#24 Thrombocytopenia in Critical Illness
Thrombocytopenia is a puzzling, yet common problem in the ambulatory setting, on the wards and in critically ill patients! Having an understanding of why it happens, why it matters, and what we should do about it, is of paramount importance. Given that patient care is first and foremost for us at Critical Care Time, we’ve teamed up - once again - with hematologist extraordinaire Matthew Rendo (X: RendOncology) to help us develop a pragmatic approach to managing the patient with thrombocytopenia. Please give it a listen and let us know what you think!
#23 Resuscitative TEE with Dr. Ross Prager
On Critical Care Time we are - of course - HUGE fans of POCUS. On this episode, Nick and Cyrus take this love for POCUS to the next level with our discussion on Resuscitative Transesophageal Echocardiography (Resus-TEE) with Canadian intensivist, Dr. Ross Prager (@ross_prager) a Resus-TEE expert aficionado! On this show, we discuss the basics of Resus-TEE including indications, pitfalls and pearls, the practicality of implementing this modality at your hospital and some of the medico-legal considerations. We had a ton of fun recording his with Ross and hope you enjoy listening to it!
#22 Bronchoscopy Emergencies w/ PulmPEEPs
(blurb)Like that time the Jetsons met the Flintstones or the more recent colab between Lululemon and Peloton, join us for an epic pairing between Critical Care Time hosts Cyrus & Nick and the PulmPEEPS - Drs. Dave Furfaro and Kristina Montemayor. On this show we use a case based approach to answer the question: How can a bronchoscope save your @$$ in the ICU and beyond? We take a practical look at airway bleeds, trach emergencies and so much more with our friends from PulmPEEPs!
#21 Feeding in Critical Illness w/ Dr. Paul Wischmeyer
On this MEGAsode of Critical Care Time, Cyrus & Nick are joined by world-renowned expert in ICU nutrition, Dr. Paul Wischmeyer (X: Paul_Wischmeyer & IG: paul_wischmeyermd) to discuss all things ICU nutrition. This episode is highly fortified with practice changing pearls from soup to nuts! In addition to getting to know who Paul is and why he does what he does, we demystify metabolic carts, talk about protein needs and metabolism in the critically ill, discuss steroids and other supplements - all while dispelling some major ICU myths regarding gastric residuals, TPN and more. Grab a healthy snack, sit back and get ready to enjoy some remarkable content in an oft overlooked field in medicine!
#20 CRRT w/ Dr. Kevin Chung
On this week’s episode of Critical Care Time, Nick and Cyrus discuss continuous renal replacement (or kidney replacement) therapy and acute kidney injury with master intensivist and extra corporeal aficionado, Dr. Kevin Chung. Dr. Chung is a retired colonel in the United States Army, the principal force behind an intensivist-run renal replacement program in San Antonio, and is currently the Chief Medical Officer for our season one sponsor, Seastar Medical.
In this episode, we discuss an approach to acute kidney injury, demystify elements of continuous renal replacement therapy, and then discuss various applications to include blood purification technology in 2024.
#19 Metabolic Acidosis w/ NephMadness
In this Critical Care Time x #NephMadness collab, Nick & Cyrus host Drs. Tim Yau and Jeff Kott for a comprehensive discussion of metabolic acidosis with a focus on critically ill patients. We start by outlining a pragmatic approach to acid/base derangements peppered with some fact finding and myth busting, CCT style! We then turn our attention to working up and treating metabolic acidosis in the ICU. If you are looking for a one stop shop when it comes to metabolic acidosis in the ICU - look no further. You may even figure out what Spanx & sodium bicarb have in common!
#17 Hyponatremia w/ Dr Joel Topf
Sit 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!
#14 Massive Hemoptysis w/ Dr. Whittney Warren
Hemoptysis 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 DVT Prophylaxis in the Critically Ill
Every 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 out-weight 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!
#8 Legal Considerations in Critical Care
The intersection between patient care and the legal system can be a tricky one to navigate. Our duty as members of the healthcare team - irrespective of a patient’s social history - is to provide the best care we can, while protecting a patient’s privacy. Unfortunately, this can sometimes be easier said than done, and traveling such choppy waters can be challenging! Join Nick & Cyrus as they host Drs. Erin DeMartino & Matthew Griffith of Scopes and Shields for a case-based discussion which will hopefully equip you with some knowledge and tools for the next time you have a patient who is in custody or otherwise involved with the legal system.
#4 Delirium w/ Dr Wes Ely
Delirium is a common but serious complication of critical illness. Nick and Cyrus discuss this important topic with Dr. Wes Ely, MD. They cover prevention, diagnosis, and treatment of delirium; Dr. Ely’s award-winning book "Every Deep Drawn Breath”, and how his life story led him to become a world expert in brain dysfunction in the ICU.