ResusX:Podcast

In this episode, Dr. Matt Salzman joins us to delve into the fascinating world of toxicology in critical care. We explore the life-saving applications of high-dose insulin therapy for beta-blocker and calcium channel blocker overdoses, and why early intervention is crucial. Dr. Salzman also sheds light on the controversial use of lipid emulsion therapy and methylene blue, providing a balanced perspective on their efficacy and potential risks. To cap it off, we dive into a fun and insightful rapid-fire round, uncovering the latest trends in toxicology, his favorite Philly tacos, and more. Tune in for a blend of expert advice and informative conversation that you won't want to miss!

 In this podcast episode, Dr. Zaf Qasim discusses the complexities and critical considerations when managing trauma in pregnant patients. He emphasizes the importance of understanding normal pregnancy physiology, including cardiovascular, respiratory, and hematological changes, to identify abnormalities effectively. Dr. Qasim highlights the priority of treating the mother first, as this also benefits the fetus, and underscores the need for early multidisciplinary involvement. He covers essential modifications in procedures, airway management, and imaging techniques tailored to pregnant trauma patients. Additionally, he addresses the resuscitative hysterotomy (perimortem cesarean section), stressing the urgency and coordination required for successful outcomes. This episode provides valuable guidance for healthcare providers facing these challenging scenarios through practical insights and detailed explanations.

In this podcast episode, Dr. Sara Crager explains how to effectively understand and respond to ventilator alarms, emphasizing that these alarms are tools to provide critical information about a patient’s pulmonary physiology. She breaks down the key concepts of resistance and compliance in the lungs and identifies two main alarms that matter most: Low Tidal Volume and High Peak Pressure. By understanding how to interpret these alarms through examining Peak and Plateau Pressures, healthcare providers can diagnose issues such as air leaks, decreased lung compliance, and increased airway resistance, thereby improving patient care and outcomes.

In this episode, Dr. Steven Haywood discusses the critical importance of allowing patients to exhale properly during non-invasive ventilation (NIV). He explains the differences between old school invasive mechanical ventilation with a two-limb circuit and modern NIV systems with a single limb, highlighting the necessity of exhalation ports to prevent mechanical and physiological dead space. Haywood elaborates on the evolution of mask designs, particularly how vented masks became essential for severe COPD and asthma exacerbations but posed challenges during the COVID-19 pandemic, leading to a switch back to non-vented masks with viral filters. He emphasizes the physician's responsibility to ensure the correct use of equipment to avoid patient harm and concludes with advice on selecting appropriate masks and ventilators for non-invasive ventilation.

In this podcast episode, Dr. Scott Weingart addresses the complexities of treating sick pulmonary embolism (PE) patients, arguing for a more nuanced classification system beyond the traditional stable, submassive, and massive categories. He suggests using five categories to guide treatment decisions better, focusing on critically ill patients. Dr. Weingart emphasizes the importance of risk stratification using vital signs, clot size, and biomarkers such as lactate and troponin levels. For sick submassive patients with low bleeding risk, he recommends a lower dose of fibrinolysis, specifically 25 mg of Alteplase over six hours, as a safe and effective option. He explains that the choice of fibrinolytic dose should be balanced with the severity of PE and the patient's bleeding risk to ensure optimal care.

In this episode of the Critical Care Lounge podcast, hosts Dr. Adam Green and Dr. Haney Mallemat with Dr. Michael Bonk delve into the nuanced use of steroids in critical care. They discuss real-life cases, including COPD, ARDS, septic shock, and severe influenza, exploring when and how to use steroids effectively. With a mix of humor and expertise, they tackle common concerns, dosing strategies, and the latest clinical trials, aiming to provide practical insights for healthcare professionals navigating the complexities of steroid use in various critical conditions. Tune in for an engaging and informative discussion that blends medical knowledge with practical advice.

In this podcast episode, emergency medicine physician Chris Reilly discusses the "6 P's of Pre-Oxygenation" crucial for successful intubation, especially in hypoxemic patients. He begins by explaining the physiology of oxygen delivery and the importance of achieving high oxygen saturation before intubation to avoid complications like post-intubation cardiac arrest. Reilly outlines the steps for effective pre-oxygenation: Positioning the patient properly, using Prongs and a Non-Rebreather mask, Pondering the patient's oxygen saturation (SAT), ensuring an adequate Pre-Ox period, Pushing medications for rapid sequence intubation, and utilizing Passive Apneic Oxygenation. He emphasizes creating an oxygen reservoir by denitrogenating the lungs and maintaining optimal oxygen levels throughout the procedure to extend safe apnea time and minimize risks.

Dr. Max Hockstein, an Intensive Care Medicine specialist, discusses the strategic use of antidysrhythmics in the ICU, tracing their historical development and critiquing classification schemes. He highlights the complexities and side effects of drugs like amiodarone, advocating for a holistic approach to treating arrhythmias.

In this episode, Dr. Marco Propersi delves into the comparative study of Femoral Artery Ultrasound versus Manual Palpation in cardiac arrest patients, highlighting its significant findings and implications for critical care. Discussing the study's objectives, methodology, outcomes, strengths, and limitations, Dr. Propersi emphasizes the importance of staying updated with emergency medicine literature and integrating innovative tools like Doppler Ultrasound into clinical practice. He underscores the potential of Femoral Artery Ultrasound as a reliable pulse detection tool while acknowledging the need for further research and validation before widespread adoption. With insightful analysis and practical implications, this episode provides valuable insights for healthcare professionals navigating critical care scenarios.

In this episode called "Norepinephrine: How High Can You Go," Dr. Salim Rezaie explores the complexities surrounding the maximum dosage of norepinephrine in critical care scenarios. Through an analysis of retrospective studies and a remarkable case report, Dr. Rezaie highlights the lack of definitive evidence and consensus on upper limits, shedding light on survival rates and associated outcomes at varying dosages. Emphasizing the importance of cautious escalation and thorough patient assessment, he provokes thoughtful discussion within the ResusX community, aiming to deepen understanding and enhance patient care strategies in emergency medicine and critical care settings.