Orthostatic hypotension (OH) is a common finding in the acute care setting. So, the question is, are there any hard and fast rules surrounding orthostatic hypotension? Are there cut-offs for activity / exercise? The quick answer is: it’s complicated and it depends. It requires knowledge, experience and clinical judgement every step of the way. Each case, each patient may have different symptoms and different levels of blood pressure dropping at different points in time. One clear point is assess...
May 13, 2025•1 hr 15 min
Happy 100th episode of Talking All Things Cardiopulm! My mission from day one was to bring Cardiopulm to the forefront of conversation, to give clinicians tools to use in their own practice and to help bridge the gap between research and the clinician. I created this podcast, because I felt like it needed to exist. I hope to continue going for as long as I can, to provide value and resources for you. If you want to support Talking All Things Cardiopulm, share an episode with a colleague, repost ...
Apr 27, 2025•22 min
Documentation continues to be one of the biggest frustrations across physical therapy. Despite the many changes in technology over the past 20 years, it can still feel time consuming and an overall arduous task. Shifting our perspective to an opportunity to showcase our clinical expertise and reasoning can be helpful. I like to look at documentation like an ESPN snapshot. Point out the highlights, the major turning points during the session, the gains, the losses and the why. Tell the story inst...
Apr 12, 2025•41 min
What makes an expert an expert? Is it their experience? Is it their knowledge? Is it their ability to teach/mentor? I can argue that it’s a compilation of all of the above. But do experts know everything? Is it even possible? I think the question is a set up for the most obvious answer. But maybe it’s not that obvious? A recent conversation spurred this discussion. Join me as tackle this question and take on a soap box or two I'm so excited to share this 3-day event hosted by my friends The Note...
Apr 05, 2025•37 min
I love a good comeback story, and typically cheer for the underdog, but the Measles can go ahead and stay in the past. As cases continue to rise, it’s time to take a look at overall pathophysiology and transmission of this very contagious virus. Join me as we discuss yet another virus taking the U.S. by storm. At the time of this recording the data available was as of 2/28/25 with 164 cases of measles, 1 death and 20% hospitalization. 1 week later, as of 3/7/25 cases have increased to 222 cases ...
Mar 08, 2025•38 min
As the winter season comes to an end, we review 1 of the 4 major viruses that has been rampant this year. Though RSV is officially on the decline, it is still very present in our communities and hospitals. Join us as we discuss virus transmission and possible precautions, that you may say in your setting. Is it Droplet or is it Contact? That seems to be a question these days and there seems to be some unclear writing on the wall. So let’s break it down. In this episode: Discuss pathophysiology o...
Feb 26, 2025•30 min
Influenza cases and hospitalizations continue to be the leading respiratory disease nationwide this season. As of Jan 25, 2025, there have been 20 million illnesses, 250,000 hospitalizations, and 11,000 deaths (including 47 pediatric deaths). At the time of this recording Feb 6th, the CDC had not issued a weekly report in 2 weeks. I am happy to report that the CDC did release a weekly report on Feb 7th. Data continues to show an uptrend in Flu A. Join me as we discuss the different types of infl...
Feb 08, 2025•35 min
We currently have a tuberculosis (TB) outbreak across the US and Kansas recently made national news in this regard. I’m here to break down the pathology of TB, and review the incidence to give some assurance, as well as, real concerns with this diagnosis. In this episode: Incidence of TB in the US over the last 5 years Current KC TB outbreak Active vs. Latent TB Signs and symptoms of TB Transmission of TB Airborne Precautions PT exam findings Join my email list , this ensures I can reach you if ...
Feb 02, 2025•41 min
What might seem like a simple task in the winter months could lead to devastation without the right education. What do we need to consider to keep our patients with heart disease safe? The concern lies in the compounding effect. The effect of cold weather on the cardiopulmonary system, age, comorbidities, and aerobic capacity all play a role in determining safety. Join me as we dive into HR response, MET levels, predictive equations, and much more. Want to sign up for a mentoring call with Dr. B...
Jan 18, 2025•37 min
As the temperature drops across the country it is important to understand the impact the cold air will have on the cardiopulmonary system. Similar to pipes in a house, the cold affects both the pipes in the lungs and body in the same way, constriction. Although these changes occur in healthy individuals, they have more profound impact on those with heart and lung conditions. Join me as we discuss these changes, and some tips to help combat them. Want to sign up for a mentoring call with Dr. Burr...
Jan 11, 2025•20 min
Leaving the last day of 2024 with a little spice. Since most of this audience is PTs, PTAs and PT(A) students, I just want to remind us to value what we do. Stand up for your skill set, educate others on the benefits and continue to advocate! Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring Interested in Jane? Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burri...
Jan 01, 2025•12 min
Review of the literature brings us an article from Japan, evaluating diaphragm and chest wall excursion in four different positions in healthy adults. Dynamic MRI was utilized for excursion measurements throughout all four positions in quiet breathing. The initial hypothesis was disproved, allowing for deeper discussion of the effect of position on diaphragm movement. Join me today as we discuss the impact of patient positioning on the diaphragm and add another tool to the toolbox. Want to sign ...
Dec 27, 2024•20 min
Have you seen the Nuss Bar Protocol? If not, this will prepare you if you ever do. This procedure is more common in the pediatric population but is a growing surgical option for patients in their 40th and 50th decade of life. Though considered a “minimally invasive technique,” it is quite an extensive procedure that navigates around multiple primary organs and has several considerations post-surgically. Join me as I discuss the evolution of the procedure and possible precautions you may need to ...
Dec 17, 2024•26 min
Tracheal Deviation, to the Left, to the Right, which way does it go? This is probably one of the most common questions that I get from students studying for the NPTE. As it often does, the answer comes down to pressures. Tune into this episode to learn ipsilateral vs. contralateral movement of the trachea. Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring Interested in Jane? Jane, is an all-in-one practice management software wit...
Dec 10, 2024•12 min
It would be unfair of me to dismiss automatic blood pressure measurements as they are used in most settings, including the ICU. It’s important to understand their normal guestimate error range and when you should consider taking a manual BP. Similar to manual blood pressures, there are a number of steps you can take to help increase their accuracy. Instead of avoiding the inevitable, let’s empower the clinician to understand their equipment. Website to check for validated BP machines: https://ww...
Nov 30, 2024•23 min
Want some tips to improve the accuracy of your blood pressure technique? I’ve got you covered. It all starts with a manual cuff, the obliteration technique and a few simple setup tips. Join me in this episode as we break down the step-by-step technique of improving accuracy with blood pressure measurements. In this episode: Set up considerations prior to taking BP Importance of cuff size Positioning with BP measurements How to perform the obliteration technique Join my main newsletter: https://a...
Nov 26, 2024•36 min
Respiratory muscle training is by far one of my favorite interventions and continues to show itself in research. Anytime RMT is added, you can hypothesize that your patient will improve in a number of different categories (gas exchange, respiratory strength, 6MWD, QOL scales, blood pressure, and the list continues). I honestly continue to be impressed by RMT. But in order to incorporate RMT, you have to have an assessment tool that can show you a true pre-post for respiratory muscle strength. Th...
Nov 16, 2024•42 min
In today’s episode, we break down 3 of the most common high-flow oxygen devices that you may see in the hospital setting: typical high-flow nasal cannula, venturi mask, and heated high-flow nasal cannula devices. Each device varies on the level of flow and FiO2 available, as well as, how the FiO2 is achieved. Each device also has pros and cons for choice of use. Join me today, as we discuss the difference between the more common high-flow oxygen devices available. Join my main newsletter: https:...
Nov 06, 2024•33 min
Time and time again, across my career, whether I’ve been in the clinic or teaching, I have come across words in healthcare that are either used interchangeably, go by different names, or simply have changed over time. Nomenclature issues can lead to confusion, errors, and miscommunication, while also limiting data collection for research. Join me on this opinion piece about nomenclature and share your nomenclature nuances. Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421 W...
Oct 30, 2024•25 min
Working with patients on oxygen can feel overwhelming with all the possible devices that can be utilized. Whether or not you are a clinician who helps in making those decisions or you are actively working with patients using these devices, it’s important to understand their range of use, the level of FiO2 available, pros and cons, as well as, special considerations for each device. Join me today, as we break down the most common low-flow oxygen devices available so you can feel confident in your...
Oct 18, 2024•43 min
There are many steps when dealing with oxygen titration. In this episode, we set the stage for what clinicians need to consider when dealing with a patient on oxygen, including our state practice act, MD orders, available devices, and titration concepts. As PTs we can take an active role in education, and, oxygen titration to optimize safety and maximize patient outcomes. In this episode: PT State Practice Act MD orders for oxygen titration Understanding oxygen devices Interdisciplinary collabor...
Oct 12, 2024•34 min
An episode about mowing, MET levels, and knowing your (your patient’s) limitations. Have you ever been asked, “Can I get back to….?” How do you help your patients make these decisions? Do you consider MET levels, HR response, or overall aerobic capacity? Using MET levels for a specific activity can be a great way to help educate patients on their current abilities or to assist in creating meaningful goals for future activities. It can be a great starting point to help determine the “it depends” ...
Oct 02, 2024•22 min
Today we discuss a recent acute care evaluation of a 52yo male s/p motocycle crash, despite multiple orthopedic injuries, both the lung and the heart played a bigger role than the initial case synopsis would think. Let’s dive into a cardiopulmonary assessment and treatment interventions for this fun and complex orthopedic case. In this episode: Lung Auscultation Chest wall Assessment Breathing exercises Cough Techniques Rib fractures Transfer techniques Join my main newsletter: https://allthings...
Sep 25, 2024•27 min
Lateral costal breathing exercise technique is a versatile approach that can be used to help improve lateral costal (side ribs) movement in a variety of patient populations. It is a go-to technique to improve motor control and expansion, as well as decrease anxiety and dyspnea. Join me in this episode and give this breathing exercise a try. In this episode: How to perform lateral costal breathing technique Discuss multiple variations of the approach What patient diagnoses or conditions to utiliz...
Sep 18, 2024•31 min
Join me today as we discuss all things pulmonary rehab, its structure, accepting diagnoses, benefits and even its continued underutilization. Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421 Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring Interested in Jane? Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized d...
Sep 13, 2024•1 hr
There are a number of reasons why a cough may be ineffective. It all starts with assessing the four phases of a cough. Once the inefficiency is highlighted it’s time to work on improving it. Pending which phase is most affected, depends on how you will approach the interventions. Whether you are utilizing posture, applying manual pressure or aiming for time, there is something beneficial for each person. More importantly are the consequences of this improvement. Tune is as we break it all down. ...
Sep 07, 2024•23 min
It’s that time of year, the start of a new semester. For some it’s their first-ever semester, for others, it may be their last. No matter where you are in your journey, my advice for the semester typically stays the same. Tune in for some real-life tips and study advice, to make the most of your semester and prepare you for future exams. In this Episode: - Semester tips to set you up for success - Study strategies - White paper test technique Join my main newsletter: https://allthingscardiopulm....
Sep 01, 2024•32 min
In today’s episode, we break down the priorities of seeing a patient with Aspergillus pneumonia (PNA). When coughing and shortness of breath are the primary limitations, what should be your primary focus during your session? As much as mobility is a huge priority in the acute care setting, it is not the only thing to consider in this patient population. As physical therapists, we should be empowered to use our whole scope of practice to prioritize assessment techniques and interventions that cat...
Aug 21, 2024•28 min
As we cruise through August we are amidst the middle to end of the COVID summer surge. With each new surge comes a new variant. And with each new variant comes new info or old info updated. Today we discuss the nomenclature of the newest variants, symptomatology, PPE, ongoing discussion of airborne vs droplet and updates on the vaccines. In this episode: COVID-19 newest variants KP.3.3.1, KP3, KP2 and LB.1 Most common symptoms of current variant Droplet vs. airborne definitions Update on vaccine...
Aug 14, 2024•35 min
Has COVID entered your home? Are you trying to prevent spreading COVID to your family members or are you trying to prevent getting COVID in your own home? Four years in, I’m sure we are all well versed in COVID transmission and how to prevent spread, but what options do we have once it has entered the home? Is it a lost cause to try and prevent transmission? Are there strategies we can take? This is one of the most common questions I get asked, usually once someone tests positive in the home. Al...
Aug 12, 2024•26 min
