In this episode we cover that rapidly progressive, big stakes entity that is Status epilepticus - the unrelenting seizure. Definition, Big Benzoes and where to go after that first line. Come listen for all things Keppra, Propofol and Ketamine.
Feb 10, 2020•43 min•Ep 76•Transcript available on Metacast In this episode we cover the last common electrolyte derangement you'll face in the ICU; hypocalcemia. From tetany to hypotension, we've got you covered for an approach to recognition and treatment.
Jan 31, 2020•15 min•Ep 75•Transcript available on Metacast In this episode we cover that rather bothersome component of your AGMA... toxic alcohols. Who is high risk, when and how to screen, and of course a tight approach to treatment. Don't forget... always call your local friendly toxicologist.
Jan 27, 2020•31 min•Ep 74•Transcript available on Metacast In this episode, we cover that daily discussion point... can this line, possibly, be infected? Come refresh yourself on diagnosis, microbiology and treatment.
Jan 14, 2020•27 min•Ep 73•Transcript available on Metacast In this hallmark episode (we just hit 500k in downloads!), we cover an approach to dominating the diuresis. We cover all the major points: -Loop diuretics and how not to screw them up -Using thiazides to maximize ongoing diuresis -When to add spironolactone -How not to always just cheat and start the CRRT machine
Jan 09, 2020•47 min•Ep 72•Transcript available on Metacast Welcome to 2020, everyone! In this fresh new podcast we cover all things severe hypothyroidism; AKA Myxedema Coma. Diagnosis. Treatment. Whats the deal with T4 vs T3. Who gets the roids. Come listen to it all!
Jan 02, 2020•23 min•Ep 71•Transcript available on Metacast Happy Holidays everyone! In this episode we cover the general support of those patients that are working hard to breathe. Come listen about NIPPV (BiPAP and High Flow Nasal Cannula).
Dec 28, 2019•38 min•Ep 70•Transcript available on Metacast In this episode, we cover that rapidly progressive, easy to miss, relatively better survived leukemia: acute promyelocytic leukemia. Come read about pathophysiology, and then listen to the summary that covers when to suspect clinical APL, the use of ATRA, and that scary hyperfibrinolysis (DIC but worse). Just to leave you with more, we cover Differentiation syndrome (aka retinoic acid syndrome).
Dec 19, 2019•18 min•Ep 69•Transcript available on Metacast In this episode, we cover all things ICU level hyponatremia . From a mild inconvenience to a refractory seizing patient, we've got you covered for diagnosis, treatment and risk stratification.
Dec 12, 2019•36 min•Transcript available on Metacast In this episode we cover that low serum potassium, aka Hypokalemia. From the minor repletion to the immediate resuscitation of a patient with VF arrest secondary to severe hypokalemia, we have you covered. So read the post, then come take a listen to review all things hypo K!
Dec 05, 2019•21 min•Ep 67•Transcript available on Metacast In this episode we cover the definition and concrete way how to identify and correctly diagnose brain death. This is something we need to get right, so grab a coffee and come take a listen.
Nov 28, 2019•21 min•Ep 66•Transcript available on Metacast In this episode we cover both accidental and non-accidental hypothermia. Come listen for a good review on: Clinical Clues Passive and Active re-warming Modification of standard ACLS approach Complications of hypothermia and much much more... PS: Many apologies to cardiac anesthesiologists and perfusionists: core after-drop is a thing, but we don't want to cloud the issue of priorities in rewarming.
Nov 21, 2019•22 min•Ep 65•Transcript available on Metacast In this episode, we cover the 2019 version of a TCA overdose: Bupropion. AKA: Wellbutrin / Illbutrin (Shoutout to Tox & The Hound). Read the post then get an audio summary of the clinical diagnosis, risk stratification, Activated charcoal, whole-bowel irrigation and finally all things VA-ECMO for the extreme toxicities.
Nov 14, 2019•18 min•Ep 64•Transcript available on Metacast In this episode, we cover that sneaky presentation of acalculus cholecystitis. When that ALP/GGT start climbing, or your chronically critically ill patient gets septic again, you need to know about this!
Nov 12, 2019•18 min•Ep 63•Transcript available on Metacast In this episode, we cover that pesky Carbon monoxide. From minor exposure to critically ill, we have you covered for: -Diagnosis -Testing -Hyperoxia -Hyperbaric -Bleeding Edge Therapies
Nov 10, 2019•33 min•Ep 62•Transcript available on Metacast Just when you thought your post MI patient has made it through the woods... they start to crump! In this episode we cover the Ddx and approach to post myocardial infarction complications. Come listen to review all the greatest hits. -Rupturing things -Pericarditis -Access issues -Arrythmias
Oct 24, 2019•20 min•Ep 61•Transcript available on Metacast In this episode we cover that rare but fun element to your cyanosed patient Ddx. When your hemoglobin gets oxidized to Fe3+, badness can ensure. Enjoy this quick refresher.
Oct 15, 2019•18 min•Transcript available on Metacast In this episode, we cover one check box on your bilateral airspace opacification differential diagnosis. Come take a listen for Diffuse alveolar hemorrhage and pulmonary vasculitis in the ICU. -Imaging findings -Bronch? -What labs to order (you can't just write "vasculitis work up")
Oct 10, 2019•25 min•Ep 59•Transcript available on Metacast We know you all have been waiting for it! Here is one of the foundational chapters for the IBCC. All things asthma. We've got everything from physiology, to bleeding edge sedation approaches. Come take a (longer) listen to solidify everything you read in the post: -Presentation / patient phenotypes -Initial management -Escalation to salvage treatments -Vent Management & ECMO
Oct 08, 2019•1 hr 11 min•Ep 58•Transcript available on Metacast In this episode, we further explore the acid-base-palooza with Metabolic Alkalosis. We give you 10 things to treat said event with, however, sometimes its best to let sleeping dragons lie. Josh even snuck in some acid infusion!
Sep 26, 2019•18 min•Transcript available on Metacast In this episode we have a quick little refresher on Non-Anion-Gap Metabolic Acidosis for you! Enjoy!!!
Sep 19, 2019•11 min•Ep 56•Transcript available on Metacast Continuing on with metabolic-palooza: Here is the core approach to Anion-Gap Metabolic Acidosis. We've got the KULT, we've got the labs/treatment and everything in between.
Sep 17, 2019•13 min•Ep 55•Transcript available on Metacast In this episode, we cover the foundations to every day clinical medicine in the ICU: Acid base. As our patients are either often too sick to regulate their own homeostasis, or what we are doing to them prevents their lungs or kidneys from doing so, we give you the approach to recognizing Acid Base disorders. Step 1: Calculate the Anion Gap Step 2: Look at the Bicarbonate level Step 3: Compare the change in Anion Gap to the Change in Bicarbonate
Sep 12, 2019•20 min•Ep 54•Transcript available on Metacast In this episode we explore the controversies in how to classify the hemodynamic effects of pulmonary embolisms. We also cover: -Risk Stratification -Thrombolysis -Anticoagulation -Novel therapies -The crashing & hypoxemic PE patient
Sep 10, 2019•1 hr 15 min•Ep 53•Transcript available on Metacast In this episode, we cover all the big hits for anticoagulant management in your bleeding patients. -Warfarin -DOAC -Anti platelets -Heparin and LMWH -And More!
Aug 29, 2019•33 min•Ep 52•Transcript available on Metacast In this episode, we cover all things you need to know cold when your patient's cells are bursting all over the place. -Life threatening Hyperkalemia - Purine Nucleotide Management -Rasburicase -Dialysis
Aug 22, 2019•22 min•Transcript available on Metacast In this episode, we take a break from controversial subjects and cover all thing magnesium related for critical care. Come take a listen for diagnosis, identification, and treatment of low and high levels of magnesium.
Aug 15, 2019•26 min•Transcript available on Metacast Here it is, a total beast of a podcast. We cover one specific approach to patients in septic shock. We highlight all the must-know aspects: -patient identification and risk stratification -fluids -vasopressors/inotropes -The Metabolic Resuscitation Protocol We even re-leak the CITRIS-ALI trial for you... its going to be an epic Doozy. So make sure you have a proper 60+min to really take it all in.
Aug 08, 2019•1 hr 11 min•Transcript available on Metacast In this episode we cover the simultaneous approach of sorting out the airway from hell, and treating both the histamine and bradykinin induced angioedema. We even snuck some novel use of TXA into the post!
Aug 01, 2019•28 min•Transcript available on Metacast In this episode, we follow-up on the very "heated" debate that this post sparked on the interwebs. Come listen to all things ICU level-hyperthermia. We've got the ice baths. The cold fluids. The dry air. We cover it all!
Jul 31, 2019•30 min•Transcript available on Metacast