The Critical Care Commute Podcast

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."

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

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

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)

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

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.

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

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.

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

As health care providers, we are often called on to manage patients with chronic pain. In the acute setting, how do we manage them well? Join us on this podcast with Dr Saifee Rashiq, as we unravel chronic pain secrets well beyond opioids and other medications. Dr. Saifee Rashiq is an Anesthesiologist and Pain Medicine Specialist at the University of Alberta in Edmonton and a Professor in its Faculty of Medicine and Dentistry. He studied medicine at University of Nottingham, anesthesia training at the University of Alberta, fellowship in Pain Medicine in Seattle, and a Master’s Degree in Clinical Epidemiology from the Harvard School of Public Health. His clinical practice combines anesthesia and treating chronic pain patients in a Multidisciplinary Pain Clinic, where his clinical interest is in medically and psychosocially complex patients and non-organic pain syndromes. He is a loving husband and father of 3 and cycles to work when the weather is fine. Note that this was an earlier recording and the sound quality is not what we are hoping to achieve.  Further Reading: 1. Beyond nociception: the imprecision hypothesis of chronic pain. G. Lorimer Moseleya, Johan W. S. Vlaeyen. Painjournalonline January 2015, Vol 156, Nr 1. http://dx.doi.org/10.1016/j.pain.0000000000000014 2. Injuries of the Nervous System: On Railway and Other Injuries of the Nervous System. London, Walton and Moberly 17-23.4349,1866. 3. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain. The SPACE Randomized Clinical Trial. Erin E. Krebs, MD, MPH; Amy Gravely, MA; Sean Nugent, BA; Agnes C. Jensen, MPH; Beth DeRonne, PharmD; Elizabeth S. Goldsmith, MD, MS; Kurt Kroenke, MD; Matthew J. Bair; Siamak Noorbaloochi, PhD. JAMA. 2018;319(9):872-882. doi:10.1001/jama.2018.0899