Welcome to the origin story of PULMCRIT! In this episode, we cover how best to practically monitor the balance between oxygenation, oxygen delivery and oxygen consumption. Controversial to say the least. Come take a listen, and learn about the pulsatility index, a space we should all be watching for in the future.
We are back! Come dust off our shows spot in your favourite podcast app, and listen to why its important to hunt for SBP like it's the Red October (forgive the Sean Connery reference, I had too). We cover diagnosis (aka tap-y-tap) and treatment.
Annnnnnnnd We are back. Sorry, but after Andor has finally finished we have now got time to discuss the old type 1 MI , aka STEMI aka Occlusive Myocardial Infarction . Come listen for all those basics and some nuances around myocardial infarction in critically unwell patients. We talk when to DAPT, who gets full anticoagulation, hemodynamic support, and when to wake our Cardiology friends up in the night.
Being Dynamic is usally a great thing... but not when youre crushing the only good way out of the left ventrile. In this episode we cover dynamic obstruction of the LVOT (specifically sub-valvular): what is it? who gets it? What to do about it. We missed ya'll, so come have alisten and brush up on a rare but important phenomena in our critically ill patients.
In this beast of a 53 minute podcast, we tackle the approach to prognosticating neurologic function of our patients after cardiac arrest. This is hard! As Dick Cheney taught us, there are lots of known and unknown-unknowns. Read through the chapter, then come listen to all things: nuances around confounders, using structural and functional tests. How imaging can lead us astray. Is there a troponin of the brain? Josh even admits to what he'd take to the proverbial desert island.
In this episode, we follow up with last week's podcast and explain the drivers of hypocapnia and subsequent respiratoy alkalosis. Come listen to a primer for all things ASA, sepsis, encephalopathy or strait mountain biking - induced panic.
In this lean and mean episode, we cover the outrageously broad topic of respiratory acidosis. Come listen to help structure your approach to Won't Breathe, Can't Breathe, and Breathing Won't Work. If you remeber nothing else, its that hypercapnia does not always mean BIPAP
In this episode we cover the rare but important driver of your patients respiratory failure: Pneumocystis Jiroveci Pneumonia. Come listen to why you should always delineate HIV status, how to approach patient workup and treatment via an invasive and non invasive manner, and why heatwaves is just a sick song.
In this episode, we cover that terrible T... Tamponade. Sit back, and get your learn on while we go beyond Beck's triad, discussing all things pulses paradox, ultrasound assessment, pitfalls, stabilization, and Josh will even melt your mind with low pressure tamponade.
In this episode, we cover all things "Upper(s)." Come listen to all things critical care level cocaine, meth and bath salts. Organ dysfunction, rapid control, immersive cooling and more!
In this episode, we cover that scary presentation where your patient goes from seemingly well, to skin melting off and in multi organ failure. Come take a listen for all things clinical presentation, anti-toxin antibiotics regimes, skin cut downs and surgical debridement.
We're back... maybe by popular demand? In this episode, we cover those two phenotypes of acute pulmonary edema: the hyper-acute sympathetic crashing acute pulmonary edema (SCAPE) patient, versus that fluid overload sub acute pulmonary edema (FOSPE). Come listen to all things NIV, nitro, and soothing calm clinical approach.
It has been a hot minute, Josh blames Adam. Adam Blames existential crisis, wildfires and the Rona. Come listen to this comeback cast: Hepatorenal Syndrome. We talk all things systemic dilation with renal constriction. We talk newish classification, albumin, pressers and more. So leave your Map goal of 60 behind you, and enjoy these pearls.
In this episode, we cover that variable response to when the lab calls with a culture positive for candida. Lines, blood, Urine. Labs, Anti-fungals, imaging... we got it all.
In this episode, we aim to arm you with a basic approach to the rhythm that loves to make the monitors go ping: atrial fibrillation. The age old argument: rate vs rhythm control. What rate is acceptable? Who gets all of the drugs? Why do we love amiodorone? When do you dust off old sparky? Come join us for 42 minutes of Josh giggling and educating us all.
In this episode we cover one of the hallmarks of the poisoned patient, that ECG tracing with a widening QRS. After reading the post, come listen for the nuances around all things hypertonic bicarb for sodium delivery, preventing acidosis with isotonic bicarb, how those sneaky-brilliant toxicologists will use lidocaine, and when to push the "panic button" on intra-lipid.
In this episode we cover the obvious, and subtleties around Valproic Acid toxicities. We talk everything from cerebral edema, giving that L-Carnitine and when to spin that IHD machine.
In this episode we summarize the new COVID Chapter (well not so new, but spot on predictions from Jan 26th). Steroids = Yes. Dose... 6mg and keep going up? Toci / Bari = maybe Cocktails / Plasma = Nope Come take a listen for all things anticoagulation, immune modulation and organ support.
In this episode we continue on the path of DIC: the scary sub-phenotype that is Purpura Fulminans. When your patient is necrosing everything, you need to act quickly before they start losing organs and digits. Come listen for identification, anticoagulation, protein C and all its goodness, when to give Vitamin K, and why to really be careful about Warfarin.
In this episode, we cover disseminated intravascular coagulation. It sounds bad, because it is. Come listen and refresh your skills around supporting the bleed-bleedy versus the cloth-clotty, how to differentiate DIC and chronic liver failure and a few more juicy clinical pearls.
In this episode, we cover the spectrum of lithium toxicity, from the acute ingestion, to the patient with saturated brain tissue. Come take a listen to explore the nuances around volume repletion, when or should you reach for dialysis, what SILENT is or does it exist.
In this episode we cover those super antigens that cause all the trouble with staph and strep infections. Come take a listen around pathophysiology, identification, antimicrobials and all things IVIG.
In this episode, we cover the OG-Farkas description of the age-old interplay between bradycardia / renal failure / AV nodal blocking agent / Shock / and Hyperkalemia. Don't just try and snipe one off at a time, carpet bomb them all at once.
In this episode we cover the crucial approach to what drives hemorrhagic shock: lots of bleeding. Come take a listen for the nuances around an organized approach to 1:1:1 and may we be as bold to say... 1:1:1:1 (fibrinogen, YAY). All things hypocalcemia, hypothermia, acidosis and what lines to use.
We were actively trying to fill your life with non-covid things... but we just had to talk about these big new things. Come take a listen of aerosol transmission, why Remdesivir just doesn't work in the real world, why not to make the same mistake with the -mab du jour, and a few other tid bits.
In this episode, we cover that daily issue: Is this a VAP? Come take listen to level up beyond leukocytosis, inflammation, consolidation, worsening oxygenation and positive cultures. Viva la Piptazo - Linezolid/Vanco diad.
In this episode, we cover another great white whale in critical care: Hemophagocytic LymphoHistiocytosis (HLH). When your macrophages turn into paceman and start chomping your own cells, you're in trouble. Com listen about genetic predisposition to unchecked immune response, and a conversation around immunomodulation.
In this episode we cover the big picture view of ileus, gastroparesis and colonic pseudo-obstruction. Come take a listen so summarize these issues you will encounter on the daily.
In this episode, we cover the DVT of the Brain... Cerebral Venous Thrombosis. Lace up your shoes, start washing those dishes, do whatever you need to do while we remind you about presentation, workup and most of all, treatment. As 1% of all strokes and the most common cause of stroke in young patients, you'll want to know this one cold.
In this episode we cover the often overlooked topic of glycemic control in the ICU. What blood sugar should we be targeting? Is that hyperglycaemia a stress response? Insulin resistance? Iatrogenic? All of the above. Come listen to our discussion, and Josh's attempt at clearing up a confused evidence base.
