored a chapter) here or on Amazon: Concepts in Surgical Critical Care, First Edition ed. Bryan Boling, DNP, ACNP; Kevin Hatton, MD, FCCM; Tonja Hartjes, DNP, ACNP-BC, CCRN, FAANP The podcast An in-depth look at the management of right heart failure, with a focus on preserving … Continue reading "Episode 9: Right heart failure and the SAVIOR protocol with Habib Srour (part 1)"

The second part of our look at a case of catastrophic intracranial hemorrhage, with a focus on goals of care, family interaction, prognostication, and other end-of-life aspects, with neurointensivist and palliative care physician Jess McFarlin (@JessMcFarlinMD). See Part 1 here. Takeaway lessons Useful phrase: “Can I tell you what to expect during the dying time?” … Continue reading "Episode 8: Palliative care with Jessica McFarlin (part 2)"

Neurointensivist and palliative care physician Jess McFarlin (@JessMcFarlinMD) walks us through a case of catastrophic intracranial hemorrhage, with a focus on goals of care, family interaction, prognostication, and other end-of-life aspects. See Part 2 here. Takeaway lessons We can undo most things except death, so in most cases, a short trial (perhaps 3 days) of … Continue reading "Episode 7: Palliative care with Jessica McFarlin (part 1)"

Neurologist and neurointensivist Gracia Mui shows us the workup, initial management, and escalation of care for a case of refractory status epilepticus. Takeaway lessons First-time unprovoked seizures usually need no further workup except screening for an underlying trigger, such as a tox screen, basic chemistries, and imaging as appropriate. Initial seizure therapy: wait around 5 … Continue reading "Episode 6: Status epilepticus with Gracia Mui"