Critical Care Time
5. Zorses and Hebras
They say that when you hear hoofbeats, you should look for horses. This age-old medical adage makes sense in many circumstances, but what do you do when the paradigm is flawed? What if what we generally accept as a common entity, is actually rare? What about the reverse? In this first episode of Zorses & Hebras, Nick & Cyrus will discuss some of these very entities in the context of critical illness, shed some light on them, and explain why focusing on the Horses & Zebras model may bite you on the tail!
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18. 18. Journal Club - DL VS VL: The Device Trial32:54On this week’s installment of Critical Care Time, Nick & Cyrus tackle the recent multicenter, randomized control DEVICE Trial, which compared direct to video laryngoscopy in 17 American ICUs & EDs with the primary outcome of interest being successful intubation on first attempt. During this episode, we’ll take a deep dive into the paper, discuss other literature, and weigh-in ourselves based upon our own experiences and the data that’s available. Give it a listen and let us know what YOU think!
17. 17. Hyponatremia in Critical Illness with Dr Joel Topf01:09:04Sit back and grab some salty treats as you enjoy the mindful musings of master nephrologist Dr. Joel Topf (X: @Kidney_Boy) who joins Nick & Cyrus to chat about hyponatremia in critical illness - a very common condition. Here we discuss diagnosis and management of hyponatremia with special attention to those in the intensive care unit. Of course, no discussion is complete without plenty of time dedicated to osmotic demyelination syndrome (aka: central pontine myelinolysis) which gets plenty of face-time during this episode. Give it a listen and leave feeling confident in your ability to diagnose and manage a very prevalent condition in our patient population!
16. 16. Pulmonary Embolism Part II01:11:28In Part II of our discussion of PE, Nick & Cyrus discuss the Pillars of PE Management! We review the literature behind lytics in non-massive PEs, talk about airway management, hemodynamics and more! Make sure you listen to Part I if you missed it as it sets the stage for this fantastic, treatment focused discussion.
15. 15. Pulmonary Embolism Part 142:01There are few things in medicine Nick & Cyrus enjoy talking about more than PE! Join the guys from Critical Care Time as they tackle this massive topic via a two part epic that’ll prove to be the best saga since The Lord of The Rings! In part one they talk about diagnosis, clinical decision support tools and demystify the pathophysiology behind pulmonary emboli. Check it out, and be sure to catch the second half in two weeks! We promise you’ll get your money’s worth!
14. 14. Massive Hemoptysis50:20Hemoptysis can be a scary thing to encounter in medicine and massive hemoptysis - i.e. life threatening hemoptysis - is a serious emergency that often requires cognitive agility and technical prowess. Join Nick & Cyrus as they talk with Dr. Whittney Warren - an intensivist and interventional pulmonologist - who walks us through her pragmatic approach to life-threatening hemoptysis. What medications can we use to stabilize these patients? How would we go about intubating such a patient? What bronchoscopic tools do we have at our disposal? Listen to this first CCT episode of 2024 and find out!
12. 12. DVT Prophylaxis In The Critically Ill54:30Every time we admit or care for a critically ill patient, we must consider their risk for deep venous thrombosis, or DVT. Many of our patients are at higher risk for DVT than the general population, but anticoagulants are not wholly benign drugs. What do we do? How do we decide who to treat medically, who to treat with mechanical compressive devices and identify patients who may NOT need anything? When do risks outweigh benefits? What agent is best?Join Nick and Cyrus as they interview hematologist & oncologist Dr. Matthew Rendo (Twitter/X: Rendoncology) as they do a deep dive into managing DVT prophylaxis in the critically ill patient!
11. 11. The Physiologically Difficult Airway01:29:12Airway management in the critically ill can be one of the most challenging, stressful and rewarding elements of critical care medicine. While the anatomically challenging airway is often the first place our minds go when discussing difficult airways, the physiologically difficult airway is both more common and often requires more savvy to overcome. Join Cyrus & Nick as they take a pragmatic, case-based approach to this topic with the hopes of equipping you with the tools you need to successfully take a physiologically difficult airway, or support an airway operator charged with this task!
10. 10. Intro to The Pleura & Conquering01:03:30Whether you work in the ICU, on the medicine wards or in the prehospital setting, you've got to be familiar with the unsung hero of the thorax - the pleura! On this episode of Critical Care Time, Cyrus & Nick extol the virtues of this humble structure, cover a little comparative physiology and spend the latter half of their chat discussing all things pneumothorax. Sit back, relax and enjoy this episode packed with pulmonary and critical care pearls that will take your breath away!