Podcasts about ecmo

ECMO does not succeed because of a single clinician, team, or device. It succeeds because of systems. In this episode of The Emergency Mind Podcast, Dan talks with Christine Stead, CEO of ELSO, about how innovation in ECMO emerges from networks of people, data, organizations, and shared purpose. From the early days of ECMO development to the global response during COVID-19, they explore how systems enable high-risk, high-complexity care to evolve under pressure.

In this episode, Alec Wilding is joined by Nikki Hewitt, a clinician who has been among the first Paramedics in the United Kingdom to deliver pre-hospital ECMO as part of London's Air Ambulance (LAA), Endovascular Cardiac Arrest Team, known as ECAT. This represents one of the most significant steps forward in resuscitation science within the pre-hospital environment, and Nikki has been at the centre of that evolution.During the conversation, Nikki guides us through the evidence base underpinning ECPR, exploring what we currently know, what remains uncertain, and how ongoing research continues to shape clinical decision-making. She also takes us inside the operational structure of the ECAT model, how the team was established, what it takes to deliver ECMO in the field, and the training, skill sets, and logistics required to make it viable outside the hospital walls.Nikki also shares her perspective on where ECPR is heading: The challenges, the opportunities, and what the future of advanced pre-hospital cardiac arrest care may look like as technology, capability, and evidence continue to advance. It is a fascinating area of practice, and Nikki brings frontline insight, experience, and clarity to a topic that is reshaping the conversation around survivability in cardiac arrest.This Podcast is sponsored by World Extreme Medicine.World Extreme Medicine provides internationally recognised education for clinicians and operators working in pre-hospital, remote, expedition, humanitarian, and high-risk environments. Their programmes focus on practical, experience-led learning, equipping professionals with the skills to make sound clinical and operational decisions when resources are limited, evacuation is delayed, and conditions are extreme.With courses covering expedition and wilderness medicine, hostile environments, dive medicine, human performance, leadership, and austere care, World Extreme Medicine brings together a global faculty with real-world experience from some of the most challenging settings on earth. To explore courses, free educational resources, and upcoming webinars, visit: ⁠www.worldextrememedicine.com

In this episode, Alec Wilding is joined by Nikki Hewitt, a clinician who has been among the first Paramedics in the United Kingdom to deliver pre-hospital ECMO as part of London's Air Ambulance (LAA), Endovascular Cardiac Arrest Team, known as ECAT. This represents one of the most significant steps forward in resuscitation science within the pre-hospital environment, and Nikki has been at the centre of that evolution. During the conversation, Nikki guides us through the evidence base underpinning ECPR, exploring what we currently know, what remains uncertain, and how ongoing research continues to shape clinical decision-making. She also takes us inside the operational structure of the ECAT model, how the team was established, what it takes to deliver ECMO in the field, and the training, skill sets, and logistics required to make it viable outside the hospital walls. Nikki also shares her perspective on where ECPR is heading: The challenges, the opportunities, and what the future of advanced pre-hospital cardiac arrest care may look like as technology, capability, and evidence continue to advance. It is a fascinating area of practice, and Nikki brings frontline insight, experience, and clarity to a topic that is reshaping the conversation around survivability in cardiac arrest.This Podcast is sponsored by World Extreme Medicine.World Extreme Medicine provides internationally recognised education for clinicians and operators working in pre-hospital, remote, expedition, humanitarian, and high-risk environments. Their programmes focus on practical, experience-led learning, equipping professionals with the skills to make sound clinical and operational decisions when resources are limited, evacuation is delayed, and conditions are extreme.With courses covering expedition and wilderness medicine, hostile environments, dive medicine, human performance, leadership, and austere care, World Extreme Medicine brings together a global faculty with real-world experience from some of the most challenging settings on earth. To explore courses, free educational resources, and upcoming webinars, visit: ⁠www.worldextrememedicine.com

Purtroppo è arrivata la notizia inevitabile. È morto il piccolo Domenico, il bambino di appena due anni a cui era stato impiantato un cuore danneggiato per una serie di errori su cui ora l'inchiesta aperta dovrà far luce.

Do you think your hospital should allow unilateral DNR orders? Under what circumstances? Through what process?  Do you think that when you obtain the assent of a family to not code their loved one, that assent DNR should be counted as a unilateral DNR order? Should we document unilateral DNR and the rationale? Why for DNR, when we don't document unilateral dialysis not offered, or unilateral no ECMO offered?  Is the assent of a family member to a statement that we will not code their loved one a nudge, and is the assent approach ethical? Reasonable people will disagree, as we do on this podcast. Our guests today are Gina Piscitello, Erin DeMartino, and Will Parker, authors of a terrific viewpoint in JAMA about the need to address inadequate documentation of unilateral DNR orders.  You might recall Gina was a guest on our lively podcast about slow codes, and we pick up where that podcast left off. We highlight the many clinical, practical, and ethical issues at stake, including Gina's finding that during Covid, 3% of critically ill patients receiving pressors had a DNR order. Black patients and those who spoke Spanish had higher rates of unilateral DNR.  That variation should trouble those in favor of unilateral DNR orders.  We talk about variation Gina found at the state and health system level, and what exactly is concerning, the variation itself, or the lack of thought and care that went into some of these policies. Are you a heartbreaker? Dream Maker? Love taker? Don't you mess around with me. (song hint) -Alex  

When air meets uncertainty, judgment matters most. We dig into the evolving landscape of airway management where video laryngoscopy, supraglottic devices, and even ECMO promise better outcomes, yet cognitive errors and non‑OR settings still account for many of the most devastating events. Drawing on recent studies, malpractice claims, and national audits, we map the pressure points that turn a difficult intubation into a crisis and show how to defuse them with clearer plans, tighter teamwork, and sharper skills.We start with three high‑yield rules that change outcomes fast: cap the number of attempts, anticipate physiologic crashes, and switch early to rescue strategies. From there, we unpack the INTUBE findings on hypoxemia and cardiovascular instability, plus data showing how repeated attempts compound failure. Video laryngoscopy gets a balanced look: why it lifts first‑pass success across ED and ICU intubations, and how overreliance can silently erode direct laryngoscopy and awake fiberoptic competence. Expect practical strategies to preserve breadth: intentional DL reps, awake FOI workshops, and shared mental models that define time limits and bailout triggers.We also tackle unsettled ground. Aspiration risk reduction remains murky; cricoid pressure under general anesthesia has not delivered clear benefits, and robust trials comparing asleep rapid‑sequence to awake, topicalized methods in high‑risk patients are missing. We offer a decision lens to tailor approach by anatomy, physiology, and available expertise. For extreme airways—think massive goiter or tracheal compression—we explore where ECMO fits: preemptive, standby, or rescue. You'll hear how activation criteria, cannulation readiness, and interprofessional rehearsal turn a complex tool into a safety net rather than a new hazard.By the end, you'll have a cleaner playbook: plan A–D that you can execute under stress, a review of device trade‑offs, and concrete ways to reduce cognitive traps that drive harm. If this conversation sharpens your next airway, share it with a colleague, subscribe for future episodes, and leave a quick review to help others find the show.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/294-from-video-laryngoscopy-to-ecmo-what-keeps-airway-management-safe/© 2026, The Anesthesia Patient Safety Foundation

In this episode, Dr. Sergio Zanotti discusses a structured approach to ECMO emergencies, focusing on recognizing cardiac arrest, organizing the team response, and early ECMO troubleshooting to support key life-saving interventions. He is joined by Dr. Waqas Akhtar, a consultant at Guy's & St Thomas' NHS Foundation Trustin the United Kingdom. Dr. Akhtar completed full postgraduate certification in Cardiology, Intensive Care & General Internal Medicine, with a particular interest in cardiogenic shock, heart transplantation, and mechanical circulatory support Additional resources: British societies guideline on the management of emergencies in patients on extracorporeal membrane oxygenation. Waqas Akhtar, et al. Intensive Care Med 2025: https://pubmed.ncbi.nlm.nih.gov/41051555/ UK multisociety consensus statement on the emergency and resuscitation of patients with left-sided Impella support. Waqas Akhtar, et al. BMJ Journals 2026: https://heart.bmj.com/content/early/2025/12/17/heartjnl-2025-326896 Books mentioned in this episode: His Dark Materials Series: The Golden Compass; The Subtle Knife; The Amber Spyglass: https://bit.ly/4cmSXgB

This episode of Akuttjournalen focuses on hypothermia as a complex and high-risk condition in prehospital and HEMS medicine. Together with Giacomo Strapazzon from the Institute of Mountain Emergency Medicine at EURAC Research, the discussion explores how hypothermia alters physiology, complicates assessment, and challenges clinical decision-making in austere environments. Key topics include field recognition, use of classification systems, transport and triage decisions, and the role of ECMO and advanced rewarming. The episode emphasizes the importance of early suspicion, temperature measurement, prevention of further cooling, and a well-coordinated chain of survival to improve outcomes in hypothermic patients.

When a patient's heart or lungs fail, ECMO (Extracorporeal Membrane Oxygenation) technology can keep them alive—but only if the team operating it works flawlessly under pressure. In this episode, Thomas Preston draws on over 30 years of experience in cardiopulmonary care to reveal what it takes to manage these life-sustaining systems.This Teamcast episode covers the specialized roles within ECMO teams, the critical relationship between perfusionists and other medical staff, and strategies for navigating crisis moments when seconds matter. Thomas discusses how trust, constant vigilance, and ongoing training form the foundation of successful outcomes in some of medicine's most intense situations. If you value this discussion, the best way to support our work and stay up to date on future episodes is to subscribe and leave us a quick rating or review. It helps us reach more people who need to hear these conversations.

Folks this right here is a JAM PACKED episode of CCT goodness for you guys to enjoy! In this show for the ages we take a deep dive into the world of Mechanical Circulatory Support (MCS) and Cardiopulmonary Critical Care with one of the best in the biz, Dr. Bindu Akkanti! We will go through several fictional patients illustrating use cases, pitfalls and pearls of tools such as the balloon pump, ECMO and the microaxial flow devices used in ICUs all over the globe to help care for the sickest of the sick. If these tools ring a bell or if you are just interested in how we optimize care for these types of patients, give us a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

Send us a textVivek Paul is a highly skilled Cardiac Perfusionist with a strong academic and clinical background in cardiovascular perfusion science. He completed his Bachelor's degree in Cardiac Perfusion Technology from the prestigious Narayana Hrudayalaya Institute of Cardiac Sciences. His professional journey has equipped him with extensive hands-on experience in conducting cardiopulmonary bypass for both adult and pediatric cardiac procedures, including minimally invasive cardiac surgeries. He is confident in operating a wide range of heart–lung machines and extracorporeal life support systems such as IABP and ECMO.Vivek is the Founder of the Global Perfusion Community, a fast-growing professional network of perfusionists with over 15,000 followers across Instagram and LinkedIn, dedicated to education, collaboration, and career growth in perfusion technology. In addition to his clinical expertise, he is also an accomplished author of several perfusion-focused books, including Perfusion Emergency & Problems and the Quick Review ECMO Handbook, reflecting his deep commitment to continuous learning and knowledge sharing.He is passionate about mentoring students and junior perfusionists and actively contributes to the profession through leadership roles. Vivek serves as an Executive Committee Member of the Indian Society of Extracorporeal Technology (ISECT) and the Association of Clinical Perfusionists in Maharashtra, India, where he works toward improving education standards, professional development, and patient safety in cardiac perfusion practice.Learn about career options from the people doing it

In this episode of The Birth Trauma Mama Podcast, Kayleigh sits down with Derek Grassley, RN CEN, CFRN, CCRN, NRP, FP-C WP-C - a flight nurse and ECMO specialist, to break down what ECMO is, when it's used, and why it can be life-saving for critically ill pregnant and postpartum patients.This powerful conversation pulls back the curtain on critical care, emergency transport, and the realities of caring for patients at the edge of survival.

衝突 chōngtú – conflict關門 guānmén – to close a door力道 lìdào – force; strength愛惜班上的公務 àixí bānshàng de gōngwù – to take care of class property愛惜 àixí – to cherish; to take care of日常 rìcháng – daily; everyday乾哥 gāngē – sworn older brother口角衝突 kǒujiǎo chōngtú – verbal dispute演變 yǎnbiàn – to develop; to evolve肢體衝突 zhītǐ chōngtú – physical conflict事先藏好 shìxiān cánghǎo – hidden in advance彈簧刀 tánhuángdāo – switchblade連刺多刀 lián cì duō dāo – to stab repeatedly頸部 jǐngbù – neck胸部 xiōngbù – chest中刀 zhòngdāo – to be stabbed大量失血 dàliàng shīxiě – heavy blood loss失去意識 shīqù yìshì – to lose consciousness救護人員 jiùhù rényuán – emergency medical personnel到場 dàochǎng – to arrive at the scene呼吸 hūxī – breathing心跳 xīntiào – heartbeat被緊急送往 bèi jǐnjí sòngwǎng – to be urgently sent to葉克膜 yèkèmó – ECMO (extracorporeal membrane oxygenation)遺憾 yíhàn – regret; sadly宣告不治 xuāngào búzhì – officially pronounced dead殺人未遂 shārén wèisuì – attempted murder正式起訴殺人罪 zhèngshì qǐsù shārén zuì – formally charged with murder遭到羈押禁見 zāodào jīyā jìnjiàn – detained and held incommunicado一審判決出爐 yìshěn pànjué chūlú – first-instance verdict announced被關起來 bèi guān qǐlái – to be imprisoned檢方 jiǎnfāng – prosecutors法院 fǎyuàn – court判得太輕 pàn de tài qīng – sentence judged too lenient提出上訴 tíchū shàngsù – to file an appeal二審 èrshěn – second trial; second instance被害學生的家屬 bèihài xuéshēng de jiāshǔ – family of the victimized student判決結果 pànjué jiéguǒ – verdict result司法制度 sīfǎ zhìdù – judicial system過度保護 guòdù bǎohù – excessive protection加害者 jiāhàizhě – perpetrator未成年 wèichéngnián – minor; underage深仇大恨 shēn chóu dà hèn – deep hatred or vendetta假釋 jiǎshì – parole檢視 jiǎnshì – to review; to re-examineFollow me on Instagram: fangfang.chineselearning !

What does it really take to build a successful ECMO program? On MedAxiom HeartTalk, host Melanie Lawson, MS, speaks with John Mehall, MD, president of Integration Health and senior vice president of Heart & Vascular Partners, about the expanding role of ECMO in cardiac care. Dr. Mehall discusses rising utilization, improved survival outcomes, economic benefits for hospitals, and the critical importance of physician leadership, training, and institutional support to sustain effective ECMO programs.

In this essential episode of the Prolonged Field Care (PFC) Podcast, host Dennis sits down with CRNA Kevin to dive deep into one of the most overlooked yet critical issues in trauma care: Hypothermia prevention and management. Even in warm environments, trauma patients can rapidly become hypothermic—leading to coagulopathy, increased bleeding, wound infections, and worse outcomes. Dennis and Kevin break down the science, real-world lessons from deployments, and practical strategies for austere and prolonged field care settings.Whether you're a medic, provider, or anyone involved in combat casualty care, this episode will change how you approach keeping patients warm under fire or in remote locations.Episode Highlights:The four main mechanisms of heat loss: radiation (40-60% of total loss), convection, conduction, and evaporation—and how to counter each one effectively.Why even healthy patients cool rapidly under anesthesia, and why trauma patients in the field are at much higher risk.Practical tips for austere environments: using tents, inflatable structures, insulation from the ground, wool blankets, and body heat to raise ambient temperature.Common mistakes that actively cool patients: wet clothing, cold airways (LMAs/ventilation), uncovered exposure, and cold blood/fluid administration.Best bang-for-buck interventions: covering the head, minimizing exposure, drying the patient, using HME filters, and insulating from the ground.Real deployed experiences: keeping trauma bays warm, pre-warming gear, using camping pads on litters, and limitations of Ready-Heat and HPMKs at altitude or in extreme cold.Advanced rewarming techniques (when available): fluid warming, bladder lavage, peritoneal lavage, and ECMO.Temperature monitoring challenges in the field: esophageal, nasopharyngeal, rectal, Foley, and forehead strips—plus how to interpret trends.Chapters:00:00 – Introduction & Why Hypothermia Matters in Trauma Care02:30 – Heat Loss in Anesthesia: Vasodilation and the First-Hour Temperature Drop04:50 – Mechanisms of Heat Loss: Radiation, Convection, Conduction, Evaporation07:10 – OR Strategies: Room Temperature, Head Covering, Fluid Warming, Bear Huggers09:29 – Environmental Control in the Field: Raising Ambient Temperature & Reducing Wind11:52 – Using Tents and Structures to Trap Body Heat14:14 – Insulation from the Ground: Litters, Wool Blankets, Camping Pads, Air Mattresses17:53 – Preventing Conduction & Pressure Sores with Padding19:56 – Avoid Actively Cooling Patients: Cold LMAs, Unheated Ventilation, Wet Clothing22:21 – Heat Moisture Exchangers (HME) & Humidified Gas26:40 – Blood Resuscitation: Cold Fluids vs. Hypovolemia—What Kills First?31:17 – Team-Based Rewarming: Minimize Exposure, Pre-Warm Gear, Dry HPMKs35:22 – Limitations of Battery-Powered Warmers & Bear Huggers in Austere Settings40:04 – Prevention First: Insulate, Cover, Dry—Then Active Rewarming Works Better42:24 – Downstream Effects of Hypothermia: Lethal Triad & Wound Infections44:51 – Aggressive Rewarming Options: Chest Tubes, Gastric/Bladder Lavage, ECMO47:15 – Temperature Monitoring in the Field: Probes, Strips, and Trend InterpretationFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠

Explore Harlequin Syndrome — differential hypoxemia seen in peripheral VA-ECMO and complex cardiopulmonary bypass cases — in this in-depth perfusion podcast. We define the hemodynamic and respiratory mechanisms behind the syndrome, review monitoring cues, and outline evidence-based approaches to diagnosis and correction. Designed for perfusionists, intensivists, and ECMO teams seeking clarity on a nuanced but critical clinical issue.

Episode 210: Heat Stroke BasicsWritten by Jacob Dunn, MS4, American University of the Caribbean. Edits and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice. Definition:Heat stroke represents the most severe form of heat-related illness, characterized by a core body temperature exceeding 40°C (104°F) accompanied by central nervous system (CNS) dysfunction. Arreaza: Key element is the body temperature and altered mental status. Jacob: This life-threatening condition arises from the body's failure to dissipate heat effectively, often in the context of excessive environmental heat load or strenuous physical activity. Arreaza: You mentioned, it is a spectrum. What is the difference between heat exhaustion and heat stroke? Jacob: Unlike milder heat illnesses such as heat exhaustion, heat stroke involves multisystem organ dysfunction driven by direct thermal injury, systemic inflammation, and cytokine release. You can think of it as the body's thermostat breaking under extreme stress — leading to rapid, cascading failures if not addressed immediately. Arreaza: Tell us what you found out about the pathophysiology of heat stroke?Jacob: Pathophysiology: Under normal conditions, the body keeps its core temperature tightly controlled through sweating, vasodilation of skin blood vessels, and behavioral responses like seeking shade or drinking water. But in extreme heat or prolonged exertion, those mechanisms get overwhelmed.Once core temperature rises above about 40°C (104°F), the hypothalamus—the brain's thermostat—can't keep up. The body shifts from controlled thermoregulation to uncontrolled, passive heating. Heat stroke isn't just someone getting too hot—it's a full-blown failure of the body's heat-regulating system. Arreaza: So, it's interesting. the cell functions get affected at this point, several dangerous processes start happening at the same time.Jacob: Yes: Cellular Heat InjuryHigh temperatures disrupt proteins, enzymes, and cell membranes. Mitochondria start to fail, ATP production drops, and cells become leaky. This leads to direct tissue injury in vital organs like the brain, liver, kidneys, and heart.Arreaza: Yikes. Cytokines play a big role in the pathophysiology of heat stroke too. Jacob: Systemic Inflammatory ResponseHeat damages the gut barrier, allowing endotoxins to enter the bloodstream. This triggers a massive cytokine release—similar to sepsis. The result is widespread inflammation, endothelial injury, and microvascular collapse.Arreaza: What other systems are affected?Coagulation AbnormalitiesEndothelial damage activates the clotting cascade. Patients may develop a DIC-like picture: microthrombi forming in some areas while clotting factors get consumed in others. This contributes to organ dysfunction and bleeding.Circulatory CollapseAs the body shunts blood to the skin for cooling, perfusion to vital organs drops. Combine that with dehydration from sweating and fluid loss, and you get hypotension, decreased cardiac output, and worsening ischemia.Arreaza: And one of the key features is neurologic dysfunction.Jacob: Neurologic DysfunctionThe brain is extremely sensitive to heat. Encephalopathy, confusion, seizures, and coma occur because neurons malfunction at high temperatures. This is why altered mental status is the hallmark of true heat stroke.Arreaza: Cell injury, inflammation, coagulopathy, circulatory collapse and neurologic dysfunction. Jacob: Ultimately, heat stroke is a multisystem catastrophic event—a combination of thermal injury, inflammatory storm, coagulopathy, and circulatory collapse. Without rapid cooling and aggressive supportive care, these processes spiral into irreversible organ failure.Background and Types:Arreaza: Heat stroke is part of a spectrum of heat-related disorders—it is a true medical emergency. Mortality rate reaches 30%, even with optimal treatment. This mortality correlates directly with the duration of core hyperthermia. I'm reminded of the first time I heard about heat stroke in a baby who was left inside a car in the summer 2005. Jacob: There are two primary types: -nonexertional (classic) heat stroke, which develops insidiously over days and predominantly affects vulnerable populations like children, the elderly, and those with chronic illnesses during heat waves; -exertional heat stroke, which strikes rapidly in young, otherwise healthy individuals, often during intense exercise in hot, humid conditions. Arreaza: In our community, farm workers are especially at risk of heat stroke, but any person living in the Central Valley is basically at risk.Jacob: Risk factors amplify vulnerability across both types, including dehydration, cardiovascular disease, medications that impair sweating (e.g., anticholinergics), and acclimatization deficits. Notably, anhidrosis (lack of sweating) is common but not required for diagnosis. Hot, dry skin can signal the shift from heat exhaustion to stroke. Arreaza: What other conditions look like heat stroke?Differential Diagnosis:Jacob: Presenting with altered mental status and hyperthermia, heat stroke demands a broad differential to avoid missing mimics. -Environmental: heat exhaustion, syncope, or cramps. -Infectious etiologies like sepsis or meningitis must be ruled out. -Endocrine emergencies such as thyroid storm, pheochromocytoma, or diabetic ketoacidosis (DKA) can overlap. -Neurologic insults include cerebrovascular accident (CVA), hypothalamic lesions (bleeding or infarct), or status epilepticus. -Toxicologic culprits are plentiful—sympathomimetic or anticholinergic toxidromes, salicylate poisoning, serotonin syndrome, malignant hyperthermia, neuroleptic malignant syndrome (NMS), or even alcohol/benzodiazepine withdrawal. When it comes to differentials, it is always best to cast a wide net and think about what we could be missing if this is not heat stroke. Arreaza: Let's say we have a patient with hyperthermia and we have to assess him in the ER. What should we do to diagnose it?Jacob: Workup:Diagnosis is primarily clinical, hinging on documented hyperthermia (>40°C) plus CNS changes (e.g., confusion, delirium, seizures, coma) in a hot environment. Arreaza: No single lab confirms it, but targeted testing allows us to detect complications and rule out alternative diagnosis. Jacob: -Start with ECG to assess for dysrhythmias or ischemic changes (sinus tachycardia is classic; ST depressions or T-wave inversions may hint at myocardial strain). -Labs include complete blood count (CBC), comprehensive metabolic panel (electrolytes, renal function, liver enzymes), glucose, arterial blood gas, lactate (elevated in shock), coagulation studies (for disseminated intravascular coagulation, or DIC), creatine kinase (CK) and myoglobin (for rhabdomyolysis), and urinalysis. Toxicology screen if history suggests. Arreaza: I can imagine doing all this while trying to cool down the patient. What about imaging?-Imaging: chest X-ray for pulmonary issues, non-contrast head CT if neurologic concerns suggest edema or bleed (consider lumbar puncture if infection suspected). It is important to note that continuous core temperature monitoring—via rectal, esophageal, or bladder probe—is essential, not just peripheral skin checks. Arreaza: TreatmentManagement:Time is tissue here—initiate cooling en route, if possible, as delays skyrocket morbidity. ABCs first: secure airway (intubate if needed, favoring rocuronium over succinylcholine to avoid hyperkalemia risk), support breathing, and stabilize circulation. -Remove the patient from the heat source, strip clothing, and launch aggressive cooling to target 38-39°C (102-102°F) before halting to prevent rebound hypothermia. -For exertional cases, ice-water immersion reigns supreme—it's the fastest method, with immersion in cold water resulting in near-100% survival if started within 30 minutes. -Nonexertional benefits from evaporative cooling: mist with tepid water (15-25°C) plus fans for convective airflow. -Adjuncts include ice packs to neck, axillae, and groin; -room-temperature IV fluids (avoid cold initially to prevent shivering); -refractory cases, invasive options like peritoneal lavage, endovascular cooling catheters, or even ECMO. -Fluid resuscitation with lactated Ringer's or normal saline (250-500 mL boluses) protects kidneys and counters rhabdomyolysis—aim for urine output of 2-3 mL/kg/hour. Arreaza: What about medications?Jacob: Benzodiazepines (e.g., lorazepam) control agitation, seizures, or shivering; propofol or fentanyl if intubated. Avoid antipyretics like acetaminophen. For intubation, etomidate or ketamine as induction agents. Hypotension often resolves with cooling and fluids; if not, use dopamine or dobutamine over norepinephrine to avoid vasoconstriction. Jacob: What IV fluid is recommended/best for patients with heat stroke?Both lactated Ringer's solution and normal saline are recommended as initial IV fluids for rehydration, but balanced crystalloids such as LR are increasingly favored due to their lower risk of hyperchloremic metabolic acidosis and AKI. However, direct evidence comparing the two specifically in the setting of heat stroke is limited. Arreaza: Are cold IV fluids better/preferred over room temperature fluids?Cold IV fluids are recommended as an adjunctive therapy to help lower core temperature in heat stroke, but they should not delay or replace primary cooling methods such as cold-water immersion. Cold IV fluids can decrease core temperature more rapidly than room temperature fluids. For example, 30mL/kg bolus of chilled isotonic fluids at 4 degrees Celsius over 30 minutes can decrease core temperature by about 1 degree Celsius, compared to 0.5 degree Celsius with room temperature fluids. Arreaza: Getting cold IV sounds uncomfortable but necessary for those patients. Our favorite topic.Screening and Prevention:-Heat stroke prevention focuses on public health and individual awareness rather than routine testing. -High-risk groups—elderly, children, athletes, laborers, or those on impairing meds—should acclimatize gradually (7-14 days), hydrate preemptively (electrolyte solutions over plain water), and monitor temperature in exertional settings. -Communities during heat waves need cooling centers and alerts. -For clinicians, educate patients with CVD or obesity about early signs like dizziness or nausea. -No formal "screening" exists, but vigilance in EDs during summer surges saves lives. -Arreaza: I think awareness is a key element in prevention, so education of the public through traditional media like TV, and even social media can contribute to the prevention of this catastrophic condition.Jacob: Ya so heat stroke is something that should be on every physician's radar in the central valley especially in the summer time given the hot temperatures. Rapid recognition is key. Arreaza: Thanks, Jacob for this topic, and until next time, this is Dr. Arreaza, signing off.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! References:Gaudio FG, Grissom CK. Cooling Methods in Heat Stroke. J Emerg Med. 2016 Apr;50(4):607-16. doi: 10.1016/j.jemermed.2015.09.014. Epub 2015 Oct 31. PMID: 26525947. https://pubmed.ncbi.nlm.nih.gov/26525947/.Platt, M. A., & LoVecchio, F. (n.d.). Nonexertional classic heat stroke in adults. In UpToDate. Retrieved September 7, 2025, from https://www.uptodate.com/contents/nonexertional-classic-heat-stroke-in-adults. (Key addition: Emphasizes insidious onset in at-risk populations and the role of urban heat islands in exacerbating classic cases.) Heat Stroke. WikEM. Retrieved December 3, 2025, from https://wikem.org/wiki/Heat_stroke. (Key additions: Details on cooling rates for immersion therapy, confirmation that anhidrosis is not diagnostic, and fluid titration to urine output for rhabdomyolysis prevention.)Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

The ethics of NRP—current debates, consent, legal/organizational policies, and team communication. Hemodynamic monitoring for the perfusionist—MAP/PPV/SVV, venous oximetry, lactate trends, and practical targets on CPB and ECMO. Learning objectives: Identify the core ethical concerns and guardrails for NRP programs. Build an explicit consent and documentation pathway with the OR/NRP team. Apply a monitoring bundle (flows, pressures, SvO₂, lactate, urine output) to guide decisions. Create checklists for escalation, troubleshooting, and handoff.

Focus: practical ECMO circuit design and live simulations covering configuration choices, tubing and oxygenator selection, flow targets, pressure monitoring, recirculation prevention, anticoagulation, and troubleshooting. Learning objectives: • Build safe ECMO circuits step-by-step. Choose pumps, oxygenators, and tubing to meet patient goals. Set and adjust flow, sweep, and pressures during simulation. Prevent and correct recirculation, chatter, and alarms.

In this special Rated Rx interview, Robbie sits down with Dr. Zack Meade, an anesthesiologist and major social media presence known for breaking down medical misinformation and educating patients online. They talk about why he started posting, how his content evolved from awkward early videos to confident patient-focused education, and why online medicine feels completely different from practicing in person. Zack opens up about the realities of online backlash, the communities that react the strongest, and the ground rules he follows to stay professional while still being funny. He also shares stories about hospital policies, case report controversies, naturopathic claims, wellness scams, and the strange world of “designer ECMO” at med spas. The conversation closes with the biggest lesson he learned from the comment section: patients need more time, more patience, and more understanding than most clinicians realize. This podcast is intended for entertainment and informational purposes only. https://www.facebook.com/people/The-Rated-Rx-Podcast/61574813907982/ https://www.youtube.com/@RatedRxPodcast https://www.facebook.com/DrZackMD https://www.youtube.com/@TheWhiteCoatCouple

Blogpost asociado  https://ecctrainings.com/te-atreverias-a-dar-tromboliticos-prehospitalarios-para-embolia-pulmonar-lo-que-revela-el-nuevo-estudio-y-como-prepararte-con-acls/" Referencia del estudio original: Harjola, J., Holmström, P., Sane, M., Hartikainen, J., & Harjola, V.-P. (2025). Prehospital fibrinolysis in high-risk pulmonary embolism – Observational data on clinical picture and outcome. Prehospital Emergency Care, 29(7), 1–8. https://doi.org/10.1080/10903127.2025.2582671 Recordatorio rápido: embolia pulmonar de alto riesgo Definición sencilla: EP de alto riesgo / masiva → se manifiesta como shock obstructivo o paro cardiaco. Fisiopatología en pocas palabras: Trombo grande en circulación pulmonar → aumento de poscarga del ventrículo derecho → falla del VD → colapso hemodinámico. Por qué es tan letal: Deterioro muy rápido, ventana terapéutica corta. Frecuentemente se presenta como paro fuera del hospital. Conectar con ACLS: La EP masiva está dentro de las "T" (tromboembolismo) en las causas reversibles del paro. Las guías ACLS contemplan el uso de trombolíticos cuando se sospecha fuertemente EP como causa del paro. ¿Cómo se ve clínicamente un paciente con EP de alto riesgo? Disnea súbita, dolor torácico, síncope, hipotensión, antecedentes de riesgo trombótico. Resumen del estudio de Harjola et al. Objetivo principal del estudio Explorar supervivencia y complicaciones hemorrágicas del uso de trombolíticos prehospitalarios para embolia pulmonar de alto riesgo. Diseño Datos de EMS del área metropolitana de Helsinki + hospital universitario. Periodo aproximado: 2007–2019. Inclusión: Pacientes con EP de alto riesgo sospechada clínicamente. Tratados con fibrinolisis intravenosa prehospitalaria. Diagnóstico de EP confirmado posteriormente por imagen o autopsia. Grupo comparador: Pacientes con EP de alto riesgo que no recibieron fibrinólisis prehospitalaria. Resultados clave Total de pacientes con EP de alto riesgo: 60. Grupo con trombolíticos prehospitalarios para embolia pulmonar: n = 23. 44% mujeres. Edad media: alrededor de 57 años. 74% se presentaron en paro cardiaco. 26% en shock obstructivo. Mortalidad: Mortalidad prehospitalaria aproximada: 35%. Mortalidad intrahospitalaria: alrededor de 27% de los que llegaron vivos. Mortalidad total combinada: cerca de 52%. Todas las muertes en este grupo fueron en pacientes que llegaron en paro cardiaco. Complicaciones: 2 pacientes con sangrado mayor. Ningún sangrado fatal. Supervivencia a 12 meses: Los pacientes trombolizados que salieron vivos del hospital seguían vivos a los 12 meses. Grupo sin trombolisis prehospitalaria: n = 37. Más añosos (edad media cercana a 72 años). Mayor proporción de paro cardiaco. Mortalidad a 12 meses más alta (≈ 76%, tendencia, p alrededor de 0.06). Comentario para desarrollar: Es un estudio observacional, con n pequeño, no podemos concluir causalidad, pero sí hay "señales" interesantes de posible beneficio. ¿Qué nos dice realmente este estudio? Mensajes principales La EP de alto riesgo fuera del hospital tiene una mortalidad muy alta aun con intervenciones agresivas. En este contexto crítico, los trombolíticos prehospitalarios para embolia pulmonar: Parecen relativamente seguros (pocas hemorragias mayores, ninguna fatal). Podrían ofrecer un beneficio en supervivencia, especialmente en pacientes seleccionados. Limitaciones para mencionar Serie de casos; no es ensayo aleatorizado. Número pequeño de pacientes trombolizados. Posible sesgo de selección: Pacientes más jóvenes y potencialmente con menos comorbilidades recibieron trombólisis. No responde preguntas como: Detalle exacto del protocolo. Diferencias entre equipos. Tiempos exactos desde el colapso hasta la trombólisis. Idea clave: No es un "permiso" para trombolizar a todo el mundo, pero sí una invitación seria a considerar que, en EP de alto riesgo, la inacción también tiene un costo muy alto. El reto práctico: decidir trombolisis en el campo Barreras en la vida real Diagnóstico presuntivo sin imagen: Dependemos de clínica, antecedentes, ECG, quizás eco focal. Miedo al sangrado: Especialmente hemorragia intracraneal. Falta de protocolos claros: Muchos sistemas de EMS no contemplan todavía trombolíticos prehospitalarios para embolia pulmonar. Falta de entrenamiento específico: No todos se sienten cómodos con indicaciones, contraindicaciones, dosis. Cómo ayuda ACLS aquí ACLS bien aprendido: Te obliga a pensar en H y T, no solo en adrenalina y ciclos. Te muestra dónde se colocan los trombolíticos prehospitalarios para embolia pulmonar dentro del algoritmo. Te entrena para liderar un equipo y tomar decisiones bajo presión. Conectar con los cursos de ECCtrainings: En nuestros ACLS discutimos escenarios de paro por EP masiva. Practicamos cómo tomar la decisión de administrar o no trombolítico. Simulamos la comunicación con el hospital receptor después de trombólisis. Caso clínico narrado Propuesta de caso Varón de 48 años. Disnea súbita, dolor torácico, antecedente de inmovilidad o TVP reciente. Hipotenso, taquicárdico, saturación baja, signos de shock. En la ambulancia entra en PEA. El equipo evalúa H y T → EP masiva muy probable. Protocolo local permite trombolíticos prehospitalarios para embolia pulmonar: Se administra el medicamento durante la RCP. Después de varios ciclos recupera pulso. Llega vivo al hospital, se confirma EP por imagen y sobrevive. Puntos a resaltar Valor de: reconocer el patrón clínico, tener protocolos, estar entrenado en ACLS. Conectar con la serie de Helsinki: "Son justamente este tipo de pacientes los que aparecen en la serie: altísimo riesgo, pero con posibilidad real de supervivencia si somos agresivos." Cómo prepararte tú y tu sistema Pasos sugeridos para líderes, educadores y clínicos de EMS Revisar la evidencia Usar este estudio como punto de partida para la discusión sobre trombolíticos prehospitalarios para embolia pulmonar. Evaluar la realidad local ¿Disponibilidad del medicamento? ¿Quién puede prescribir y administrar? ¿Qué soporte hospitalario hay (UCI, hemodinamia, ECMO)? Desarrollar protocolos claros Criterios de inclusión y exclusión. Algoritmo que integre ACLS y trombólisis. Entrenamiento formal No basta con escribir el protocolo; hay que entrenarlo en simulación. Cursos ACLS con escenarios específicos de EP. Simulaciones y revisión de casos Simulacros periódicos con roles definidos. Morbimortalidad / debriefing de casos reales o simulados. Comunidad: seguir la conversación en ECCnetwork ECCnetwork: Comunidad en línea para profesionales de emergencias, cuidado crítico, medicina táctica, etc. Espacios para discutir artículos, casos, protocolos, dudas. Invitar a que compartan: ¿Su sistema consideraría trombolíticos prehospitalarios para embolia pulmonar? ¿Qué barreras ven? ¿Experiencias que puedan comentar? Recursos adicionales y blogpost Recordar el blogpost: URL:

Join Iain Beardsell and Hutch as they review key insights from the Trauma 2030 conference hosted by the Institute of Pre-Hospital Care, part of London's Air Ambulance. The discussion highlights the emphasis on speed in damage control resuscitation, the ongoing debate on 'scoop and run' versus 'stay and play' approaches, and the nuanced use of resuscitative thoracotomy. The episode delves into advanced therapies like ECMO, their expanding role in trauma care, and the importance of relentless self-evaluation in medical practice. Discover how London's focused approach can provide broader lessons for trauma care and the potential for innovative treatments to become more widespread. Look out for more podcasts from Trauma 2030 over the coming weeks, where we will talk about team leadership in pre-hospital teams, more on damage-control pre-hospital care, nuancing the management of traumatic cardiac arrest, the increasing use of ECMO, and the shocked trauma patient. The Institute of Pre-Hospital Care The Institute of Pre-Hospital Care is part of London's Air Ambulance Charity, focused on advancing pre-hospital care. They train clinicians, use case studies to guide our priorities, develop new clinical interventions and conduct research. They are also proud to educate and inspire the next generation of pre-hospital care experts through our two degree programmes, co-convened with Queen Mary University London (QMUL). Through the training and education of The Institute of Pre-Hospital Care, they ensure their unique team of doctors and paramedics are there for London, today, tomorrow, always. Listen on MedPod Learn MedPod Learn is a new app that turns medical podcasts into structured learning. Alongside the audio, you get concise learning points, exam-style MCQs, and short reflection prompts — with listening time and activity logged automatically for CPD and appraisal. If you already learn through podcasts, this is a way to make that learning count. Available now on iOS and Android.

Kurt Bramer from Advanced CPR Solutions comes back for a final look at Head-Up CPR as we pull all the pieces from the earlier four episodes together. Dr. Joe Holley is back to bring in the latest research into the process as well. We will tie all this back to the global health disaster that is sudden cardiac arrest. Recent research from across the emergency medical community has pointed to impressive improvements in both return of spontaneous circulation (ROSC) as well as survival to discharge and neurologically intact survival when compared to conventional supine CPR performance. We’ll have links below to some of those studies and papers. Research Bibliography for Head-Up CPR Studies The episode is co-hosted again by our regular hosts, Sam Bradley and Jamie Davis. Elevated CPR Series Episode One Elevated CPR Series Episode Two Elevated CPR Series Episode Three Elevated CPR Series Episode Four CARES Registry for Cardiac Arrest Stats Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Head-Up CPR Research Update Jamie and Sam discussed the upcoming podcast episode, which will focus on wrapping up the last four episodes about head-up CPR and recent research. They mentioned the challenges of implementing new approaches in rural systems with volunteer staff. Sam noted that Dr. Joe and Kurt Bramer have been working on presenting the information in a way that can be applied responsibly. Joe briefly mentioned that SENA teams were activated to assist with floods in Seattle. The main focus of the episode will be on the latest data on head-up CPR, including improved physiology, survival rates, and neurological function, particularly for non-shockable rhythms like asystole. Advantages of Head-Up CPR Studies Sam, Kurt, and Joe discussed the significance of two seminal studies on head-up CPR. The 2016 preclinical animal study showed significant improvement in perfusion when compared to standard CPR, with a synergistic effect when using additional devices like the ITD and suction cup. The 2022 independent registry analysis demonstrated that head-up CPR resulted in a five times greater likelihood of neurologically intact survival compared to conventional CPR, even up to 20 minutes post-cardiac arrest. Joe explained that the bundled care approach for cardiac arrest patients involves multiple components, including appropriate ventilation, high-quality CPR, and post-resuscitation care, all of which contribute to improved outcomes. Bystander CPR System Implementation The discussion focused on the importance of proper implementation of bystander CPR, AEDs, and advanced techniques like impedance threshold devices and suction cup CPR to improve patient outcomes, particularly neurologic ones. Kurt emphasized the need for a system-wide approach, from first responders to hospital care, highlighting successful partnerships like Louisville’s, where continuity of care is prioritized. Jamie inquired about best practices for implementing this system-wide approach, to which Kurt responded with examples from different regions, noting that while ideal partnerships exist, proactive agencies can still achieve good outcomes even with less supportive hospitals. Cardiac Arrest Resuscitation Bundle Implementation The team discussed the importance of addressing multiple aspects of cardiac arrest resuscitation simultaneously, as highlighted by Joe, who emphasized that successful outcomes require implementing all elements of the care bundle equally. Jamie inquired about training approaches, to which Joe responded that effective training involves both initial instruction and ongoing feedback through quality improvement processes, stressing that successful resuscitations require adherence to the entire bundle rather than just some components. Prioritizing Tasks in Resuscitation Joe and Kurt discussed the importance of prioritizing tasks during resuscitation, emphasizing the need to focus on the overall process rather than individual steps. They highlighted the benefits of the Head-Up CPR model, which organizes priorities and reduces chaos during medical emergencies. Kurt explained that this method allows for more efficient and coordinated delivery of therapies, leading to better patient outcomes. Head-Up CPR Survival Benefits The group discussed two significant studies on CPR techniques. Kurt presented findings from a 2023 preclinical study showing that early administration of head-up CPR resulted in a 40% 24-hour survival rate compared to 9% for delayed conventional CPR. Joe highlighted an observational study from 2024 showing that head-up CPR improved survival rates for non-shockable rhythms from 2.8% to 7.6%, representing a nearly 3-fold improvement. Both studies suggested that head-up CPR could significantly enhance survival chances, particularly when administered early. Non-Perfusible Rhythm Blood Flow Method The group discussed a new methodology for perfusing patients with non-perfusible rhythms, which allows for continued blood flow and preserves neurological status. Joe explained that this could open up windows for interventions like ECMO or cardiac catheterization while CPR is underway. Kurt shared anecdotal evidence from agencies that have gained confidence in staying longer during arrests, leading to increased rates of ROSC in non-shockable rhythms. The group also touched on the importance of proper ventilation during CPR, with Joe highlighting the lack of focus on this aspect in many clinical trials. Head-Up CPR Survival Benefits Joe explained the concept of pressure-volume loops in CPR, demonstrating that head-up CPR generates greater blood flow and pressures compared to standard CPR. Kurt presented data from two studies comparing outcomes between CARES and head-up CPR data, showing improved survival rates for head-up CPR patients over one and five-year periods. The research suggests that head-up CPR may lead to better patient outcomes, though these findings were not included in the 2025 American Heart Association guidelines. Cardiac Arrest Economic Impact Discussion The group discussed the economic impact of cardiac arrests, with Kurt noting that the total cost per person in the US is approximately $4,000 annually, highlighting the need for improved resuscitation techniques. Jamie emphasized the importance of community contributions from survivors, while Joe provided recommendations for enhancing CPR quality, including the use of the Lucas 3.1 device with its enhanced lift feature and avoiding overly tight cervical collars during CPR to maintain blood flow. Improving Sudden Cardiac Arrest Response The meeting focused on sudden cardiac arrest, emphasizing its global impact as a leading cause of death. Kurt and Joe discussed the need for first response agencies and emergency managers to explore research and improve care delivery to enhance patient survivability. Joe highlighted the importance of understanding the physiology of cardiac arrest and considering new approaches, as current CPR methods have not changed in 50 years. Jamie suggested applying disaster management strategies to sudden cardiac arrest to improve outcomes. Joe mentioned upcoming procedural cadaver labs and ongoing work on superglottic studies and new airway management tools. Kurt provided contact information for further discussions and was invited to return for future updates on research. Podcast Series Conclusion and Future Plans The group discussed the conclusion of a podcast series on medical topics, with Kurt expressing gratitude for the opportunity to share his message and Jamie inviting him back for future episodes. They agreed to continue the conversation on social media and the Disaster Podcast website, with Kurt planning to draft questions for potential CEU credits. The group the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group. Catch the full episode using the player above or on your favorite podcast platform, and don't forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

Join Mawi and Shelly for a discussion on how people are presenting with groin injuries, an update to the previously discussed case that progressed to ECMO, a rock and a hard place with a cerebral ischemic event in a patient with a recent shoulder surgery, and a patient with percretia to bilateral iliac vessels. 

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

Dr. Catherine Allan, Director of the Cardiac Care Unit and Inpatient Cardiology at the Cleveland Clinic joins us to talk about readiness for teams to perform pediatric ECMO, a high-risk, high-complexity therapy that staff might only see a third as often as they see patients on ventilators. ECMO can also be called for during CPR, which greatly increases the time pressure and complexity of the procedure. During ECPR, there is not only the ICU resuscitation microteam but also the surgical team and the perfusion team, leading to potentially having up to 20 people working in the room when running an ECPR case. We discuss how leaders can help connect seemingly imposed efforts like checklists and huddles to what it is that frontline workers are trying to achieve and are meaningful to them, and how simulation program designers must do the same in order to make sure that training is not a top-down checklist but rather a mutually owned process that gets teams where they believe they need to go. Host & Co-Producer: Chris Roussin, PhD, Senior Director, CMS-ALPS (https://harvardmedsim.org/chris-roussin/) Producer: James Lipshaw, MFA, EdM, Assistant Director, Media (https://harvardmedsim.org/james-lipshaw/) Consulting and readiness with CMS-ALPS: https://harvardmedsim.org/alps-applied-learning-for-performance-and-safety Dare to Be Ready on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP Dare to Be Ready on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Anterior mediastinal masses make even seasoned anesthesiologists pause, and for good reason: a stable, upright patient can decompensate with a single change in position or a single dose of the wrong drug. We walk through a clear, stepwise approach that starts with anatomy and symptom red flags, then translates imaging, echocardiography, and pulmonary function testing into real-world decisions at the bedside. The focus stays practical: how to pick the safest setting, when to avoid general anesthesia, and what to prepare before anyone touches the airway.We break down adult and pediatric risk criteria, including mass-to-chest ratio, degree of tracheal compression, SVC obstruction, pericardial effusion, and standardized tumor volume in children. From there, we outline sedation-first strategies using ketamine, dexmedetomidine, and carefully titrated remifentanil to preserve spontaneous ventilation and avoid precipitous loss of tone. For patients who truly need general anesthesia, we share an OR playbook: lower-extremity access when SVC flow is threatened, semi-upright preoxygenation, slow induction while maintaining spontaneous ventilation, awake intubation options, and selective use of short-acting agents to test tolerance of positive pressure.Ventilation choices can make or break the case. We explain why long expiratory times and low respiratory rates reduce air trapping and auto-PEEP, and how fiberoptic bronchoscopy can guide tube position, predict extubation risk, and inform postoperative support. Rescue pathways are explicit: repositioning and CPAP, mechanical stenting with an endotracheal tube or rigid bronchoscope, rapid escalation to airway stents, and ECMO when distal collapse or cardiovascular compromise persists. We also spell out who needs ICU monitoring after surgery and why the safest path often means doing less.If this topic raises your heart rate, you're not alone. Tune in to sharpen your plan, align your team, and build a safer pathway from preop to postop for both adults and kids. Subscribe, share with your OR team, and leave a review with your best tip for managing high-risk mediastinal masses.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/283-how-to-plan-induce-and-recover-patients-with-anterior-mediastinal-mass-without-triggering-collapse/© 2025, The Anesthesia Patient Safety Foundation

What happens when life depends on perfect coordination between human and machine? In this episode, Thomas Preston — a veteran ECMO expert and executive leader at Integration Health — joins us to explore the high-stakes world of ECMO (extracorporeal membrane oxygenation) and the complex teamwork it demands.

How do we measure what truly matters in acute care — and why does it finally feel possible to do it well? In this week's episode, co-hosts Dr. Nicole Neveau and Dr. Leo Arguelles sit down with Dr. Caitlyn Crandall and Dr. Lindsey Fresenko, two contributors to the new clinical practice guideline, “A Core Set of Outcome Measures to Assess Physical Function for Adults Participating in Physical Therapist Treatment in the Hospital.” Together, they unpack how this Core Outcome Measures (COMs) Set was built, what makes each measure clinically feasible, and how the guideline is already reshaping evaluation, communication, and discharge planning across hospital-based physical therapy. Caitlyn and Lindsey share what surprised them during development, how psychometric rigor and real-world feasibility shaped the final set, and why standardized measurement doesn't replace clinical reasoning — it strengthens it. They also preview their upcoming APTA Acute Care webinar and reflect on how a shared measurement language can help clinicians advocate for staffing, demonstrate value, and elevate patient care. Whether you're an ICU therapist, med-surg clinician, educator, or student, this conversation offers a clearer, more confident path for integrating outcome measures in acute care. Today's Guests: Dr. Caitlyn Crandall, PT, DPT, CCS, RYT Email: caitlyn.crandall@unchealth.unc.edu LinkedIn: https://www.linkedin.com/in/caitlyn-crandall-dpt Instagram: @CaitlynCrandall   Dr. Lindsey Fresenko, PT, DPT, PhD Email: lindsey.fresenko@utoledo.edu Publications: • PTJ CPG: https://academic.oup.com/ptj/article/105/6/pzaf076/8140951 • CC&E Journal: https://journals.lww.com/ccejournal/fulltext/2024/12000/rehabilitation_and_social_determinants_of_health.8.aspx Guest Quotes: Caitlyn: “These outcome measures aren't meant to replace clinical decision-making — they're meant to support it.” Lindsey: “The importance of having an evidence-based core outcome measure set is now utilizing it in practice.” Caitlyn: “Parts of these outcome measures are already what we're doing. The COMs help organize and standardize it.” Rapid Responses: What's the dumbest way you've injured yourself? • Caitlyn: “I fell off my horse — he stopped, I kept going.” • Lindsey: “I stepped on my own pinky toe in middle school and broke it.” You know you work in acute care when… • Caitlyn: “You've led a parade down the hallway with ECMO, an IABP, and half the team following behind.” • Lindsey: “Carrying socks in your pocket is an everyday thing.” Links: A Core Set of Outcome Measures to Assess Physical Function for Adults Participating in Physical Therapist Treatment in the Hospital- https://pubmed.ncbi.nlm.nih.gov/40403754/

The Silent Rise of Chronic Pulmonary Embolism and the Tech That's Changing Everything From portable ECMO to catheter breakthroughs, the treatment of pulmonary embolism has come a long way. Dr. Richard Channick takes us behind the scenes of cutting-edge interventions and shares the empowering truth: even community hospitals now have lifelines to expert centers. The care you need might be closer than you think. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com #phawareMD #CTEPH @rchannick @UCLAHealth  

Join us for an “In The Know” special edition where our experts discuss the Neonatal ECMO Program at Children's Health and how it's providing lifesaving support to the smallest patients.  Learn more about Dr. Gillory.  Learn more about Dr. Makkar.

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

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Zara Shirazi, a congenital cardiac surgery post-fellow at the National Institute of Cardiovascular Diseases, about advancing pediatric cardiac surgery in Pakistan using what she learned from her fellowship in Austria. Chapters 00:00 Intro 02:28 Vince TAVR Roundtables 03:05 Foreign Body, Case of the Month 03:49 JANS 1, Temporary MCS Guidelines 13:50 JANS 2, Parenting as a CT Surgeon 16:20 JANS 3, Utilization of Long Distance Donors 18:20 JANS 5, Multi-A Grafting in Redo CABG 20:58 Career Center 21:20 Video 1, Pulm & Tricuspid Endocarditis 22:35 Video 2, Valvular Heart Disease Guidelines 27:05 Video 3, Thoraflex Hybrid Graft Insertion 28:16 Zara Shirazi Interview 39:30 Upcoming Events 42:42 Closing They explored the advantages of working in a hospital in Pakistan compared to Austria, as well as the different techniques and operations, such as extracorporeal membrane oxygenation (ECMO). Dr. Shirazi also shared her experiences as a fellow in Austria and the valuable insights she gained from that experience. Additionally, she discussed her vision for the growth of her unit over the next five years and provided an overview of what a typical surgical week looks like in Pakistan.   Joel also highlights recent JANS articles on the EACTS/STS/AATS guidelines on temporary mechanical circulatory support in adult cardiac surgery, the unique challenges and positive impacts on children raised by cardiothoracic surgeon mothers, evolving changes in center-level utilization of longer distance donors in heart transplantation, and multiarterial grafting in redo coronary artery bypass grafting.  In addition, Joel explores pulmonary and tricuspid valve endocarditis, an interview with Drs. Borger and Marin-Cuartas on the guidelines for the management of valvular heart disease, and Thoraflex Hybrid graft insertion in a patient with Marfan syndrome. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery   2.) Parenting From the OR: The Unique Challenges and Positive Impacts on Children Raised by Cardiothoracic Surgeon Mothers  3.) Evolving Changes in Centre-Level Utilization of Longer Distance Donors in Heart Transplantation  4.) Multiarterial Grafting in Redo Coronary Artery Bypass Grafting: Type of Arterial Conduit and Patient Sex Determine Benefit  CTSNet Content Mentioned  1.) Pulmonary and Tricuspid Valve Endocarditis: A Late Sequelae of Unrepaired Double Chambered Right Ventricle in an Adult  2.) Guidelines for the Management of Valvular Heart Disease: An Interview With Drs. Borger and Marin-Cuartas  3.) Thoraflex Hybrid Graft Insertion in a Patient With Marfan Syndrome  Other Items Mentioned  1.) Adapting Global Innovations to Local Realities: Advancing Pediatric Cardiac Surgery in Pakistan—Lessons From Austria  2.) Roundtable: Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani   3.) Case of the Month: The Case of a Foreign Body  4.) Resident Video Competition  5.) The Cardiac Recovery Room  6.) Career Center   7.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

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

Kristen Pyrc, M.D. and Wini King welcome a truly inspiring mother-daughter duo to Raising Joy: Emerson Bucci and her mother, Ashlee. In an episode that celebrates the power of the human spirit, they share Emerson's incredible journey of survival and recovery.In August 2024, at just 12 years old, Emerson faced a very rare and life-threatening allergic reaction to the common antibiotic Bactrim. Her lungs were severely compromised, leading to a 36-day stay in the ICU at Cook Children's and being placed on ECMO life support.Tune in to hear:·         The terrifying process of searching for a diagnosis, the family's emergency transfer, and the very real possibility of a lung transplant.·         How Emerson, despite being on life support, remained fully awake and even did schoolwork.·         The inspiring story behind Emerson's life-affirming catchphrase, "I got this," which became the family's mantra and even inspired a special tattoo.·         Emerson's deep faith and remarkable maturity in viewing her ordeal as "temporary".·         How this experience has inspired Emerson to pursue a future career as a physical therapist to help others walk their own road to recovery.This conversation is a powerful testimony to family love, perseverance, and the miracle of hope.

Send us a textIn this CHNC 2025 episode, The Incubator speaks with Dr. Sandy John (Seattle Children's) and Dr. Kelsey Montgomery (Riley Children's Hospital) about the collaborative work of the CDH Focus Group within the consortium. They discuss a national effort to evaluate bivalirudin versus heparin for ECMO anticoagulation in infants with congenital diaphragmatic hernia—a shift driven by promising anecdotal evidence but lacking robust data. Through shared cases, systematic review, and consensus guideline development, the group aims to unify practice and elevate research quality. The conversation highlights how real-time collaboration accelerates learning, improves care consistency, and fosters innovation across Level IV NICUs nationwide.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textWhat does it take to learn to sit again, then stand, then chase the horizon at the Ironman World Championship? We sit down with endurance athlete and keynote speaker Elmar Sprink to trace the steps from sudden cardiac arrest and seven months on ECMO to a disciplined, data‑driven comeback fueled by routine, empathy, and stubborn hope. Elmar opens up about the invisible work of recovery—why he treated hospital life like a training plan, how a visitor spreadsheet kept his spirits up, and the role therapy and humor played when the outcome was uncertain.We unpack the nuts and bolts of training after a heart transplant: threshold testing to set safe zones, the difference denervated hearts can make to heart rate response, and why indoor cycling and carefully staged swim returns protect against infection while rebuilding fitness. Elmar explains how steady training lowered his blood pressure and reduced medications, and he shares the small, daily wins—like a perfect cappuccino—that kept his motivation alive. Along the way, he reflects on gratitude for his unknown donor and the ritual of honoring that gift at every finish line.Anna also spotlights creative sparks and community momentum: new children's stories in the Living with CHD series that portray everyday family life with honesty, plus highlights from the SV-ONE conference where scientists, clinicians, and advocates collaborate for single ventricle care. We share upcoming inclusion goals, from an ASL episode to a new German episode featuring Elmar, and we talk candidly about organ donation advocacy—what messaging moves people, and how real stories can shift culture and save lives.If you're navigating CHD, recovery, or any long road back, this conversation offers a clear playbook: start small, be consistent, protect your body, lean on your people, and celebrate the quiet victories. Subscribe, share this episode with someone who needs a lift, and leave a review with your biggest takeaway—we'd love to hear what small win you're chasing this week.Support the showAnna's Buzzsprout Affiliate LinkBaby Blue Sound CollectiveSocial Media Pages:Apple PodcastsFacebookInstagramMeWeTwitterYouTubeWebsite

Title:  “The Ripple Effect: Maggie Luken's Journey of Loss, Love, and Life”  

In this 320th episdode I welcome Drs. Essandoh and Cody back to the show to discuss the latest data and guidelines around the use of the Impella device and how it compares to IABP and ECMO.Our Sponsors:* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor and use my code accrac50off for a great deal: https://www.factor75.com* Check out Truelearn: https://tinyurl.com/ACCRACTL* Check out Uncommon Goods: https://uncommongoods.com/ACCRACAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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 of The Pulling Curls Podcast, hosts Hilary Erickson and Dr. Janene Fuerch, a neonatologist at Stanford, dive into what every pregnant family should know about the NICU (Neonatal Intensive Care Unit). They discuss why it's important to understand NICU basics—even if you're planning a smooth delivery—and share practical tips on how to cope if your baby needs extra care, including ways to stay connected, manage stress, and support bonding. The episode also highlights exciting innovations aimed at making NICU stays safer and more comfortable for babies and families, plus insights on hospital levels and advocacy for neonatal advancements.   Big thanks to our sponsor Laborie -- LifeBubble® Umbilical Catheter Securement System LifeBubble is made of a Soft Medical Grade Silicone to minimize skin irritation, Reduces the Risk of Catheter Migration and Early Discontinuation, and Protects the Insertion Site of our most vulnerable patients. Find them on Instagram @laborie_ob Today's guest is Janene Fuerch, MD. She is a Clinical Associate Professor of Pediatrics, Division of Neonatal and Developmental Medicine, Associate Director of the Biodesign Innovation Fellowship Program at Stanford University, and Co-Director of Impact1 where she mentors and advises entrepreneurs in the pediatric and maternal space through all aspects of medical device development, from identifying clinical needs to commercialization. Her specific areas of investigational interest include the development and commercialization process of neonatal, pediatric and maternal health medical devices. She is a national leader in neonatal resuscitation, ECMO, device development and has been an AHRQ, FDA and NSF funded investigator. But her work extends outside of the academic realm to industry having co-founded EMME (acquired by Simple Health 2022) an award-winning reproductive health company, medical director for Novonate (acquired by Laborie 2023) a neonatal umbilical catheter securement company and notable consultant for Vitara (EXTEND - artificial environment to decrease complications of prematurity), Laborie, Ceribell, Novocuff and Avanos™. Janene is passionate about improving the health of children and newborns through medical device innovation and research. Links for you: Previous Laborie Episode on Forceps (260) Timestamps: 00:00 NICU Challenges: Bonding & Separation 06:55 Choosing the Right Hospital Level 09:47 Bonding with Baby After Separation 14:06 NICU Innovation: Challenges and Opportunities 15:14 Umbilical Catheter Infection Solution 18:17 NICU Bonding and Communication Tips 21:59 Premature Baby Care Innovations 25:04 Prioritizing Investment in Children's Future Keypoints: Many families are surprised when their baby needs to go to the NICU, so it's important for all pregnant families to know some basics about what to expect. The NICU can range from having just a couple of extra staff in the delivery room to having 15 people if a baby needs help, making the birth experience much more intense and involved. Planning ahead with your partner about who will go with the baby in case of separation can help make a stressful situation a little easier. About 10% of babies need some help breathing at birth, but most recover quickly; only a small percentage require NICU care beyond the basic interventions. NICUs are graded by levels (I-IV), and knowing what level your hospital offers can help families prepare—higher-level NICUs can treat more complex issues but aren't always necessary for uncomplicated births. If your hospital isn't a level III or IV, babies needing higher-level care may need to be transferred, which could mean temporary separation from parents; hospitals always work to reunite families as quickly as possible. NICU nurses are passionate, skilled, and deeply care about the babies and their families, creating a loving and safe environment even during stressful times. Parents can support their recovery and milk production by getting rest and using NICU technologies (like webcams) to stay connected—it's okay to take breaks and trust the NICU staff. Emerging technologies like Labry's Life Bubble are making NICU stays safer and more comfortable, allowing parents to hold their babies even when special catheters are in place. Skin-to-skin contact in the NICU is highly beneficial for both babies and parents, helping with bonding, milk production, and even neurodevelopment; parents are encouraged to ask staff about timing and any concerns about wires or tubes. Producer: Drew Erickson Keywords: NICU, neonatal intensive care unit, premature babies, neonatologist, types of NICU levels, level 1 NICU, level 2 NICU, level 3 NICU, level 4 NICU, hospital delivery, separation from baby, bonding with baby, skin-to-skin contact, umbilical catheters, infection prevention, NICU innovations, Labry, Life Bubble, technology in NICU, neonatal health, maternal health, NICU nurses, milk production, pumping breast milk, trauma of NICU stays, baby monitoring, necrotizing enterocolitis, artificial womb therapy, premature birth complications, hospital transfer, parental tips for NICU, emotional impact of NICU  

Today we are exploring cardiac surgery in elderly patients.This podcast is sponsored by Macquarie University Hospital, part of Macquarie University Health – a trailblazer in healthcare, education and research.Professor Michael Vallely is a leading cardiothoracic surgeon who has clinical and academic interests in minimising the invasiveness of cardiothoracic surgery and is a world authority on total arterial, anaortic, off-pump coronary artery bypass surgery. He also has interests in minimally invasive cardiac surgery (MICS and Da Vinci robotic surgery), transcatheter (TAVI and Mitra-Clip) cardiac surgery, thoracic aortic surgery, geriatric cardiac surgery, and hybrid procedures including the use of ECMO.Dr Nargis Shaheen is a consultant geriatrician with a special interest in perioperative medicine working at Macquarie University Hospital and Concord Hospital. She is a member of the ANZCA perioperative care working group and is involved in perioperative medicine teaching.

Maternal safety changes when we stop relying on heroics and start building systems. We open the door to the 2025 APSF Stolting Conference series with a fast, practical tour of what truly reduces morbidity and mortality: collaboration across anesthesia, obstetrics, cardiology, and nursing; open‑source AIM bundles; early warning tools; and standards that compress time-to-treatment when minutes matter. Along the way, we confront the three deadly D's—denial, delay, dismissal—and replace them with teamwork, tools, timeliness, and trust.We dig into the history that got us here, from case reports and confidential inquiries to robust maternal mortality review committees and rapid-cycle data that power real change. Then, we zero in on the leading cause of pregnancy-related death—cardiovascular disease—and why risk spikes in the postpartum period. A vivid case of peripartum cardiomyopathy shows how quickly decompensation unfolds and why anesthesia must be in the room early: shaping plans, managing hemodynamics, placing monitors, coordinating with cardiology and OB, and, when needed, activating ECMO. We highlight actionable steps like antenatal anesthesia consults for high‑risk patients, postpartum telemetry monitoring, and pregnancy heart teams that make escalation the rule, not the exception.Progress is real for hemorrhage and hypertension, but disparities remain stark for Black, Hispanic, and Asian Pacific Islander patients. We talk about implicit bias, access, and respectful care, and we share multilingual urgent maternal warning signs so patients and clinicians recognize danger sooner. The ASA's recommendations give a clear roadmap for anesthesiologist leadership—on review committees, quality teams, simulation programs, and implementation of SOAP and ACOG frameworks—so that safety becomes predictable.If this conversation sparks ideas for your unit, we'd love to hear them. Subscribe, share with a colleague who works on labor and delivery, and leave a review telling us the one system change you'll champion this month.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/276-maternal-care-transformed/© 2025, The Anesthesia Patient Safety Foundation

Whether you are a thoracic surgeon and you are going to break through the ceiling on survival for mesothelioma, an adult cardiac surgeon tackling structural valve deterioration, or a community cardiothoracic surgeon improving outcomes for ECMO patients, identifying and building a niche is exciting and rewarding. In this blog article, hear from Dr. Brian Bateson on how you can successfully build a niche with care, passion, and understanding.

Show NotesIn this special live episode from the 2025 North American Congress of Clinical Toxicology (NACCT), Ryan takes you inside the conference to hear directly from the researchers themselves. Covering 11 abstracts that span high-stakes management decisions, surprising case reports, and challenges to toxicology dogma, this year's highlights feature everything from amlodipine overdoses to naturopathic misadventures, metformin-associated blindness, and more. The show kicks off with a foreword from Ryan and Dr. Jon Cole (abstract co-chair for AACT) discussing some of their favorite research from the conference. If you couldn't make it to NACCT or just want to catch up on some of the most impactful new research in our field, this episode will give you a front-row seat. Check below for links to the published abstracts, the full list of studies discussed, and timestamps for where you can hear each one.Link to published abstract manuscriptForeword with Dr. Jon Cole 10:24 #7. Is beta blocker toxicity associated with hypoglycemia?Lead author: Dr. Megan Audette, MD17:58 #237. V-A ECMO as a treatment for vasoplegic shock in amlodipine poisoning: a comparisonLead author: Dr. Daniel Tirado, MD27:59 #247. Blocked but not beaten: ECMO's role in severe amlodipine toxicity – a poison center case seriesLead author: Dr. Carlos Saldarriaga, MD28:39 #26. Amlodipine double-dose therapeutic errors reported to Poison CentersLead author: Johanne Freeman30:19 #27. Dosing on the edge: unpacking inadvertent amlodipine ingestions reported to a single poison centerLead author: Dr. Tiana Patriarca, PharmD33:44 #292. Intravenous administration of sodium zirconium cyclosilicate resulting in deathLead author: Dr. Stephen Thornton, MD Researcher interviews43:57 – #21. Quantitative analysis of amlodipine removal by plasmapheresisGuest: Dr. Keahi Horowitz, MD – Acute and Intensive Care Research Award winner48:14 – #23. Relationship between reported ingestion dose and outcome in amlodipine poisoningGuest: Dr. Colleen Cowdery, MD51:18 – #24. Management of severe amlodipine toxicity with high-dose calcium aloneGuest: Dr. Vincent Ma, MDHigh dose norepinephrine in amlodipine overdose Case report of calcium death 56:37 – #70. Iatrogenic exposure to long-acting buprenorphine injectable in an opioid-naïve patientGuest: Dr. Conor Young, MD59:52– #182. Left in the dark: a case of blindness in the setting of metformin toxicityGuest: Dr. Madison Bombard, MD61:52 – #169. Just because it's natural doesn't mean it's safe: a case of pediatric toxicity from topical and herbal remediesGuest: Dr. Aria Darling, MD64:12 – #203. Serotonin syndrome after vaping MoocahGuest: Dr. Connor Murphy, MD66:47 – #307. Intravenous ozone autohemotherapy: a retrospective observational case seriesGuest: Nicole McLarty 71:06 – #134. Do they really need n-acetylcysteine? Exploratory analysis of outcomes in patients with elevated liver function

Could hospital employment be your path to practicing 100% interventional radiology (IR)? In this episode of BackTable, host Dr. Ally Baheti sits down with Dr. Ryan Trojan, an interventional radiologist at INTEGRIS Health in Oklahoma City, to discuss the pros and cons of hospital employment contracts in IR.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISThe physicians take a deep dive into the evolving employment models in the IR landscape. Dr. Trojan shares his journey from a private IR-DR blended practice to becoming directly employed by a hospital, highlighting the financial challenges, contract negotiations, and administrative dynamics along the way. He explains the growing loss of IR talent to lucrative diagnostic contracts and emphasizes the importance of advocating for IR's value to hospital systems, from decreasing length of stay to supporting ECMO, trauma, and transplant services. The discussion covers financial security, administrative support, and the benefits of having aligned goals with the hospital in order to grow an IR practice. Dr. Trojan also addresses common misconceptions about IR and private practice, detailing how the landscape is likely to change over the coming years, and offers advice on navigating employment contracts. ---TIMESTAMPS00:00 - Introduction03:02 - Transition to Hospital Employment12:15 - Advocating for IR's Value16:07 - Contract Structures and Compensation Models25:07 - Benefits and Downsides of the Employed Model28:27 - Negotiating Contracts and Fair Market Value41:12 - Conclusion---RESOURCESDr. Trojan's contact information:ryan.trojan@integrishealth.org

In this reposted episode, Courtney shares her journey of receiving her daughter Annie's Trisomy 21 diagnosis, navigating the NICU, and walking through open-heart surgery complicated by pulmonary hypertension. She talks about the power of community, the unexpected strength she discovered in herself, and how vulnerability and advocacy have shaped her motherhood. Courtney reminds us that love, connection, and collective wisdom can carry families through the hardest seasons while celebrating Annie's resilient and joyful spirit. Resources mentioned in this episode: Annie Louise Foundation – A resource hub for parents and caregivers Follow Courtney on Instagram Read Courtney's most recent blog post about how the Annie Louise Foundation helped with Central Texas Flood relief in Kerrville, TX

Thank you for tuning in to Episode 303 of the Down Cellar Studio Podcast. Full show notes with photos can be found on my website. This week's segments included:   Off the Needles, Hook or Bobbins On the Needles, Hook or Bobbins From the Armchair Knitting in Passing In my Travels KAL News Ask Me Anything On a Happy Note Quote of the Week   Off the Needles, Hook or Bobbins   Gabriella's Unicorn Pattern: Shy Little Unicorn by Ana Paula Rimoli Hook: C (2.75 mm) Yarn: Red Heart Super Saver (white), Knit Picks Brava Worsted (cotton candy & various solids) Ravelry Project Page Total for Stash Dash: 116 meters   Sum-Sum-Summertime socks Yarn: Woolens & Nosh SW Targhee Sock in the colorway Sum-Sum-Summertime Pattern: OMG Heel Socks by Megan Williams ($5 knitting pattern available on Ravelry) Needles: US 1.5 (2.5 mm) Ravelry Project Page About the Colorway- thinner stripes- 2 colors of aqua, lime green, pink and an orange/peachy yellow. CC mini in lime Total for Stash Dash: 293.3 meters   Stash Dash Total for this episode: 8,715.2 meters   On the Needles, Hook or Bobbins   Hot pink spinning Fiber: Mountain Vewe Coopworths Fiber in hot pink (no specific colorway name)- three 4oz bumps Ravelry Project Page Twist direction: singles = Z plied = S This means when I'm spinning, my wheel is spinning clockwise and when plying my wheel is moving counter-clockwise. Progress: ~1/2 way through first bump. 1st bobbin full and the second is started I've now spun in July and August so I've only missed 2 months so far this year.   Log Cabin Blanket Pattern: Log Cabin Square by Julie Harrison. Free crochet pattern available on Ravelry. Video tutorial available on the Little Woollie Makes YouTube Channel Yarn: Legacy Fiber Artz Minis (mostly from Advent calendars 2023 & 2024) Hook: I (5.5 mm) Ravelry Project Page Inspired by Rachel (treehousefiberarts on Instagram) and Sue & Chelsea (Legacy Fiber Artz on Instagram). Check out the Floss Toss Ravelry Group for details on their Scrappy Blanket CAL. Ends December 21st (but you don't have to finish. 2 prize drawings will be done). My color placement is inspired by this project/pattern available on Ravelry.     From the Armchair   Famous Last Words by Gillian McAllister. Amazon Affiliate Link. My Friends by Fredrik Backman. Amazon Affiliate Link.   Note: Some links are listed as Amazon Affiliate Links. If you click those, please know that I am an Amazon Associate and I earn money from qualifying purchases.   Knitting in Passing   I shared a story about a little girl in the nail salon who asked her mom if they could come talk to me because she wants to learn to knit.   In My Travels Travel packing tips Packing cubes- here's an Amazon affiliate link to the set I purchased 6 years ago and still love! I always pack some clothes pins/ metal or wood that I use for snacks/drink mix pouches and/or to keep curtains closed in hotel. I have a standard packing list in Evernote that I customize for each trip. It saves so much time and frustration. Pack a travel power strip- to keep all of those chraging cords in one place (also less likely to leave one behind) Knitting project approach At least 2 socks/stockinette hats for waiting, sitting etc. A project that occupies my brain and makes a long flight go by easier. Queue the audiobooks & download podcasts   KAL News   Splash Pad Final Winners were announced!   Pigskin Party '25 Sponsor Sign Up is Open- click here for details Key Dates: Registration starting Thursday August 20, 2025 KAL Starts- Thursday September 4, 2025 KAL Ends- Monday February 9, 2026 Form Teams- starting Monday August 25, 2025 Virtual Kick Off- Friday September 5 & Saturday September 6   Ask Me Anything   Tune in to hear the answers to these questions: Pat- loonyhiker asked: I know you have probably told this before, but I'd love to hear how you and your honey met. I also would love to hear how your parents met. (bonus audio of my parents talking about this by the pool in 2017) Sandy, sjh801 asked:  Favorite children's book? Both as a child and now as an adult. Children's Book (purely for sentimental reasons): Walk Rabbit Walk by Colin McNaughton. Amazon Affiliate Link. Hardcover available for ~$20 & paperback for around $7 Adult book: Pillars of the Earth by Ken Follett. Amazon Affiliate Link.John Lee does the audiobooks for what is now this series of books. Book 1 of 5 now in this series. I love them all. Dianne, woohoogirl asks: Do you have a Dream project that you'd really like to make that you just haven't made the time, or plans, for yet? The Traveler by Andrea Mowry ($9 knitting pattern available on Ravelry & the Drea Renee Knits website). This may be my favorite version:a handspun Traveler knit by Emily Curtis. Check out her Instagram post. Click here for a post about the handspun yarn Carrie, Gooberdawn asks: Do you have a project you have created that you feel most proud of? If so, which one and why? ETA: it doesn't have to be yarn-related. Laura, LauraKnitsPA asks: What is one book you would read over and over, and one movie you would watch over and over? Book- The Invisible Life of Addie LaRue by V.E. Schwab. Amazon Affiliate Link Movie: You've Got Mail Dani, stitchintime82-  Any updates on designing? I've enjoyed your patterns and am wondering if you have any plans to make more patterns.   On a Happy Note I was able to get my Apple watch to charge again after I thought it was dead. Oikos yogurt shake/drinks with 23g of protein. My friend Nathan had a heart and kidney transplant just over 1 year ago. He's still learning to walk again after ECMO caused major nerve damage in his legs- and we just went to see the musical he directed. Sometimes this world feels so dark right now but this made me incredibly happy. The night we had tickets for the show, we lost power, so we made it a full date night and went for dinner too. A visit from my cousin Gayle. We enjoyed a great pool day on Sunday and dinner in our town Monday night followed by a walk along the harbor. Gayle chose Mom's Trickle shawl as the item she wanted of hers. I took a photo of her and Google photos turned it into a pop-out. Trickle Shawl- Ravelry | LoveCrafts I gifted Gayle the pair of Stranger Things 2 socks from DVD as an early birthday gift and she sent me a cute photo of her wearing them the next morning. Great customer service from an Etsy maker to order pins. I had fun putting together photos Millie, Teaghan and Rhiannon asked me to take a couple weekends ago at the pool of them jumping off the diving board and making their bodies into the shape of the letters of the alphabet. Fun memories!   Quote of the Week “It's not hotels and nightclubs I crave, or even spectacular beaches -- it's isolation and solitude, time away from the human world and a chance to measure life on a different kind of yardstick.” ― Peter S. Adler   ------ Thank you for tuning in. Remember show notes for this episode can be found at www.downcellarstudio.com/# If you have a moment to leave a review on Apple Podcasts, I'd greatly appreciate it. I can be found on Ravelry as BostonJen and I'd love it if you came over to join our lively and engaged Down Cellar Studio Ravelry Group. Check me out on Instagram at BostonJen1 if you want to see what I'm up to between episodes. Check out my Down Cellar Studio YouTube Channel Email me at downcellarstudio@gmail.com   For website: Thank you for tuning in!   Contact Information: Check out the Down Cellar Studio Patreon! 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