Critical Concepts

The basics of liver, kidney, and pancreas transplants and their post-ICU care. Now at icu101.com.

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Do you attend rapid responses? Aka the most chaotic place you're likely to experience outside of a natural disaster? We share some tips for organizing the scene, the case, and the team.

icuscenarios.com/episode-98-r...

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I’ll be speaking about the history of the HEARTSafe Communities program in the US and potential international applications in Dubai next week. See you all there!

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We chat with Keith Lamb about the nuances of nebulizer therapies.

icuscenarios.com/lightning-ro...

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How do we handle ICP crisis in the neuro ICU? icuscenarios.com/episode-97-m...

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How to approach a toxicology case - now in the MICU course at ICU101.com.

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Gastric bypass can cause steatosis and severe hyperammonemia. So can rituximab. Your joint effusion patient may have ureaplasma. Did you know all this? Prem teaches us all in the latest episode icuscenarios.com/episode-96-u...

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probably to detect hypercarbic encephalopathy

So I'm looking for a better affirmation. How do I acknowledge without elevating myself above them?

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After a difficult shift or resus I will often thank a nurse for their help, or tell them they did well. But I now realize this creates a power dynamic of sorts; who am I to judge their work, and who says they were trying to help me?

Instead, point out what they actually did (especially if it involved hard work). This highlights their efforts, and requires no judgment, only noticing, which everyone appreciates.

I now realize this should probably apply at work.

One interesting lesson I learned as a parent: don't constantly praise your kid. It not only cheapens the words, it conveys a message of judgment and emphasis on success—I am the arbiter of worth and I deem your efforts worthy.

Clint Leonard gives us the scoop on the odd, sweaty place that is the burn ICU. icuscenarios.com/lightning-ro... #medsky #emimcc

After some hemming and hawing on this, I think I agree. VL with Mac is a more versatile skill and helps teach DL. But if you want a single skill for someone who will probably never move beyond a basic skillset, and who can trust always having VL available, hyperangulated is probably easier.

We dive into the subtle art of placing, understanding, and interpreting the PA (Swan Ganz) catheter, on a new lesson at icu101.com.

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either result would seem hard to rationally apply, from a Bayesian perspective

Agreed… this is some skinny love

Bad reason to place: patient is in shock
Good reason to place: shock is labile

No more PSV trials! RSBI is not a weaning parameter! Respiratory muscle fatigue is a myth! And more hot takes from the great Martin Tobin, this week on the show.

icuscenarios.com/episode-95-s...

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Connecticut humans (also a remote option): I will be speaking at the Bridgeport Hospital CME conference on November 8 with a deep dive into shock. Check it out if interested!

e.givesmart.com/events/KFO/

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The great Tom Bleck shares his insights on treating seizures. Which benzo? When do you load an ASM, and which one? What drug to intubate, which drip? What's the ketamine deal? And more.

icuscenarios.com/episode-94-m...

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New lesson on Pacemakers at the Intensive Care Academy - TCP, TVP, epicardial, PPMs, and more, including management in critical illness, the problem of false capture, and more.

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buddy I am with you x.com/critconcepts...

I had two minds to write a letter to the editor on the obvious physiologic error, but ran out of motivation

This week on the podcast, Jon-Emile Kenny on fluid resuscitation and his wireless doppler device for predicting responsiveness

icuscenarios.com/episode-93-f...

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Prophylaxis is growing on me. Nothing worse than withdrawal developing in someone admitted to the ICU for another reason

We explore the rare but scary phenomena of propofol infusion syndrome (PRIS) and propylene glycol toxicity, with our favorite toxicologist Jerry Snow.

icuscenarios.com/episode-92-p...

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Because like all peripherals, they can fail

We demo a simulated goals of care conversation on this week's episode at icuscenarios.com/episode-91-a...

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But like amio, I think many times, after a day or two the need has passed. Much of our RVR is transient

same as amio

hard to hurt anyone with a dose or two