TIRBO 51: Critical care problems are syndromes
The core disorders of critical care are mostly syndromes, not diseases. What should this mean to us?

The core disorders of critical care are mostly syndromes, not diseases. What should this mean to us?
Discussing the new 2023 AAN/AAP/CNS/SCCM Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline, with the joint first authors: Dr. Ariane Lewis, neurointensivist, professor of neurology and neurosurgery at NYU Langone, director of neurocritical care, and chair of the Langone ethics committee, and Dr. Matthew Kirschen, pediatric neurointensivist and associate director of pediatric … Continue reading "Lightning rounds #35: Brain death updates, with Ariane Lewis a...
If you produce academic work, use the research to produce multiple products. Once is a waste.
We learn about liver transplant with Dr. Meera Gupta, transplant surgeon at the University of Kentucky Healthcare Transplant Center, and surgical director of the Kidney and Pancreas Transplant Program. We discuss eligibility, triage, the peri-operative course, and important post-op complications. Find us on Patreon here! Buy your merch here! Takeaway lessons
Explaining the ultimate expression of prognosis: Morbidity = (Severity x Duration)/Reversibility
When should you…
Which site should you select for your central line placement? A discussion of some considerations.
We learn about pancreaticoduodenectomy (the Whipple) with Michael Cavnar (@DrMikeCavnar), surgical oncologist at University of Kentucky, with a fellowship in Complex General Surgical Oncology from Sloan Kettering. He specializes in GI surgical oncology (liver, pancreas, stomach, etc), with ongoing research in GI stromal tumors and hepatic artery infusion pump chemotherapy. Find us on Patreon here! … Continue reading "Episode 67: Whipples with Michael Cavnar"...
A review of the physiological and practical reasons to position patients with ARDS in the prone position.
We chat with Janelle Bludorn (@JanelleRBlu), former emergency medicine PA, Assistant Professor and Academic Coordinator at the Duke PA program, about transitioning from clinical work into teaching and academia. Find us on Patreon here! Buy your merch here! Resources
The value of being curious about practice differences, not judgmental.
We explore aortic dissection with Travis Hughes, vascular surgery fellow from the University of Kentucky, including classification, medical management, and nuances of the surgical perspective. Find us on Patreon here! Buy your merch here! Takeaway lessons
What are the ways that patients fail breathing trials, and what can they tell us about how to optimize them for next time?
We chat with Leon Chen about his work setting up infrastructure for clinical POCUS at Memorial Sloan Kettering. Leon is an Adult/Gerontology Acute Care Nurse Practitioner in the ICU, Clinical Program Manager of Research and Simulated Learning, and an Associate Professor at Columbia University School of Nursing. Find us on Patreon here! Buy your merch … Continue reading "Lightning rounds #32: Creating a POCUS system with Leon Chen"...
A brief discussion of the stuff in your pockets as you practice medicine.
We discuss the nuts and bolts of urinary infection with an obstructing stone with Ashley Winter (@AshleyGWinter), board certified urologist with a fellowship in male and female sexual medicine, and chief medical officer of Odela Health. Find us on Patreon here! Buy your merch here! Takeaway lessons
From the Critical Concepts blog, thoughts on our personal biases and lack of humility when contemplating end-of-life decision making.
Bryan and Brandon chat about holding down jobs, conflict resolution and interpersonal skills, and how to protect yourself as an employee.
When are patient outcomes your fault?
We explore the cutting edge practice of point-of-care ultrasound of the brain, including optic nerve sheath measurement, transcranial doppler, assessing midline shift, and more, with Aarti Sarwal, neurologist and neurointensivist, director of the neurocritical care unit at Wake Forest, and director of their neurovascular lab and ultrasound courses. Find us on Patreon here! Buy your … Continue reading "Episode 64: Neurologic POCUS with Aarti Sarwal"...
Dealing with the good and bad aspects of tissue mobility during percutaneous procedures.
We chat with friend of the podcast Matt Siuba (@msiuba), Mr. Zentensivist, to share our distinct perspectives on the relationship between APPs (PAs or NPs) and the intensivists we work alongside.
The dilemma of lung-protective ventilation in patients with strong spontaneous breathing.
We dive into when to initiate renal replacement therapy, the modalities, settings, and physics involved, troubleshooting problems, and more, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky. Find us on Patreon here! Buy your merch here! Takeaway lessons
5 things you pretty much must be doing if you want to be excellent at critical care. See also on the blog: The ten laws of critical care Practicing medicine like an adult
We chat with Callie Tennyson, DNP, ACNP-BC, AACC, CHSE, assistant professor from the Duke University School of Nursing, about the use of the internet and social media for medical education: trends, challenges, and principles for doing it right.
The value of performing chart checks to see how your patients are doing after your care.
Bryan puts Brandon through the paces, discussing the nuts and bolts of managing a code. Find us on Patreon here! Buy your merch here! Takeaway lessons
The importance of using an app to keep notes and establish a second, more reliable medical memory.
We chat about why people get burned out in medicine, how to weigh the pros and cons of our work, and the right perspective on job satisfaction.