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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!
Dr. Kwadwo Kyeremanteng is Head of Critical Care at The Ottawa Hospital. He's also a researcher and advocate for patients, through media interviews and his own podcast — Prevention Over Prescription. On top of all that, he's a co-chair of The Ottawa Hospital Foundation's $500 million Campaign to Create Tomorrow. In this conversation, Dr. K, as he's known, takes us into the day in the life of his role at the hospital. He discusses his research and the focus on making the most out of our healthcare dollars. We also dive into this historic fundraising campaign — why it's vital to our community and his message to others to join the movement. (22:05)
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.
Welcome back to the tasty morsels of critical care podcast. This is the second of 2 parts on PE in critical care. The first focused on risk stratification and this one will focus on management. There is a link to a transcript of a more comprehensive talk with references on emergencymedicineireland.com for those keen enough to dive a little deeper. As noted in the last podcast this one leans very heavily on “in the my experience” level of the evidence pyramid and should be weighted as such. For this discussion I’m going to assume your patient is in the ESC High risk category, ie hypotensive with a PE on imaging and you’re satisfied that the PE is causing the hypotension. I do believe there is a tiny cohort of the PE population who warrant aggressive reperfusion even with a normal appearing BP but at this stage I cannot say I have any evidence or guidance to really identify who they are and back that up. For the original talk I gave on this to an EM audience, I split the interventions into helpful , distractions, and not helpful. It was probably a little bit of a provocative division if I’m honest. The slide is on the site for reference and viewing it will likely make what follows more edifying. For the resus room patient in the first 30-60 mins I feel comfortable to standby my assertion that a short list of “helpful interventions” should includes lysis, anticoagulation, noradrenaline, oxygen and some CPR. In the ICU however we’re often present both at the first 30-60 mins but over next hours and many of the items on the “distraction” list become a little more relevant with time. Number 1 on my list of helpful interventions is thrombolysis. As mentioned, if you have found PE and you have satisfied yourself that the sickness and hypotension you’re seeing is caused by that PE then you need to have a good reason not give thrombolysis. The evidence base is not high level RCTs but it is a class 1 recommendation on the ESC guidelines and the list of class 1 interventions is really quite short. In the 25 year old in resus with a massive PE day 3 after an arthroscopy the decision here seems pretty straightforward. However in the post trauma patient in the ICU with massive PE with a small traumatic SAH and an improving SDH and a recent laparotomy then the decision is orders of magnitude more complex and you may well find a very good reason why lysis is not an option. There is not a straightforward answer to lysis because it will vary from patient to patient but I would emphasis that it is a question worth dedicating a decent chunk of your cognitive bandwidth to. Dosing in an unstable patient is often 10mg of alteplase followed by 90mg over 2 hrs. Dosing in a cardiac arrest situation is typically a 50mg bolus. Anticoagulation is one of the other class 1 recommendations on the ESC list. Opinions vary on agent of choice. With my ICU hat on I will almost always advocate for UFH as I feel confident that if i stop it, the heparin effect will be gone in a couple of hours when the inevitable bleeding starts. Opinions vary and I know smart people who advocate for LMWH in this scenario with one of the arguments being you probably get more reliable and quicker anti Xa effect. Both the guidelines and your esteemed narrator recommend against volume resuscitation. Dumping a litre of crystalloid into the venous circulation will shift the IVS further towards the left impairing cardiac filling and doing the opposite of what you intended. A much better resuscitation fluid would be noradrenaline. This is remarkably effective in improving BP and perfusion and I have often used it when I am 90% sure the patient has a PE but haven’t quite got the CT scan to prove it. The noradrenaline can also buy you a little time to make a better decision about the lysis and reperfusion, converting what would have been an immediate decision into something that you maybe have more like 30 mins to make. Certainly if the noradrenaline dosage is rising and the right heart is struggling then adrenaline would be my add on inotrope of choice. Of course we know in the ICU we have a plethora of other agents available to us with lots of theoretical advantage on pulmonary vascular resistance etc. They would rarely be my first line, certainly not in the ED population but I would often reach for them a little further down the line once i have a better handle on the physiology and what they might tolerate. Enough to say that staring someone on 0.5mcg/kg/min milrinone as a single agent with a starting BP of 60/40 is not likely to end well in this context Oxygenation is strongly endorsed given its proclivity for reduction in PVR, however intubating someone in this context to facilitate oxygenation is likely to result in a catastrophic haemodynamic collapse. The adage “resuscitate before you intubate” or even “reperfuse before you intubate” has some relevance here. I find CPR to be helpful in the context of massive PE, not simply for the usual reasons of preserving some degree of forward flow but I suspect there is a mechanical effect of breaking up or moving clot more distally. I have frequently seen stuttering intermittent ROSC in this context. I would suggest caution with the mechanical CPR devices as the presence of a liver lac in the context of tPA is unlikely to be well tolerated. While not available or that relevant to the emergency medicine population I do think the addition of nitric in the ventilated ICU patient who develops nasty PE seems like a low risk intervention with potentially massive gains. There is a small RCT of nitric in the spontaneous breathing PE population that did not however show benefit. I put mechanical devices in the “distraction” category in my original talk as I don’t think they have much relevance in the early stage of resuscitation. However if you have kept them alive long enough or if you have a true contraindication to lysis or a failed lysis then they may well have a role. I have found the evidence base so far here decidedly underwhelming and for catheter directed lysis in particular i struggle to see how a mg/hr tpa via a pulmonary catheter is any different than a mg/hr of tpa via a peripheral IV line given that the entire venous return ends up in the pulmonary circulation either way. The thrombectomy devices are certainly more compelling from a physiological perspective and the obvious and dramatic changes in physiology on removal of clot are quite compelling. But they are a tremendous faff requiring a catheter akin to an ECMO catheter to be threaded into the pulmonary circulation. The recent PEERLESS trial gave an average 90 min procedure time emphasizing the need to keep the patient alive long enough to receive the intervention. I do feel this has a role in our management quiver I am just unsure what that role is, but more evidence in the coming years will likely clarify VA ECMO is undoubtedly a fantastic physiological support for a dying PE patient but bear in mind it is almost definitely not available to you in the vast majority of hospitals in the Ireland and the UK. PERT teams are groups of relevant physicians willing to weigh in on difficult PE cases to advise on management. I put PERT teams in the distraction category. And I feel bad about that because they're usually filled with knowledgeable and enthusiastic people . But there are 2 errors I've seen on this that we should be aware of. One is on us as primary clinicians where we outsource the decision to lyse in someone who has a clear indication. This is not necessarily the fault of the PERT team but there is risk to the patient in delaying as it is a tremendous faff trying to get hold of the relevant people and then get them to agree. The second distraction that can happen is the recommendation for interventions in a patient that they have not seen and are not present to. A couple of times I have had to talk people out of IR interventions that frankly were not needed because the patient was getting better with conventional treatment. Do not underestimate the importance of being at the bedside and seeing the patient and evaluating response to treatment. Surgery, in terms of pulmonary embolectomy is the third and final class 1 recommendation in the ESC guidelines for high risk PE. All be it with a very low evidence rating. It gets talked about in papers and guidelines but you're talking about taking someone who is already mostly dead into theatre, lined, anaesthetised, chest opened and onto bypass. There probably is a role for it somewhere and in certain institutions and it's often raised in the context of contraindications to lysis but those same contraindications to lysis usually apply to the 30000 units of heparin you need to get them on bypass. It seems to suffer from the old goldilocks flaw of “not sick enough” for theatre or “too sick” for theatre I have clearly done way beyond my usual brevity in this scenario but honestly didn’t think anyone could tolerate a 3rd part on PE. Full refunds are available on request For further reading it is probably best to visit the original lecture post where the relevant papers are all listed with a little smattering of critical appraisal thrown in for good measure.
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
Kaleida Health critical care physician Dr. James Hereth on blood clots full 339 Tue, 11 Nov 2025 09:30:00 +0000 oPsFcWHYps9w9rzmuqFKjY4IVBx6ybg6 hockey,nhl,buffalo sabres,buffalo,news,jiri kulich,wben,kaleida health,blood clots,dr. james hereth WBEN Extras hockey,nhl,buffalo sabres,buffalo,news,jiri kulich,wben,kaleida health,blood clots,dr. james hereth Kaleida Health critical care physician Dr. James Hereth on blood clots Archive of various reports and news events 2024 © 2021 Audacy, Inc. News False https://player.amperwa
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.
Event Objectives:Review the need for a Pediatric Emergency and Critical Care (PECC) fellowship in low-resource settings.Discuss the challenges, opportunities, and lessons learned in developing a PECC fellowship in resource-limited environments.Explore the role of international collaboration in the success and sustainability of PECC fellowship programs.Claim CME Credit Here!
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.
In this episode, we're diving into the journey of Zoe Boswell, a dedicated paramedic, mother, and community volunteer with the Great Western Air Ambulance Charity (GWAAC). Zoe brings over a decade of experience as a road paramedic, all while balancing the demands of family life and volunteering with the GWAAC Heartstarters program.Zoe's story is a powerful example of resilience, progression, and passion within the pre-hospital care world. Her ability to manage complex clinical challenges on scene, train at an advanced level, and still give back to the community through CPR education speaks volumes about her commitment to the profession.In our conversation, we explore her motivations, her aspirations from road to critical care paramedic, the emotional impact of high-acuity cases, and the unique perspective she brings as a parent working on the front line. Whether you're a student paramedic, a seasoned clinician, or just curious about the realities of life on the HEMS pathway, Zoe's insights are both inspiring and deeply grounded in the realities of modern pre-hospital care. Let's dive into this episode with Zoe Boswell.This episode is brought to you by IndieBase.IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers.Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.IndieBase EPR made simple, wherever you are.Find out more at https://indiebase.net/This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/
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
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
Mentorship can be transformative, especially for immigrant critical care professionals navigating unique career challenges. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Ludwig Lin, MD, speaks with Fajun Wang, MD, a neurocritical care specialist and assistant professor at St. Louis University School of Medicine, about his experience in SCCM's Immigrant Critical Care Professional (ICCP) mentorship program. Dr. Wang shares his journey from medical school in China to building a neurocritical care service line in the United States, highlighting how mentorship shaped his path at every stage. He reflects on the challenges of entering a healthcare system in a new country and emphasizes the benefits of connecting mentors and mentees who share similar backgrounds and experiences. Dr. Wang's ICCP mentor provided guidance during the launch of his ICU leadership role, offering insights into service line development and support during challenging situations. The ICCP program, developed from a proposal by José L. Díaz-Gómez, MD, MAS, FASE, FCCM, launched its first six-month pilot in January 2024. The program focuses on five key domains: psychological and emotional support, self-efficacy, career development, scholarly support, and role modeling. A second pilot, currently under way, extends the mentorship to a full year. This episode will inspire listeners to seek mentorship and community to advance their careers and grow their confidence. Mentorship is not just about guidance—it's about building relationships that empower individuals to lead, innovate, and give back.
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
Cultivating Joy in Medicine: Dr. Madeline Lagina on PERMA and Positive PsychologyIn this episode of The Girl Doc Survival Guide, Dr. Madeline Lagina, Clinical Assistant Professor at the University of Michigan, delves into the importance of joy in education and medicine. Drawing from her paper on the PERMA model—a framework for well-being comprising Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment—Dr. Lagina shares personal anecdotes and insights on how joy and other positive emotions can significantly impact both educators and learners. The discussion explores how fostering joy can counteract burnout and enhance professional fulfillment, especially among physician educators.00:00 Introduction and Guest Welcome00:34 Personal Anecdote: The Impact of a High School Teacher02:48 The Concept of Communicable Emotions04:02 Exploring the PERMA Model06:13 Applying PERMA to Physician Educators12:57 Tips for Flourishing in Career and Life15:34 Final Thoughts and Conclusion
Join us on this episode of the PCICS podcast for a discussion about the innovative and essential roles that Child Psychologists play in the care of children with congenital heart defects. As we aim for the best clinical outcomes for our patients, Dr. Mejia (Phoenix Children's) and Dr. Harley (Stanford Medicine Children's Health) describe their holistic and multidisciplinary interventions to help patients and families weather some of the most stressful and traumatic times in their lives. Learn how a child psychologist plays an essential role in your patient's care and successful long-term outcome in the CVICU and beyond. Host: Christopher Knoll, MD (Phoenix Children's) Editor: Christopher Knoll Executive Producer: Christopher Knoll
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.
Learning how to perform procedures on patients is an important part of medical training, but how do programs decide what to teach? And how do they integrate the latest technology? Host Eddie Qian, MD, from Vanderbilt University Medical Center, talks to Meredith Pugh, MD, MSCI, and Kaele Leonard, MD, of Vanderbilt University Medical Center. Together, they discuss how they think about working with trainees and fellows when it comes to teaching important procedures.
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.
Fluid overload is a common problem in critically ill patients. In this episode, Dr. Sergio Zanotti discuss recognizing and managing fluid overload in the ICU with guest Dr. Michael J. Connor, Jr., a practicing intensivist and nephrologist. Dr. Connor is a Professor and Senior Physician of Critical Care Medicine & Nephrology at the Divisions of Pulmonary, Allergy, Critical Care, and Sleep Medicine and Renal Medicine at Emory University School of Medicine. Additionally, he serves as the director of critical care nephrology at the Emory Critical Care Center at Grady Memorial Hospital. Additional resources European Society of Intensive Care Medicine Clinical Practice Guideline on fluid therapy in adult critically ill patients: Part 3- fluid removal at de-escalation phase. Intensive Care Med 2025: https://pubmed.ncbi.nlm.nih.gov/40828463/ Optimizing Fluid Therapy in the Critically Ill. International Fluid Academy website – 2025: https://www.fluidacademy.org/2025/01/17/optimising-fluid-therapy-in-the-critically-ill-introduction-to-7d/ Fluid overload in the ICU: evaluation and management. R. Claure-Del Granado and R. L. Mehta. BMC Nephrology 2016: https://pubmed.ncbi.nlm.nih.gov/27484681/ Books and music mentioned in this episode: Think Again: The Power of Knowing What You Don't Know. By Adam Grant: https://bit.ly/4gZvz9c RUSHMERE. By Mumford & Sons: https://bit.ly/473FzKc
Andrew Gabrielson is a pediatric urology fellow at Lurie Children's Hospital of Chicago. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A.T. Gabrielson and C. Corwin. Occupational Health and Safety on the Chopping Block — What's at Stake? N Engl J Med 2025;393:1353-1355.
This week on Critical Care Time, Nick & Cyrus discuss the recent article in the Journal of Critical Care titled “Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications.” Is this bunk or is this practice changing? Did they select the right population for this study or is the question they asked and answered... maybe not such a great question? We'll cover all this and more during this week's episode! Please take a listen, react, reach out & as always - don't forget to leave a review! Hosted on Acast. See acast.com/privacy for more information.
This week we review a recent report of the use of phenoxybenzamine for the reduction of SVR in children undergoing congenital heart surgery in India. How does this agent work and what might be the advantage versus other agents like nitroprusside or milrinone which are more commonly used? How does the cost of this agent (or phentolamine) compare with newer agents? We speak with Dr. Rohit Loomba of Lurie Children's Hospital. For those interested, in addition to working as a critical care cardiologist, Dr. Loomba is also a noted cardiac morphologist and his wonderful videos can be seen at the following web address:https://www.youtube.com/@Talking_HeartsToday's paper:DOI: 10.4103/jpbs.jpbs_868_25
Originally posted in April of 2023, we are sharing this episode of Critical Matters again as Dr. Sergio Zanotti's discussion about the long journey to healing and recovery for those who've survived critical illness in the ICU remains pertinent and important. This conversation features Dr. Margaret Herridge, Professor of Medicine, Senior Scientist in Critical Care and Respiratory Medicine at the University of Toronto. Dr. Herridge is also Director of Critical Care Research. Director of the RECOVER Program, and Clinical Director of the Grace RECOVER Program for Chronic Critical Illness, in the University Health Network, Toronto, Canada. Additional Resources: Outcomes after Critical Illness. M. Herridge and E. Azoulay: https://pubmed.ncbi.nlm.nih.gov/36884324/ Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. Hopkins RO, et al: https://pubmed.ncbi.nlm.nih.gov/10390379/ One-year outcomes in survivors of the acute respiratory distress syndrome. Herridge m, et al: https://pubmed.ncbi.nlm.nih.gov/12594312/ Long-term cognitive impairment after critical illness. Pandharipande PP, et al: https://pubmed.ncbi.nlm.nih.gov/24088092/ The RECOVER Program: disability risk groups and 1-year outcome after 7 or more days of mechanical ventilation. Herridge M, et al: https://pubmed.ncbi.nlm.nih.gov/26974173/ Determinants of long-term outcome in ICU survivors: results from the FROG-ICU study. Gayat E, et al: https://pubmed.ncbi.nlm.nih.gov/29347987/ Symptoms of anxiety and depression in family members of intensive care unit patients. Pochard F, et al: https://pubmed.ncbi.nlm.nih.gov/11588447/ Books Mentioned in this Episode: Bel Canto. By Ann Patchett: bit.ly/3nWs7Vp Commonwealth. By Ann Patchett: bit.ly/43pWSCt
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