The Internet Book of Critical Care Podcast

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Brought to you by a partnership that transcends the 49th parallel. Join Adam Thomas and Josh Farkas in the podcast that accompanies The Internet Book of Critical Care. The IBCC podcast will explore key points in each chapter. Initially the release of podcasts may lag a bit behind the chapters for logistic reasons. However, our goal is to eventually have a podcast for each chapter. Subsequently, the podcast will discuss updates to the IBCC based on new evidence.

Adam Thomas & Josh Farkas


    • May 13, 2023 LATEST EPISODE
    • infrequent NEW EPISODES
    • 28m AVG DURATION
    • 136 EPISODES

    4.9 from 613 ratings Listeners of The Internet Book of Critical Care Podcast that love the show mention: icu nurse, critical care, pa, practice, cheers, well researched, based, wow, guys, fantastic, keep up the good, awesome, informative, helpful, look forward, work, learn, information, job, love this podcast.



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    Latest episodes from The Internet Book of Critical Care Podcast

    IBCC Episode 128 - ABG, VBG and Pulse Oximetry

    Play Episode Listen Later May 13, 2023 36:10


    Welcome to the origin story of PULMCRIT!    In this episode, we cover how best to practically monitor the balance between oxygenation, oxygen delivery and oxygen consumption. Controversial to say the least. Come take a listen, and learn about the pulsatility index, a space we should all be watching for in the future.

    IBCC Episode 127 - Spontaneous Bacterial Peritonitis (SBP)

    Play Episode Listen Later Apr 28, 2023 30:59


    We are back! Come dust off our shows spot in your favourite podcast app, and listen to why its important to hunt for SBP like it's the Red October (forgive the Sean Connery reference, I had too). We cover diagnosis (aka tap-y-tap) and treatment.   

    IBCC Episode 126 - Myocardial Ischemia

    Play Episode Listen Later Dec 2, 2022 55:08


    Annnnnnnnd We are back. Sorry, but after Andor has finally finished we have now got time to discuss the old type 1 MI, aka STEMI aka Occlusive Myocardial Infarction. Come listen for all those basics and some nuances around myocardial infarction in critically unwell patients. We talk when to DAPT, who gets full anticoagulation, hemodynamic support, and when to wake our Cardiology friends up in the night. 

    IBCC Episode 125 - Left Ventricular Outflow Tract Obstruction

    Play Episode Listen Later Aug 2, 2022 22:18


    Being Dynamic is usally a great thing... but not when youre crushing the only good way out of the left ventrile.  In this episode we cover dynamic obstruction of the LVOT (specifically sub-valvular): what is it? who gets it? What to do about it. We missed ya'll, so come have alisten and brush up on a rare but important phenomena in our critically ill patients.

    IBCC Episode 124- Neuroprognostication After Cardiac Death

    Play Episode Listen Later Apr 9, 2022 53:03


    In this beast of a 53 minute podcast, we tackle the approach to prognosticating neurologic function of our patients after cardiac arrest. This is hard! As Dick Cheney taught us, there are lots of known and unknown-unknowns. Read through the chapter, then come listen to all things: nuances around confounders, using structural and functional tests. How imaging can lead us astray. Is there a troponin of the brain? Josh even admits to what he'd take to the proverbial desert island. 

    IBCC Episode 123 - Respiratory Alkalosis

    Play Episode Listen Later Mar 7, 2022 14:19


    In this episode, we follow up with last week's podcast and explain the drivers of hypocapnia and subsequent respiratoy alkalosis. Come listen to a primer for all things ASA, sepsis, encephalopathy or strait mountain biking - induced panic. 

    IBCC Episode 122 - Respiratory Acidosis

    Play Episode Listen Later Mar 1, 2022 16:22


    In this lean and mean episode, we cover the outrageously broad topic of respiratory acidosis. Come listen to help structure your approach to Won't Breathe, Can't Breathe, and Breathing Won't Work.  If you remeber nothing else, its that hypercapnia does not always mean BIPAP

    IBCC Episode 121 - Pneumocystis Jiroveci Pneumonia

    Play Episode Listen Later Feb 21, 2022 29:57


    In this episode we cover the rare but important driver of your patients respiratory failure:  Pneumocystis Jiroveci Pneumonia. Come listen to why you should always delineate HIV status, how to approach patient workup and treatment via an invasive and non invasive manner, and why heatwaves is just a sick song.

    IBCC Episode 120 - Tamponade

    Play Episode Listen Later Dec 15, 2021 48:38


    In this episode, we cover that terrible T... Tamponade. Sit back, and get your learn on while we go beyond Beck's triad, discussing all things pulses paradox, ultrasound assessment, pitfalls, stabilization, and Josh will even melt your mind with low pressure tamponade.

    shock beck tamponade
    IBCC Episode 119 - Sympathomimetic Toxicity

    Play Episode Listen Later Dec 1, 2021 37:56


    In this episode, we cover all things "Upper(s)." Come listen to all things critical care level cocaine, meth and bath salts. Organ dysfunction, rapid control, immersive cooling and more!

    IBCC Episode 118 - Necrotising Fasciitis

    Play Episode Listen Later Oct 28, 2021 25:16


    In this episode, we cover that scary presentation where your patient goes from seemingly well, to skin melting off and in multi organ failure. Come take a listen for all things clinical presentation, anti-toxin antibiotics regimes, skin cut downs and surgical debridement.

    fasciitis
    IBCC Episode 117- SCAPE

    Play Episode Listen Later Oct 25, 2021 32:48


    We're back... maybe by popular demand? In this episode, we cover those two phenotypes of acute pulmonary edema: the hyper-acute sympathetic crashing acute pulmonary edema (SCAPE) patient, versus that fluid overload sub acute pulmonary edema (FOSPE). Come listen to all things NIV, nitro, and soothing calm clinical approach. 

    IBCC Episode 116 - Hepatorenal Syndrome

    Play Episode Listen Later Aug 16, 2021 27:01


    It has been a hot minute, Josh blames Adam. Adam Blames existential crisis, wildfires and the Rona. Come listen to this comeback cast: Hepatorenal Syndrome. We talk all things systemic dilation with renal constriction. We talk newish classification, albumin, pressers and more. So leave your Map goal of 60 behind you, and enjoy these pearls.

    IBCC Episode 115 - Invasive Candidiasis

    Play Episode Listen Later Jun 29, 2021 23:13


    In this episode, we cover that variable response to when the lab calls with a culture positive for candida. Lines, blood, Urine. Labs, Anti-fungals, imaging... we got it all. 

    IBCC Episode 114 - Atrial Fibrillation

    Play Episode Listen Later Jun 21, 2021 43:39


    In this episode, we aim to arm you with a basic approach to the rhythm that loves to make the monitors go ping: atrial fibrillation. The age old argument: rate vs rhythm control. What rate is acceptable? Who gets all of the drugs? Why do we love amiodorone? When do you dust off old sparky? Come join us for 42 minutes of Josh giggling and educating us all.

    IBCC Episode 113 - Sodium Channel Blocker Toxicity

    Play Episode Listen Later Jun 3, 2021 30:41


    In this episode we cover one of the hallmarks of the poisoned patient, that ECG tracing with a widening QRS. After reading the post, come listen for the nuances around all things hypertonic bicarb for sodium delivery, preventing acidosis with isotonic bicarb, how those sneaky-brilliant toxicologists will use lidocaine, and when to push the "panic button" on intra-lipid.

    IBCC Episode 112 - Valproic Acid Toxicity

    Play Episode Listen Later May 10, 2021 28:15


    In this episode we cover the obvious, and subtleties around Valproic Acid toxicities. We talk everything from cerebral edema, giving that L-Carnitine and when to spin that IHD machine. 

    acid toxicity l carnitine carnitine ihd valproic
    IBCC COVID-19 Update #8

    Play Episode Listen Later Mar 11, 2021 56:27


    In this episode we summarize the new COVID Chapter (well not so new, but spot on predictions from Jan 26th). Steroids = Yes. Dose... 6mg and keep going up? Toci / Bari = maybe Cocktails / Plasma = Nope Come take a listen for all things anticoagulation, immune modulation and organ support.

    IBCC Episode 111- Purpura Fulminans

    Play Episode Listen Later Feb 19, 2021 25:19


    In this episode we continue on the path of DIC: the scary sub-phenotype that is Purpura Fulminans. When your patient is necrosing everything, you need to act quickly before they start losing organs and digits. Come listen for identification, anticoagulation, protein C and all its goodness, when to give Vitamin K, and why to really be careful about Warfarin.

    IBCC Episode 110 - Disseminated Intravascular Coagulation

    Play Episode Listen Later Jan 18, 2021 35:16


    In this episode, we cover disseminated intravascular coagulation. It sounds bad, because it is. Come listen and refresh your skills around supporting the bleed-bleedy versus the cloth-clotty, how to differentiate DIC and chronic liver failure and a few more juicy clinical pearls.

    IBCC Episode 109 - Lithium Toxicity

    Play Episode Listen Later Jan 14, 2021 25:44


    In this episode, we cover the spectrum of lithium toxicity, from the acute ingestion, to the patient with saturated brain tissue. Come take a listen to explore the nuances around volume repletion, when or should you reach for dialysis, what SILENT is or does it exist.

    IBCC Episode 108 - Toxic Shock Syndrome

    Play Episode Listen Later Dec 23, 2020 37:00


    In this episode we cover those super antigens that cause all the trouble with staph and strep infections. Come take a listen around pathophysiology, identification, antimicrobials and all things IVIG.

    foam ivig toxic shock syndrome
    IBCC Episode 107 - BRASH Syndrome

    Play Episode Listen Later Dec 15, 2020 30:08


    In this episode, we cover the OG-Farkas description of the age-old interplay between bradycardia / renal failure / AV nodal blocking agent / Shock / and Hyperkalemia. Don't just try and snipe one off at a time, carpet bomb them all at once. 

    IBCC Episode 106 - Massive Transfusion Protocol

    Play Episode Listen Later Dec 11, 2020 32:04


    In this episode we cover the crucial approach to what drives hemorrhagic shock: lots of bleeding. Come take a listen for the nuances around an organized approach to 1:1:1 and may we be as bold to say... 1:1:1:1 (fibrinogen, YAY). All things hypocalcemia, hypothermia, acidosis and what lines to use. 

    massive transfusion protocol
    IBCC COVID-19 Update #7

    Play Episode Listen Later Dec 4, 2020 20:24


    We were actively trying to fill your life with non-covid things... but we just had to talk about these big new things. Come take a listen of aerosol transmission, why Remdesivir just doesn't work in the real world, why not to make the same mistake with the -mab du jour, and a few other tid bits.

    IBCC Episode 105 - Ventilator Associated Pneumonia

    Play Episode Listen Later Dec 1, 2020 27:28


    In this episode, we cover that daily issue: Is this a VAP? Come take listen to level up beyond leukocytosis, inflammation, consolidation, worsening oxygenation and positive cultures. Viva la Piptazo - Linezolid/Vanco diad.  

    IBCC Episode 104 - Hemophagocytic LymphoHistiocytosis (HLH)

    Play Episode Listen Later Nov 28, 2020 36:03


    In this episode, we cover another great white whale in critical care: Hemophagocytic LymphoHistiocytosis (HLH). When your macrophages turn into paceman and start chomping your own cells, you're in trouble. Com listen about genetic predisposition to unchecked immune response, and a conversation around immunomodulation.

    IBCC Episode 103 - Gastrointestinal hypomotility in critical care

    Play Episode Listen Later Nov 16, 2020 30:41


    In this episode we cover the big picture view of ileus, gastroparesis and colonic pseudo-obstruction. Come take a listen so summarize these issues you will encounter on the daily.

    IBCC Episode 102 - Cerebral Venous Thrombosis

    Play Episode Listen Later Oct 23, 2020 22:03


    In this episode, we cover the DVT of the Brain... Cerebral Venous Thrombosis. Lace up your shoes, start washing those dishes, do whatever you need to do while we remind you about presentation, workup and most of all, treatment. As 1% of all strokes and the most common cause of stroke in young patients, you'll want to know this one cold.

    IBCC Episode 101 - Stress Hyperglycemia in the ICU

    Play Episode Listen Later Oct 19, 2020 22:51


    In this episode we cover the often overlooked topic of glycemic control in the ICU. What blood sugar should we be targeting? Is that hyperglycaemia a stress response? Insulin resistance? Iatrogenic? All of the above. Come listen to our discussion, and Josh's attempt at clearing up a confused evidence base.

    IBCC Episode 100 - Wernicke encephalopathy

    Play Episode Listen Later Oct 16, 2020 20:43


    We've reached a milestone, 100 episodes! In this podcast, we cover ICU level thiamine deficiency, not just your white-whale of Wernicke encephalopathy. Come take a listen for dosing, clinical features and complications.

    IBCC Episode 99 - Hypertriglyceridemic Pancreatitis

    Play Episode Listen Later Oct 13, 2020 24:09


    In this episode, we cover the approach to the   not-so-rare cause of ICU level pancreatitis: hypertriglyceridemia. Come take a listen for nuances around insulin management, and second thoughts around using heparin and plasmapheresis.

    IBCC Episode 98 - Antifungal Agents

    Play Episode Listen Later Sep 14, 2020 25:00


    In this episode we simplify the approach to covering your invasive fungal infections in critically unwell patients.  Yeast vs Mold vs Endemic Mycoses Azoles vs Echinocandins vs Amphotericin

    IBCC Episode 97 - Nausea & antiemetics

    Play Episode Listen Later Sep 12, 2020 28:22


    Its the rare occasion you go one complete day without treating Nausea and vomiting in the ICU. In this episode, we cover the ddx you can't miss, and the multiple receptors to target in your patients.

    IBCC Episode 96 - Analgesia for the critically ill patient

    Play Episode Listen Later Aug 28, 2020 37:35


    In this episode, we cover the essentials of analgesia for your critically ill patients. Spoiler alert, multimodal approaches are the way to go. If your MAR only has opiates on it, there may be a problem.    Come listen for a new twist on the ladder approach, all things ketamine / precedes and lidocaine... with much much more.

    IBCC Episode 95 - Inhaled Pulmonary Vasodilators

    Play Episode Listen Later Aug 8, 2020 31:10


    In this episode we cover the widely use, but poorly supported inhaled pulmonary vasodilators: -Oxygen -Nitroglycerin / Nitric Oxide -Epoprostenol -Milrinone

    IBCC Episode 94 - Hyperosmolar Hyperglycemic State

    Play Episode Listen Later Aug 6, 2020 23:33


    In this episode, we cover the more sinister twin of DKA... HONK aka HHS (Hyperosmolar Hyperglycemic State). Come listen to how not to blow up your patients brain in the tug-of-war between glucose and sodium.

    IBCC Episode 93 - Guillain-Barre Syndrome

    Play Episode Listen Later Jul 28, 2020 31:11


    In this episode we cover Guillain-Barre Syndrome. Everything from presentation, to why you should stop checking negative inspiratory pressure and just stick with FVC. Read the post then come take a listen.

    IBCC Episode 92 - Intracranial hemorrhage

    Play Episode Listen Later Jul 23, 2020 31:15


    In this episode we cover one of the most fatal and moribund conditions we see regularly, Intracranial hemorrhage. Etiology, diagnosis and treatment (of course we spend time on BP goals).

    IBCC Episode 91 - Catastrophic Antiphospholipid Syndrome

    Play Episode Listen Later Jul 22, 2020 20:02


    In this episode we cover Catastrophic Antiphospholipid Syndrome. A very rare and often missed diagnosis. Come take a listen to brush up on high risk patient population, clinical diagnosis, labs, steroids / anticoagulation and more treatment options.

    IBCC Episode 90 - Fever

    Play Episode Listen Later Jul 18, 2020 34:32


    In this episode we talk about fever... fever in the ICU... ICU acquired fever. It is not all VTE or VAPS, Chole or CLABSI. We cover a thoughtful approach to not just sending pan culture, and adding piptazo-vanco.

    IBCC Episode 89 - CAUTI

    Play Episode Listen Later Jul 10, 2020 21:16


    In this episode, we cover the sasquatch of ICU derived fever: catheter associated urinary track infection. Farkas is on the fence whether it is clinically relevent: Come listen for those pearls: IDSA diagnostic criteria. Treatment coverage. Purple bag syndrome, and more!

    IBCC Episode 88 - Sickle Cell Acute Chest Syndrome

    Play Episode Listen Later Jul 8, 2020 40:44


    In this episode we cover a major cause of mortality for our sickle cell patients: Acute Chest Syndrome. This is a very serious entity you must keep a low clinical threshold for working up and treating. Diagnosis Pain Control, Volume Resuscitation Antimicrobials Exchange transfusions and more

    IBCC Episode 87 - Epiglottitis

    Play Episode Listen Later Jul 2, 2020 27:45


    In this episode, we cover the rare but life threatening Epiglottitis.  Highlights: Presentation not as you learned in medical school Vast majority do not need intubation, but for those that due it can be catastrophic Nasolaryngoscopy, Steroids, broad spectrum antibiotics and early airway plans are the way to go

    IBCC Episode 86 - PJP Pneumonia

    Play Episode Listen Later Jun 29, 2020 28:44


    In this episode, we cover ICU level Pneumocystic Jirovicii Pneumonia (previously known as Pneumocystic Carinii Pneumonia). Suggested approach: HIV +(ve) vs HIV -(ve) Invasive vs Non invasive diagnostic strategy Treatment w. Septra vs other line therapies

    IBCC Episode 85 - Vocal Cord Dysfunction

    Play Episode Listen Later Jun 22, 2020 18:27


    In this episode, we cover the lesser of evil stridor aetiologies: Vocal cord dysfunction, a.k.a paradoxical vocal cord motion, a.k.a Paradoxical Vocal Fold Movement. Read the post, then listen to review approach, diagnostic modalities (fibre-optic visualization, CT scan to rule out other entities) and treatment.

    IBCC Episode 84 - Invasive pulmonary aspergillosis

    Play Episode Listen Later Jun 15, 2020 25:56


    In this episode we cover that not so friendly-Fingi: Aspergillus Come get acquinted with the two forms: angioinvasive (think neutropenia) vs bronchoinvasive (the not so immunosuppressed). Don't forget to add this to your Ddx for nosocomial post-influenza & COVID-19.  

    IBCC Episode 83 - Refeeding Syndrome

    Play Episode Listen Later Jun 8, 2020 14:27


    In this episode we cover the often overlooked entity that is re-feeding syndrome. High Risk populations Signs & Symptoms Insulin mediated edema, and more

    IBCC Episode 82 - Takotsubo Cardiomyopathy

    Play Episode Listen Later Jun 1, 2020 30:35


    In this episode, we cover the presentation, clinical signs / symptoms and workup of takotsubo cardiomyopathy. Come take a listen so you'll never miss that octopus-trap of a clinical confounder, with juicy pearls around LVOT obstruction.

    IBCC Episode 81 - Unfractionated heparin (UFH), LMWH, fondaparinux, argatroban, and bivalirudin

    Play Episode Listen Later May 26, 2020 35:17


    In this episode we cover the work horses we use daily in critical care patients: anticoagulants: Unfractionated heparin (UFH), LMWH, fondaparinux, argatroban, and bivalirudin. We also cover BID dosing of LMWH prophylaxis and the essential section here is on heparin resistance. Enjoy!

    IBCC Episode 80 - Acute Exacerbation of COPD

    Play Episode Listen Later May 19, 2020 28:17


    In this episode, we cover that bread and butter presentation, chronic obstructive pulmonary disease. Clinical Features Respiratory support Pharmacotherapy Approach to ventilation and extubation

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