Critical Care Practitioner

Latest Episodes:

Arterial Lines: Do we always need them. A chat with Tom (Duracell Bunny) Apr 09, 2026

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Tom, one of my colleagues from the Critical Care Outreach Team and I discuss this paper and its findings reaching our own conclusions. Deferring Arterial Catheterisation in Patients with Septic Shock.

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Decompensated Alcohol Related Liver Disease Part 2 Jan 13, 2026

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We return to our 48-year-old patient: jaundiced, hypotensive, drowsy, and bleeding. In decompensated cirrhosis, every treatment targets a disrupted system — splanchnic vasodilation, portal hypertension, toxin accumulation, and renal hypoperfusion.Although these patients look fluid overloaded, they are effectively hypovolaemic. Start with small aliquots of balanced crystalloid, avoiding 0.9% saline. In hepatorenal syndrome or tense ascites, 20% albumin is […]

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Decompensated Alcohol Related Liver Disease Jan 08, 2026

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In this episode, I walk through the real-world critical care management of acute decompensated alcohol-related liver disease, using a high-risk ICU case to anchor the discussion. The focus is on understanding the underlying physiology—portal hypertension, rebalanced haemostasis, hepatic encephalopathy, infection, and hepatorenal syndrome—and translating that physiology into clear first-hour priorities at the bedside. Listeners are […]

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Non Invasive Ventilation Nov 13, 2025

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This episode offers a structured, bedside-focused exploration of Non-Invasive Ventilation (NIV) for acute hypercapnic respiratory failure in COPD, aligned with NICE NG115 and BTS/ICS 2016 guidance. Aimed at early-career critical care nurses, it breaks the topic down into physiology, practical setup, monitoring, and escalation.Key Topics CoveredMechanisms behind acute-on-chronic hypercapnic respiratory failure in COPD.How NIV improves […]

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HHS (Hyperosmolar Hyperglycaemic State) Oct 31, 2025

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HHS (Hyperosmolar Hyperglycaemic State) is the quiet counterpart to DKA. It develops slowly in older type 2 diabetics with residual insulin, leading to extreme hyperglycaemia and dehydration without ketosis. In this 2-hour deep dive, Jonathan explains why HHS kills through water loss and hyperviscosity rather than acid, and how to manage it safely.Key Learning Points:· Pathophysiology: Relative […]

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DKA- Fluids, Potassium and Insulin Oct 24, 2025

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Hypophosphatemia in Critical Care Oct 13, 2025

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Summary:In this episode, we spotlight a stealthy ICU disruptor — hypophosphataemia. Based on a 2024 narrative review in the Journal of Clinical Medicine, we explore why phosphate matters, how it goes missing in critically ill patients, and why you should care even when it’s just “a little low.”What’s Covered:The vital role of phosphate in energy, […]

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DKA in Critical Care Oct 01, 2025

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Mobilisation in Critical Care- Barriers and Culture Sep 24, 2025

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Mobilisation in the ICU raises two big questions: is it safe, and will staff embrace it?In this discussion, Jonathan explores both sides of the story:Safety first:Large prevalence studies show mobilisation is happening, though often inconsistently.A systematic review of 1,800+ sessions found serious adverse events in only 0.6% — most minor and short-lived.Even patients on CRRT can safely mobilise […]

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Episode 1- Mobilisation in the ICU Sep 16, 2025

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SummaryFor much of critical care history, immobility was the norm: patients were sedated, kept still, and “protected.” But decades of research have revealed the hidden costs — profound muscle wasting, delirium, and long-term disability.Jonathan explores how our understanding of mobilisation in ICU has evolved — from the recognition of harm caused by bedrest, to the […]

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