Critical Care Scenarios

Rory Spiegel, an emergency physician and intensivist at MedStar Washington Hospital Center, dives deep into the world of Airway Pressure Release Ventilation (APRV). He discusses the practicalities of APRV through a case study of a patient with respiratory distress, highlighting its advantages over conventional methods. Listeners learn about crucial settings, spontaneous breathing's role, and how to tailor ventilation to individual needs. Spiegel also addresses the implications of lung injuries and hypotension, advocating for APRV's benefits in critical care scenarios.

We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital. Find us on Patreon here! Buy your merch here!

We discuss the field of rehabilitation psychology, and how it can help patients with persistent critical illness, with Dr. Megan Hosey (@DrMeganHoseyPhD), clinical psychologist and assistant professor at Johns Hopkins School of Medicine, where she practices in the medical ICU. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources

We explore the profession of respiratory therapy in the US, including their role and training and how to optimize our clinical relationships, with Keith Lamb (@kdlamb1), RRT, RRT-ACCS, FAARC, FCCM. Keith is an RT at the University of Virginia in Charlottesville, working clinically in neuro/surgical/trauma critical care, who has been active in research and has … Continue reading "Lightning rounds 41: Respiratory therapy with Keith Lamb"

Exploring the balance between familiarity and pushing boundaries in clinical practice, stepping out of comfort zone for growth. Emphasizing the significance of thorough preparation and knowledge acquisition before medical procedures. Stressing active learning and structured preparation for safe experiences.

Ben Fabry, a biophysics professor, discusses automatic tube compensation in modern ventilators. They cover ATC's role in reducing patient breathing effort, comparing it to CPAP, and addressing airway resistance. The podcast explores pressure-controlled ventilation, calculating tracheal pressure, and optimizing tube compensation for patients on breathing trials. They also touch on negative airway pressure risks, using ATC in pressure-targeted modes, and challenges in implementing ATC across different ventilator devices.

Discover the latest best practices for point-of-care ultrasound (POCUS) in this thought-provoking discussion. Hear about the creation of a cross-disciplinary consensus aimed at unifying POCUS guidelines across various specialties. The guest explains the Delphi process behind the expert panel's decision-making. Key topics include ethical considerations for educational scans, patient consent, and the importance of proper documentation. Tune in for insights on maintaining probe integrity and safeguarding patient data.

Sarah Lorenzini from Rapid Response RN podcast joins Critical Care Scenarios to discuss obstructive shock, highlighting causes like tension pneumothorax and treatments such as IV thrombolytics. The podcast covers managing deteriorating patients, optimizing PE response teams, and diagnosing tension pneumothorax with prompt interventions.

We chat about pulmonary/critical care medicine fellowship with recent graduate Nicholas Ghionni (@pulmtoilet), a first-year attending at the MedStar Baltimore Hospital system. He completed PCCM fellowship at MedStar Washington Hospital Center where he also served as chief fellow. Find us on Patreon here! Buy your merch here!

Exploring the importance of distinguishing between people and institutions in the workplace, and the significance of personal relationships over perceived loyalty from employers. Navigating complexities of workplace relationships and acknowledging boundaries within professional settings.