Critical Care Scenarios

When the lessons of memory, clinical experience, and time may be more deceptive than instructive. Find us on Patreon here! Buy your merch here!

We tackle the knotty dilemma of diagnosing and treating hyponatremia, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources

A review of the basics of blood donation, storage, typing, screening, matching, and transfusion. Transfusion medicine series at Critical Concepts Find us on Patreon here! Buy your merch here!

A candid discussion of our flaws, mistakes, weaknesses, and errors, and a look at why it’s important to reflect on these things in medicine, acknowledge them, and try to improve. Find us on Patreon here! Buy your merch here!

A review of the methods of PEEP setting, including stress index, PV loops, esophageal manometry, and PEEP tables, and finally my preferred method of driving pressure trials. Find us on Patreon here! Buy your merch here!

Discussing the psychology of emergency response, team dynamics, and debriefing with Dan Dworkis, MD, PhD, FACEP. He’s the Chief Medical Officer at the Mission Critical Team Institute, a board-certified emergency physician, and an assistant professor of emergency medicine at the Keck School of Medicine of USC where he works at LAC+USC. He performed his emergency … Continue reading "Episode 56: Resu...

An important cognitive bias in medicine, and how the COVID pandemic has shown us that generalizing the assumption of competence is a treacherous pitfall. Find us on Patreon here! Buy your merch here!

After our recent episodes on publishing papers and giving talks, we close off with a review of leadership and academic rank: sitting on committees, educational roles, faculty appointments, and more. Find us on Patreon here! Buy your merch here!

On today’s TIRBO: A sinister pitfall that may lead you to injuring lungs and worsening outcomes. Find us on Patreon here! Buy your merch here!

How to evaluate the patient with unexplained encephalopathy, and a practical approach to diagnosing autoimmune encephalitis with an emphasis on anti-NMDA receptor encephalitis—with Dr. Casey Albin (@CaseyAlbin), neurologist and neurointensivist, assistant professor of Neurology and Neurosurgery at Emory, and part of the NeuroEmcrit team. Claim your CME credit here! Find us on Patreon here! Buy … C...

On today’s TIRBO: A couple common lines I’d rather stop hearing people say in the ICU.

A general discussion about how we recognize patients are dying, how we steer into discussions regarding goals of care, and the many biases and errors we often bring to the table. Two-part blog post at Critical Concepts on palliative care ICU admissions, including a detailed script for the conversation. Three-part blog post at Critical Concepts … Continue reading "Lightning rounds #23: How we do en...

On today’s TIRBO, a couple things worth saying when a patient is struck down with unexpected critical illness: it’s going to take time, and it wasn’t anyone’s fault. Find us on Patreon here! Buy your merch here!

We look at the patient with known pulmonary hypertension admitted for new issues like sepsis and pneumonia, and how they differ from our usual bread and butter, with help from Dr. Raymond Foley, director of the medical ICU and the pulmonary/critical care fellowship at UConn Health, as well as director of their pulmonary vascular disease … Continue reading "Episode 54: The critically ill patient wi...

Much is made of “staying cool” during emergencies, but what does this really mean? What is calm, what role does it play in a clinical environment, when is it appropriate, and how do we learn it? This and more on today’s TIRBO. Find us on Patreon here! Buy your merch here!

Bryan and Brandon go through their default, go-to drugs for common clinical indications in the ICU: stress ulcer prophylaxis, empiric antibiotics, hypertension, and more.

You have a trainee, orientee, intern/resident/fellow, student, or other learner who just seems slower than the rest. What should that mean to you? A perspective on this week’s TIRBO.

An exploration of clinical documentation and billing/coding with Dr. Robert Oubre (@Dr_Oubre), full-time hospitalist and CDI Medical Director for a community hospital in southern Louisiana. Takeaway lessons References

How to locate, secure, and dress your lines so they’ll stay put and stay clean.

Updates on the podcast, including how to claim credit for continuing education, how to support us by becoming a patron or buying merchandise, and our general perspective on making money through free medical education. Find us on Patreon here! Buy your merch here!

Understanding the various needles in your central line kit, how to get really, really good at ultrasound guidance, what to do when your view stinks, and more needle-related tips.

Discussing pleural effusions in the critically ill, including how and when to drain them, methods of drainage, interpreting laboratory studies, and managing complications, with Dr. Emily Fridenmaker (@emily_fri), pulmonologist and intensivist at Charleston Area Medical Center in West Virginia. Continuing education for this episode CME credit provided courtesy of Academic CME. To claim your CME … C...

Ensuring patient and operator safety with Seldinger guidewires, with considerations such as losing wires, transecting them, and perforating vessels.

Brandon and Bryan chat about tricks and methods of increasing efficiency and getting things done at work.

A deep dive into dilation during Seldinger techniques, such as central line placement: tips, pitfalls, and pearls.