ICU Rounds

Latest Episodes:

Thermal Injuries Aug 13, 2007

Show notes

An introduction of the biology of thermal injuries and the initial care of the patient with thermal injuries in critical condition.

Metabolic Acidosis in the ICU Jul 26, 2007

Show notes

A common problem in the ill or injured patient is a metabolic acidosis. In this episode we will review the common etiology of a metabolic acidosis as well as some lesser known causes.

Bomb and Blast Injuries Jul 06, 2007

Show notes

Bomb and blast injuries: In the past blast injuries were limited to the battlefield of a rare industrial accident. The events of the past week are a reminder that civilian population centers are targets for bombing attacks. Most civilian providers has no to limited knowledge or experience treating patients with such injuries. This episode is dediacated to a discussion of some of the unique properties and injuries associated with blast injuries. In the event of a terrorist attack, like those attempted in London this past week, the injuries will be in the hundreds.

Early Surgery Improves Outcomes Following Critical Burns Jun 29, 2007

Show notes

Early surgical excision is likely to be the most significant individual variable to imporve the outcome of a patient (adult or child) with a critical burn. Nevertheless, many nonburn physicians still want to apply to 1970 treatment paradigms to this population of injured patients. This episode will hopefull replace these falsehoods with fact supported in the literature.

Metabolism: Starvation versus Stress Jun 20, 2007

Show notes

Not feeding an injured or ill patient is not that same as a normal individual who is fasting. A pound of weight loss in the stress patient is significantly different than a pound of weight loss in someone on a diet. A basic understanding of stress metabolism is needed prior to a discussion of nutrition.

Blood Conservation in the ICU Jun 14, 2007

Show notes

When should a patient receive a transfuse of blood? What is an acceptable hemoglobin concentration in an ICU patient and should we use EPO? Summer is a time when the blood banks often have a single day's worth of blood. Perhaps with more conservative transfusion practices we can avoid or certainly help with some of the blood shortages. Everyone wants to put patients on Epo, but does it increase the hemoglobin concentration enough to off set its high cost?

Burns: Fluid Creep Jun 07, 2007

Show notes

Excessive fluid resuscitations lead to horrible complications such as abdominal compartment syndrome. This article takes a critical look and challanges many of our practices in fluid resuscitation of burn patients.

Renal Replacement Therapy: SCUF, SLED, CVVH, CVVHD, IHD--what does it all mean Jun 01, 2007

Show notes

Renal replacement therapy (RRT) is rather a confusing topic. What do all those initials mean and why use one therapy over another? This podcast will explain the difference between intermittent and continous. What are the various forms of continuous and how do they differ? What are the concepts of ultrafiltration, diffusion, and convection? These questions will be answered in this introduction to renal replacement.

Intraosseous Vascular Access: not just for the kids anymore May 29, 2007

Show notes

Intraosseous vascular access was was developed for use in adult trauma patients over 80 years ago. Only recently has this technique regained popularity for rapid and safe access to the vascular space in patients in extremis.

Weaning (Liberating) from the mechanical ventilator May 25, 2007

Show notes

Don't wean people from their ventilators-- liberate them!! When are people ready to come off the ventilator? What are weaning parameters? How does one do a spontaneous weaning trial? What is the role of noninvasive ventilation (NIV)?

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