Critical Care Scenarios

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.

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)"