#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!
#18 Journal Club: VL versus DL
On this week’s installment of Critical Care Time, Nick & Cyrus tackle the recent multicenter, randomized DEVICE Trial, which compared direct vs 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 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!
#16 Pulmonary Embolism Part 2
in 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 Pulmonary Embolism Part 1
There 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 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!
#13 ICU Rounds: Focusing on the Patient
In critical care, it's easy to get distracted. Patients are dynamic, learners are hungry, and families eagerly await updates on their loved ones. As important as all of these elements are - it's the patient that we need to focus on, and sometimes patient care can take a backseat when clinicians lean on the rounding conventions of old. On this episode of Critical Care Time, Nick & Cyrus discuss their opinions on rounding in the ICU and present strategies from their own practice which may enable you to be a more effective - and efficient - educator, communicator, mentor and ICU clinician!
#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!
#11 The Physiologically Difficult Airway
Airway 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 to equip you with the tools you need to successfully tackle a physiologically difficult airway, or support an airway operator charged with this task!
#10 Pneumothorax & Pleural Disease
Whether 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!
#9 Leading a Cardiac Arrest
Running a code is a stressful proposition. The code team leader is responsible for conducting an orchestra in a most austere environment, with the goal of guiding the team towards success - defined hopefully by a successful resuscitation. The code team leader needs to have the presence of mind to lead, but also needs to know how to delegate responsibilities and quickly cultivate a shared mental-model between the various team members. Join Nick and Cyrus as they try to demystify some of the elements of leading a code by providing practical pearls and shedding light on potential pitfalls during this episode on Cardiac Arrest and Running a Code
#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.
#7 Vasopressors Part 2: Beyond the Basics
On this episode of Critical Care Time, Cyrus and Nick go beyond the basics of vasopressor management. During this episode - jam-packed with high-yield pearls - we discuss important topics such as how to titrate vasopressors, what can be done when vasopressors seem to be failing a patient and how to wean patients from vasopressors in order to successfully get them out of the ICU and ultimately home. Sit back, relax, and enjoy this hour long master-class on Vasopressors - Beyond the Basics!
#6 Vasopressors Part 1: Pressor Basics
On this episode of Critical Care Time, Cyrus and Nick explore the basics of vasopressors, providing a framework for understanding them. When to start them, how to titrate them, when to use push dose vasopressors, and when a central line is needed. If you use vasopressors to treat your patients, this is the episode for you! Whether you are ordering them, titrating them or looking out for complications associated with their use, Nick & Cyrus have got your back!
#5 Zorses & Hebras: A New Take on an Old Adage
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.
#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.
#3 Journal Club: Platelets Before Central Lines?
Join Nick & Cyrus as they take on their first journal club episode! This week the duo provides their take on the NEJM paper from van Baarle and colleagues entitled Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia. They also provide some of their tips and tricks for safe central line placement. Give it a listen and let us know what you think!
#2 Undifferentiated Shock Part 2
We've already discussed how to identify shock, or how to assess a patient whom you are worried may be in shock... but what's next? Listen as Nick & Cyrus discuss the Pump, Pipe & Tank framework for determining the type of shock your patient is suffering from. In this episode we discuss the pathophysiology of the different types of shock, the tools you can use to help differentiate one type of shock from another, and scratch the surface on some initial treatment considerations.
#1 Undifferentiated Shock Part 1
In critical care medicine - it's not just a priority, but it's critical that you know how to identify, assess and stratify shock.
Join Nick & Cyrus in Part 1 of a 2-part, deep-dive into undifferentiated shock. On this episode we discuss how we define and assess a patient in shock; laying down the foundation for our shock framework.
Introducing CCT
Introducing the new podcast for everyone who cares for the critically ill.
In this episode, Nick & Cyrus share a little about themselves and a lot about what Critical Care Time is... and isn't!"