In this episode, number 35, I welcome Dr. David Feller-Kopman to the show. Dr. Feller-Kopman is an associate professor of medicine and Otolaryngology and the director of Bronchoscopy and Interventional Pulmonology here at Johns Hopkins. I interview him about pleural effusions including what they are, where they come from, how to categorize them, how to treat them and how to deal with them if they recur.
The NEJM article on the use of TPA and DNAse is here: http://www.nejm.org/doi/full/10.1056/NEJMoa1012740#t=abstract
In this episode, episode 33, I welcome cardiac anesthesiologist Dr. Rosanne (Rosie) Sheinberg to the show to discuss ECMO. We go through a comprehensive overview of what ECMO is, how it is used, how it is managed, the complications that can be seen and how to manage them and how to wean it off.
In this episode, episode 31, I welcome one of our amazing chief residents to the show, Dr. Stephen Freiberg. Stephen has taken an interest in massive transfusion and he goes over the highlights of when to do it, how to do it, what complications you see from it and how to manage those complications.
In this episode, episode 30, I discuss the new American College of Cardiology Guidelines for the periprocedural management of anticoagulation for patients with non-valvular atrial fibrillation. This includes whether to stop, when to stop, whether to bridge, how to bridge, and how and when to restart.
Outline by Brian Park: AC for Afib Outline
In this episode, episode 29, I welcome to the show Dr. Glenn Whitman. Dr. Whitman is a cardiac surgeon and intensivist and runs the cardiac surgical ICU here at Johns Hopkins. I interview Dr. Whitman about PA catheters. We discuss when to place them, when not to place them, how to use them and when to take them out.
In this episode I welcome Dr. Laeben Lester to the show. Dr. Lester is trained in Emergency Medicine and Anesthesiology and has completed fellowship training in Cardiac Anesthesiology. He shares with us his “Nearly Needleless 5-Step Approach” to airway topicalization for awake intubation.
In this episode I review the ABA topic of airway management. This is obviously a huge topic but in this episode I highlight key points about the components of airway management recommended by the ABA including identification of a difficult airway, management of a difficult airway, the difficult airway algorithm, different tools and adjuncts, and different types of tubes. This will be the final post of 2016. Thanks so much to all of you for listening and being a part of ACCRAC’s inaugural year in 2016. Here’s wishing you a wonderful start to your 2017!
In this episode I welcome Dr. Amit Prabhakar, one of our critical care fellows, to the show to discuss Sugammadex, a relatively recently approved (in the USA) reversal agent for Rocuronium and Vecuronium.
Outline by Brian Park: Sugammadex outline
In this episode I am joined once again by Dr. Scott Stephens as we review advanced ventilator modes, prone positioning, and ventilation of patients on VV ECMO.
The fantastic review article I mentioned is: Mireles-Cabodevila E. Et al. Alternative Modes of mechanical ventilation: A review for the hospitalist. Cleveland Clinic Journal of Medicine. 2009(75);7:417-430.
Pubmed link here
In this episode I first suggest you take a look at the recently published (ahead of print) VANCS study on the use of vasopressin as a sole agent in the treatment of vasoplegic shock. Then I review the reasons never to use sodium bicarbonate in lactic acidosis.
The Vancs study: https://www.ncbi.nlm.nih.gov/pubmed/27841822
The two articles I recommend on bicarb:
Outline by Brian Park: Outline