Critical Care Scenarios

Latest Episodes:

Episode 12: Flight medicine with Tyler Christifulli and Sam Ireland (part 2) Jul 26, 2020

Show notes

Part two of our interfacility transfer from Hell. Tyler Christifulli, FP-C, EMT-P (@christifulli88) and Sam Ireland FP-C, EMT-P (@ireland_sam1) show us how they handle GI bleeding, arrhythmias, shock, cardiac arrest, and more, all from the confines of a helicopter. Listen to Part 1 here. Check out the great educational content from Tyler and Sam over … Continue reading "Episode 12: Flight medicine with Tyler Christifulli and Sam Ireland (part 2)"

Episode 11: Flight medicine with Tyler Christifulli and Sam Ireland (part 1) Jul 12, 2020

Show notes

A grueling interfacility transfer gives Tyler Christifulli, FP-C, EMT-P (@christifulli88) and Sam Ireland FP-C, EMT-P (@ireland_sam1) the opportunity to show us how they handle airway management, GI bleeding, mechanical ventilation, cardiac arrest, and more, all from the confines of a helicopter. Check out the great educational content from Tyler and Sam over at FOAMfrat, including … Continue reading "Episode 11: Flight medicine with Tyler Christifulli and Sam Ireland (part 1)"

Episode 10: Ventilator dyssynchrony Jun 28, 2020

Show notes

A restless patient experiences a series of dyssynchrony events during mechanical ventilation. Come see how Bryan wades through it all, and allow us to offer an academic, yet practical approach to this sometimes-confusing subject. Case files Takeaway lessons Start with ABCs and stabilizing the patient, then put on your thinking cap and try to optimize … Continue reading "Episode 10: Ventilator dyssynchrony"

Episode 9: Right heart failure and the SAVIOR protocol with Habib Srour (part 2) Jun 14, 2020

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The book Buy the new textbook (Bryan edited, Brandon authored a chapter) here or on Amazon: Concepts in Surgical Critical Care, First Edition ed. Bryan Boling, DNP, ACNP; Kevin Hatton, MD, FCCM; Tonja Hartjes, DNP, ACNP-BC, CCRN, FAANP The podcast The second piece of our in-depth look at the management of right heart failure, with … Continue reading "Episode 9: Right heart failure and the SAVIOR protocol with Habib Srour (part 2)"

Episode 9: Right heart failure and the SAVIOR protocol with Habib Srour (part 1) May 31, 2020

Show notes

The book Buy the new textbook (Bryan edited, Brandon authored a chapter) here or on Amazon: Concepts in Surgical Critical Care, First Edition ed. Bryan Boling, DNP, ACNP; Kevin Hatton, MD, FCCM; Tonja Hartjes, DNP, ACNP-BC, CCRN, FAANP The podcast An in-depth look at the management of right heart failure, with a focus on preserving … Continue reading "Episode 9: Right heart failure and the SAVIOR protocol with Habib Srour (part 1)"

Episode 8: Palliative care with Jessica McFarlin (part 2) May 19, 2020

Show notes

The second part of our look at a case of catastrophic intracranial hemorrhage, with a focus on goals of care, family interaction, prognostication, and other end-of-life aspects, with neurointensivist and palliative care physician Jess McFarlin (@JessMcFarlinMD). See Part 1 here. Takeaway lessons Useful phrase: “Can I tell you what to expect during the dying time?” … Continue reading "Episode 8: Palliative care with Jessica McFarlin (part 2)"

Episode 7: Palliative care with Jessica McFarlin (part 1) Apr 27, 2020

Show notes

Neurointensivist and palliative care physician Jess McFarlin (@JessMcFarlinMD) walks us through a case of catastrophic intracranial hemorrhage, with a focus on goals of care, family interaction, prognostication, and other end-of-life aspects. See Part 2 here. Takeaway lessons We can undo most things except death, so in most cases, a short trial (perhaps 3 days) of … Continue reading "Episode 7: Palliative care with Jessica McFarlin (part 1)"

Episode 6: Status epilepticus with Gracia Mui Apr 27, 2020

Show notes

Neurologist and neurointensivist Gracia Mui shows us the workup, initial management, and escalation of care for a case of refractory status epilepticus. Takeaway lessons First-time unprovoked seizures usually need no further workup except screening for an underlying trigger, such as a tox screen, basic chemistries, and imaging as appropriate. Initial seizure therapy: wait around 5 … Continue reading "Episode 6: Status epilepticus with Gracia Mui"

Episode 5: Cardiogenic shock and ECMO with Brendan Riordan Mar 29, 2020

Show notes

Cardiothoracic critical care PA Brendan Riordan (@concernecus) shows us his initial approach to the patient in cardiogenic shock, including initiating mechanical support, managing ECMO (plus Impella), and eventual weaning and discontinuation of support. Some pearls Anticoagulation on VA ECMO can be titrated to bleeding risk, with a balance between bleeding and circuit longevity—the latter being … Continue reading "Episode 5: Cardiogenic shock and ECMO with Brendan Riordan"

Special episode: COVID-19 brief Mar 13, 2020

Show notes

A fast-tracked update: what we know about the active pandemic of the novel coronavirus (SARS-CoV-2) and its resulting respiratory syndrome, COVID-19. Takeaway lessons Treat like viral pneumonia/ARDS. High PEEP. Prone early. Keep fluid balance dry. Probably avoid CPAP/BiPAP except perhaps for very short trials. Unclear role for HFNC. Watch out for myocarditis-type picture with cardiogenic … Continue reading "Special episode: COVID-19 brief"

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