Surviving Sepsis Campaign (part 2)
We continue our discussion of the Surviving Sepsis Campaign (SSC). This includes fluids types, steroids, rhAPC (Xigris), and blood sugar control.
May 15, 2008•34 min
ICU Rounds
A podcast dedicated to the teaching of critical care. The focus audience is physicians, residents, medical students, nurses, therapists, and paramedics. These are topics that arise while on teaching rounds in the Burn ICU at Vanderbilt Medical Center. A broad scope of critical care and prehospital topics are presented as well as recent journal articles and medical news.
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Episodes
Surviving Sepsis Campaign (part 1)
The Surviving Sepsis Campaign (SSC) is concensus document that attempts to provide the best evidence to assist in the care of the septic patient. All providers who provide care to the septic patient should be aware of the contents of the SSC.
May 12, 2008•32 min
Hemoglobin Based Blood Substitutes: Increased Morbidity and Mortality
In this week's Journal of the American Medical Association a meta-analysis was published that concluded that use of hemoglobin based blood substitutes result in an increased morbidity and mortality. Included in the same journal is an editorial critical of the method the research has been regulated by the US FDA.
May 04, 2008•25 min
Glucometers in the ICU: how accurate are they?
There is a large emphasis on intensive control of blood glucose in the ICU, but how accurate are the monitors we use to follow glucose? This episode reviews someof the limitations of deploying an instrument designed for control of outpatient diabetes management to tight control of blood glucose in the ICU.
Apr 24, 2008•20 min
Clostridium difficile Colitis
Clostridium difficile colitis is a problematic complication of antibiotic theraoy in hospitalized and critically ill patients. It is increasing in frequency and can be lethal.
Apr 16, 2008•25 min
Traumatic Shock and Fluid Resuscitation
Fluid resuscitation done poorly can result in significant complications to the patient. This episode will present some of the newer considerations in fluid resuscitation in traumatic shock.
Apr 01, 2008•42 min
Polypharmacy in the Elderly
Patients are often admitted to the ICU with an entire list of home medications. In this episode I talk about the implications and dangers of polypharmacy.
Mar 23, 2008•29 min
Drug-induced QT prolongation
Prolonged QT is the most common reason why medications are restricted or removed from the US market. This episode will explain what it is and why you should look for it in your ICU patients.
Mar 08, 2008•26 min
Do Steroid Improve Survivial in Sepsis? CORTICUS Trial
The results of the CORTICUS trial are discussed.
Feb 28, 2008•23 min
Atrial Fibrillation
Atrial fibrillation is a common problem in ICU patients, but it is a problem with many potential causes, and not always a well defined treatment.
Feb 20, 2008•39 min
Pediatric Burns
Pediatric burns: all burns are serious, both big and small. This episode reviews the objectives of burn care to result in the best functional outcome. Also, burn is a very common method of child abuse and we detail how these children are injured and what to look for to identify possible abuse.
Feb 13, 2008•48 min
Pharmacology of Shock
This is a basic introduction of some of the drugs used in various forms of shock.
Feb 08, 2008•38 min
Sepsis - Part 2
In this episode we discuss that ICU care of the patient with sepsis. This includes an introduction to various vasopressors.
Feb 01, 2008•33 min
Sepsis - Part 1
Sepsis is a common cause of death in the intensive care unit. In this episode I present some of the statistics on septic deaths, introduce the definitions, and present the basic science. Part 2 will cover fluid and drug therapy for septic shock.
Dec 11, 2007•34 min
HIT: Heparin Induced Thrombocytopenia
Large numbers of patients in ICUs are on heparin and what is this complication of heparin induced thrombocytopenia?
Oct 27, 2007•20 min
Smoke Inhalation Injury: CO and Cyanide Toxicity
The onset of cold weather will bring with it an increase in structure fires. The leading cause of deaths in fires is complications from the inhalation of smoke-- not burns. Learn why smoke is so deadly as well as what are the appropriate methods to treat smoke related asphyxiation.
Oct 15, 2007•39 min
Blood Products
Blood products: pRBCs, fresh frozen plasma, platelets, cryoprecipitate when and how should we use it? What are the risks? You may order them like IV fluids but do you really know how these potentially deadly products are to be used.
Oct 01, 2007•38 min
Control of hyperglycemia improves outcomes
A great deal is being presented and published on control of blood sugar in the ICU as well as the postoperative period. How much control is enough and what is the data?
Sep 24, 2007•34 min
Antibiotic Considerations in the ICU
Why do we choose the antibiotics that we do? How long do we continue the course of therapy? Should we use some antibiotics together? These topics are covered in the episode.
Sep 14, 2007•54 min
Crush Syndrome
Earthquakes are horrible natural events causing loss of lives in the thousands. Following earthquakes, building collapses, and cave-ins, large number of victims will suffer from renal failure and death following crush syndrome.
Aug 20, 2007•19 min
Thermal Injuries
An introduction of the biology of thermal injuries and the initial care of the patient with thermal injuries in critical condition.
Aug 13, 2007•40 min
Metabolic Acidosis in the ICU
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.
Jul 26, 2007•37 min
Bomb and Blast Injuries
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 atte...
Jul 06, 2007•32 min
Early Surgery Improves Outcomes Following Critical Burns
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.
Jun 29, 2007•24 min
Metabolism: Starvation versus Stress
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.
Jun 20, 2007•29 min
Blood Conservation in the ICU
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?
Jun 14, 2007•28 min
Burns: Fluid Creep
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.
Jun 07, 2007•22 min
Renal Replacement Therapy: SCUF, SLED, CVVH, CVVHD, IHD--what does it all mean
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.
Jun 01, 2007•32 min
Intraosseous Vascular Access: not just for the kids anymore
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.
May 29, 2007•18 min
Weaning (Liberating) from the mechanical ventilator
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)?
May 25, 2007•26 min
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