Critical Care Practitioner

Tom, one of my colleagues from the Critical Care Outreach Team and I discuss this paper and its findings reaching our own conclusions. Deferring Arterial Catheterisation in Patients with Septic Shock. The post Arterial Lines: Do we always need them. A chat with Tom (Duracell Bunny) appeared first on Critical Care Practitioner .

We return to our 48-year-old patient: jaundiced, hypotensive, drowsy, and bleeding. In decompensated cirrhosis, every treatment targets a disrupted system — splanchnic vasodilation, portal hypertension, toxin accumulation, and renal hypoperfusion. Although these patients look fluid overloaded, they are effectively hypovolaemic. Start with small aliquots of balanced crystalloid, avoiding 0.9% salin...

In this episode, I walk through the real-world critical care management of acute decompensated alcohol-related liver disease, using a high-risk ICU case to anchor the discussion. The focus is on understanding the underlying physiology—portal hypertension, rebalanced haemostasis, hepatic encephalopathy, infection, and hepatorenal syndrome—and translating that physiology into clear first-hour priori...

This episode offers a structured, bedside-focused exploration of Non-Invasive Ventilation (NIV) for acute hypercapnic respiratory failure in COPD, aligned with NICE NG115 and BTS/ICS 2016 guidance. Aimed at early-career critical care nurses, it breaks the topic down into physiology, practical setup, monitoring, and escalation. Key Topics CoveredMechanisms behind acute-on-chronic hypercapnic respir...

HHS (Hyperosmolar Hyperglycaemic State) is the quiet counterpart to DKA. It develops slowly in older type 2 diabetics with residual insulin, leading to extreme hyperglycaemia and dehydration without ketosis. In this 2-hour deep dive, Jonathan explains why HHS kills through water loss and hyperviscosity rather than acid, and how to manage it safely. Key Learning Points:·         Pathophysiology: Re...

The post DKA- Fluids, Potassium and Insulin appeared first on Critical Care Practitioner .

Summary:In this episode, we spotlight a stealthy ICU disruptor — hypophosphataemia. Based on a 2024 narrative review in the Journal of Clinical Medicine, we explore why phosphate matters, how it goes missing in critically ill patients, and why you should care even when it’s just “a little low.”What’s Covered:The vital role of phosphate in energy, […] The post Hypophosphatemia in Critical Care appe...

The post DKA in Critical Care appeared first on Critical Care Practitioner .

Mobilisation in the ICU raises two big questions: is it safe, and will staff embrace it? In this discussion, Jonathan explores both sides of the story:Safety first:Large prevalence studies show mobilisation is happening, though often inconsistently. A systematic review of 1,800+ sessions found serious adverse events in only 0.6% — most minor and short-lived. Even patients on CRRT can safely mobili...

SummaryFor much of critical care history, immobility was the norm: patients were sedated, kept still, and “protected.” But decades of research have revealed the hidden costs — profound muscle wasting, delirium, and long-term disability. Jonathan explores how our understanding of mobilisation in ICU has evolved — from the recognition of harm caused by bedrest, to the […] The post Episode 1- Mobilis...

Sedation practices in the ICU have evolved dramatically over the past decade — but are we truly following the evidence? In this episode of The Critical Care Practitioner Podcast, Jonathan takes you through the key milestones in sedation guidance, the persistent gap between recommendations and real-world practice, and the emerging shift toward human-centered, wakeful care. What You’ll […] The post...

OverviewIn this episode we explore the three main sedatives used in critical care and how to choose the right agent for the right patient. HighlightsBenzodiazepines: once the workhorse of ICU sedation, but now linked to more delirium and longer ventilation. Still useful in alcohol withdrawal and seizures. Propofol: rapid on/off, easy to titrate, helpful for daily sedation […] The post Episode 5 —...

The post Episode 4: Sedation Protocols – Turning Knowledge into Practice appeared first on Critical Care Practitioner .

The post Episode 3: Sedation Depth Why going too deep can hurt. appeared first on Critical Care Practitioner .

In this episode, I explore the origins and evolution of the daily sedation hold — also known as the spontaneous awakening trial (SAT) — one of the most influential shifts in ICU sedation practice. I unpack the key trials that demonstrated SATs could safely reduce ventilation time and ICU stay, and examines how these findings became standard care. But it's […] The post CCP Podcast: Episode 2 The se...

In this episode, I explore how sedation practices in critical care have evolved over time — from the routine use of deep, continuous sedation to the early evidence that challenged it. You'll hear about pivotal studies that revealed the risks of over-sedation, the emergence of structured sedation protocols, and the beginnings of a culture shift […] The post CCP Podcast: Episode 1 A short history of...

This is a conversation I had with Francesca Trotta, a nurse from Rome who is at the last stages in her PhD. This was at the BACCN conference in Aberdeen in 2024. The post CCP Podcast: Whats an ITU stay like for patients families? appeared first on Critical Care Practitioner .

This is a chat I had with David Wightwick who is the CEO of UK Med a humanitarian medical aid charity. This happened at the BACCN 2024 conference in Aberdeen. The post CCP Podcast: Working in war zones and Disaster Areas appeared first on Critical Care Practitioner .

This is a conversation I had with professor Tim Buchman who is Professor of Surgery and founding director at the Emory Centre for Critical Care in the US.  We discuss the advent of Advanced Practice in the US and how it will inform the same developments in the UK The post Are ACCPs here to stay? appeared first on Critical Care Practitioner .

AI is here! How will it effect us and how can we use it to make learning fun with AI, or not use it to help with our work? Aarti gives some easy to understand explanations of the key concepts. The post CCP Podcast: AI with Aarti Sarwal appeared first on Critical Care Practitioner .

This is a chat with Rowan Grieves, who works in Belfast, about her journey to become an ACCP and the hurdles she had to overcome when starting this new role. The post CCP Podcast: So you want to be an ACCP? appeared first on Critical Care Practitioner .

This was originally a Facebook livestream with an ex patient- Carol Billian, Christine representing ICU Steps, a group helping support ICU survivors and Peter Nydahl from Germany who also aims to support the same group. The post CCP Podcast- Patient Diaries appeared first on Critical Care Practitioner .

This is a chat I had with Dr Daniel Watkin about his QI project to assess compliance with the guidelines and how they went about improving it.  You can find the paper here- 'Beyond Audit: Embracing QI methodology to drive improvements in lung-protective ventilation' The post CCP Podcast- Lung Protective Ventilation- How to improve our practice. appeared first on Critical Care Practitioner .

This is a chat with Tamas Szakmany about the paper 'Impact of early tracheostomy versus late or no tracheostomy in nonneurologically injured adult patients: a systematic review and meta analysis' and his editorial 'When more could mean less intervention: the tale of tracheostomy timing in critical illness' The post CCP Podcast: When to do the tracheostomy appeared first on Critical Care Practition...

This is a chat with Professor John Laffey about the WEAN_SAFE study.  Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study The post CCP Podcast- Weaning our patients. appeared first on Critical Care Practitioner .