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The Critical Care Commute Podcast

Latest episodes

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5 snips
Apr 29, 2023 • 19min

Life, Death and the Bridges in Between - Part II, with Dr Sam Shemie.

Dr. Sam Shemie is a world-renowned expert in the field of critical care and the determination of brain death. He is a pediatric critical care physician and a professor of Pediatrics and Critical Care Medicine at McGill University in Montreal, Canada. Dr. Shemie is also the founder and director of the Canadian Donation and Transplantation Research Program, a national research program focused on improving organ donation and transplantation in Canada.Throughout his distinguished career, Dr. Shemie has made significant contributions to the understanding and practice of brain death determination, which is a critical component of organ donation and transplantation. He has published numerous scholarly articles on the subject, and he has served as an advisor to the World Health Organization, the Canadian Blood Services, and other organizations on issues related to organ donation and transplantation.In this podcast, Dr. Shemie shares his expertise on brain death determination and the ethical considerations that surround this complex topic. Listeners will gain valuable insights into the science of brain death determination, as well as the challenges that clinicians and families face in making these difficult decisions. Dr. Shemie's thoughtful and compassionate approach to this topic will leave listeners with a deeper understanding of the critical role that organ donation and transplantation play in saving lives.
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Apr 29, 2023 • 24min

Life, Death and the Bridges in Between - Part I, with Dr Sam Shemie.

Dr. Sam Shemie is a highly respected expert in the field of critical care medicine. He is a pediatric critical care physician (our first peaditric critical care specialist on the podcast) and a professor of Pediatrics at McGill University in Montreal, Canada. Dr. Shemie has dedicated his career to improving the care of critically ill patients, particularly children. He has a special interest in organ donation and transplantation, and has made significant contributions to the development of donation policies and practices in Canada and around the world.  In this podcast, Dr. Shemie shares his extensive knowledge and experience in the field critical care medicine, as he takes us on a journey of "Life, Death and the Bridges in Between."
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Apr 20, 2023 • 32min

Vaccines are for adults too! A multidisciplinary guide to pneumococcal jabs with Dr. Robyn Harrison.

Dr Robyn Harrison is a clinical professor in infectious diseases at the University of Alberta, Canada, and the vice-chair of NACI (the National Advisory Committee on Immunization). She joins us for a topical chat to coincide with new guidelines, and to explore what we can ALL do to keep our patients safer from one of the ICUs biggest issues: that dastardly bacterium Streptococcus Pneumoniae. Many thanks, Robyn; go adult vaccines!   Further Reading: 1. Sprague E, Reynolds S, Brindley P. Patient Isolation Precautions: Are They Worth It?. Can Respir J. 2016;2016:5352625. doi:10.1155/2016/5352625 2. https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/public-health-level-recommendations-use-pneumococcal-vaccines-adults-including-use-15-valent-20-valent-conjugate-vaccines/summary-february-2023.html 3. https://www.cdc.gov/vaccines/adults/index.html
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Apr 13, 2023 • 32min

Prof. Mervyn Singer on Sepsis, SIRS, Syndromes, and the State of the Art.

Mervyn Singer is a ludicrously busy and accomplished intensivist and professor at University College London. He is a prolific and provocative publisher, researcher and innovator, and our go to guy for all things Sepsis, Syndromes and (basic) Science. This is a fun and informative chat: many thanks Merv!   Further Reading: 1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287 2. Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):775-787. doi:10.1001/jama.2016.0289 3. Póvoa P, Coelho L, Dal-Pizzol F, et al. How to use biomarkers of infection or sepsis at the bedside: guide to clinicians. Intensive Care Med. 2023;49(2):142-153. doi:10.1007/s00134-022-06956-y 4. Singer M. Personalizing Sepsis Care. Crit Care Clin. 2018;34(1):153-160. doi:10.1016/j.ccc.2017.08.011 5. Singer M. Sepsis: personalization v protocolization?. Crit Care. 2019;23(Suppl 1):127. Published 2019 Jun 14. doi:10.1186/s13054-019-2398-5 6. Morelli A, Ertmer C, Westphal M, et al. Effect of heart rate control with esmolol on hemodynamic and clinical outcomes in patients with septic shock: a randomized clinical trial. JAMA. 2013;310(16):1683-1691. doi:10.1001/jama.2013.278477 7. Singer M, Shipley R, Baker T, Cowell A, Brealey D, Lomas D. The UCL Ventura CPAP device for COVID-19. Lancet Respir Med. 2020;8(11):1076-1078. doi:10.1016/S2213-2600(20)30422-7
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Mar 31, 2023 • 24min

Prof. Mark Wilson on the GoodSAM platform.

Dr Mark Wilson is one clever, busy and productive chap. His day job is as Neurosurgeon, Pre Hospital Resuscitation Doc and a Professor at Imperial College London. Most relevant to our podcast he is co-founder of GoodSAM (http://www.goodsamapp.org/), a platform that alerts doctors, nurses, paramedic and those trained in basic life support to emergencies around them. Listen, learn, and sign up for GoodSam.   Link to BBC show: https://www.bbc.co.uk/sounds/play/m0018x4p Link to GoodSAM evidence: GoodSAM (goodsamapp.org)
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Mar 29, 2023 • 11min

Pharmacy Whiteboard: Why we need pharmacists in the ED with Dr. Jonathan Mailman (@pharmastache)

Every department, that uses clinical pharmacists on their team has one: A pharmacy whiteboard! A whiteboard for education. These take tons of work before a single note is written, and great care is taken to ensure accuracy and relevance. Join us on this new short segment called "the Pharmacy Whiteboard" as we learn from pharmacists using their whiteboard ideas. In this his first one, we are joined by Dr Jonathan Mailman, a clinical pharmacist from Victoria BC, Canada, as he discusses the value of clinical pharmacists in the ED. No better time than now as pharmacy appreciation month draws to a close. Further reading: Here's the short selection Pharmacy Practice literature (in PMID) by category:Sepsis PMID: 24904184 PMID: 27503060 Trauma PMID: 23943183 PMID: 25797938 PMID: 25768964PMID: 29079370 Resuscitation PMID: 29276268 PMID: 21665406PMID: 18349308 PMID: 22095821 Stroke PMID: 28759998 PMID: 29623155 Cost saving: PMID: 29276268PMID: 30079985PMID: 35158260 BPMH:PMID: 17381374
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Mar 21, 2023 • 31min

The Conference is dead! Long live the post-COVID Conference! A discussion with Drs. Oliver Flower and Roger Harris.

This one is a biggie! Join us as we chat with Drs. Roger Harris and Oli Flower, the gurus behind the SMACC and CODA conferences. The topic is, naturally enough, the past and future of the medical conference.
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Mar 7, 2023 • 36min

Professor Tim Caulfield on Misinformation, Tribalism and Positive Moderation.

Tim Caulfield (professor, best selling author, Netflix presenter and Order of Canada recipient) joins us for a spirited discussion of so much that matters to so many: COVID, vaccines, masks, science, tribalism and public debate. Informative provocative and (surprisingly?) upbeat. Further Reading:  On the harm of misinformation: https://cca-reports.ca/reports/the-socioeconomic-impacts-of-health-and-science-misinformation/ Debunking sudden death https://www.thestar.com/news/canada/2022/11/07/why-wont-a-debunked-conspiracy-theory-about-doctors-harmed-by-the-covid-vaccine-go-away.html And a recent study that is relevant: https://www.nature.com/articles/s41467-022-35653-z
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Feb 28, 2023 • 28min

Trauma with Dr. Sandy Widder

Dr Sandy Widder is a Trauma Surgeon, Intensivist and overall amazing human being. She works as an associate professor in the departments of critical care and surgery at the University of Alberta, and is the Assistant Zone Director on Integrated Quality Management for the Edmonton zone in Alberta, Canada. She is passionate about Quality Improvement/Patient Safety and somehow finds time for Health administration in her busy schedule. We were lucky to get her on our podcast!  Join us as she talks about what the general intensivist needs to know about the trauma patient.  Further reading: ABC assessment: Early prediction of massive transfusion in trauma: simple as ABC (assessment of blood consumption)?  Nunez TC, Voskresensky IV, Dossett LA, Dutton WD, Cotton BA.  J. Trauma.  2009.  Feb 66 (2): 346-52. TXA: Effects of transexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant hemorrhage (CRASH-2): a randomized, placebo-controlled trial.  Lancet.  2010.  376: 23-32. Fibrinogen: Reversal of trauma-induced coagulopathy using first-line coagulation factor concentrates or fresh frozen plasma (RETIC): a single-centre, parallel-group, open label, randomized trial.  Innerhofer P, Fries D, Mittermayer M, Innerhofer N, von Langen D, Hell T et al.  Lancet Haematology.  2017.  4 (6): 258-271. Stop the bleed:  www.stopthebleed.org VTE Prophylaxis: Updated guidelines to reduce venous thromboembolism in trauma patients: a Western Trauma Association critical decisions algorithm.  Let EJ, Brown C, Moore E, et al.  The Journal of Trauma and Acute Care Surgery.  2020.  89 (5): 971-981. Geriatric trauma: ACS TQIP Geriatric Trauma Management Guidelines.  HTTPS:\\www.facs.org/media/314or1oq/geriatric_guidelines.pdf Rib fractures: Western Trauma Association Critical Decisions in Trauma: Management of rib fractures.  Brasel KJ, Moore E, Albrecht RA et al.  2017.   Journal of Trauma and Acute Care Surgery.  82 (1): 200 - 203.
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Feb 14, 2023 • 35min

The physiologically difficult airway - Dr Jarrod Mosier

Doctor Jarrod Mosier is a bit of a polymath, and we were delighted he could squeeze us into his busy life. His day jobs include Intensive Care Medicine and Emergency medicine in Tucson, where he is a professor (at the other UofA: Arizona).He is an expert in all aspects of airway management, ranging from the physiologically difficult airway, through the importance of first pass success, including how to optimize for intubation, the roles of ultrasound and extracorporeal support, and all the way to safe extubation. This was the focus of our wide-ranging entertaining conversation. When away from work Jarrod throws a mean football, dotes on his two kids, and loves getting up into the mountains to snap superb nature photographs. Further reading: 1. Mosier JM, Sakles JC, Law JA, Brown CA 3rd, Brindley PG. Tracheal Intubation in the Critically Ill. Where We Came from and Where We Should Go. Am J Respir Crit Care Med. 2020;201(7):775-788. doi:10.1164/rccm.201908-1636CI 2. Mosier JM. Physiologically difficult airway in critically ill patients: winning the race between haemoglobin desaturation and tracheal intubation. Br J Anaesth. 2020;125(1):e1-e4. doi:10.1016/j.bja.2019.12.001

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