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We discuss the shift to prehospital blood to treat shock sooner. Hosts: Nichole Bosson, MD, MPH, FACEP Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Prehospital_Transfusion.mp3 Download Leave a Comment Tags: EMS, Prehospital Care, Trauma Show Notes Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below. Course Highlights: Credit: 12.5 AMA PRA Category 1 Credits™ Curriculum: Comprehensive coverage of Core Emergency Medicine, with 12 modules spanning from Critical Care to Pediatrics. Cost: Free for NYU Learners $250 for Non-NYU Learners Click Here to Register and Begin Module 1 What is prehospital blood transfusion Administration of blood products in the field prior to hospital arrival Aimed at patients in hemorrhagic shock Why this matters Traditional US prehospital resuscitation relied on crystalloid ED and trauma care now prioritize early blood Hemorrhage occurs before hospital arrival Delays to definitive hemorrhage control are common Earlier blood may improve survival Supporting rationale ATLS and trauma paradigms emphasize blood over fluid National organizations support prehospital blood when feasible EMS already manages high risk, time sensitive interventions Evidence overview Data are mixed and evolving COMBAT: no benefit PAMPer: mortality benefit RePHILL: no clear benefit Signal toward benefit when transport time exceeds ~20 minutes Urban systems still experience long delays due to traffic and geography LA County median time to in hospital transfusion ~35 minutes LA County program ~2 years of planning before launch Pilot began April 1 Partnerships: LA County Fire Compton Fire Local trauma centers San Diego Blood Bank 14 units of blood circulating in the field Blood rotated back 14 days before expiration Ultimately used at Harbor UCLA Continuous temperature and safety monitoring Indications used in LA County Focused rollout Trauma related hemorrhagic shock Postpartum hemorrhage Physiologic criteria: SBP < 70 Or HR > 110 with SBP < 90 Shock index ≥ 1.2 Witnessed traumatic cardiac arrest Products: One unit whole blood preferred Two units PRBCs if whole blood unavailable Early experience ~28 patients transfused at time of discussion Evaluating: Indications Protocol adherence Time to transfusion Early outcomes Too early for outcome conclusions California collaboration Multiple active programs: Riverside (Corona Fire) LA County Ventura County Additional programs planned: Sacramento San Bernardino Programs meet monthly as CalDROP Focus on shared learning and operational optimization Barriers and concerns Trauma surgeon concerns about blood supply Need for system wide buy in Community engagement Patients who may decline transfusion Women of childbearing age and alloimmunization risk Risk of HDFN is extremely low Clear communication with receiving hospitals is essential Future direction Rapid national expansion expected Greatest benefit likely where transport delays exist Prehospital Blood Transfusion Coalition active nationally Major unresolved issue: reimbursement Currently funded largely by fire departments Sustainability depends on policy and payment reform Take-Home Points Hemorrhagic shock is best treated with blood, not crystalloid Prehospital transfusion may benefit patients with prolonged transport times Implementation requires strong partnerships with blood banks and trauma centers Early data are promising, but patient selection remains critical National collaboration is key to sustainability and future growth Read More
Dr. Lillian Liang Emlet is a Professor of Critical Care Medicine at the University of Pittsburgh, dually trained in Emergency Medicine and Critical Care. She's also a certified energy leadership coach and the CEO founder of Transforming Healthcare Coaching. She also hosts a podcast by the same name. We talk about a common phenomenon in healthcare: clinicians who are exceptional at their work getting promoted into leadership roles without the skills or support to succeed. Lillian shares how she helps healthcare leaders at all levels—physicians, nurses, NPs, PAs, pharmacists, executives—develop as whole people first before tackling the complexities of leading teams and systems. Lillian explains what energy leadership coaching actually means, and why healthcare will always need guides for its leaders even as we work to transform the culture. If you enjoy the show, please leave a ⭐⭐⭐⭐⭐ rating on Apple or a
Roger Seheult, MD of MedCram discusses three tech innovations that can help increase sunlight exposure. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on December 29th, 2025) Roger Seheult, MD is the co-founder and lead professor at: www.medcram.com He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine. MEDCRAM WORKS WITH MEDICAL PROGRAMS AND HOSPITALS: MedCram offers group discounts for students and medical programs, hospitals, and other institutions. Contact us at customers@medcram.com if you are interested. MEDIA CONTACT: Media Contact: customers@medcram.com Media contact info: https://www.medcram.com/pages/media-contact Video Produced by Kyle Allred Edited by Daphne Sprinkle of Sprinkle Media Consulting, LLC FOLLOW US ON SOCIAL MEDIA: Facebook: www.facebook.com/MedCram Twitter/X: www.twitter.com/MedCramVideos Instagram: www.instagram.com/medcram DISCLAIMER: MedCram medical videos are for medical education and exam preparation, and NOT intended to replace recommendations from your doctor. #tech #sunlight #innovation
As we close out this Best of 2025, these episodes represent far more than download numbers or chart positions. They reflect the conversations that resonated most with you, the ones that challenged practice, reinforced fundamentals, and reminded us why this work matters.From Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest with Mike Christian, to The Evolving Nature of Major Incidents with Adam Desmond, Paediatric Assessment in Critical Care with Anna Dobbie, Frailty in Geriatric Patients with Iain Wilkinson and James Adams, and The Last Year of Life focusing on Palliative and End of Life Care; each episode speaks to a different phase of life, a different clinical challenge, and a different kind of responsibility. Together, they capture the full spectrum of pre-hospital and emergency care: from critical care decisions to thoughtful, values-based care at the end of life.They remind us that excellence in practice is not just about technical skill or clinical algorithms, but about clear communication, teamwork, and compassion, whether we are managing traumatic cardiac arrest, supporting families during major incidents, caring for critically unwell children, advocating for frail older adults, or walking alongside patients in their final year of life.Thank you for being part of our podcast community throughout 2025. Your engagement is what makes these conversations possible, and it is a privilege to continue them with you into the year ahead. Finally, thank you to PAX bags for their continued support of the podcast. You can find the best-in-class medical bags here: https://www.pax-bags.com/en/
Endotrachael intubation is a highly important critical care procedure, and as such, clinicians are working to improve the procedure to ensure the best patient outcomes. As Stephanie DeMasi, MD, MS, assistant professor of emergency medicine at Vanderbilt University Medical Center, goes through the detailed review she wrote, along with her colleagues, on different evidence-based decisions clinicians face when intubating a patient, with host Eddie Qian, MD, Vanderbilt University Medical Center. Read Dr. DeMasi's paper, "Evidence-based Emergency Tracheal Intubation": https://www.atsjournals.org/doi/10.1164/rccm.202411-2165CI
Feeling overwhelmed or overworked? It might be time for a reset! Take a moment to reflect and recharge your mind. Join us next week as we dive into effective strategies formanaging stress, improving productivity, and finding balance in our busy lives. Don't miss out on this opportunity to revitalize your routine!
Welcome back to the tasty morsels of critical care podcast. Today we’re going to have a quick overview of the oesophageal balloon. If you’re directed to a patient in your long case who has an oesophageal balloon in, then you’re probably having a bad day. It would seem very unfair to have too many questions on this but an awareness of their existence and some cliff notes on their basic use might come in handy especially if you’re doing well and you’re in the medal type territory of the exam. Exams aside they’re a useful gateway drug into some important respiratory mechanics that are relevant to all of us. At their most basic these are fancy NG tubes with an inflatable balloon that should end up in the lower third of the oesophagus. Inflating the balloon with a small amount of air allows you to transduce the pressure at the area the balloon lies. While that sounds straightforward there are large sections of review papers dedicated to troubleshooting placement and means of assuring the number you generate is actually accurate. I refer you to the below references for further reading. The pressure measured is called the oesophageal pressure, often abbreviated to Pes because it seems the Americans won the spelling war on that one. Oesophageal pressure is a reasonable surrogate (with assumptions of course) for pressure within the pleural space. Once we have an estimate of pleural pressure we can subtract that from the plateau pressure displayed on the vent and we end up with a fancy number called the transpulmonary pressure. The transpulmonary pressure or Ptp is the distending pressure applied to the lung either from the muscles of spontaneous ventilation or from positive pressure ventilation from the ventilator. Whoopdy do says the examiner – you now have another number you don’t really know what to do with. What should we use this data for, the examiner is asking? Well a short list of useful aspects you can look at with the oesophageal balloon include compensating for the effect of the chest wall on respiratory mechanics appropriate titration of PEEP assessing the contribution of respiratory muscle use to potential lung injury assessing triggering and synchrony issues At this stage you’d be hoping the examiner is satiated and you can move on to something else but in the unlikely and terrifying event that they ask for more detail you might want to mention some of the following. Our typical approach to safe ventilation in the passively ventilated patient is to look at driving pressures and tidal volumes. But this takes no account for the contribution of the chest wall. In the very obese patient there is a lot of flesh pressing down on the chest wall, this leads to an increasingly positive pleural pressure. It would make sense that we would need more pressure to distend the lungs in this scenario. The balloon in this scenario will allow you to set your PEEP appropriately. The Ptp at end expiration needs to sit somewhere in the 0-10cmH20 range to avoid derecruitment and in end inspiration it needs to be less than 25cmH20. This may need a lot more PEEP or less driving pressure than you’re used to giving and the balloon can help you feel safe about doing that. In the patient weaning from the ventilator in a spontaneous mode the oesohpageal balloon can be used to make an estimate of the contribution of the patients muscular effort to the transpulmonary pressure. Your patient may be on 10/5 on a pressure support mode and you may well be lulled into a false sense of security that because the pressure numbers on the vent are modest then the pressures being exerted across the lung are also modest. What we are not measuring in this scenario is the distending pressure being applied to the lungs by the respiratory muscles, the Pmus. The balloon in this scenario can give an estimate of this as it reflects the negative pleural pressure generated by the patients inspiratory efforts allowing us to come up with a Ptp number that takes Pmus into consideration. Sometimes this might encourage you to increase the support from the vent, sometimes this might encourage you to increase the sedation depending on the context. So given all the wonderful things the balloon can do for us why are we not doing it on everyone? A list of reasons not to use oesophagaeal balloons might include cost – these fancy NG tubes are pricier than you would think compatible software on the ventilators. These frequently don’t come as standard appropriate placement. These are tricky to get right and knowing that the number generated is valid is not entirely straightforward. Lots of assumptions are made the Pes number reflects pleural pressure only at a single location and does not take account of heterogeneity. the evidence base is unclear if this adds anything over doing something like simply following the high PEEP table from ARDSnet. Interestingly several research groups (thinking the folk from Toronto or Luigi Camporata in london) have used balloons to identify surrogate ways of measuring recruitment or estimating Pmus that we can easily measure on a standard ventilator set up. This may well be a way of bringing the important concepts of transpulmonary pressure to the bedside. Reading: The Toronto Mechanical Vent Course was an excellent intro for resp mechanics for me. They offer a virtual version Mauri, T. et al. Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives. Intens Care Med 42, 1360–1373 (2016). Yoshida, T., Grieco, D. L. & Brochard, L. Guiding ventilation with transpulmonary pressure. Intensive Care Med 45, 535–538 (2019). Mireles-Cabodevila, E., Fischer, M., Wiles, S. & Chatburn, R. L. Esophageal Pressure Measurement: A Primer. Respir. Care respcare.11157 (2023) doi:10.4187/respcare.11157. Jonkman, A. H., Telias, I., Spinelli, E., Akoumianaki, E. & Piquilloud, L. The oesophageal balloon for respiratory monitoring in ventilated patients: updated clinical review and practical aspects. Eur. Respir. Rev. 32, 220186 (2023). Deragned Physiology LITFL
Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Sarah Cogle, PharmD, BCNSP, FASPEN Evolving evidence supports the shift from single-source to multi-source intravenous lipid emulsions in parenteral nutrition. These newer formulations may offer improved metabolic, inflammatory, and hepatic outcomes, particularly for vulnerable patient populations. Joining Dr. Charles Turck to discuss the clinical rationale and operational considerations for these formulations is Dr. Sarah Cogle, who's a Clinical Pharmacist Specialist at Vanderbilt University Medical Center in Nashville, Tennessee.
In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn N. Bulloch, PharmD, BCPS, FCCM, speaks with Olfa Hamzaoui, MD, PhD, professor of intensive care at Robert Debré Hospital in Reims, France, about her Peter Safar Honorary Lecture at the 2025 Critical Care Congress. The conversation centers on tissue perfusion, microcirculation, and shock, with a focus on bridging the gap between bench research and bedside practice. Dr. Hamzaoui shares insights on current scientific understanding of microcirculation and shock, including research on tools to monitor microcirculation, such as handheld video microscopy. The discussion highlights the utility of capillary refill time as a simple, noninvasive tool for guiding resuscitation. Dr. Hamzaoui advocates for early and repeated echocardiographic assessment in shock management, including during de-resuscitation. She also discusses her 2023 article in Clinical Medicine, which proposed titrating norepinephrine to individualized targets. This episode offers a compelling look at how emerging tools and research can refine shock management and promote precision care in critical illness. This podcast is sponsored by Fresenius Kabi. Resources referenced in this episode: Effects of a Resuscitation Strategy Targeting Peripheral Perfusion Status versus Serum Lactate Levels Among Patients with Septic Shock. A Bayesian Reanalysis of the ANDROMEDA-SHOCK Trial (Zampieri FG, et al. Am J Respir Crit Care Med. 2020;201:423-429) The Eight Unanswered and Answered Questions about the Use of Vasopressors in Septic Shock (Hamzaoui O, et al. J Clin Med. 2023;12:4589) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021 (Evans L, et al. Crit Care Med. 2021;49:e1063-e1143)
In this episode, Dr. Hesham A. Hassaballa, Medical Director of Critical Care and Respiratory Therapy at Rush-Copley Medical Center, discusses how AI is transforming clinical care, the irreplaceable human elements of medicine, and the leadership values that guide his work. He also shares insights on physician excellence, system-level improvement, and what inspires him as he looks ahead to 2026.
Welcome to UnMASKing with Male Educators. As we close out the year, we're revisiting some of the most downloaded and most meaningful conversations of the season. This replay with Dr. William (Bill) Penuel is one of those episodes that continues to resonate deeply with educators who are navigating burnout, discipline challenges, and the emotional weight of teaching in today's schools.Dr. Bill Penuel is a former middle school teacher, professor at the University of Colorado Boulder, and a nationally recognized scholar focused on educational change, compassion, and justice in school communities. He is the co-author of Creating Compassionate Change in School Communities, a book that invites educators to rethink discipline, grading, and leadership through an inside-out approach rooted in self-compassion and collective care.As we prepare for a new season of UnMASKing with Male Educators, returning with fresh conversations and exciting news about where we're headed—we invite you to slow down, reflect, and revisit this powerful dialogue. This episode reminds us that schools are often sites of suffering, and that compassion is not weakness, it's a skill, a practice, and a path toward justice.Wishing you and your loved ones a restful and restorative holiday season.In this conversation, we explore how educators can cultivate compassion for themselves and their students while navigating the real challenges of classrooms and school systems. You'll hear:How to shift your relationship to pain in order to best serve yourself and your studentsHow educators can put self-compassion into actionWhat does skillful care look like for children who are systemically marginalized?What is an “inside-out” approach to school change?(0:00) Class in session(2:00) Bill introduces himself(3:40) Bill and Ashanti share their teacher personas(11:20) Applying “contemplative practice” and “meditation” to teaching and education(12:30) Getting close to your resentment(17:20) Sitting with your pain and suffering in order to help others(22:00) Working as a bouncer and what it teaches you about servicing others(29:00) Finding common humanity, and how it helps navigating difficult situations(34:50) Critical Care - an important subject in the field of education(39:00) Deservingness gets in the way of compassion(41:30) Bill's approach to helping boys in schools and confirming dignity(51:00) Bill's book and where to find it---Connect with Bill Penuel:Bill's book: https://www.colorado.edu/crowninstitute/compassionate-change-schools-book LinkedIn: https://www.linkedin.com/in/bill-penuel-8069b5/ Instagram: https://www.instagram.com/crowninstitutecu Facebook: https://www.facebook.com/CrownInstituteCU ---Contribute to our Dance-a-thon fundraiser: https://charity.pledgeit.org/EFC-DanceAThon Join our Skool Community: https://www.skool.com/efc-young-mens-advocates-2345 Email us questions and comments at totmpod100@gmail.com Create your own mask anonymously at https://millionmask.org/ ---Connect with Ashanti Branch:Instagram: https://www.instagram.com/branchspeaks/Facebook: https://www.facebook.com/BranchSpeaksTwitter: https://twitter.com/BranchSpeaksLinkedIn: https://www.linkedin.com/in/ashantibranch/Website: https://www.branchspeaks.com/---Support the podcast and the work of the Ever Forward Club: https://podcasters.spotify.com/pod/show/branch-speaks/support ---Connect with Ever Forward Club:Instagram: https://www.instagram.com/everforwardclubFacebook: https://www.facebook.com/everforwardclubTwitter: https://twitter.com/everforwardclubLinkedIn: https://www.linkedin.com/company/the-ever-forward-club/
Dr. Rajeev Iyer MD, is a board-certified anesthesiologist and a Professor of Anesthesiology and Critical Care at the University of Pennsylvania. He is the founder & CEO of a company IMG Secrets, that specializes is hiring of international medical graduates through the new unique paths through state laws, alternate entry paths and other options. IMG Secrets also provides career consulting & mentoring to doctors trained outside the USA & local US graduates. (Disclaimer: IMG Secrets is an independent organization and is NOT affiliated with the University of Pennsylvania.) Please take a moment to complete this short survey for the AALN so we can ensure we continue to offer topics that meet the needs of members. https://www.surveymonkey.com/r/LM-Podcastfeedback
Why Tuberculosis is still the most deadly infectious disease.Attention, DNA detectives! We've got a rat on the loose – but don't worry, not the snitching, double-agent kind. We're talking about the whiskered, hyper-skilled, tiny agents who aren't snitching - they're sniffing out one of the world's deadliest diseases: tuberculosis (TB).Tuberculosis might sound old-timey, but it's still the globe's top infectious killer– growing tougher, more drug-resistant, and hitting hardest where access to care falls short. So for our Season 5 finale, host Dr. Kaylee Byers digs into TB's fascinating backstory, and teams up with microbiologist Dr. Jennifer Guthrie to figure out why this ancient disease still has such a tight grip, and how genomics is helping track its every move. Along the way, Dr. Zolelwa Sifumba shares her story as a multidrug-resistant TB survivor, and how her treatment journey fuels her advocacy today.Buckle up: this investigation has it all : science, politics, global inequities… and a squad of extraordinary rats.Special thanks to APOPO for sending us field recordings and interviews from their HeroRAT training program.Highlights(3:42) The history of TB(8:19) Why TB sits at the top of the global disease podium(15:30) Meet Zolelwa - a multi-drug-resistant TB survivor(30:48) The power of education–Show Notes/Resources:1. Giant Rats Trained to Sniff Out Tuberculosis in Africa- National Geographic2. The Making of a HeroRAT: From Tiny Pup to Life-saving Hero- APOPO3. Tuberculosis: an ancient disease that remains a medical, social, economical and ethical issue- Journal of Preventive Medicine and Hygiene4. History of World TB Day- CDC5. The history of tuberculosis- Respiratory Medicine6. Chapter 12: An introductory guide to tuberculosis care to improve cultural competence for health care workers and public health professionals serving Indigenous Peoples of Canada- Canadian Journal of Respiratory, Critical Care, and Sleep Medicine7. Everything is Tuberculosis- John Green
Brought to you in partnership with Collins AerospaceAs Europe ramps up defence investment in the wake of the Ukraine crisis, the spotlight is turning to how nations sustain their growing fleets. In this episode of Critical Care, produced by Shephard Studio in partnership with Collins Aerospace, we travel to Heidelberg, Germany — home to a regional sustainment hub that's proving crucial for fast, local support across Europe and beyond.We hear from Holger Eckstein, Michael Mayer and Michael Nelson – leaders within Collins' sustainment operations – as they explain how the Heidelberg service centre is handling everything from Eurofighter and Tornado repairs to complex electronics for helicopters and land platforms. They reveal how deep regional expertise, long-term partnerships with primes like Airbus and BAE Systems, and close ties to international customers are transforming the speed and scale of military readiness.From reducing reliance on transatlantic repair cycles to enabling more responsive support for customers like the Royal Saudi Air Force, this episode explores how Heidelberg's model of forward sustainment is setting a new benchmark. We also look at how Europe's fragmented defence landscape is starting to shift towards more unified, collaborative approaches — not just for procurement, but for long-term support.What emerges is a clear message: rapid, reliable sustainment isn't a nice-to-have. It's essential for operational credibility in a fast-changing world.Coming up next: we head to the Netherlands to see what happens when Collins' engineers go embedded with the Royal Netherlands Air Force, working side by side on the hangar floor.
In this episode, our Chief Medical Officer Dan Dworkis works with Alex Hodson, a seasoned critical care physician assistant, to explore the dynamics of high-functioning multi-professional healthcare teams, the training pipeline for APPs, and the importance of feedback and teamwork across disciplines. Gain insights into the challenges and rewards of working in high-stress environments and understand how multidisciplinary and multi-professional collaboration shapes effective patient care.
Paul Sax, MD, FIDSA, sits down with infectious disease and critical care physician, Matthew Brigmon, MD, of the University of Texas at San Antonio, to explore his unique path as a double-boarded physician. They discuss the challenges and rewards of combining the two specialties and share guidance for trainees interested in forging a career in ID Critical Care.This holiday season, you can help strengthen the infectious diseases workforce and support the people who advance patient care and public health every day. All donations to the IDSA Foundation through December 31 are matched up to $50,000. Learn more and double your impact at idsafoundation.org.
Enid Martinez, MD is a Senior Associate in Critical Care at Boston Children's Hospital, and an Assistant Professor of Anaesthesia at Harvard Medical School. She is the Director of the Pediatric Critical Care Nutrition Program in the Division of Critical Care Medicine and Principal Investigator for a clinical-translational research program on gastrointestinal function and nutrition in pediatric critical illness.Learning Objectives:By the end of this podcast, listeners should be able to:Recognize the impact of nutritional status on outcomes of critically-ill children.Describe the key aspects of the metabolic stress response in critical illness.Discuss a clinical approach to accurately estimating and prescribing nutrition in critically-ill children.Reflect on an expert's approach to managing aspects of nutrition in critically-ill children where there may not be high-quality evidence. Selected references:Mehta et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):706-742. doi: 10.1177/0148607117711387. Epub 2017 Jun 2. PMID: 28686844. Fivez et al. Early versus Late Parenteral Nutrition in Critically Ill Children. N Engl J Med. 2016 Mar 24;374(12):1111-22. doi: 10.1056/NEJMoa1514762. Epub 2016 Mar 15. PMID: 26975590.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!
ECMO is the topic of this week's episode of Pediheart. We speak with Assistant Professor of Pediatrics and cardiac critical care specialist at Northwell Health, Dr. Ivana Capin about a recent ELSO database study she conducted to assess outcomes in single ventricle patients who were treated with ECMO prior to single ventricle palliation. What factors were associated with worse overall outcomes? Can this therapy be used to stabilize the HLHS patient with an intact atrial septum? Why have outcomes for this high risk patient group not appreciably improved in the recent decade? How can these data improve prognostic clarity when speaking with families in this difficult situation.Also joining us briefly is Associate Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai, Dr. Scott Aydin to discuss his co-author and mentor, Dr. George Ofori-Amanfo as we approach the 4th anniversary of his untimely and tragic passing. DOI: 10.1017/S1047951125001386
I spoke with Dr. Elaine Cheng, a neonatologist at Loyola, to learn about her experiences with navigating the challenges she faces in the NICU and how it's shaped her perspective on striking the balance between being clinically efficient while consistently being supportive and empathetic towards patients and families.Episode produced by: Anumitha AravindanEpisode recording date: 11/10/25www.medicuspodcast.com | medicuspodcast@gmail.com | Donate: http://bit.ly/MedicusDonate
Send us a textToday's guest is someone who brings compassion, intellect, and a genuine love for medicine to everything he does. Dr. Mahmoud Ibraheem is a Pulmonary and Critical Care physician whose medical journey has taken him from Bahrain to New York, Florida, and Texas. Those experiences shaped who he is as a physician. Beyond medicine, Dr. Ibraheem is passionate about mental health, music, and making medicine more human. He's also a proud husband to a brilliant cardiologist and devoted dog dad to Xena and Blue. In other words, he's very well-rounded.You might know him from Instagram, where he shares insight and humor about life in medicine under the handle @icuboy_meded.As Mahmoud told his story, I was filled with wonder at his joyful personality. His journey reminds us that medicine isn't just about surviving intense situations; it's about bringing heart, humor, and humanity into every encounter.In the five-minute snippet: Mahmoud's gone to the dogs! For Mahmoud's bio, visit my website (link below).Tik TokThreadsXContact The Conversing Nurse podcastInstagram: https://www.instagram.com/theconversingnursepodcast/Website: https://theconversingnursepodcast.comYour review is so important to this Indie podcaster! You can leave one here! https://theconversingnursepodcast.com/leave-me-a-reviewWould you like to be a guest on my podcast? Pitch me! https://theconversingnursepodcast.com/intake-formCheck out my guests' book recommendations! https://bookshop.org/shop/theconversingnursepodcast I've partnered with RNegade.pro! You can earn CE's just by listening to my podcast episodes! Check out my CE library here: https://rnegade.thinkific.com/collections/conversing-nurse-podcast Thanks for listening!
Enid Martinez, MD is a Senior Associate in Critical Care at Boston Children's Hospital, and an Assistant Professor of Anaesthesia at Harvard Medical School. She is the Director of the Pediatric Critical Care Nutrition Program in the Division of Critical Care Medicine and Principal Investigator for a clinical-translational research program on gastrointestinal function and nutrition in pediatric critical illness. Learning Objectives:By the end of this podcast, listeners should be able to:Recognize the impact of nutritional status on outcomes of critically-ill children.Describe the key aspects of the metabolic stress response in critical illness.Discuss a clinical approach to accurately estimating and prescribing nutrition in critically-ill children.Reflect on an expert's approach to managing aspects of nutrition in critically-ill children where there may not be high-quality evidence. Selected references:Mehta et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):706-742. doi: 10.1177/0148607117711387. Epub 2017 Jun 2. PMID: 28686844. Fivez et al. Early versus Late Parenteral Nutrition in Critically Ill Children. N Engl J Med. 2016 Mar 24;374(12):1111-22. doi: 10.1056/NEJMoa1514762. Epub 2016 Mar 15. PMID: 26975590.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.
Dr. Sumedha Sonde, pulmonologist and critical care physician at Hamilton Physician Group - Specialty Care in Dalton, Georgia. Dr. Sonde completed residency training in Anesthesia and Pain Management and additional residency training in Internal Medicine. She then completed a Pulmonary and Critical Care fellowship in New York.Dr. Sonde treats patients with sleep or pulmonary disorders. chronic obstructive pulmonary disease (also referred to as COPD), asthma, pulmonary fibrosis, lung cancer, COVID conditions, pneumonia, acute and chronic pulmonary hypersensitivity conditions, pulmonary hypertension, bronchiolitis, and more. For more information or an appointment at Hamilton Physician Group - Specialty Care, call 706-529-3072 or visit VitruvianHealth.com/specialtycare. This program in no way seeks to diagnose or treat illness or to replace professional medical care. Please see your healthcare provider if you have a health problem.
Conversación con los autores del caso clínico publicado en International Journal of Emergency Medicine (2025) En este episodio del ECCpodcast, conversamos con los autores del caso "Cardiopulmonary resuscitation-induced consciousness in an elderly patient: a case report in the prehospital setting"—un fenómeno sorprendente y todavía poco comprendido: la conciencia inducida por RCP (CPRIC). Hablamos con Jose Daniel Yusty-Prada y Jose Luis Piñeros-Alvarez, quienes documentaron la historia de un paciente de 80 años que, sin haber recuperado pulso, comenzó a moverse, hacer sonidos y quitarse el equipo… durante las compresiones torácicas. Este caso abre una conversación fundamental sobre la fisiología, el manejo clínico, la ética y la capacitación necesaria para enfrentar CPRIC en entornos reales. Contexto del Caso El paciente colapsó en un área pública, rápidamente reconocido como un paro cardíaco presenciado. Los testigos iniciaron compresiones inmediatas, y un equipo BLS llegó con un AED, confirmando un ritmo desfibrilable. Durante los ciclos iniciales de RCP, el paciente comenzó a: flexionar las piernas, mover brazos, intentar remover el BVM y los parches, vocalizar sonidos, y mover la cabeza. Todo esto sin pulso palpable y sin signos de perfusión sostenida. Los movimientos desaparecían al detener las compresiones y reaparecían al reanudarlas: un patrón clásico de CPRIC. Esto provocó interrupciones prematuras por parte del equipo, dudas entre los testigos e incluso conflictos psicológicos en los rescatistas, quienes inicialmente pensaron que el paciente "despertaba". Finalmente, tras múltiples desfibrilaciones y sin sedación disponible en protocolo, se logró ROSC. ¿Qué es CPR-Induced Consciousness (CPRIC)? Los autores explican que CPRIC es un fenómeno real, probablemente subdiagnosticado, en el cual un paciente sin pulso presenta: Formas interferentes Intentar quitarse dispositivos Empujar a los rescatistas Movimientos coordinados Vocalizaciones Mover cabeza, brazos o piernas Formas no interferentes Parpadeo Mirada fija o seguimiento Suspiros Movimientos mínimos La evidencia señala que CPRIC ocurre más en: paros presenciados, ritmos desfibrilables, paro de causa cardiaca, CPR de alta calidad, y pacientes sin daño cerebral previo severo. Cada vez vemos más casos porque estamos dando mejor RCP, con mayor perfusión cerebral y más equipos con feedback. Retos del Caso: Técnica, logística y psicología Uno de los aspectos más valiosos del episodio es cuando los autores discuten cómo el fenómeno impacta al equipo. 1. Interrupciones prematuras Los movimientos llevaron al equipo a detener compresiones 30–40 segundos antes del análisis del AED, y esto puede comprometer el éxito de la desfibrilación. 2. Manejo de vía aérea Los movimientos orales hicieron imposible avanzar más allá del OPA + BVM. Intentar insertar una supraglótica se volvió riesgoso. 3. Interferencia del público Familiares y testigos gritaban que el paciente estaba "despertando" y pedían detener la RCP. Esto modificó la toma de decisiones del equipo. 4. Dilema ético y emocional Los autores describen la experiencia como "desconcertante", incluso sabiendo que el paciente estaba en VF refractaria. Sedación en CPRIC: ¿Cuándo? ¿Cómo? ¿Con qué? El artículo y los autores coinciden en que la evidencia actual favorece el uso de ketamina para manejar CPRIC interferente: 0.5–1 mg/kg IV o bolos de 50–100 mg Ventajas: No compromete presión arterial No deprime respiración Inicio muy rápido Ayuda en estrés psicológico post-evento Sin embargo: La mayoría de los sistemas en Latinoamérica no tienen protocolos Providers temen administrar sedación en pleno paro No existe guía formal de AHA o ERC ILCOR solo tiene un best practice statement Los autores recalcan que la sedación debe considerarse solo si CPRIC interfiere con las maniobras. Lecciones para EMS y emergencias Los autores destacan tres grandes enseñanzas: 1. CPRIC no es ROSC Si no hay pulso, no hay circulación espontánea, aunque el paciente hable o se mueva. 2. La educación pública es crucial Los testigos pueden ejercer presión equivocada. Es necesario explicar durante la escena qué está pasando. 3. Los sistemas deben crear protocolos ya Incluyendo: reconocimiento temprano decisiones sobre sedación documentación comunicación con familiares entrenamiento en simulación Por qué este caso es importante Este artículo es uno de los pocos reportes en un paciente geriátrico, resalta desafíos culturales en Latinoamérica y propone la urgente necesidad de estandarización internacional. CPRIC seguirá aumentando porque la RCP sigue mejorando. Y si no lo reconocemos, aumentarán: interrupciones innecesarias, conflictos en escena, mala calidad de RCP, y peor pronóstico. Llamado a la acción para la comunidad Si este episodio te hizo reflexionar: ðŸ'‰ Únete al ECCnetwork: https://ecctrainings.circle.so ðŸ'‰ Conoce nuestros cursos premium: ACLS, Manejo Avanzado de Vía Aérea, Emergency Nursing, Critical Care, TCCC-CMC www.ecctrainings.com ðŸ'‰ Lee el artículo completo: https://link.springer.com/article/10.1186/s12245-025-01032-w Yusty-Prada, J.D., Portuguez-Jaramillo, N.E. & Piñeros-Alvarez, J.L. Cardiopulmonary resuscitation-induced consciousness in an elderly patient: a case report in the prehospital setting. Int J Emerg Med 18, 230 (2025). https://doi.org/10.1186/s12245-025-01032-w
Dr. Sumedha Sonde, pulmonologist and critical care physician at Hamilton Physician Group - Specialty Care in Dalton, Georgia. Dr. Sonde completed residency training in Anesthesia and Pain Management and additional residency training in Internal Medicine. She then completed a Pulmonary and Critical Care fellowship in New York.Dr. Sonde treats patients with sleep or pulmonary disorders. chronic obstructive pulmonary disease (also referred to as COPD), asthma, pulmonary fibrosis, lung cancer, COVID conditions, pneumonia, acute and chronic pulmonary hypersensitivity conditions, pulmonary hypertension, bronchiolitis, and more. For more information or an appointment at Hamilton Physician Group - Specialty Care, call 706-529-3072 or visit VitruvianHealth.com/specialtycare. This program in no way seeks to diagnose or treat illness or to replace professional medical care. Please see your healthcare provider if you have a health problem.
Send us your questions and comments!We break down the latest ACLS changes so you don't have to read 200 pages of guidelines. Fast, fun, and packed with the stuff that actually counts during a code.For more information about ROSC Healthcare - visit www.roschealthcare.com
In this episode, we start off with an RSI featuring Joey Sandolo who discusses cardiac changes during pregnancy. Then, we discuss some of the philosophy behind critical care medicine with Dr. Josh Trester.
Medical education has a potentially powerful role in global health. This breakout will explore some ways that medical education can not only support patient care but also augment research capacity building to better care for critically ill patients in resource-limited countries.
Smoking is the main risk factor for COPD in the United States and many other countries. However, it is important to recall that there are other causes of COPD, from birth experiences to environmental exposures. COPD expert Meilan K. Han MD, MS, University of Michigan Health, discusses non-smoking causes of COPD, what patients can do to manage their symptoms, and how clinicians and communities can help. Air Health Our Health podcast creator Erika Moseson, MD, MA, of Legacy Health in Oregon hosts. Patient resources: - ATS COPD resources: https://site.thoracic.org/patient-resources/chronic-obstructive-pulmonary-disease-copd - GOLD COPD resources: https://goldcopd.org/patients-advocacy-groups/ - American Lung Association COPD resources: https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/resource-library - UpToDate COPD resources: https://www.uptodate.com/contents/stable-copd-overview-of-management
Dr. Sumedha Sonde, pulmonologist and critical care physician at Hamilton Physician Group - Specialty Care in Dalton, Georgia. Dr. Sonde completed residency training in Anesthesia and Pain Management and additional residency training in Internal Medicine. She then completed a Pulmonary and Critical Care fellowship in New York.Dr. Sonde treats patients with sleep or pulmonary disorders. chronic obstructive pulmonary disease (also referred to as COPD), asthma, pulmonary fibrosis, lung cancer, COVID conditions, pneumonia, acute and chronic pulmonary hypersensitivity conditions, pulmonary hypertension, bronchiolitis, and more. For more information or an appointment at Hamilton Physician Group - Specialty Care, call 706-529-3072 or visit VitruvianHealth.com/specialtycare. This program in no way seeks to diagnose or treat illness or to replace professional medical care. Please see your healthcare provider if you have a health problem.
In this World Shared Practice Forum Podcast, Dr. Vinay Nadkarni discusses emergent tracheal intubation in pediatric critical care. Drawing from the NEAR4KIDS registry and comparing with recent adult-focused evidence, Dr. Nadkarni discusses the challenges of airway management in children, emphasizing the importance of patient-specific physiology. He highlights how patient positioning and equipment choices can improve intubation outcomes. Additionally, the episode explores the benefits of video laryngoscopy and apneic oxygenation. This content is pertinent for healthcare professionals seeking to enhance their understanding of pediatric airway management, offering practical insights supported by recent research. LEARNING OBJECTIVES - Compare pediatric and adult emergency tracheal intubation evidence and practices - Explore the role of the NEAR4KIDS registry in improving pediatric intubation practices - Identify effective strategies to enhance first-attempt success in tracheal intubations - Assess the impact of patient positioning and equipment choices on intubation outcomes - Evaluate the benefits of video laryngoscopy and apneic oxygenation in pediatric settings AUTHORS Vinay Nadkarni, MD, MS Professor, Anesthesiology Critical Care and Pediatrics University of Pennsylvania Perelman School of Medicine Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: November 25, 2025. ARTICLES REFERENCED - DeMasi SC, Casey JD, Semler MW. Evidence-based Emergency Tracheal Intubation. Am J Respir Crit Care Med. 2025;211(7):1156-1164. doi:10.1164/rccm.202411-2165CI - Garcia-Marcinkiewicz AG, Kovatsis PG, Hunyady AI, et al. First-attempt success rate of video laryngoscopy in small infants (VISI): a multicentre, randomised controlled trial. Lancet. 2020;396(10266):1905-1913. doi:10.1016/S0140-6736(20)32532-0 - Hagberg CA, Artime CA, Aziz MF, eds. Hagberg and Benumof's Airway Management. 5th ed. Philadelphia, PA: Elsevier; 2023. - Khanam D, Schoenfeld E, Ginsberg-Peltz J, et al. First-Pass Success of Intubations Using Video Versus Direct Laryngoscopy in Children With Limited Neck Mobility. Pediatr Emerg Care. 2024;40(6):454-458. doi:10.1097/PEC.0000000000003058 - Waheed S, Kapadia NN, Jawed DR, Raheem A, Khan MF. Randomized controlled trial to assess the effectiveness of apnoeic oxygenation in adults using a low-flow or high-flow nasal cannula with head side elevation during endotracheal intubation in the emergency department. BMC Res Notes. 2025 Jul 1;18(1):264. doi: 10.1186/s13104-025-07328-7. Erratum in: BMC Res Notes. 2025 Sep 8;18(1):384. doi: 10.1186/s13104-025-07412-y. PMID: 40598378; PMCID: PMC12219693. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/mr2657n4ckgpz7g3tw37gbx/202511_WSP_Nadkarni_transcript Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Nadkarni V, Burns JP. Pediatric Intubation Practices: Insights from NEAR4KIDS. 11/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/pediatric-intubation-practices-insights-from-near4kids-by-v-nadkarni-openpediatrics.
In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn Bulloch, PharmD, BCPS, FCCM, speaks with Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation, about her Norma J. Shoemaker Honorary Lecture at the 2025 Critical Care Congress and the transformative impact of the 4Ms framework—What Matters, Medication, Mentation, and Mobility—on age-friendly critical care. Dr. Fulmer shares her journey from bedside critical care nurse to national leader in geriatric health, emphasizing the need to adapt healthcare systems to meet the needs of an aging population. She discusses the development of the Age-Friendly Health Systems initiative, a collaboration among the John A. Hartford Foundation, Institute for Healthcare Improvement, American Hospital Association, and Catholic Health Association. Now implemented in nearly 5000 facilities, the initiative is supported by evidence from models such as the Acute Care of the Elderly (ACE) units, Hospital Outcomes Program for Elders (HOPE) initiative, and Nurses Improving Care for Healthsystem Elders (NICHE) program. The episode highlights the January 2025 adoption of a Centers for Medicare and Medicaid Services measure that incorporates the 4Ms into inpatient care standards. Dr. Fulmer explains how hospitals of all sizes can implement age-friendly practices using existing resources and how multiprofessional collaboration is key to success. She also discusses findings from a national survey from Age Wave and the John A. Hartford Foundation, which revealed that only 19% of older adults feel their clinicians consistently address all 4Ms. Listeners will gain insight into how the 4Ms framework improves outcomes and promotes functional recovery in older adults. Whether you're a clinician, educator, or healthcare leader, this episode offers practical strategies and a compelling call to action to join the age-friendly health systems movement.
Roger Seheult, MD of MedCram examines a new study comparing ICU stay durations to IR exposure. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on November 15th, 2025) Roger Seheult, MD is the co-founder and lead professor at: www.medcram.com He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine. MEDCRAM WORKS WITH MEDICAL PROGRAMS AND HOSPITALS: MedCram offers group discounts for students and medical programs, hospitals, and other institutions. Contact us at customers@medcram.com if you are interested. MEDIA CONTACT: Media Contact: customers@medcram.com Media contact info: https://www.medcram.com/pages/media-contact Video Produced by Kyle Allred Edited by Daphne Sprinkle of Sprinkle Media Consulting, LLC FOLLOW US ON SOCIAL MEDIA: Facebook: www.facebook.com/MedCram Twitter/X: www.twitter.com/MedCramVideos Instagram: www.instagram.com/medcram DISCLAIMER: MedCram medical videos are for medical education and exam preparation, and NOT intended to replace recommendations from your doctor. #infrared #IR #light
In this episode of the Brown General Surgery Podcast, PGY-4 resident Evan Mitchell sits down with two Brown Surgery faculty—one of our senior Trauma surgeons, Dr. Andrew Stephen, MD and one of our newest Trauma faculty Dr. Holden Spivak, MD (fresh off fellowships in Trauma/Critical Care at Shock Trauma and MIS at Stony Brook)—to explore the evolving role of robotics in trauma and acute care surgery.Key topics include:Why robotic surgery remains rare in acute trauma (hemodynamic instability, docking delays, and the risks of insufflation in unstable patients)Real-world exceptions: robotic splenectomy videos, liver laceration repairs, and selective use in stable obese patients with bowel injuriesThe nationwide decline in operative trauma since 1990 and the rebranding from “trauma surgeon” to “acute care surgeon”How emergency general surgery and elective MIS cases now sustain operative volumeTraining pathways: Is residency robotic experience now enough to skip a second fellowship year? Should future acute care surgeons pair a 1-year SCC fellowship with a dedicated MIS year?Will the classic 2-year AAST/ACS fellowship curriculum need to pivot toward more robotics and less ortho/neuro month-rotations?Job market realities: Being robotic-ready is nice, but sound decision-making (“when to operate and how”) remains the most valuable skillWhy open surgery will never become obsolete in a field driven by source control and hemorrhage controlAdvice for trainees: seek broad exposure, lean on mentors, prioritize supportive groups, and don't fear creative (even non-traditional) training routesWhether you're a med student eyeing surgical critical care, a resident deciding on fellowships, or a program director shaping tomorrow's curriculum, this candid conversation offers an honest look at where the field stands today—and where it's headed tomorrow.Tune in for practical insights from surgeons who are living the transition.
In Part 3 of the conversation, Giuseppe Savoja, Western Europe Senior Business Director, Cardiac Surgery Business at Medtronic, talks about his outlook for the future of his field, his views on how the industry and clinicians can collaborate more effectively and the healthcare changes he is most excited about. Guest bio Giuseppe Savoja is Senior Business Director for Cardiac Surgery in Western Europe at Medtronic, where he leads the business with a focus on transformation, growth, and patient impact. With 20+ years in the medical device industry and leadership roles across Europe and Asia, he brings a blend of engineering expertise, commercial experience and a passion for developing high-performing teams. Born in Rome and having lived around the world, he's now back in the Italian capital with his family. Outside work, Giuseppe enjoys windsurfing, snowboarding, sailing and motorbiking. Follow us on Instagram: @emj.gold
In Part 2 of the conversation, Giuseppe Savoja, Western Europe Senior Business Director, Cardiac Surgery Business, Medtronic, shares how ECMO has transformed over the decades and explores how clinicians and industry can work together to support the most vulnerable patients in intensive care. Guest bio Giuseppe Savoja is Senior Business Director for Cardiac Surgery in Western Europe at Medtronic, where he leads the business with a focus on transformation, growth, and patient impact. With 20+ years in the medical device industry and leadership roles across Europe and Asia, he brings a blend of engineering expertise, commercial experience and a passion for developing high-performing teams. Born in Rome and having lived around the world, he's now back in the Italian capital with his family. Outside work, Giuseppe enjoys windsurfing, snowboarding, sailing and motorbiking. Follow us on Instagram: @emj.gold
We explore the fascinating intricacies and unique features of the burned critically ill patient, with Clint Leonard, NP in the burn ICU at Vanderbilt and ABLS instructor. Learn more at the Intensive Care Academy! Want to work at the University of Kentucky? UK's Anesthesia Critical Care department is hosting a hiring webinar on November 20, … Continue reading "Lightning rounds 57: Burn critical care with Clint Leonard"
Show Notes: What does it take to move ICU rehab forward — and who's leading the charge? In this episode, co-hosts Dr. Leo Arguelles and Dr. Daniel Young sit down with Dr. Monica Silva Damasceno (MD Anderson Cancer Center) and Dr. Vinh Tran (University of New Mexico) — two clinicians who shared the stage at CSM's ICU Rehab panel alongside Dale Needham, Jen Ryan, and Chris Wells. Together, they unpack what's changing in critical care physical therapy — from dismantling barriers and writing mobility into unit culture, to building true interprofessional collaboration that lasts beyond a single champion. Monica shares her journey from Brazil to Houston Methodist's Critical Care Fellowship, and how mentorship shaped her vision for ICU practice. Vinh reflects on his path from cardiac medicine to academia, bridging implementation science with bedside experience. The conversation highlights the power of structure, communication, and persistence in advancing early mobility — especially in smaller hospitals where “doing more with less” is a daily reality. Today's Guests: Monica Damasceno PT, DPT, CCS monicasdapt@gmail.com linkedin.com/in/monica-silva-damasceno-pt-dpt-ccs-03989965 Vihn Tran PT, DPT, PhD, CCS https://www.linkedin.com/in/vinh-tran-169015200/ Guest Quotes: 15:25 Vihn “ I agree in the shorter duration just because by necessity, if they're in the ICU, they're medically unstable, right? So you're limited on how aggressive you can be, although I do think we can be more aggressive than the average person thinks. So yeah, I think that seems reasonable to, to shorter sessions, but perhaps more frequently. With a caveat that there is potential out there to do longer sessions in certain really niche or precise circumstances.” 20:24 Advice for those therapists that working like the smaller kind of rural community hospitals that wanna kind of make a dent and or wanna start implementing more ICU rehab? Vihn “ ..really, it's not just a PT or rehab driven process, right. Like we in rehab can just flick a switch and all of a sudden this happens. It requires an extensive amount of collaboration between providers, nurses, techs, your own staff, your equipment managers. Everyone needs to be on board with what the overall aim is. So in order to really get the ball rolling first to me, like identify champions in, in allied communities. So whether it's a nursing manager that potentially sees the value in early mobility, perhaps it's a Mutually beneficial relationship where we can provide higher quality therapy or an earlier timeframe. At the same time, we can relieve some of the mobility tasks that nursing might have to do or help them do it in a more safe aspect.” Monica “ ..having an agreement with your team and having the the champions. One from or multiple people from different groups, a doctor, nurses, and then have a plan of what you see for your unit in the future with this, those people, and create your practices like every day. Cultivating that practice of mobility and encouraging and helping each other.” 29:06 Monica “ one of the strategies to try to encourage more mobility is asking. What is the mobility plan during the rounds? Any rounds you have to have an answer. Then, then you think about mobility.” Rapid Responses: What's your go-to karaoke song? Monica: “it is Mariah Carey. It's song Mariah Carey. Always Mariah Carey. Yeah. Any song that I can find? Mariah Carey. Which is the hardest to sing. Can you imagine talking about the scales there? Vihn: I'm from St. Louis and I love Nelly, so I just gotta go with Nelly.” You know you work in acute care when… Vihn: “ When you don't care what you're wearing in the work or how you look, I should say that way.” Monica: “ The scrubs have extra scrubs, I would say and all. And also having the safety pins in your pocket to secure the lines.” Links: https://orcid.org/0009-0009-6275-4362
This week, Isabel is joined by Giuseppe Savoja, Western Europe Senior Business Director, Cardiac Surgery Business at Medtronic, for a deep-dive into the evolution and future of ECMO, innovation in critical care and the realities of leading in the MedTech space. In Part 1 of the interview, Giuseppe talks about what attracted him to the medical device industry, what his day-to-day role involves and what advice he would give to anyone considering joining the MedTech sector. Guest bio Giuseppe Savoja is Senior Business Director for Cardiac Surgery in Western Europe at Medtronic, where he leads the business with a focus on transformation, growth, and patient impact. With 20+ years in the medical device industry and leadership roles across Europe and Asia, he brings a blend of engineering expertise, commercial experience and a passion for developing high-performing teams. Born in Rome and having lived around the world, he's now back in the Italian capital with his family. Outside work, Giuseppe enjoys windsurfing, snowboarding, sailing and motorbiking. Follow us on Instagram: @emj.gold
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode1077. In this episode, I'll discuss the AHA/NCS scientific statement on critical care management of patients after cardiac arrest. The post 1077: Sedation and Analgesia Statements From the AHA/NCS Scientific Statement on Critical Care Management of Patients After Cardiac Arrest appeared first on Pharmacy Joe.
Host: Brian P. McDonough, MD, FAAFP Guest: Phil Ayers, PharmD, BCNSP, FMSHP, FASHP With the potential to reduce infection risk, improve operational efficiency, and enhance safety through standardization, multi-chamber bags are increasingly being used as an alternative to traditional compounded parenteral nutrition. To explore this approach and how it can be implemented in hospital and home care settings, Dr. Brian McDonough speaks with Dr. George Phillip Ayers. He's an Associate Clinical Professor at the University of Mississippi School of Pharmacy as well as the Chief of Clinical Pharmacy Services in the Department of Pharmacy at the Mississippi Baptist Medical Center in Jackson.
SOFA-2 is here — a major advance in assessing organ dysfunction in critical illness
Beyond the Pearls: Cases for Med School, Residency and Beyond (An InsideTheBoards Podcast)
About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions MedPrepTGo Step 2 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices
On this episode of JHLT: The Podcast, the Digital Media Editors host a discussion on the paper, "Impact of donor specific antibodies on longitudinal lung function and baseline lung allograft dysfunction." They are joined by the first author, Muhtadi Alnababteh, MD, Assistant Professor at the University of Maryland and Staff Clinician at the National Institutes of Health, and senior author Michael Keller, MD, of the Pulmonary and Critical Care division at the University of Maryland. The discussion explores: Common characteristics of patients who developed donor-specific antibodies (DSA) Differences in outcomes depending on when DSA developed Associations between the development of DSA and antibody-mediated rejection, and related time frames For the latest studies from JHLT, visit www.jhltonline.org/current, or, if you're an ISHLT member, access your Journal membership at www.ishlt.org/jhlt. Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.
In this episode of the NCS Podcast Perspectives series, Nicholas Morris, MD, speaks with Andrew Kofke, MD, emeritus professor of anesthesiology and critical care at the University of Pennsylvania. Dr. Kofke reflects on his remarkable path from a teenage ambulance volunteer to a pioneering leader in neuroanesthesia and neurocritical care. He discusses the origins of Penn's neuro ICU program, his collaborations with influential figures like Peter Safar and Alan Ropper and his research on cerebral blood flow and opioid neurotoxicity. Dr. Kofke also shares insights on the evolution of multimodal neuroprotection, the future of noninvasive cerebral monitoring and how curiosity and physiology have guided his decades-long career. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.
TopMedTalk's Andy Cumpstey recorded this piece recently for us at the Royal College of Anaesthetists' Centre for Perioperative Care's (CPOC) annual meeting in London. The conversation features key figures from CPOC, including: David Selwyn, Acting Chief Executive at Sherwood Forest Hospitals NHS Foundation Trust, appointed as the inaugural Director of CPOC in May 2019, Denny Levitt, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), Scarlett McNally, Consultant Orthopaedic Surgeon in Eastbourne DGH, UK since 2002, Deputy Director at the COPC (2020-26) and an honorary clinical professor at Brighton and Sussex Medical School, Jugdeep Dhesi, Deputy Director for CPOC, Clinical lead for the innovative and award winning POPS (Perioperative medicine for Older People undergoing Surgery) service, Honorary Reader at King's College London and Associate Professor at University College London, and Lawrence Mudford, who transitioned from a healthcare professional to a patient, following a cancer diagnosis. Following his successful treatment, he took up his current role as a patient representative for CPOC. The panel explore the creation and evolution of CPOC since its inception in 2019, highlighting the collaborative efforts to improve surgical pathways by integrating patient and multidisciplinary voices. They discuss various initiatives, guidelines, and successful practices aimed at enhancing patient-centered care, managing conditions like frailty, diabetes, and anaemia, and promoting shared decision-making. The episode also delves into future goals, such as addressing the implementation gap, fostering digital transformation, and operationalizing educational curricula for healthcare professionals to further support perioperative care.
Beyond the Pearls: Cases for Med School, Residency and Beyond (An InsideTheBoards Podcast)
About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions MedPrepTGo Step 2 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices
In this World Shared Practice Forum podcast, Dr. Robinder Khemani, co-author of the PALICC-2 guidelines, discusses the real-world application of pediatric ARDS management strategies. Through a case-based conversation, Dr. Khemani shares nuanced insights on intubation timing, ventilator settings, neuromuscular blockade, and rescue therapies, including ECMO. He also introduces the REDvent trial, a novel approach to lung and diaphragm protective ventilation. This content is ideal for clinicians, respiratory therapists, and healthcare educators seeking to deepen their understanding of evidence-informed, physiology-driven care in pediatric acute respiratory distress syndrome. LEARNING OBJECTIVES - Analyze the clinical decision-making process for intubation in pediatric ARDS - Apply PEEP titration techniques to assess lung recruitability in patients with PARDS - Evaluate the role of neuromuscular blockade in maintaining lung protective ventilation - Identify appropriate advanced rescue therapies based on PARDS phenotypes - Explore the principles and outcomes of the REDvent trial in ventilator management AUTHORS Robinder "Roby" Khemani, MD, MsCI Professor of Pediatrics, Vice Chair of Research University of Southern California, Department of Anesthesiology and Critical Care Medicine Children's Hospital Los Angeles Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: October 28, 2025. ARTICLE REFERENCED Khemani RG, Bhalla A, Hotz JC, et al. Randomized Trial of Lung and Diaphragm Protective Ventilation in Children. NEJM Evid. 2025;4(6):EVIDoa2400360. doi:10.1056/EVIDoa2400360 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/47wbxnvxtcpvv54p48gc2v/202510_WSP_Khemani_Transcript.pdf Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Khemani RG, Burns JP. Practical Strategies for Management of Patients with Pediatric ARDS. 10/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/practical-strategies-for-management-of-patients-with-pediatric-ards-by-r-khemani-openpediatrics.
In this episode, Dr. Sergio Zanotti discusses the administration of vasopressor agents through peripheral intravenous lines (or what we refer to as “peripheral vasopressors”). He is joined by Dr. Elizabeth Munroe, a practicing pulmonary/critical care physician and an Assistant Professor of Pulmonary and Critical Care at Intermountain Health in Salt Lake City, Utah. Her research interests include evidence-based resuscitation practices in early sepsis and septic shock, vasopressor administration practices, peripheral vasopressor use, and clinical trials, particularly novel, pragmatic clinical trial designs. Additional resources: Peripheral Vasopressor Use in Early Sepsis-Induced Hypotension. ES Munroe, et al. JAMA Network 2025: https://pubmed.ncbi.nlm.nih.gov/40864467/ Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. Shapiro NI, et al. CLOVERS Trial. New Engl J of Med 2025: https://pubmed.ncbi.nlm.nih.gov/36688507/ Overview of Peripheral Vasopressor Use in an Academic Health System. D Shyu, et al. Ann Am Thorac Soc 2025: https://pubmed.ncbi.nlm.nih.gov/40126143/ Safety of peripheral intravenous administration of vasoactive medication. J Cardenas-Garcia, et al. J Hosp Med 2015: https://pubmed.ncbi.nlm.nih.gov/26014852/ Books mentioned in this episode: Ending Medical Reversal- Improving Outcomes, Saving Lives. By Vinayak K. Parsad, et al: https://bit.ly/4nhCNam
When we think of sunlight, vitamin D is usually the first thing that comes to mind. But the truth is, the full spectrum of light that we get exposed to when we spend time outside plays a vital role in how we sleep, how we feel and even how our cells create energy. This week's returning guest is Dr Roger Seheult, who believes that sunlight is one of the most accessible and underutilised tools we have for improving health – and the science he shares is compelling. I'm delighted to welcome back to my Feel Better, Live More podcast for our third conversation. Roger is a quadruple board-certified physician in Internal Medicine, Pulmonary Diseases, Critical Care and Sleep Medicine. He is also an Associate Clinical Professor at the University of California, Riverside, and Assistant Clinical Professor at Loma Linda University. Alongside his clinical practice, he co-founded MedCram, a medical education platform with over one million YouTube subscribers, widely used by hospitals and medical schools worldwide. Roger is also a sought after lecturer and has received multiple awards for his contributions to medicine and education. His passion lies in making complex medical science accessible, and he regularly lectures to schools, hospitals and media outlets. In this conversation, we discuss: Why deficiency in sunlight can show up as fatigue, poor sleep, inflammation or even raised cholesterol. The three “macronutrients” of light – visible, ultraviolet and infrared – and how each plays a different role in mood, immunity and cellular energy. How infrared light penetrates deep into the body, supporting mitochondrial function and how it may help protect against diseases such as diabetes and dementia. Why spending 15–20 minutes a day outside – even in the shade – can be enough to recharge our cells. The growing evidence that sunlight exposure lowers the risk of all-cause mortality, cancer and heart disease. Practical strategies for getting the benefits of sunlight safely, even if you live in colder climates or spend much of your day indoors. Roger also shares his “eight laws of health” – simple, timeless principles that include nutrition, rest, fresh air and sunlight – and explains how neglecting them leads to the chronic conditions he often sees in his work in intensive care. This is a fascinating conversation that will change how you think about sunlight. It isn't just something that makes us feel good – it's a fundamental part of how our bodies stay healthy. And the best part? It's free and available to us all. I hope you enjoy listening. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com. Thanks to our sponsors: https://www.boncharge.com/livemore https://www.calm.com/livemore https://thriva.co/ Show notes https://drchatterjee.com/586 DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.
Michael J. Welsh, MD, Professor of Internal Medicine–Pulmonary, Critical Care, and Occupational Medicine at The University of Iowa, joins the discussion with cystic fibrosis patient Grace to explore the intersection of research and real-world treatment. Dr. Welsh shares insights from his groundbreaking work in cystic fibrosis research, while Grace offers her personal experience living with the condition.
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