Lightning rounds #7: Operationalizing clinical skill

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Lightning rounds #7: Operationalizing clinical skill

FromCritical Care Scenarios

ratings:

Length:

37 minutes

Released:

Sep 19, 2021

Format:

Podcast episode

Description

Discussing a pickle of a topic: outside of academic milestones, how do we recognize, acknowledge, reward, and move towards clinical excellence in medicine after one’s training is complete? In fact… do we?

Released:

Sep 19, 2021

Format:

Podcast episode

Titles in the series (100)

An educational podcast presenting practical critical care scenarios. By Brandon Oto, PA-C and Bryan Boling, ACNP. New episodes weekly.

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Episode 28: Diuresis, deescalation, and liberation with Matt Siuba: How to take the well-resuscitated critically ill patient, get fluid out of them, deescalate their antibiotics, wean their sedation, reduce vent support, extubate, and get them out of the ICU—with Dr. Matt Siuba (Twitter: @msiuba), by Critical Care Scenarios
66 min listen
Episode 27: Wilderness medicine with Ross Hofmeyr: Management of an alpine medicine scene including discussion of HAPE (High Altitude Pulmonary Edema), HACE (High Altitude Cerebral Edema), and suspension syndrome, with Dr. Ross Hofmeyr (@rosshofmeyr), anesthesiologist in the Department of Anaesthesia a... by Critical Care Scenarios
69 min listen
Episode 22: Aneurysmal subarachnoid hemorrhage with Thomas Lawson: Initial approach, supportive care, risk stratification, and management of the troublesome complications for ruptured subarachnoid aneurysm, with Thomas Lawson (@TomLawsonNP), nurse practitioner in the neurocritical care unit at OSU Wexner Medical Cente... by Critical Care Scenarios
46 min listen
Episode 36: Preventing and managing complications: Back in the arena with one of our favorites, Matt Siuba (@msiuba), Cleveland Clinic intensivist and Mr. Zentensivism, to discuss complications in critical care and how to prevent and manage them. Today we focus on atrial fibrillation with RVR and bleed... by Critical Care Scenarios
63 min listen
Lightning rounds #5: Career development for critical care APPs: Conceiving, planning, and building your career as a critical care PA or NP. Determining if this field is for you, finding your first job, pinpointing your interests or “niche” during your early career, nurturing your growth during the mid-career period... by Critical Care Scenarios
68 min listen
Special episode: Surviving COVID-19 with Eve Leckie: The COVID-19 pandemic will hopefully wind down this year. What happens next with these patients? A powerful discussion with Eve Leckie (@browofjustice), RN, CCRN, formerly of the CVCC at Dartmouth-Hitchcock and now disabled after contracting COVID. by Critical Care Scenarios
55 min listen
Episode 21: Trauma resuscitation with Scott Weingart: A patient with multiple abdominal gunshot wounds, resuscitated before and after damage control surgery by the legendary Scott Weingart (@emcrit): emergency physician, surgical intensivist by way of Shock Trauma in Baltimore, by Critical Care Scenarios
40 min listen
Lightning rounds #9: Notes and documentation: Bryan and Brandon chat about notes: what makes a good one, their many and conflicting purposes, some structures and approaches, system- versus problem-based charting, and more. by Critical Care Scenarios
57 min listen
Episode 23: COVID-19 pneumonia with Nicole King: Best practices in care of the critically ill patient with COVID-19 pneumonia are not known at this time. However, practical lessons from the ground are filtering in from those who have seen many of these patients, and Dr. by Critical Care Scenarios
56 min listen
Episode 35: When to operate in trauma with Dennis Kim: Looking at trauma from the perspective of a surgeon, with a focus on the perennial dilemma of when a patient needs surgery. Our guest is trauma surgeon Dr. Dennis Kim (@traumaicurounds), associate professor of Clinical Surgery at UCLA and medical direc... by Critical Care Scenarios
63 min listen
Lightning rounds #8: Five things you’re getting wrong: Bryan’s off this week, so Brandon flies solo to explain five wrong-headed notions that many people believe without thinking about them. Are diuretic infusions more effective than intermittent boluses? Are antipsychotic (neuroleptic) agents a good treat... by Critical Care Scenarios
12 min listen
Episode 34: Lightning rounds #4: Wrapping up our series on procedures with a talk about airway management. Who should manage airways in the ICU? What’s the role of intensivists, APPs, anesthesia, etc? What’s the “correct” balance of expertise, distribution of labor, and training? by Critical Care Scenarios
63 min listen
Episode 24: Rural retrieval medicine with Minh Le Cong: Scene management, logistics, and stabilization of a blunt trauma patient in the Australian outback with Dr. Minh Le Cong (@ketaminh), rural GP and retrieval physician for the Royal Flying Doctor Service and host of the PHARM podcast. by Critical Care Scenarios
63 min listen
Episode 20: Post-CABG emergencies with Kris Ramilo and Brendan Riordan: Looking at the workflow of a fresh post-op open heart surgery patient, as well as what to do when it devolves into cardiac tamponade, with (returning) guest Brendan Riordan, cardiothoracic ICU PA (@concernecus) at the University of Washington, by Critical Care Scenarios
55 min listen
Lightning rounds #10: Physical examination in the ICU: Bryan and Brandon talk about the physical exam: how we apply it in the ICU, its utility and changing role in the setting of modern diagnostic modalities, and its best and most practical use-cases. References McNamara LC, Kanjee Z. by Critical Care Scenarios
53 min listen
Episode 37: Airway management for COVID-19: Back again with Dr. Ross Hofmeyr (@rosshofmeyr), anesthesiologist in the Department of Anaesthesia and Perioperative Medicine at the University of Cape Town, to discuss an expert’s perspective on airway management in the COVID-19 patient. by Critical Care Scenarios
58 min listen
Episode 38: GI bleeding with Elliot Tapper: Back with returning guest Dr. Elliot Tapper (@ebtapper), gastroenterologist, transplant hepatologist, and director of the cirrhosis program at the University of Michigan in Ann Arbor, to talk about critical GI bleeding. by Critical Care Scenarios
50 min listen
Episode 25: Rhabdomyolysis: Initial workup, fluid management, renal replacement, and other subtleties of caring for the critically ill patient with rhabdomyolysis. Takeaway lessons Rhabdomyolysis is defined by elevated levels of creatinine kinase and/or myoglobin in the serum sec... by Critical Care Scenarios
33 min listen
Episode 40: Making the diagnosis with André Mansoor: Dr. André Mansoor (@AndreMansoor), associate professor of medicine in Portland, Oregon, author of the excellent Frameworks for Internal Medicine, and contributor to Physical Diagnosis PDX, talks us through a complex case of encephalopathy and respirato... by Critical Care Scenarios
70 min listen
Episode 31: Practical mobility, awakening, and delirium prevention with Kali Dayton: The art of taking a critically ill, heavily sedated, floridly delirious patient on aggressive vent support and pulling them out of the loop of sedation, immobility, and delirium. With Kali Dayton, ACNP-BC (@HomeIcu), by Critical Care Scenarios
61 min listen
Episode 44: Physical therapy with Heidi Engel: A look at rehabilitation and mobility in the critically ill, from the perspective of our skilled therapists—with Heidi Engel, PT, DPT of UC San Francisco, long-term provider of acute care therapy, researcher in ICU rehabilitation, by Critical Care Scenarios
69 min listen
Episode 32: Lightning rounds #3: Following up from the last lightning rounds on vascular procedures, we look at non-vascular bedside procedures in the ICU: paracentesis, thoracentesis (including chest tubes), lumbar punctures, and bronchoscopy. How do we tap, what are our tricks, by Critical Care Scenarios
46 min listen
Episode 46: Neurologic catastrophe and brain death with Casey Albin: We review a case of massive intraparenchymal hemorrhage progressing to brain death, including the process of brain death testing and declaration, with Dr. Casey Albin (@CaseyAlbin), neurologist and neurointensivist, by Critical Care Scenarios
70 min listen
Lightning rounds #6: Point of care ultrasound: We chat about focused, clinician-performed point-of-care ultrasound (POCUS) in the ICU. How do you learn it? What are our favorite applications? What are some of the particulars and caveats surrounding credentialing, documentation, and billing? by Critical Care Scenarios
40 min listen
Lightning rounds #11: Reflections on two years of the podcast: Bryan and Brandon look back on the two-year anniversary of the show and reflect on where it’s been, where it’s going, lessons learned, and other deep thoughts. by Critical Care Scenarios
40 min listen
Episode 45: Amniotic fluid embolism with Stephanie Martin: We discuss the clinical presentation and management of AFE with guests Dr. Stephanie Martin (Twitter: @OBCriticalCare, Instagram: @criticalcareob), medical director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist in Scottsd... by Critical Care Scenarios
47 min listen
Episode 29: Lightning rounds #2: A vascular access roundtable, discussing our practices surrounding arterial lines, central lines, PICC lines and midlines, and PA catheters. When do we place them? When can they come out? What sites do we like? When (and how) do we use ultrasound? by Critical Care Scenarios
38 min listen
Episode 39: ECMO for COVID-19 with Kim Boswell: An overview of VV ECMO with a focus on COVID-19, with Dr. Kimberly A. Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. We discuss evaluating for candidacy, induction, maintenance, by Critical Care Scenarios
58 min listen
Episode 26: ICU sedation, mobility, and delirium with Dale Needham: How to manage the intubated critically ill patient while keeping them awake, non-delirious, and mobile, with Dr. Dale Needham, FCPA, MD, PhD. Dr. Needham is a Professor of Pulmonary and Critical Care Medicine as well as Physical Medicine and Rehabilita... by Critical Care Scenarios
45 min listen
Episode 33: Ischemic stroke with Thomas Lawson: Evaluation of ischemic stroke, decisions for tPA and thrombectomy, supportive critical care, and monitoring for cerebral edema—with returning guest Thomas Lawson (@TomLawsonNP), nurse practitioner in the neurocritical care unit at OSU Wexner Medical Ce... by Critical Care Scenarios
43 min listen

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Lightning rounds 40: Critical care medicine fellowships with Nicholas Ghionni: We chat about pulmonary/critical care medicine fellowship with recent graduate Nicholas Ghionni (@pulmtoilet), a first-year attending at the MedStar Baltimore Hospital system. He completed PCCM fellowship at MedStar Washington Hospital Center where he ... by Critical Care Scenarios
39 min listen
TIRBO 60: They don’t care about you: The difference between people and institutions. Find us on Patreon here! Buy your merch here! by Critical Care Scenarios
13 min listen
Episode 73: POCUS for nephrology, with Abhilash Koratala: We discuss the role of point-of-care ultrasound in evaluating the patient with kidney injury and assessing volume status, with Abhilash Koratala (@nephroP), nephrologist, Director of Clinical Imaging for Nephrology at the Medical College of Wisconsin, by Critical Care Scenarios
54 min listen
TIRBO 59: Volume vs pressure control: Should you use volume or pressure control ventilation? Find us on Patreon here! Buy your merch here! by Critical Care Scenarios
21 min listen
Lightning rounds 39: Understanding flight medicine with Jace Mullen: We explore critical care transport medicine from both a clinical and career perspective, including helicopters (HEMS), fixed wing jet, and ground ambulance transports, with Jace Mullen, flight paramedic and airway educator out of Denver. by Critical Care Scenarios
52 min listen
TIRBO 58: Difficult cases: When do patients deaths bother us? by Critical Care Scenarios
13 min listen
Episode 72: CPR-induced consciousness with Jack Howard: Find us on Patreon here! Buy your merch here! We discuss the phenomenon of CPR-induced consciousness (i.e. patients demonstrating awakeness during resuscitation) with Jack Howard, Intensive Care Paramedic at Ambulance Victoria in the northern suburbs o... by Critical Care Scenarios
41 min listen
TIRBO 57: Volume vs pressure control: Should you use volume or pressure control ventilation? Find us on Patreon here! Buy your merch here! by Critical Care Scenarios
19 min listen
Lightning rounds 38: Working in APP leadership, with Jason Wieland: We talk about working in critical care APP leadership positions, with Jason Wieland, PA, Lead Pulmonary & Critical Care APP at WakeMed Health System in Raleigh, NC. Find us on Patreon here! Buy your merch here! by Critical Care Scenarios
47 min listen
TIRBO 56: Transfixing vessels: You poked through the deep wall of a vessel. Now what? Find us on Patreon here! Buy your merch here! by Critical Care Scenarios
14 min listen
Episode 71: Transplant medications with Olivia Philippart: We discuss the medications typically used after organ transplant, their impact on critical illness, and how to manage them when these patients show up sick—with Olivia Philippart, transplant clinical pharmacist specializing in liver and kidney transpla... by Critical Care Scenarios
55 min listen
TIRBO 55: Bowel regimens: How I make patients poop. Find us on Patreon here! Buy your merch here! by Critical Care Scenarios
13 min listen
Lightning rounds 37: Weaning the deliriosedated patient (SCCM roundup): A roundup of opinions from attendees at SCCM’s 2024 Critical Care Congress in Phoenix on strategies for rescuing the patient stuck in a loop of deep sedation and agitation. Thanks to Pat Posa, Martha Roberts, Juliana Barr, Kelly Drumright, by Critical Care Scenarios
9 min listen
TIRBO 54: Documenting POCUS studies: How to document your ultrasound findings. Find us on Patreon here! Buy your merch here! by Critical Care Scenarios
9 min listen
Episode 70: Airway evaluation for non-anesthesiologists, with Jed Wolpaw: We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr. Jed Wolpaw, anesthesiologist and intensivist from Johns Hopkins, anesthesiology residency program director, by Critical Care Scenarios
58 min listen
TIRBO 53: Who needs an arterial line?: Arterial lines are resuscitative tools. by Critical Care Scenarios
12 min listen
Lightning rounds 36: Nurses are from Venus: Bedside nurses and providers (physicians, PAs, NPs) tend to see the world differently, much of it driven by their training and the systems they work within. We chat about reconciling this and how to best function as a team. by Critical Care Scenarios
43 min listen
TIRBO 52: Reliable is better than perfect: In general, medical decisions that avoid error are better than those that optimize care. by Critical Care Scenarios
10 min listen
Episode 69: Head and neck surgery with Alexandra Kejner: We discuss head and neck surgery with Dr. Alexandra Kejner, otolaryngologist at the Medical University of South Carolina specializing in transoral robotic surgery, reconstructive surgery including microvascular free tissue transfer, by Critical Care Scenarios
20 min listen
TIRBO 51: Critical care problems are syndromes: The core disorders of critical care are mostly syndromes, not diseases. What should this mean to us? by Critical Care Scenarios
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Lightning rounds #35: Brain death updates, with Ariane Lewis and Matthew Kirschen: Discussing the new 2023 AAN/AAP/CNS/SCCM Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline, with the joint first authors: Dr. Ariane Lewis, neurointensivist, professor of neurology and neurosurgery at NYU Langone... by Critical Care Scenarios
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TIRBO #50: Never do anything once: If you produce academic work, use the research to produce multiple products. Once is a waste. by Critical Care Scenarios
9 min listen
Episode 68: Liver transplant with Meera Gupta: We learn about liver transplant with Dr. Meera Gupta, transplant surgeon at the University of Kentucky Healthcare Transplant Center, and surgical director of the Kidney and Pancreas Transplant Program. We discuss eligibility, triage, by Critical Care Scenarios
46 min listen
TIRBO #49: The universal acuity equation: Explaining the ultimate expression of prognosis: Morbidity = (Severity x Duration)/Reversibility by Critical Care Scenarios
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Lightning rounds #34: … When?: When should you… by Critical Care Scenarios
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TIRBO #48: Choosing a line site: Which site should you select for your central line placement? A discussion of some considerations. by Critical Care Scenarios
17 min listen
Episode 67: Whipples with Michael Cavnar: We learn about pancreaticoduodenectomy (the Whipple) with Michael Cavnar (@DrMikeCavnar), surgical oncologist at University of Kentucky, with a fellowship in Complex General Surgical Oncology from Sloan Kettering. by Critical Care Scenarios
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TIRBO #47: Why do we prone?: A review of the physiological and practical reasons to position patients with ARDS in the prone position. by Critical Care Scenarios
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Lightning rounds #33: Transitioning to academics with Janelle Bludorn: We chat with Janelle Bludorn (@JanelleRBlu), former emergency medicine PA, Assistant Professor and Academic Coordinator at the Duke PA program, about transitioning from clinical work into teaching and academia. Find us on Patreon here! by Critical Care Scenarios
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TIRBO #46: Being curious: The value of being curious about practice differences, not judgmental. by Critical Care Scenarios
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Lightning rounds #7: Operationalizing clinical skill

Lightning rounds #7: Operationalizing clinical skill

Description

Titles in the series (100)

More Episodes from Critical Care Scenarios