Episode 151: Advanced Practice Providers in the ICU

In this 151st episode I welcome Brandon Oto to the show. Brandon is an ICU PA and we discuss the roles and relationships of APPs in the ICU environment.

Brandon’s blog is http://critcon.org/

Brandon is on Twitter @critconcepts

Episode 149: Transitioning: From Intern to CA-1 year and Beyond

In this 149th episode I discuss common challenges to the transition from intern year to CA1 year including some of why it’s difficult, the mistakes commonly made, the causes of those mistakes and some suggested solutions. Although I focus on the intern to CA1 transition, much of this applies to any major transition in life.

Episode 148: Marijuana Use In Healthcare Providers with Mike Fitzsimons

In this 148th episode I welcome Dr. Fitzsimons back to the show to discuss the use of marijuana in healthcare providers. We discuss what we know about prevalence, what the potential consequences are, what the status of testing is, and what we may see happen in the future.

NEJM article on adverse effects of marijuana: https://www.ncbi.nlm.nih.gov/pubmed/24897085

Episode 147: Lower Extremity Nerve Blocks Part 2: Front of Leg

In this 147th episode I welcome back Drs. Segna and Rayaz to finish up our discussion of lower extremity nerve blocks. This time we cover the front of leg blocks (femoral, adductor canal, fascia iliaca and obturator).

Episode 146: Critical Care Ultrasound with Lee Goeddel

In this 146th episode I welcome back Dr. Lee Goeddel to the show to discuss critical care ultrasound including how it differs from POCUS and how people can prepare for the new certification exam.

References:

Pears and Pitfalls in Critical Care Ultrasonography: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693549/

Episode 145: Personalized PEEP with Dr. Wiener-Kronish Live from ASA 2019

In this 145th episode recorded live from Anesthesiology 2019, the annual ASA meeting, I welcome Dr. Jeanine Wiener-Kronish to the show to discuss the progress we’ve made with mechanical ventilation and how we can personalize the way we deliver it to our patients to improve their outcomes.

References:

Pereira, SM, Tucci, MR, Morais, CCA, Simões, CM, Tonelotto, BFF, Pompeo, MS, Kay, FU, Pelosi, P, Vieira, JE, Amato, MBP Individual positive end-expiratory pressure settings optimize intraoperative mechanical ventilation and reduce postoperative atelectasis. Anesthesiology 2018; 129:1070–81

Kacmarek, RM, Villar, J Lung-protective ventilation in the operating room: Individualized positive end-expiratory pressure is needed! Anesthesiology 2018; 129:1057–9

Nice figure that demonstrates what we know: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2714239

Additional background articles:

https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2734055

https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2673265

https://anesthesiology.pubs.asahq.org/article.aspx?articleid=1932236

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289131/

https://www.ncbi.nlm.nih.gov/pubmed/31399381

Episode 144: The Anesthesiologist-Surgeon Relationship with Jeffrey Cooper Live From ASA 2019

In this 144th episode we record live from Anesthesiology 2019 in Orlando Florida. I welcome Dr. Jeffrey Cooper to the show to discuss the relationship between anesthesiologists and surgeons and what can be done to improve it in a way that will foster patient safety.

Correction: The Center for Medical Simulation is not part of Harvard Medical School. It is an independent non-profit organization.

Dr. Cooper’s article on the topic: https://www.ncbi.nlm.nih.gov/pubmed/30045093

This is no humbug book: https://www.amazon.com/This-Humbug-Reminiscenes-Department-Massachusettes/dp/0971537607

Thanks for the feedback book: https://www.amazon.com/Thanks-Feedback-Science-Receiving-Well/dp/0143127136/ref=sr_1_1?keywords=thank+you+for+the+feedback&qid=1571603512&s=books&sr=1-1

Episode 143: Fluid management and cardiac output monitors in ERAS with Michael Scott

In this 143rd episode I welcome Dr. Michael Scott to the show to discuss fluid management in ERAS cases and how cardiac output monitoring may help us do that well.

Topmedtalk: https://www.topmedtalk.com

Episode 142: Driving Pressure and Transpulmonary Pressure with Marcos Vidal Melo

In this 142nd episode I welcome Dr. Marcos Vidal Melo to the show to discuss Driving Pressure and Transpulmonary pressure. We discuss what they are, how they differ from plateau pressure, and how they may help guide safe mechanical ventilation.

References:

  1. Driving Pressure and Transpulmonary Pressure: How Do We Guide Safe Mechanical Ventilation? Williams EC, Motta-Ribeiro GC, Vidal Melo MF. Anesthesiology. 2019 Jul;131(1):155-163. 
  2. Loring SH, Topulos GP, Hubmayr RD: Transpulmonary pressure: The importance of precise definitions and limiting assumptions. Am J Respir Crit Care Med 2016; 194:1452–7
  3. Mauri T, Yoshida T, Bellani G, Goligher EC, Carteaux G, Rittayamai N, Mojoli F, Chiumello D, Piquilloud L, Grasso S, Jubran A, Laghi F, Magder S, Pesenti A, Loring S, Gattinoni L, Talmor D, Blanch L, Amato M, Chen L, Brochard L, Mancebo J; PLeUral pressure working Group (PLUG—Acute Respiratory Failure section of the European Society of Intensive Care Medicine): Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives. Intensive Care Med 2016; 42:1360–73
  4. Akoumianaki E, Maggiore SM, Valenza F, Bellani G, Jubran A, Loring SH, Pelosi P, Talmor D, Grasso S, Chiumello D, Guérin C, Patroniti N, Ranieri VM, Gattinoni L, Nava S, Terragni PP, Pesenti A, Tobin M, Mancebo J, Brochard L; PLUG Working Group (Acute Respiratory Failure Section of the European Society of Intensive Care Medicine): The application of esophageal pressure measurement in patients with respiratory failure. Am J Respir Crit Care Med 2014; 189:520–31