Podcasts about ICU

Send us a textAs 2025 comes to a close, Ben and Daphna reflect on a year of growth, community, and evolution for The Incubator Podcast. In this end-of-year wrap-up, they preview major changes coming in 2026, including new standalone podcast feeds, expanded journal club content, CME opportunities, and exciting partnerships with organizations like the Vermont Oxford Network and PAS. They also share what's ahead for the Delphi Conference and offer a candid look at their personal and professional goals for the year ahead. Thank you for being part of this extraordinary neonatal community. 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!

Join Sandra for a breathtaking conversation with Heather Vandermeyden, a woman who didn't just have one Near-Death Experience—she had a series of them. At just twenty years old, Heather faced a catastrophic medical crisis (ulcerative colitis, sepsis, and organ failure) that kept her in the ICU for three months. While her body withered away to 79 pounds and endured thirteen emergency surgeries, her spirit was busy traveling beyond the veil. In this episode, Heather details the more than twenty times she popped out of her body to escape the pain. She shares vivid descriptions of the "Ancient Healing Waters" that saved her liver, a visit to a Hall of Records (the Library), and a heartwarming reunion with her deceased grandmother and great-grandfather. She also describes seeing God stand in the doorway of the hospital room—a being of pure, non-judgmental love with vibrant blue eyes. Perhaps most miraculously, Heather describes meeting two specific children on the other side. Years later, unable to carry a pregnancy due to her surgeries, she fostered and adopted two children who matched the exact description of the souls she met in Heaven. Get Heather's new book "Miracles from the Other Side" on Amazon: https://amzn.to/3Muuefn Visit Heather's website: https://www.heathervandermeyden.com *Connect with Sandra Champlain: * Website (Free book by joining the 'Insiders Club, Free empowering Sunday Gatherings with medium demonstration, Mediumship Classes & more): http://wedontdie.com *Patreon (Early access, PDF of over 790 episodes & more): Visit https://www.patreon.com/wedontdieradio  *Don't miss Sandra's #1 "Best of all things afterlife related" Podcast 'Shades of the Afterlife' at https://shadesoftheafterlife.com

Send us a textTransitioning from fellowship to your first attending job? You're probably not prepared for the business side of medicine—and that's exactly the problem Dr. Tung Giep addresses in this episode. Dr. Giep, a neonatologist with over 30 years of experience, shares hard-earned lessons from building and selling a private practice in Houston, navigating toxic work environments, and eventually finding his place in telemedicine. His new book, The Business of Medicine: The Definitive Guide to Help New Physicians Start Their Career on the Right Path and Avoid Costly Mistakes, tackles what medical training ignores: contract negotiation, non-competes, choosing the right CPA and attorney, and understanding your self-worth.Ben and Dr. Giep discuss why new physicians get blindsided by job offers, how to vet a practice properly, and the reality of community neonatology versus academic medicine. They also explore the growing role of AI in healthcare and what it means for the next generation of physicians. Whether you're finishing fellowship or reconsidering your current position, this conversation offers practical guidance on taking control of your career—and avoiding costly mistakes along the way. 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!

'twas the day after The Night Before Christmas, and all through the house, nobody really wanted to be responsible for making other people work. So I didn't. Uh... not even a mouse, or whatever. Today, we'll all take a moment to relax--whether you have reason to or not--and think back to a time when Christmas meant the impending departure of Donald Trump. A simpler time, when we didn't yet know that someone had blown a city block of Nashville sky high, on Trump's "watch." You could be forgiven for forgetting, though, since he also launched a MAGA assalut on the U.S. Capitol less than two weeks later. So, yes, please enjoy this, our December 24, 2020 episode! David Waldman, opens today's KITM yawning like the MGM lion, waking us up for Christmas eve: Donald Trump keeps handing out pardons like moist candy canes to anyone that met him under the mistletoe over the last few years. Donald pardoned Jesse Benton as a gift to his employers, Ron Paul and Mitch McConnell and the uncle of Benton's wife, Rand Paul… (Jesse will probably be Matt Gaetz' son by the end of the day.) Trump pardoned a former Maryland police officer whose heart he knew was in the right place. (They need to be arrested faster than Trump can pardon them.) Merry Christmas! Trump's Blackwater pardons aren't bringing much cheer to their victim's families, however. There's bound to be more today, but Dad's saving the nicest ones for under the tree in Mar-a-Lago. Greg Dworkin reminds us that actually, Donald Trump doesn't give gifts to anyone but himself. If he can take someone else's gift, it's even better. Merry F***ing Christmas to everyone in Congress with the Gop at each other's throats and Democrats trying to pull $2000 checks out of the fireplace. It seems that Trump might be a little over his head still on how government works, or how reality works for that matter. Kelly Loeffler, too. Two Republican House members voted by proxy — while simultaneously suing to ban the use of proxy voting . Ron DeSantis figures, why appoint experts when he can be the guy that says expert things? Rep.-elect Luke Letlow checked himself into the hospital for no particular reason, and is now thinking about checking out the ICU for the holidays. People who are immunocompromised or otherwise allow coronavirus to hang around for while might encourage unfortunate mutations. Did Bill Barr arrest Lev Parnas to keep him from testifying against Donald Trump? Did a Democratic House candidate lose by 6 votes after 22 votes were improperly excluded in Iowa? Did the Kansas City Star misreport on Black Kansas Citians for generations? Yes.

Many people experience trauma not from accidents or violence—but from medical events. ICU stays, surgery, birth trauma, or even routine procedures can leave lasting emotional wounds. In this conversation, Emma McAdam (Therapy in a Nutshell) and Christen Mullane, LMHC, unpack what medical trauma really is, how it differs from medical PTSD, and practical ways to heal. Christen explains how medical experiences can damage trust in your body and in healthcare systems, why “health anxiety” is sometimes actually trauma, and how to gently rebuild a sense of safety and empowerment. Looking for affordable online counseling? My sponsor, BetterHelp, connects you to a licensed professional from the comfort of your own home. Try it now for 10% off your first month: https://betterhelp.com/therapyinanutshell Learn more in one of my in-depth mental health courses: https://courses.therapyinanutshell.com Support my mission on Patreon: https://www.patreon.com/therapyinanutshell Sign up for my newsletter: https://www.therapyinanutshell.com Check out my favorite self-help books: https://kit.co/TherapyinaNutshell/best-self-help-books  Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health. In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger Institute for my overall understanding of our ability to choose our life's direction. And deeper than all of that, the Gospel of Jesus Christ orients my personal worldview and sense of security, peace, hope, and love https://www.churchofjesuschrist.org/comeuntochrist/believe If you are in crisis, please contact the National Suicide Prevention Hotline at https://suicidepreventionlifeline.org or 1-800-273-TALK (8255) or your local emergency services. Copyright Therapy in a Nutshell, LLC

In this episode of Unwritten, host Trevor Barreca sits down with Chase Maly to share a story marked by suffering, mercy, and unexpected hope.

Join me for a profound conversation with Camille Scott-Wiles, an ICU nurse turned financial educator who transformed personal tragedy into a mission to help everyday professionals build lasting wealth. Camille's story begins in East New York, Brooklyn, where she grew up in poverty despite having a millionaire father, creating a complex relationship with money that would shape her entire financial philosophy. Camille shares the pivotal moment when both her parents died of cancer just 19 hours apart, leaving her to navigate two estate settlements across multiple countries while launching her nursing career. This experience revealed critical gaps in financial planning that most families face—from missing life insurance policies to unprotected assets—and ignited her passion for teaching others how to avoid the same pitfalls. Throughout our conversation, Camille reveals why she allocated 75% of her portfolio to precious metals, how she uses index universal life insurance policies that the wealthy have leveraged since 1913, and why she checks her investments daily in today's volatile economic climate. She breaks down complex concepts like the gold-to-silver ratio, wealth cycles, and the geopolitical shifts that are reshaping how we should think about protecting our assets. This episode is essential listening for anyone who wants to take control of their financial education and build wealth that can weather any economic storm. Key Topics: What you learn about money from watching your parents' struggles—and why sometimes the best lessons come from what NOT to do How losing both parents within 19 hours forces you to become financially savvy overnight and manage estates across countries Why life insurance is the first line of defense in estate planning—and the policy types most people never hear about How to educate yourself on alternative investments while working full-time by following wealth cycles and market pioneers Why diversifying into precious metals offers peace of mind when traditional markets face geopolitical and economic turbulence What the gold-to-silver ratio reveals about when to enter and exit commodity investments for maximum returns How index universal life insurance policies let you build tax-free retirement wealth the way elites have since 1913 Why checking your portfolio daily keeps you ahead of market shifts and helps you rebalance for changing economic conditions Connect with Camille online: Website: https://stan.store/PreciousMetalsMasterclass LinkedIn: https://www.linkedin.com/in/camillewiles/   Find more from Syama Bunten: Instagram: @syama.co, @gettingrichpod Join Syama's Substack: https://thewealthcatalystwithsyama.substack.com/ Website: https://wealthcatalyst.com Download Syama's Free Resources: https://wealthcatalyst.com/resources Wealth Catalyst Summit: https://wealthcatalyst.com/summits Speaking: https://syamabunten.com Big Delta Capital: www.bigdeltacapital.com  

Like most people, when Deb Krier was told she had metastatic breast cancer in 2015, she went into a tailspin. She previously worked for an oncologist and later, the American Cancer society and still was not prepared. What stuck with her was something the oncologist had said years earlier: 99% of survival is in your head. Deb shared with us how hard she worked to maintain an upbeat attitude. Always upbeat, throughout her life, she was always independent. As an only child, raised in the mountains of CO, her mother encouraged her to take care of herself.However, chemotherapy treatment almost killed her - 7 weeks with septic shock in the hospital, in and out of ICU and 30 surgeries. This experience and two other bouts with cancer led Deb to devote her life to helping people live life while fighting cancer. And so, she created the website, https://www.tryingnottodie.live. The site offers information and support packages: Bear hugs and other ways to brighten the lives of people you care for with cancer.It is 10 years now. In addition to managing her website and still living with cancer, Deb volunteers with the University of Colorado, is involved with the National Beagle Club of America and reads and gardens with her husband who is a huge source of support. “We are in charge of how we manage our lives when living with cancer: I choose life.” - Deb KrierThank you to our sponsor, Women's Connection, a nonprofit women's group with chapters around the country. Members are vibrant, accomplished women, age 50 and forward, who connect around common interests, empower each other to thrive, and stick together as they travel through the stuff of life, no matter what comes their way. https://www.womenconnecting.org.Women Over 70 is a proud member of the Age-WISE Collective, a group of women-hosted podcasts featuring stories from women 50+ and conversations that promote the pro-aging movement. This week we feature Suzy Rosenstein, host of Women in the Middle: Loving Life After 50. This weekly podcast explores a wide range of topics designed to help women get excited about their lives again. Women in the Middle®: Loving Life After 50 - Midlife Coach

What really happens when a nurse walks through a patient's front door instead of a hospital doorway? In this episode of Home Health Revealed, host Hannah Vale heads into the field with home health nurses in snowy Northeast Ohio and then sits down with leaders from Lorain County Community College and the Ohio Council for Home Care & Hospice to unpack what she witnessed firsthand. You'll hear from: Christopher Hirschler, Dean of the Health and Wellness Science Division at Lorain County Community College Lisa Von Lemden, Ohio Council for Home Care & Hospice Hannah DiVencenzo, Program Developer at Lorain County Community College Cynthia Kushner, Director of School, Workforce and Community partnerships Abigail Farabaugh, Career and Academic Advisement Professional Together, they share powerful stories from recent ride‑alongs: organizing overflowing baskets of medications, navigating homes transformed into care spaces, and supporting families through heartbreaking seasons with remarkable resilience. You'll also hear about those “oh no” moments—like expired blood tubes in the trunk—and how strong team backup turns solo visits into a true network of care. Listen in to learn: Why being invited into a patient's home is “sacred” work and how it reveals social determinants of health in real time, from housing quality to family support to mental health. How home health nurses flex between roles—clinician, educator, advocate, problem‑solver, even “therapist”—often in the same visit. What schedule flexibility, point‑based pay models, and documentation from home actually look like in a real nurse's day (including coffee breaks between visits). How AI and technology are changing preparation for visits, decision‑making, and mentorship for newer nurses entering home health.  Why home care can be a smart career move for nurses who want autonomy, meaningful one‑on‑one time with patients, and strong earning potential—without punching a time clock. The episode also highlights new workforce and education partnerships, including a $2 million Department of Higher Education investment into the Center for Community Based Care to grow and support the next generation of home health and hospice clinicians across Ohio. Lorain County Community College shares how it is exposing students to home health early—through ride‑alongs, pathways content, and mentorship—so they can discover if this deeply relational kind of nursing is the right fit. If you're: A nursing student wondering what's beyond the ICU or med‑surg, A nurse craving more control over your time and deeper patient relationships, or An educator or leader trying to build stronger home health pathways… …this episode will challenge your assumptions about what nursing “has” to look like and show you what's possible when care comes to the couch instead of the bedside. Learn more & get connected: Ohio Council for Home Care & Hospice / Center for Community Based Care: visit www.ochch.org and use the Contact Us form to inquire about tuition support, grants, and workforce opportunities across Ohio. Interested in educational pathways at... Chapters (00:00:02) - Home Health Revealed: Why the Home Matters(00:01:28) - Home Health: The Journey(00:07:35) - The Home Health Care Nurse Experience(00:13:13) - The Day in the Life of Home Health(00:16:30) - Social determinants of health in the home(00:20:06) - What is Home Health Care for People?(00:22:17) - The role of nurses in the field(00:25:59) - Home Health Nurse Training: Flexibility(00:31:39) - Home Care and Hospice Programs(00:36:08) - Home Care: The Career Choice(00:42:31) - Riding Along With a Home Health Nurse(00:45:58) - Home Health Care: A Personal Experience

In one ICU room, patients repeatedly report seeing the same silent man standing in the same corner—often just before sudden clarity, recovery, or death. Nurses notice the pattern. Doctors document an unusual concentration of terminal lucidity. The room keeps being used. In this episode of The Box of Oddities, Kat and Jethro explore a real medical mystery involving repeating end-of-life visions tied to a single hospital room, and why science struggles to explain why place—not patient—seems to matter. Then, we examine ancient Christmas folklore warning that animals speak at midnight—and that overhearing them reveals forbidden knowledge, often about death. From hospital wards to medieval superstition, this episode asks: what if clarity at the end comes after something leaves? Listener discretion advised. Learn more about your ad choices. Visit megaphone.fm/adchoices

Episode Summary    In this inspiring episode of WarDocs, we are honored to feature the extraordinary journey of Retired Army Brigadier General Clara Adams-Ender. Rising from humble beginnings as one of ten children born to sharecroppers with limited formal education, she defied expectations to become a trailblazer in military medicine. Her story is a testament to the power of education, resilience, and the relentless pursuit of excellence. Although she initially dreamed of becoming a lawyer, she honored her father's wishes to attend nursing school, a decision that launched a remarkable 34-year career culminating in her service as the 18th Chief of the Army Nurse Corps.    BG(R) Adams-Ender shares powerful anecdotes that defined her leadership philosophy, starting with her first assignment as a Second Lieutenant in an ICU. She recounts a tragic incident involving a Marine shot by a friend during horseplay, a moment that taught her the stark difference between "book learning" and the practical responsibilities of an officer to care for the discipline and safety of troops. She also details the grit required to become the first woman to earn the Expert Field Medical Badge (EFMB). Refusing to settle for the lower physical standards set for women at the time, she marched the full 12 miles alongside her male counterparts, proving that competence knows no gender.   Throughout the conversation, she emphasizes the evolution of the Army Nurse Corps from a workforce viewed merely as labor to leaders in healthcare policy and administration. She discusses her time as an educator during the Vietnam War, mentoring students facing the draft and ethical dilemmas. General Adams-Ender passionately argues for the necessity of nurses having a "seat at the table" in healthcare leadership, noting that without a voice in policy, the profession cannot control its destiny. As the Army Nurse Corps approaches its 125th anniversary, she reflects on the core values of clinical excellence, administration, research, and education (CARE), offering timeless advice for the next generation of military medical professionals.   Chapters (00:00-06:40) From Sharecropper's Daughter to Nursing School (06:40-11:45) A Tragic Lesson in Leadership and Troop Welfare (11:45-17:15) Breaking Barriers to Earn the Expert Field Medical Badge (17:15-22:42) Educating Nurses During the Vietnam War Era (22:42-37:55) The Power of Policy and Having a Seat at the Table (37:55-45:34) Core Values and the Legacy of the Army Nurse Corps   Chapter Summaries (00:00-06:40) From Sharecropper's Daughter to Nursing School The guest discusses her family background, emphasizing her parents' deep value for education despite their limited schooling. She shares how she initially aspired to be a lawyer but followed her father's directive to attend nursing school, eventually discovering a passion for the challenge the profession provided. (06:40-11:45) A Tragic Lesson in Leadership and Troop Welfare Reflecting on her first assignment at Fort Dix, the guest describes the transition from academic theory to the practical realities of military nursing. She recounts a harrowing story of a young Marine shot due to horseplay, which served as a pivotal lesson on an officer's responsibility to maintain discipline and care for the troops beyond clinical duties. (11:45-17:15) Breaking Barriers to Earn the Expert Field Medical Badge The conversation shifts to the guest's historic achievement as the first woman to earn the EFMB. She details her determination to meet the same physical standards as the male soldiers, including marching 12 miles instead of the required 8 for women, viewing the grueling training as an opportunity to prove her capabilities. (17:15-22:42) Educating Nurses During the Vietnam War Era The guest describes her time as an instructor at Walter Reed, where she taught students from diverse backgrounds. She highlights the challenges of mentoring nursing students during the Vietnam War, helping them navigate their fears and obligations regarding deployment to a combat zone. (22:42-37:55) The Power of Policy and Having a Seat at the Table Moving into administration, the guest explains how she learned that writing good policy allows a leader to influence far more outcomes than hands-on care alone. She stresses the importance of nurses securing leadership roles to ensure they are in charge of their profession's destiny and not merely following orders from others. (37:55-45:34) Core Values and the Legacy of the Army Nurse Corps As the 125th anniversary of the Army Nurse Corps approaches, the guest reflects on the enduring values of the profession, using the acronym CARE. She concludes with a dedication to her mentors and offers advice to current nurses on maintaining standards and commitment to the mission.   Take Home Messages Leadership Requires Practical Adaptability Success in military medicine often requires unlearning the rigid structures of "book learning" to adapt to the practical realities of the environment. True competence is demonstrated not just by clinical knowledge, but by the ability to handle unexpected situations and the human dynamics of the troops under one's command. The Responsibility of the Officer Extends Beyond Patient Care A medical officer's duty is not confined to the hospital bed or the clinic; it encompasses the overall welfare, discipline, and safety of the soldiers. Preventing tragedy through discipline and looking out for the troops is as vital as treating the wounds that result when safety protocols fail. Equality is Proven Through Standards Breaking barriers and earning respect often comes from a refusal to accept lower standards based on gender or background. By voluntarily meeting the more rigorous requirements set for counterparts, a leader demonstrates resilience and capability that silences doubters and inspires the team. Influence Through Policy and Administration While direct patient care is the heart of medicine, long-term impact is achieved by securing a "seat at the table" in administration and policy-making. Writing effective policy allows a medical professional to guide the hands of thousands of others, shaping the destiny of the profession and improving care on a systemic level. Total Commitment to the Profession Medical service is difficult, demanding work that requires a full "all-in" mentality. The key to longevity and success is to make a firm decision to commit to the profession; once that decision is made, energy should be directed toward the mission and patient care rather than complaints or negativity.   Episode Keywords Clara Adams-Ender, Army Nurse Corps, EFMB, Expert Field Medical Badge, Military Medicine, Leadership, Women in Military, Black History, Vietnam War Nursing, Walter Reed, Nursing Education, Healthcare Policy, Mentorship, WarDocs, Army General, Brigadier General, Nursing Administration, Military History, Veteran Stories, Medical Podcast Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation. Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms.   Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast

🧭 REBEL Rundown 🗝️ Key Points 💨 Peak vs. Plateau Pressures: PIP reflects total airway resistance and compliance, while Pplat isolates alveolar compliance—elevations in both suggest decreased lung compliance (e.g., ARDS, pulmonary edema, pneumothorax).🧱 PEEP Protects Alveoli: Maintains alveolar recruitment and prevents collapse; typical range 5–8 cmH₂O, but higher levels may benefit moderate–severe ARDS.️ Driving Pressure (ΔP = Pplat − PEEP): Lower ΔP reduces atelectrauma and improves outcomes; optimize by adjusting PEEP thoughtfully.💥 Prevent VILI: Keep Pplat < 30 cmH₂O, use low tidal volumes (6 mL/kg IBW), and monitor for barotrauma, volutrauma, atelectrauma, and biotrauma.📚 Evidence-Based Practice: ARDSNet and subsequent trials confirm that lung-protective ventilation—low Vt, limited pressures, and individualized PEEP—improves survival in ARDS. Click here for Direct Download of the Podcast. 📝 Introduction This episode reviews essential ventilator pressures and how to interpret them during ICU rounds. 🚀 Under Pressure Peak Inspiratory Pressure (PIP)Definition: Total pressure required to deliver a breath.Reflects: Airway resistance + lung/chest wall compliance.Common Causes of ↑ PIP:Mucus pluggingBiting the endotracheal tubeKinked tubing or bronchospasmPlateau Pressure (Pplat)Definition: Alveolar pressure measured after an inspiratory hold.Reflects: Lung compliance (stiffness of lung tissue).When Both PIP & Pplat Are Elevated:→ Indicates poor compliance (e.g., ARDS, pulmonary edema, pneumothorax).Positive End-Expiratory Pressure (PEEP)Definition: Pressure remaining in airways at end-expiration to prevent alveolar collapse.Typical Range: 5–8 cmH₂O but needs to titrated to meet patient requirements Notes:Provides physiologic “glottic” PEEP in intubated patients.Using high PEEP strategy shows mortality benefit only in moderate–severe ARDS in meta-analysis.Driving Pressure (ΔP)Definition: ΔP = Pplat − PEEP.Reflects: Pressure needed to keep alveoli open during the respiratory cycle.Goal: Lower ΔP → less atelectrauma & improved outcomes.Optimize: Increase PEEP to reduce ΔP and alveolar cycling. 📖 Interpreting High PIP/High Pplat ↑ PIP & ↑ PplatInterpretation: ↓ ComplianceCommon Causes: ARDS, pulmonary edema, pleural effusion, pneumothorax↑ PIP & Normal/Low PplatInterpretation: ↑ Airway ResistanceCommon Causes: Mucus plug, bronchospasm, tube obstruction or biting 🤕 Ventilator-Associated Lung Injury (VILI) Barotrauma:Mechanism: Excessive airway pressure damages alveoli.Prevention: Keep Pplat < 30 cmH₂O.Volutrauma:Mechanism: Overdistension from excessive tidal volumes.Prevention: Use low tidal volume ventilation (6 mL/kg ideal body weight).ARDSNet trial: 6 mL/kg → lower mortality compared to 12 mL/kg.Ideal Body Weight: Based on height and sex, not actual weight.Typical patient: Tidal Volume: 6–8 mL/kg IBWARDS: Tidal Volume: 4–6 mL/kg IBWAtelectrauma:Mechanism: Repeated opening/collapse of unstable alveoli.Prevention: Optimize PEEP to keep alveoli open and reduce driving pressure.Biotrauma:Mechanism: Inflammatory cascade (↑ IL-6, TNF-α) from mechanical injury.Effect: Can trigger systemic inflammation & multiorgan dysfunction.Prevention: Minimize all other forms of VILI. Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Joel Rios Rodriguez, MD PGY 3 Internal Medicine Resident Cape Fear Valley Internal Medicine Residency Program Fayetteville NC Aspiring Pulmonary Critical Care Fellow 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator When you take the airway, you take the wheel and ... Thoracic and Respiratory Read More REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes Mechanical ventilation can feel overwhelming, especially when faced with a ... Thoracic and Respiratory Read More REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes For many medical residents, the ICU can feel like stepping ... Thoracic and Respiratory Read More REBEL Core Cast 140.0: The Power and Limitations of Intraosseous Lines in Emergency Medicine The sicker the patient, the more likely an IO line ... Procedures and Skills Read More REBEL Core Cast 139.0: Pneumothorax Decompression On this episode of the Rebel Core Cast, Swami takes ... Procedures and Skills Read More The post REBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple appeared first on REBEL EM - Emergency Medicine Blog.

Dr. Tessa Damm, an ICU physician turned metabolic health advocate, shares her insights on why women often miss early signs of metabolic dysfunction and how to take back control of their health. Drawing from years in critical care and personal experience with chronic illness, Dr. Damm explains how lifestyle interventions can prevent life-threatening diseases and improve quality of life at any age. She also describes her 12-week Metabolic Transformations™ program, which blends science, coaching, and community to help women achieve lasting health transformations. This episode is a compelling reminder that chronic disease is not inevitable—and that vibrant health is within reach. In this episode, you'll discover: Why 88% of American adults have some degree of metabolic dysfunction How signs like fatigue, brain fog, and stubborn belly fat are often dismissed as "normal aging" The major flaws in our healthcare system's approach to chronic disease Why accountability and community support are essential for successful health changes The surprising results women experience—including increased energy, reduced pain, and regained self-confidence How Dr. Damm's approach differs from traditional medicine with personalized biometrics and weekly habit tweaks What to consider when investing in preventive health instead of waiting for a crisis Memorable Quotes: "No one is coming to save you. Our healthcare system is designed to react to disease, not prevent it." "Chronic disease is not inevitable—and your everyday habits are your most powerful tool." "The real magic is mental—women stop obsessing over their bodies and reclaim their confidence." Bio: Dr. Tessa Damm is an ICU physician who has spent years caring for critically ill adults—often seeing undiagnosed metabolic dysfunction driving life-threatening disease. She now leads Metabolic Transformations™, a high-touch program helping women take back control of their health, reshape their metabolism, and create a future they're excited about. Her work focuses on restoring metabolic flexibility, preserving strength, and mastering lifestyle habits—because the most powerful changes happen outside the doctor's office. Through experimenting with delivery models, she discovered that coaching is the most effective approach. By prioritizing frequent touch-points, individualized lifestyle education, and small-group support with women on the same journey, she consistently helps clients achieve meaningful, lasting change. Her mission is simple: show that chronic disease is not inevitable—and give women the tools to rewrite their health trajectory. Mentioned in This Episode: MetabolicTransformations.com Links to Resources: Health Coach Group Website: thehealthcoachgroup.com Special Offer: Use code HCC50 to save $50 on the Health Coach Group website Leave a Review: If you enjoyed the podcast, please consider leaving a five-star rating or review on Apple Podcasts.

“There are hundreds, maybe thousands, of drug repurposing opportunities just waiting to be uncovered,” explains David Fajgenbaum, M.D.  David Fajgenbaum, M.D., physician-scientist, bestselling author of Chasing My Cure, co-founder of Every Cure, and leader in the global push for drug repurposing, joins us today to explain why the cures of tomorrow may already be on pharmacy shelves today—and how his team is racing to uncover them. - From college athlete to ICU (~3:15) - Finding a cure (~7:20) - Hope needs to drive action (~9:45) - Repurposing drugs (~11:10) - Use cases of generic drugs (~13:30) - Lithium for bipolar & Alzheimer's (~16:00) - Lidocaine & breast cancer (~17:25) - GLP-1 for longevity benefits (~19:20) - Increasing awareness in the healthcare system (~20:10) - The 3 main hurdles for repurposing drugs (~22:00) - Opportunities in the space (~23:10) - 14 advanced repurpose treatments (~28:00) - The power of AI (~32:50) - Using AI for personalized medicine (~34:30) - AI for treatment options (~37:45) - Common drugs with big potential (~41:00) - The future of healthcare & drug discovery (~44:50) - How you can help (~49:30) Referenced in the episode:  - Follow Fajgenbaum on Instagram (@dfajgenbaum)  - Check out his website (https://davidfajgenbaum.com/)  - Pick up his book, Chasing My Cure (https://www.amazon.com/Chasing-My-Cure-Doctors-Action/dp/1524799637/)  - Listen to his TED Talk (https://www.youtube.com/watch?v=sb34MfJjurc)   - Learn more about Every Cure (https://everycure.org/) We hope you enjoy this episode, and feel free to watch the full video on YouTube! Whether it's an article or podcast, we want to know what we can do to help here at mindbodygreen. Let us know at: podcast@mindbodygreen.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, I'm answering your YouTube questions, including why my histology shirt is back, and then diving into a mystery case straight from the ICU. A sedated teenager with a swollen face, red eyes, and a whole lot of chemosis needs help, and I show up with… my ophthalmologist luggage. What I found is something every ICU clinician has seen but doesn't always recognize: exposure keratopathy, the completely preventable eye emergency that happens when the lids won't close, the tears disappear, and the cornea gets sacrificed to hospital airflow. Takeaways: How facial edema and chemosis in the ICU create the perfect setup for exposure keratopathy and why it often goes unnoticed. Why artificial tears twice a day are nowhere near enough for a sedated patient who can't blink. The simple bedside tools ophthalmologists bring to evaluate non-responsive patients (including the portable slit lamp). Why corneal abrasions in hospitalized patients can become dangerous fast and how to stop them before they start. The easiest ICU intervention ever: ointment, moisture chambers, and remembering that eyelids exist for a reason. To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Today's episode is brought to you by Microsoft Dragon Copilot. Dragon Copilot is an AI clinical assistant that streamlines documentation, surfaces critical information, and automates routine tasks — empowering healthcare teams to focus more on patients and less on administrative work. Learn more at ⁠⁠https://glau.cc/Dragon⁠⁠ Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

December 18, 2025 - Dr. Jon Arnold, Dr. Patrick Sylvester and Amber Vest, RN, Director of Nursing Operations, join Byers & Co to talk about the Intensivist Model used in the Hospital as well the work being done in the ICU with ventilators to improve patient outcomes. Listen to the podcast now!See omnystudio.com/listener for privacy information.

TW: This episode contains mentions of miscarriages and pregnancy complications. On this episode of Friends & Enemas, we're joined by Mama Tina, a labor and delivery nurse, for a candid and entertaining conversation about the realities of L&D nursing. We dive into new grad submission stories sent in by listeners, along with unforgettable tales sourced from a Reddit rabbit hole, sharing the highs, lows, and chaos that come with working in labor and delivery.Mama Tina breaks down what makes L&D its own unique world the gals a banter about how drastically different it of an experience it is from Lindsey's work in the ICU. From patient acuity and workflows to communication styles and emotional intensity, we explore why these specialties often feel like completely different planets within healthcare. Available now on Spotify, Apple Podcasts, and YouTube!Find us on social:The Guest: @mama_nurse_tinaThe Pod: @friends.and.enemasThe Host: @scrubhacks

In the hospital setting, neurologists may be responsible for managing common end-of-life symptoms. Comprehensive end-of-life care integrates knowledge of the biomedical aspects of disease with patients' values and preferences for care; psychosocial, cultural, and spiritual needs; and support for patients and their families. In this episode, Teshamae Monteith, MD, FAAN, speaks with Claudia Z. Chou, MD, author of the article "End-of-Life Care and Hospice" in the Continuum® December 2025 Neuropalliative Care issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Knox is an assistant professor of neurology and a consultant in the Division of Community Internal Medicine, Geriatrics and Palliative Care at Mayo Clinic in Rochester, Minnesota. Additional Resources Read the article: End-of-Life Care and Hospice Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Monteith: This is Dr Teshamae Monteith. Today I'm interviewing Dr Claudia Chou about her article on end-of-life care and hospice, which is found in the December 2025 Continuum issue on neuropalliative care. Welcome to our podcast. How are you? Dr Chou: I'm doing well. Thank you for having me. This is really exciting to be here. Dr Monteith: Absolutely. So, why don't you introduce yourself to our audience? Dr Chou: Sure. My name is Claudia Chou. I am a full time hospice and palliative medicine physician at Mayo Clinic in Rochester. I'm trained in neurology, movement disorders, and hospice and palliative medicine. I'm also passionate about education, and I'm the program director for the Hospice and Palliative Medicine fellowship here. Dr Monteith: Cool. So just learning about your training, I kind of have an idea of how you got into this work, but why don't you tell me what inspired you to get into this area? Dr Chou: It was chance, actually. And really just good luck, being in the right place at the right time. I was in my residency and felt like I was missing something in my training. I was seeing these patients who were suffering strokes and had acute decline in functional status. We were seeing patients with new diagnosis of glioblastoma and knowing what that future looked like for them. And while I went into neurology because of a love of neuroscience, localizing the lesion, all of those things that we all love about neurology, I still felt like I didn't have the skill set to serve patients where they perhaps needed me the most in those difficult times where they were dealing with serious illness and functional decline. And so, the serendipitous thing was that I saw a grand rounds presentation by someone who works in neurology and palliative care for people with Parkinson's disease. And truly, it's not an exaggeration to say that by the end of that lecture, I said, I need to do palliative care, I need to rotate in this, I need to learn more. I think this is what I've been missing. And I had plans to practice both movement disorders neurology and palliative care, but I finished training in 2020… and that was not a long time ago. We can think of all the things that were going on, all the different global forces that were influencing our day-to-day decisions. And the way things worked out, staying in palliative care was really what my family and I needed. Dr Monteith: Wow, so that's really interesting. Must have been a great lecturer. Dr Chou: Yes, like one of the best.  Dr Monteith: So why don't you tell me about the objectives of your article? Dr Chou: The objectives may be to fill in some of the gaps in knowledge that may be present for the general neurologist. We learn so much in neurology training, so much about how to diagnose and treat diseases, and I think I would argue that this really is part and parcel of all we should be doing. We are the experts in these diseases, and just because we're shifting to end-of-life or transitioning to a different type of care doesn't mean that we back out of someone's care entirely or transition over to a hospice or palliative care expert. It is part of our job to be there and guide patients and their care partners through this next phase. You know, I'm not saying we all need to be hospice and palliative care experts, but we need to be able to take those first steps with patients and their care partners. And so, I think objectives are really to focus in on, what are those core pieces of knowledge for end-of-life care and understanding hospice so we can take those first steps with patients and their care partners? Dr Monteith: So, why don't you give us some of those essential points in your article? Dr Chou: Yeah. In one section of the article, I talk about common symptoms that someone might experience at the end of life and how we might manage those. These days, a lot of hospitals have order sets that talk us through those symptoms. We can check things off of a drop-down menu. And yet I think there's a little bit more nuance to that. There may be situations in which we would choose one medication over another. There may be medications that we've never really thought of in terms of symptom management before. Something that I learned in my hospice and palliative medicine fellowship was that haloperidol can be helpful for nausea. I know that's usually not one of our go-tos in neurology for any number of reasons. So, I think that extra knowledge can take us pretty far when we're managing end of life symptoms, particularly in the hospital setting. And then I think the other component is the hospice component. A lot of us may have not had experience talking about hospice, talking about what hospice can provide, and again, knowing how to take those first steps with patients. We may be referring to social work or palliative medicine to start those conversations. But again, I think this is something that's definitely learnable and something that should be part of our skill set in neurology. Dr Monteith: Great. And so, when you speak about symptom management and being more comfortable with the tools that we have, how can we be more efficient and more effective at that? Dr Chou: Think about what the common symptoms are at end of life. We may know this kind of intuitively, but what we commonly see are things like pain, nausea, dyspnea, anxiety, delirium or agitation. And so, I think having a little bit of a checklist in mind can be helpful. You know, how can I systematically think through a differential, almost, for why my patient might be uncomfortable? Why they might be restless? Have I thought through these different symptoms? Can I try a medication from my tool kit? See if that works, and if it does, we can continue on. If not, what's the next thing that I can pivot to? So, I think these are common skills for a little bit of a differential diagnosis, if you will, and how to work through these problems just with the end-of-life lens on it. Dr Monteith: So, are there any, like, validated tools or checklists that are freely available? Dr Chou: I don't think there's been anything particularly validated for end-of-life care in neurologic disease. And so, a lot of our treatments and our approaches are empiric, but I don't think there's been anything validated, per se. Dr Monteith: Great. So, why don't we talk a little bit about the approach to discussions on hospice? We all, as you kind of alluded to, want to be effective neurologists, care for our patients, but we sometimes deal with very debilitating diseases. And so, when we think that or suspect that our patient is kind of terminally ill, how do we approach that to our patients? Of course, our patients come from different backgrounds, different experiences. So, what is your approach? Dr Chou: So, when we talk about hospice and when a patient may be appropriate for hospice, we have to acknowledge that we think that they may be in the last six months of their disease. We as the neurologist are the experts in their disease and the best ones to weigh in on that prognosis. The patient and their care partners then have to accept that the type of care that hospice provides is what makes sense for them. Hospice focuses on comfort and treating a patient's comfort as the primary goal. Hospice is not as interested in treating cancer, say, to prolong life. Hospice is not as interested in life-prolonging measures and treatments that are not focused at comfort and quality of life. And so, when we have that alignment between our understanding of a patient's disease and their prognosis and the patient care partner's goal is to focus on comfort and quality of life above all else, that's when we have a patient who might be appropriate for hospice and ready to hear more about what that actually entails. Dr Monteith: And what are some, maybe, myths that neurologist healthcare professionals may have about hospice that you really want us to kind of have some clarity on? Dr Chou: That's a great question. What we often tell patients is that hospice's goal is to help patients live as well as possible in the time that they have left. Again, our primary objective is not life prolongation, but quality of life. Hospice's goal is also not to speed up or slow down the natural dying process. Sometimes we do get questions about that: can't you make this go faster or we're ready for the end. But really, we are there to help patients along the natural journey that their body is taking them on. And I think hospice care can actually be complex. In the inpatient setting, in particular in neurology, we may be seeing patients who have suffered large strokes and have perhaps only days to a few weeks of life left. But in the outpatient setting and in the home hospice setting, patients can be on hospice for many months, and so they will have new care needs, new urinary tract infections, sometimes new rashes, the need to change their insulin regimens around to avoid extremes of hyperglycemia or hypoglycemia. So, there is a lot of complexity in that care and a lot that can be wrapped up under that quality-of-life and comfort umbrella. Dr Monteith: And to get someone to hospice requires a bit of prognostication, right? Six months of prediction in terms of a terminal illness. I know there's some nuances to that. So how can you make us feel more comfortable about making the recommendations for hospice? Dr Chou: I think this is a big challenge in the field. We're normally guided by Medicare guidelines that say when a patient might be hospice-appropriate. And so, for a neurologic disease, this really only encompasses four conditions: ALS, stroke, coma, and Alzheimer's dementia. And we can think of all the other diseases that are not encompassed in those four. And so, I think we say that we paint the picture of what it means to have a prognosis of six months or less. So, from the neurologic side, that can be, what do you know about this disease and what end-stage might look like? What is the pattern of the patient's functional decline? What are they needing more help with? Are there other factors at play such as heart failure or COPD that may in and of themselves not be a qualifying diagnosis for hospice, but when it's taken together in the whole clinical picture, you have a patient who's very ill and one that you're worried may die in the next six months or less? Dr Monteith: Then you also had some nice charts on kind of disease-specific guidelines. Can you take us a little bit through that? Dr Chou: The article does contain tables about specific criteria that may qualify someone for hospice with these neurologic conditions. And they are pretty dense. I know they're a checklist of a lot of different things. And so, how we practice is by trying to refer patients to hospice based on those guidelines as much as possible and then using our own clinical judgment as well, what we have seen through taking care of patients through the years. So, again, really going back to that decline. What is making you feel uncomfortable about this patient's prognosis? What is making you feel like, gosh, this patient could be well supported by hospice, and they could have six months or less? So, all of that should go into your decision as well. And all of that should go into your discussion with the patient and their care partners. Dr Monteith: Yeah. And reading your article, what stood out was all the services that patients can receive under hospice. So, I think sometimes people think, okay, this is terminal illness, let's get to hospice for whatever reasons, but not necessarily all the lists and lists and lists of benefits of hospice. So, I don't know that everyone's aware of all those benefits. So, can you talk to us a little bit about that? Dr Chou: Yeah, I like that you brought that up because that's also something that I often say to patients and their care partners when we're talking about hospice. When the time is right for a patient to enroll in hospice, they should not feel like they're giving anything up. There should be no more clinical trial that they're hoping to chase down, and so they should just feel like they're gaining all of those good supports: care that comes to their home, a team that knows them well, someone that's available twenty-four hours a day by phone and can actually even come into the home setting if needed to help with symptom management. Hospice comes as well with the psychosocial supports for just coping with what dying looks like. We know that's not easy to be thinking about dying for oneself, or for a family member or care partner to be losing their loved one. So, all of those supports are built into hospice. I did want to make a distinction, too, that hospice does not provide custodial care, which I explain to patients as care of the body, those daily needs for bathing, dressing, eating, etc. Sometimes patients are interested in hospice because they're needing more help at home, and I have to tell them that unfortunately, our healthcare system is not built for that. And if that's the sole reason that someone is interested in hospice, we have to think about a different approach, because that is not part of the hospice benefit.  Dr Monteith: Thank you for that. And then I learned about concurrent care. So why don't you tell us a little bit about that? That's a little bit of a nuance, right? Dr Chou: Yeah, that is a little bit of a nuance. And so, typically when patients are enrolling in hospice, they are transitioning from care the way that it's normally conducted in our healthcare system. So, outpatient visits to all of the specialists and to their primary care providers, the chance to go to the ER or the ICU for higher levels of care. And yet there are a subset of patients who can still have all of those cares alongside hospice care. That really applies to two specific populations: veterans who are receiving care through the Veterans Administration, and then younger patients, so twenty six years old and less, can receive that care through, essentially, a pediatric carve out. Dr Monteith: Great. Well, I mean, you gave so much information in your article, so our listeners are going to have to read it. I don't want you to spill everything, but if you can just kind of give me a sense what you want a neurologist to take away from your article, I think that would be helpful. Dr Chou: I think what I want neurologist to take away is that, again, this is something that is part of what we do as neurologists. This is part of our skill set, and this is part of what it means to take good care of patients. I think what we do in this transition period from kind of usual cares, diagnosis, full treatment to end of life, really can have impact on patients and their care partners. It's not uncommon for me to hear from family members who have had another loved one go through hospice about how that experience was positive or negative. And so, we can think about the influence for years to come, even, because of how well we can handle these transitions. That really can be more than the patient in front of us in their journey. That is really important, but it can also have wide-reaching implications beyond that. Dr Monteith: Excellent. And I know we were talking earlier a little bit about your excitement with the field and where it's going. So why don't you share some of that excitement? Dr Chou: Yeah. And so, I think there is a lot still to come in the field of neuropalliative care, particularly from an evidence base. I know we talked a lot about the soft skills, about presence and communication, but we are clinicians at heart, and we need to practice from an evidence base. I know that's been harder in palliative care, but we have some international work groups that really are trying to come together, see what our approaches look like, see where standardization may need to happen or where our differences are actually our strength. I think there can be a lot of variability in what palliative care looks like. So, my hope is that evidence base is coming through these collaborations. I know it's hard to have a conversation these days without talking about artificial intelligence, but that is certainly a hope. When you look at morbidity, when you look at patients with these complicated disease courses, what is pointing you in the direction of, again, a prognosis of six months or less or a patient who may do better with this disease versus not? And so, I think there's a lot to come from the artificial intelligence and big data realm. For the trainees listening out there, there is no better time to be excited about neuropalliative care and to be thinking about neuropalliative care. I said that I stumbled upon this field, and hopefully someone is inspired as well by listening to these podcasts and reading Continuum to know what this field is really about. And so, it's been exponential growth since I joined this field. We have medical students now who want to come into neuropalliative care as a profession. We have clinicians who are directors of neuropalliative care at their institutions. We have an international neuropalliative care society and neuropalliative care at AAN. And I think we are moving closer to that dream for all of us, which is that patients living with serious neurologic illness can be supported throughout that journey. High-quality, evidence-based palliative care. We're not there yet, but I think it is a possibility that we reach that in my lifetime. Dr Monteith: Well, excellent. I look forward to maybe another revision of this article with some of that work incorporated. And it's been wonderful to talk to you and to reflect on how better to approach patients that are towards the end of life and to help them with that decision-making process. Thank you so much.  Dr Chou: Yeah, thank you for having me. And we're very excited about this issue. Dr Monteith: Today. I've been interviewing Dr Claudia Chou about her article on end-of-life care and hospice, which is found in the December 2025 Continuum issue on neuropalliative care. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

This week, I had the incredible opportunity to sit down with Rachel Godfrey- Blonde. Wild. Spiritual. Disruptive. Delusionally Optimistic.

Rachel is a former physiotherapist, professional trainer, and high-performance mentor with over 19 years of experience operating at the intersection of health, strength, and leadership. She has built multiple performance consulting and digital businesses, advised senior executives and entrepreneurs, and had her work published globally in outlets including Oxygen Magazine, Shape, Cosmopolitan, Men's Fitness, Entrepreneur.com, the Sydney Morning Herald, and The National UAE. Known as the “A-Players Mentor” and co-director of Chase Life Consulting, Rachel has earned a reputation for working with people who operate at the top — and who refuse to be managed with soft answers.At the core of Rachel's work is a simple but confronting question: do you want kindness, or do you want nice? Raised as a tomboy in Wales, forged through rugby, and shaped early in her career by treating severely injured soldiers in a military ICU, Rachel learned that real performance is built through emotional resilience, personal responsibility, and doing the minimum effective work required — not endless grind. Her coaching blends scientific precision with deep identity and mindset work, challenging high-achieving women (especially over 35) to rebalance strength, femininity, and self-worth without abandoning ambition.Today, Rachel mentors executives and entrepreneurs to align body, business, and identity through strength training, intelligent supplementation, and direct, no-nonsense coaching. Her work focuses on sustainable performance, fast belief-building wins, and teaching clients how to lead with both power and awareness. This episode is an unfiltered conversation about trauma, discipline, mindset, and what it actually takes to perform at a high level — without losing yourself in the process.P.S. Don't forget to follow Rachel on Instagram @rachelgodfrey and check out Chase Life Consulting and The House of Onyx for more resources and coaching. Links are in the show notes!

As our wellness theme continues, today we're focused on student wellness, which is essential to producing competent, confident, and emotionally healthy CRNAs. Erin and Greg welcome Matthew Zinder, DNAP, CH, CRNA, practice owner, educator, wellness researcher, and co-founder of Program Prep, to break down the realities of stress inside anesthesia programs and what both faculty and students can do about it. Here's some of what you'll hear in this episode:

Dana was diagnosed with Type 1 Diabetes at age 6 and has now lived with it for over 24 years. As an ICU nurse working long, intense shifts, she found herself bouncing from the 50s to the 300s, feeling exhausted, ashamed, and frustrated that she couldn't “get it together” — especially as a medical professional. In this episode, she shares how she went from an A1C of nearly 11 to 6.4, what finally helped her break through the “stuck at 7” plateau, and the mindset work that let her feel in control of her diabetes for the first time. If you've ever felt alone, burnt out, or like your body is failing you, Dana's story will give you both hope and tools.What we cover:What it's really like to manage T1D while working 12-hour ICU shiftsThe shame of being a nurse with “uncontrolled” numbersHow Dana went from an A1C of ~11 down into the 6sWhy she stopped going to her endo for a season — and what changedUsing the A1C Shift Method + coaching to finally break past 7.0The power of pre-bolus, pattern-tracking, and reflection (not perfection)How sleep mode on her pump changed her overnights and energyMoving from diabetes controlling her life to her feeling in chargeKey takeaways:1️⃣ Mindset is the first tool. Before anything else shifted, Dana had to move from “I can't do this” to “I can figure this out with time and support.”2️⃣ You can't treat a complex condition with 15-minute visits alone. Endo appointments gave tiny tweaks. What really moved the needle was education, ongoing support, and accountability.3️⃣ Small wins add up to big change. From celebrating a 110 fasting BG to turning on sleep mode, Dana's transformation came from consistent small shifts, not one giant fix.What's next:

WAIT UNTIL YOU HEAR NATHAN'S STORY Have you heard of Nathan Barkocy? He sent me this about his story:My story begins when I was 16 years old. Top ten in the Nation for competitive road cycling. I would compete in stage races against semi-professionals in their 30's and became the New Mexico State Champion and road race leader for the state. I am still the youngest to ever win the Tour of the Gila in the category which I was competing. January 23 of 2016 was the day it all changed. Being hit by a car at 60 MPH, I was declared dead at the scene. After being in a coma for two weeks, I miraculously opened my eyes. Paralyzed on my left side. I was in the ICU for a month, then I went to Craig Hospital in Denver for two months, where I learned how to live again. A nationally ranked cyclist who had to relearn how to walk, eat, talk, function again. And it only gets better from there. He joins me at 1pm to tell you the rest of it. Find him online and buy his new book here! You know I'm a sucker for an overcoming adversity story.

Welcome to Doc Talk, I'm your host, Mark Houston. This month, we're celebrating the Best of 2025 and revisiting some of our most informative and popular episodes from the past year. This week it's Episode 151 with Dr. Leslie Van Dyne.As a Trauma Surgeon and Critical Care Specialist at Rapid City Hospital, Leslie Van Dyne, M.D. shares her unique perspective on caring for patients in a rural area known for outdoor adventure and seasonal risks. Dr. Van Dyne explains the differences between trauma surgery and emergency medicine, discusses caring for critical patients in the ICU and relates how activities like ATV riding, horseback riding and summer tourism impact the trauma cases she sees. Hosted on Acast. See acast.com/privacy for more information.

What happens when life-and-death decisions must be made by a team rather than an individual? In this episode, Dr. Mark Ramzy — cardiothoracic intensivist, emergency physician, and Co-Editor-in-Chief of REBEL EM — joins us to explore how teams think, decide, and act under pressure inside the ICU

A physician-mom sits across from us and tells the truth: she loved a good, kind man whose alcoholism, fueled by unhealed PTSD, dismantled their family one crisis at a time. From quiet home drinking to ER runs, withdrawal hallucinations, and an ICU ventilator, her story captures the clinical realities of alcohol use disorder and the human cost families carry in silence. She walks through safety plans for her kids, a neighbor's garage that became a refuge, and a courthouse morning where getting a restraining order had to look “normal” so the children wouldn't panic.We dig into the mechanics of stigma—how judgment from colleagues, self-stigma as a physician, and the fear of losing a job keep people quiet. We talk person-first language, trauma-informed care, and the practical wisdom of respond, don't react. She shares the hard boundary every caregiver eventually faces: sobriety can't matter more to you than to the person using. Along the way, community shows up in surprising forms: a packed church, meals left at the door, volunteers finishing a half-built treehouse, hikes that reopen space to breathe, and faith that survives anger and doubt.You'll hear concrete takeaways for supporting loved ones with alcohol addiction: naming the disease without shaming the person, building child-first safety plans, seeking counseling that treats PTSD and substance use together, and finding support that fits your life when formal groups aren't possible. Above all, you'll hear hope—gritty, ordinary, persistent. If you're carrying a similar weight, you are not alone. Listen, share this with someone who needs it, and leave a review to help more families find real support. Subscribe for more conversations that put compassion, science, and action at the center of addiction care.

In this powerful episode of Keeping Abreast, Dr. Jenn Simmons sits down with Taylor Dukes, former ICU nurse, functional health advocate, and founder of Taylor Dukes Wellness, to explore what happens when conventional medicine stops asking deeper questions.Taylor shares her journey from the ICU to facing her own brain tumor diagnosis, an experience that reshaped her understanding of health, healing, and the healthcare system. Together, she and Dr. Jenn discuss the emotional and spiritual toll carried by front line providers, the limitations of modern medical education, and why chronic and childhood illness have become increasingly normalized.This conversation highlights the role of nutrition, detoxification, stress management, and faith in healing, while emphasizing personal responsibility and advocacy in a toxic world. Taylor also shares how her family became part of her mission, creating accessible wellness solutions rooted in foundational health.

This episode of the Atomic Anesthesia Podcast focuses on dexmedetomidine (Precedex), a highly selective α2-adrenergic agonist that provides cooperative, arousable sedation, analgesia, anxiolysis, and sympatholysis with minimal respiratory depression for perioperative and ICU care. Aimed at nurse anesthesia residents, it reviews dexmedetomidine's α2-selective pharmacology, rapid distribution and hepatic metabolism, and its ability to mimic non-REM sleep via locus coeruleus inhibition while significantly reducing MAC and opioid requirements. Listeners learn practical dosing strategies for OR, ICU, and procedural sedation, common indications such as awake fiberoptic intubation, MAC cases, withdrawal management, and pediatric emergence delirium, and key safety considerations including bradycardia, hypotension, transient hypertension with rapid loading, and the ongoing need for vigilant airway and hemodynamic monitoring when incorporating dexmedetomidine into multimodal anesthetic plans.Want to learn more? Grab our Cardiac Pharm Course --> [HERE]⚛️ CONNECT:

In this episode, AAST Disaster Committee Chair Dr. Adam Fox discusses the intersection of trauma surgery, disaster response, emergency management, and prehospital care. He outlines how trauma surgeons contribute across the continuum of care during mass casualty incidents, hurricanes, earthquakes, critical care transport operations, and austere environments. He highlights the skillset required for field trauma care, critical care stabilization, crush injury management, amputations, ICU-level transport, and providing both surgical and primary care support during large-scale disasters. 

In this podcast episode, Courtney Stathis DNP, FNP-BC, RN and Catherine Wilson-Mooney, MSN, RN discuss the growing use of GLP-1 medications for weight loss and the urgent need to address their psychological, ethical, and social implications. Although these drugs can lead to significant weight reduction, they do not automatically improve body image or mental health, and may even be linked to depression and suicidal ideation. The conversation highlights the role of psychiatric nursing in educating patients, assessing emotional well-being, and ensuring safe use, especially as social media and cultural pressures drive patients to seek quick fixes. Concerns are raised about cost disparities, mail-order or compounded versions, and the increasing prescription to children, whose physical and emotional development may be at risk. The conversation underscores the importance of ethical prescribing, practitioner oversight, and deeper attention to the psychological side of weight management, beyond the physical outcomes. Read the related article, "The physiologic and psychologic effects of glucagon-like peptide-1 receptor agonists" in the September issue of Nursing2025. Courtney Stathis DNP, FNP-BC, RN is a family nurse practitioner who received her FNP from CUNY Lehman College and DNP from Case Western Reserve University in Cleveland, Ohio. Her nursing career has included pediatric, telemetry, neuro and surgical stepdown nursing as well as neuro ICU. She has extensive experience as a Stroke Nurse Practitioner with international collaboration with experts in stroke at the University College Cork in Ireland. As an Assistant Professor of nursing at Kingsborough Community College, she enjoys teaching pediatric nursing to her students. She continues to pursue evidence- based research to apply to her practice. Catherine Wilson-Mooney, MS, RN is a Nurse Educator who received her MS in Nursing Management and Leadership from Walden University and a BSN from the City University of New York at the College of Staten Island. Her nursing career has included medical surgical nursing and operating room nursing with the majority focus of her career in women and children's health and nursing leadership. She implemented and facilitated the first postpartum depression support group in the New York City area in 1996 and started her teaching journey with the City University of New York in 2014. She is an Assistant Professor at Kingsborough Community College and enjoys teaching Nursing the Emotionally Ill and Maternal Child Health Nursing to her students. Transcript

1. A Little Taste of Tonight's Case Tonight's story starts exactly where so many good things do: a quiet country town, a family lunch, and a plate of something fancy – beef Wellington. It ends with three people dead, one clinging to life, and an entire nation asking how a dish that sounds like it belongs on MasterChef ended up in the Supreme Court. This episode takes you into the Leongatha mushroom case – the so-called “death cap dinner” – told from my Tale Teller perch, with all the atmosphere, care, and candlelit narration you've come to expect… plus a healthy dollop of “what on earth, humans?” 2. What's Actually in the Episode? A lunch that looked ordinary… and wasn't We start at the table. No gore, no exploitation – just that quiet, uneasy sense that something is off. You'll hear: How a country family lunch in Victoria became international news. Who sat at that table, how they were connected, and why this wasn't strangers in a headline, but an entire web of family history colliding over one meal. I walk you through the day itself like you're there in the corner of the room, watching the plates go down and not yet knowing what they carry. What a death cap actually does to you Then we get a little… biological. I take you inside the body and explain – in proper, story-ified fashion – what happens when you eat a death cap mushroom: The eerie, silent first hours, when your body acts like nothing's wrong while amatoxins quietly slip into your bloodstream. The fake food-poisoning phase – all vomiting and diarrhoea and “oh that's just a nasty bug” – while your liver is secretly being dismantled cell by cell. The false recovery, that cruel moment where the symptoms ease and you think you're on the mend… just as your liver throws in its resignation letter. And finally, the crash: jaundice, confusion, liver failure, the scramble for transplants and ICU care. It's dramatic, it's descriptive, and it's rooted in the real medical picture – because if we're going to be horrified, we may as well be accurately horrified. Inside the relationships and the almost-motive We also pull back from the plate and talk about the human mess behind it all: The long, complicated relationship between Erin and her ex, The money tensions, the child support drama, the messages that went from “family” to “lost cause” in record time, And how the courts actually handled motive – or rather, how they never truly nailed one down. I keep it respectful: we're not here to psychoanalyse a stranger's soul from our couches. But we do explore the emotional landscape that sat behind that lunch, because that's where the story really starts to ache. The sentence, the silence, and the questions We end in the courtroom: the verdicts, the life sentence, and the judge openly admitting that only she knows why. Then I leave you with the questions that linger: Is a murder with no clear motive creepier than one done for money? How much does “why” matter once “what” is already this bad? And who do we trust at our table, really? 3. Thank You, You EPIC, Wonderful Lovelies! I cannot overstate this: you are the reason I get to dig into stories like this properly – slowly, carefully, with time to research, script, narrate, and edit instead of belting them out between life admin and cold tea. Every time you support on Patreon, you're not just “tipping the podcaster” – you're literally funding: The hours it takes to turn a complex case into a coherent, respectful narrative. The hosting, tools, and tea and caffeine supply chain that keep SFGT alive. The space for me to ask, “How do I tell this without turning real pain into entertainment?” – and then actually follow through on that. So thank you: For trusting me with your ears. For backing this strange little corner of the audio world where horror and empathy share the same cup. For letting me sit by your side, late at night, and tell you stories that stay with you long after the episode ends. You are, quite genuinely, the legends who keep the lights on and the kettle boiling. Stay safe, stay curious, and maybe – just for me – don't eat any mysterious mushrooms you find on a weekend wander, yeah? With all the tea and all the thanks, Your Tale Teller

Expert physician researcher Sunil Wimalawansa explains why Vitamin D plays a critical role in immune system function, the physiology various forms of vitamin D and how to ensure you keep a level compatible with optimal health.Dr Sunil J. Wimalawansa, MD, PhD is a globally respected clinician-scientist, educator, over three decades of leadership in endocrinology, osteoporosis, metabolic bone disease, and nutrition. He served as professor and chief of endocrinology at leading U.S. medical institutions, including the Robert Wood Johnson Medical School/Rutgers University.CONSULT DR MAXInitial consult - https://www.drmaxgulhane.com/offers/5jfDvLyH/checkoutSUPPORT MY WORK

Join Sandra for an incredible conversation with Joshua Silverberg, the Executive Producer of the new hit series "Miracle" on Angel Studios (hosted by Bear Grylls). Joshua isn't just documenting stories of medical impossibilities; he lived one. In 2021, Joshua was in the ICU with failing organs and oxygen levels so low that doctors told him, "People like you don't survive." In this episode, Joshua shares the riveting story of how a friend felt a divine pull to drive three hours and talk his way into a high-security lockdown to pray for him. Joshua also describes his Near-Death Experience where he surrendered to death, saying, "I'm coming in for the hug," only to be met by the "Mind of God"—a place where worry does not exist. PLUS - we talk about the INCREDIBLE episodes of the new series MIRACLE. Watch the series "Miracle" on Angel Studios: https://www.angel.com/watch/miracle Joshua is a songwriter, musician, and producer whose work has topped the Billboard charts, been featured in major films, achieved platinum status, and earned him 11 Dove Award nominations…Grammy and Emmy nominations, and the unofficial but deeply valued title of "Best Dad." *Connect with Sandra Champlain: * Website (Free book by joining the 'Insiders Club, Free empowering Sunday Gatherings with medium demonstration, Mediumship Classes & more): http://wedontdie.com *Patreon (Early access, PDF of over 790 episodes & more): Visit https://www.patreon.com/wedontdieradio  *Don't miss Sandra's #1 "Best of all things afterlife related" Podcast 'Shades of the Afterlife' at https://bit.ly/ShadesoftheAfterlife

In this episode, Dr. Zanotti discusses the role of Procalcitonin in the ICU. He is joined by Dr. Simran Gupta, an infectious disease specialist at Brigham & Women's Hospital in Boston. Dr. Gupta has additional training in Clinical Research, Transplant, and Infectious Disease. She recently published an article on reassessing the role of Procalcitonin in critically ill patients with sepsis. Additional resources: Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial. S. Gupta, et al. Clinical Infectious Disease 2025: https://pubmed.ncbi.nlm.nih.gov/40579227/ Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial. JAMA 2025: https://pubmed.ncbi.nlm.nih.gov/39652885/ Procalcitonin-guided antibiotic therapy may shorten the length of treatment and may improve survival- a systematic review and meta-analysis. M Papp, et al. Crit Care 2023: https://pubmed.ncbi.nlm.nih.gov/37833778/ Books and entertainment mentioned in this episode: Shantaram: A Novel. By Gregory David Roberts: https://bit.ly/4ovVHKX SHANTARAM – Apple TV series: https://tv.apple.com/us/show/shantaram/umc.cmc.atxsrive40xli3zh3uxjimut

Send us a textWhat happens when a single crash erases days of memory and rewrites the rules of your life? We sit down with Nicholas Ruchlewicz to trace his arc from a storage-lot motorcycle crash to surgeries, rehab, and the gritty work of reclaiming identity after a traumatic brain injury. He opens up about the 12-day void he can't remember, the moment he realized he had to relearn how to walk, and the unexpected tools that pulled him out of isolation.Nicholas walks us through the realities of right-side brain injury—executive function, attention, vision—and the emotional whiplash of anxiety and depression that followed. He shares how continuity of care became a battle with the health system and why protecting a trusted therapist can be the difference between treading water and moving forward. Along the way, he uncovers practices that actually help: naming the feeling under anger, pausing before you react, and choosing an opposite action to shift momentum.Then the story turns to music and games. Heavy music lowered his pain spikes in the ICU and later became a bridge to community and purpose. Following Lacuna Coil across cities, he transformed gratitude into connection and advocacy. At the tabletop, role-playing games rebuilt fine motor skills, memory, and focus while offering a safe, inclusive space for players to belong. Painting miniatures during the pandemic anchored his nerves and gave him a daily ritual of calm.We wrap with clear takeaways for anyone facing trauma or supporting someone who is: you are not alone, healing is not a zero-sum game, and hope is free medicine. If you're looking for real talk about recovery—and practical ways to find your footing again—this conversation will meet you where you are and hand you a next step.If this resonated, follow the show, share it with a friend who needs it, and leave a rating or review so others can find these stories.LinkTree - https://linktr.ee/giftofperspectiveYouTube - https://www.youtube.com/@NPR_NerdSpotify (link in my LinkTree)- https://open.spotify.com/user/31vgmhbu654nulf6pcfso4khw6i4 Support the show

What if the moment your life shattered also became the beginning of your transformation?In this powerful and deeply moving episode, host Teresa Reiniger sits down with Jenny Brandemuehl, author of Forever Fly Free, to share the unimaginable story of her husband Mark's fiery plane crash, the five months of life-or-death battles inside a burn ICU, and the profound grief journey that followed.Jenny opens her heart as she shares how a heroic stranger, love in action, intuition, community support, and micro-moments of joy helped her navigate one of life's most devastating losses. This episode is a testament to resilience, hope, and the possibility of rediscovering yourself after your world falls apart. If you're navigating grief, trauma, or rebuilding a life you didn't choose, this episode offers comfort, perspective, and powerful reminders that healing is possible — one small moment at a time.✨ Featured GuestJenny BrandemuehlAuthor of Forever Fly Free: One Woman's Story of Resilience and the Power of Hope and Love

Show Notes  Specialization can shape a therapist's confidence, identity, and long-term trajectory — but the pathways to get there aren't always clear. In this episode of Acute Conversations, co-hosts Dr. Leo Arguelles and Dr. Nicole Neveau sit down with Dr. Leslie Ayres, Rajashree Mondkar, and Dr. Terry Schwing to explore what it really takes to pursue the Cardiovascular & Pulmonary (CCS) specialty. Together, they unpack three very different journeys: the traditional pathway, residency-based training, and fellowship experience. Leslie reflects on how a single listserv email led her to a CVP residency five years into practice. Rajashree shares what it meant to become one of the first CCS clinicians in Texas back in 1994. Terry explains how fellowship training and outcomes research shaped his voice in ICU mobility and cardiopulmonary care. Across their stories, one message stands out: there is no single “right” pathway — but there is always a spark. Listeners will hear candid reflections on mentorship, research expectations, clinical identity, and how specialization deepens bedside reasoning across acute care settings. Whether you're a student curious about your future or a clinician considering your next step, this conversation offers clarity, inspiration, and practical insight into navigating the specialization journey. Today's Guests: Leslie Ayers PT, DPT, EdD, CCS leslie.ayres@unthsc.edu Rajashree Mondkar PT, MSPT, CCS MondkarR@gmail.com Terry Schwing PT, DPT CCS Guest Quotes: 6:47  Leslie “ And that's really what inspired me was just, I was thinking, I want to know more about these patients. I wanna get better at treating these patients. I wanna be an expert at this.” 17:34 Terry “ I think specialization really gives you an opportunity to delve deep into what you're interested in and learn probably a lot more than you maybe thought you would need to know or I topics outside of maybe what your niche current interest is in. And it opens up your world as to all the different things that physical therapy is able to provide for patients.” 20:07 Rajashree “ I think they students, definitely very important because even if you're not ready to do specialization, as soon as you are out, because you need few years of experience, you need to find where you are passionate about. You can see that even if there, there are many places, maybe the residencies are not available for cardiopulmonary, but you can reach out… You can find mentoring, mentorship, you can find avenues how to get there. And people are, I think people are eager to always guide others. To get to where you are. And that's how our profession grows.” Rapid Responses:  How fast do you think you could run a hundred meters pushing a crash cart? Leslie “ So my rule for running is to finish in the upright position, but you don't have to be first. So as long as you get there cart intact, it doesn't matter how long it takes.” Rajashree “ And my goal is to get there and not that crash cart meeting for me.” Terry “ Yeah. I don't know. I feel like a lot of the crash carts sometimes have rickety wheels, so I might just be trying to get it there as well. And just not falling and tipping the whole cart with me.” You know you work in acute care when… Leslie “ when you spent 30 minutes with a patient just to go to the restroom and their question is. That's all we're doing today.” Rajashree “when you are untangling lines and wiping somebody's bumps. I did not know in PT school when I went that I'll be. “ Terry “ I guess I might say you're an acute therapist and I always think about whenever I'm watching like TV shows or something like that and I see like someone intubated or an eek g on the screen and things like that. And I'm like, I'm always like, okay, is that the appropriate rhythm or intubation like method for like for this patient at that time? And I'm always like they did okay.” Links: Vital Pathways Webinar Connect with our host and the podcast!

Neurologists are privileged to act as guides for patients as they navigate the complex course of serious neurologic illnesses. Because of the impact on quality of life, personhood, and prognosis, neurologists must be able to conduct serious-illness conversations to improve rapport, reduce patient anxiety and depression, and increase the likelihood that treatment choices agree with patient goals and values. In this episode, Teshamae Monteith, MD, FAAN speaks with Jessica M. Besbris, MD, author of the article "The Approach to Serious-Illness Conversations" in the Continuum® December 2025 Neuropalliative Care issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Besbris is an assistant professor of neurology and internal medicine, and the director of the neuropalliative care, at Cedars-Sinai Medical Center in Los Angeles, California. Additional Resources Read the article: The Approach to Serious-Illness Conversations Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Guest: @JessBesbris Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Monteith: Hi, this is Dr Teshamae Monteith. Today I'm interviewing Dr Jessica Besbris about her article on the approach to serious illness conversation, which is found in the December 2025 Continuum issue on neuropalliative care. How are you? Dr Besbris: I'm doing great. Thank you so much for having me here today. Dr Monteith: Well, thank you for being on our podcast. Dr Besbris: My pleasure. Dr Monteith: Why don't we start off with you introducing yourself? Dr Besbris: Sure. So, my name is Jessica Besbris. I am a neurologist with fellowship training in palliative care, and I am currently at Cedars Sinai Medical Center in Los Angeles, where I am the director of our neuropalliative care program. Dr Monteith: Excellent. So, how did you get involved in that? Dr Besbris: Like, I think, many neurologists, I always knew I wanted to be a neurologist---or, I should say, from the moment I decided to be a doctor I knew that that was the type of doctor I wanted to be, a neurologist. So, I went into medical school with the aim of becoming a neurologist. And very quickly, when I started my clinical years, I was exposed to patients who were living with very serious illnesses. And I found myself really drawn to opportunities to help, opportunities to make people feel better, opportunities to improve quality of life in situations that on the face of it seemed really challenging, where maybe it seemed like our usual treatments were not necessarily the answer or were not the only answer. And so, I pretty quickly recognized that taking care of patients with serious illness was going to be a big part of my life as a neurologist and that palliative care was the way I wanted to help these patients and families. Dr Monteith: And you mentioned you're leading the group. So, how many colleagues do you have in the program? Dr Besbris: We have a very large palliative care group, but within neuropalliative care, it's myself and one other physician, a nurse practitioner, and a social worker. Dr Monteith: Okay, well, I know you guys are busy. Dr Besbris: Yes, we are very happy to be busy. Dr Monteith: Yes. So, let's talk about the objectives of your article. Dr Besbris: Sure. So, the goal of this article is to impress upon neurologists that it really is all of our jobs as neurologists to be having these conversations with our patients who are affected with serious illness. And then, in most areas of neurology, these conversations will come up. Whether it's giving a life changing diagnosis, or talking about treatment choices, or treatment not going the way that we had hoped, or even sometimes progression of disease or end-of-life care. These topics will come up for most of us in neurology, and really, we're hoping that this article not only makes the case that neurologists can and should be having these conversations, but that there are skills that we can teach in this article and with other resources to improve the skill level and sense of confidence that neurologists have when they enter into these conversations. Dr Monteith: Great. I read that there are some developments in the field, on organizational levels, about really making these skills part of standard of care in terms of education. So, can you speak to that? Dr Besbris: Yes. So, there have been a couple of really landmark papers and changes in the educational landscape that I think have really brought neuropalliative care in general, and serious illness conversation in particular, to the forefront. So, there were the position statements released by the American Academy of Neurology in 1996 and 2022, both of which really said, hey, all neurologists should be doing this and receive training on how to have these conversations and provide this care. And the ACGME, the Accreditation Council for Graduate Medical Education, also requires neurology residency programs to learn how to communicate with patients and families, assess goals, and talk about end-of-life care. So, there's a real structural imperative now for neurologists to learn early on how to have serious illness conversations with their patients. Dr Monteith: Great. If there's anything for our listeners to get out of this conversation, what are the essential points? Dr Besbris: If you only take away one or two things from this conversation, I hope that they're that this is an awesome responsibility to be in a moment with a patient going through something challenging, to meet them in that moment with thoughtful, honest, empathic conversations about who they are and what's important to them. And that, just like any other procedure, these are skills that can be taught so that you can feel really confident and comfortable being in these moments. Dr Monteith: Excellent. Wow. Okay, I feel your energy and your empathy already. And so, why don't we just talk about skills? What is the best way to deliver tough news? I read this wonderful chart on SPIKES protocol. Dr Besbris: Yeah, the SPIKES protocol is one really well-known way to deliver serious news. And what's nice about SPIKES is it gives a mnemonic. And as neurology learners, we all love a good mnemonic to help you really center yourself when you're entering into these conversations so that you have a structured format to follow, just like with any procedure. So, the SPIKES protocol stands for Setting: so, making sure you have the right environment; Perception, or assessing what your patient or surrogate decision maker knows already so that you know where to begin; receiving an Invitation to deliver serious news. And then K stands for Knowledge, delivering in a clear and concise way the information that you want to make sure the family or patient walk away with. E for exploring Emotion; and S for really Summarizing what's been discussed and Strategizing on next steps. I think that having these kinds of conversations, it's just like being expert in anything. When you first start learning, it's helpful to have a set of very concrete steps you can follow. And you might even think through the mnemonic as you get ready to walk into that room. And as you become more expert, the flow becomes more natural. And maybe what you do before walking in to prepare is just honing what is that headline? What is that concise statement that I'm really going to give? And the rest may start to feel more natural and less protocolized. Dr Monteith: And there are a few other mnemonics. There's the NURSE mnemonic, which I like. You know, there's a balance between saying things and sounding kind of… you know, sometimes they're like, well, how could you understand what I'm going through? Have you been through something like this? And people shy away, and they're afraid to kind of be a part of these conversations. So how do we approach that with this, a NURSE mnemonic in a way that's kind of sincere? Dr Besbris: Absolutely. So, the NURSE mnemonic, unlike SPIKES, is not a step-by-step protocol. So, NURSE is a mnemonic, but you don't go through each letter and sort of give a naming statement and then an understanding statement and then a respecting statement and so on. Nurse is really a toolkit of different types of statements that we can give in response to emotions so that when you find yourself in a situation where a patient or family member is tearful, is scared, is angry, is expressing feelings, you have some phrases ready that feel authentic to you and that you feel are going to meet the moment and allow you to empathically respond to those emotions. Because until we do that, we really can't move further in this conversation with our patients and families feeling heard and respected. So, that NURSE mnemonic, those Naming, Understanding, Respecting, Supporting and Exploring statements, are really examples of statements that we can use to meet that moment with empathy and understanding and without implying that we have walked in their shoes. We want to avoid being presumptuous and really focus on just being present and empathic. Dr Monteith: So, let's just kind of run through, I think it's really important. Let's run through some of these examples. Maybe if someone's crying hysterically, how would we respond to that? Dr Besbris: So, this is an opportunity for Naming. And I made this one, I think, in the chart, a little bit obvious, meaning that we recognize when someone is crying that they are feeling probably very sad. This is an opportunity for us to name and thus normalize that emotion. I just think something as simple as, I think anyone would be really sad hearing this. These responses are not intended to fix this emotion. I'm not trying to get someone to stop crying or to, you know, necessarily not feel sad. It's really just to say, yeah, it's normal that you're feeling sad. It's okay. I'm here with you while you're feeling sad. And I'm going to be with you no matter what you're bringing to the table. Dr Monteith: Yeah. Let's go through just a couple of others. I mean, these are really good. Dr Besbris: Sure. Maybe Respecting. Dr Monteith: Yeah. So, my Dad is a fighter. Only God, not doctors, can know the future. Dr Besbris: Yeah. So, I love giving these examples with our learners because these statements, things like my Dad is a fighter or God will bring me a miracle or you don't know the answer. Only God knows what's going to happen, I think that they give a lot of doctors a feeling of confrontation, a feeling of anxiety. And I think there are a few reasons for that. And I think one of the main ones is that they're statements that imply that we as doctors are not all-powerful and it's our patients or families sort of looking for a different locus of control, whether it's internal fortitude or a higher power. They're looking to something other than us, and maybe that makes us feel a little bit uncomfortable. And I think that sometimes physicians think that these statements imply that someone doesn't even understand what's going on. But maybe they're coming to this from a place of denial. And I would argue that when someone comes to you with a statement like my dad is a fighter or, you know, I'm looking to God to bring me a miracle or to show me the future. I think that what they're really saying is, wow, I'm really hearing that things are serious, so much so that I'm reaching for these other resources to give me strength and hope. I don't think anyone asks for a miracle if they think that a miracle is not needed, if the problem is easy to fix. And so, rather than come to these types of statements from a confrontational place of I'm the doctor and I know best, I think this is a great opportunity to show some respect and give some respecting statements. Your dad is a fighter. I don't think he could have come this far without being a fighter. Or, you know, I am so grateful that you have your faith to lean on during times like these to give you strength. These are also nice opportunities for exploring statements. For example, I'm so grateful to learn more about your dad. Can you tell me what it is that he has been fighting for all of this time? Dr Monteith: I love that. It's like a follow-up, and also validating. Dr Besbris: Yeah, it's validating. And it allows us to learn a little bit more about this person and to learn, well, is he fighting for a life that we can still achieve with our interventions to lead into the next part of a conversation? Or, is God is going to bring me a miracle? Well, tell me what a miracle looks like for you. I can't tell you how many times I thought someone was going to tell me that a miracle would be cure. And sometimes that is what comes up. But other times I hear, a miracle would be, you know, my loved one surviving long enough for the rest of the family to gather. And, you know, that is certainly something we can work towards together. Dr Monteith: So, why don't we talk a little bit about approach to goals of care discussions? They are tough, and let's just put it into perspective to the critical care team. It's time, the person's been in the ICU, the family wants everything thrown at medically. And it's to the point that the assessment is that would be medical futility. Dr Besbris: Lots to unpack there. Dr Monteith: I wanted to make it hard for you. Dr Besbris: No, no, this is good! I mean, this is something- I work in a, you know, almost one thousand-bed hospital with a massive critical care building. And so, these are not unusual circumstances at all. First of all, I would just say that goals of care conversations are not only about end-of-life care. And I make that point a few different times in the article because I think when people imagine goals of care, and one of the reasons that I think clinicians may sometimes shy away from goals of care discussions, is that they think they have to be sad, they have to be scary, they have to be about death and dying. And I would argue that, really, goals of care discussions are about understanding who a person is, how they live their life, what's most important to them. Most of these conversations should be about living. How are we going to together achieve a quality of life that is meaningful for you and treatments that are going to fit your needs and your preferences? But there is a little slice of that pie in the pie chart of goals of care discussions that is in the arena of end-of-life care. For example, ICU care with, really, the highest levels of intensity of care, and having to talk about whether that still is meeting the moment from the perspective of goals as well as the perspective of efficacy. So, from the goals standpoint, I approach these conversations just like any other goals of care conversation. Usually at this point, we're speaking to family members and not our patients because in a neurocritical care unit, if someone is that sick, they probably are incapacitated. And so, it's a moment to really sit down with family and say, please tell me about the human being lying in that bed. They can't introduce themselves. What would they tell me about themselves if they could speak right now? What kinds of things were important to them in the course of their treatment? What kind of a life did they want to live or do they want to live? So that then we can reflect on, well, can our treatment achieve that? And this process is called shared decision making. This is really where we take in data from the family, who are experts in the patient, and then our own expertise in the illness and what our treatments can achieve, and then bring all of that information together to make a recommendation that aligns with what we believe is right for a particular patient.  So, in the example that you gave, the extreme circumstance where someone is receiving maximal intensive care and we're starting to reach the point of futility, I think that we need to first really understand, well, what does futility mean for this particular patient? Is it that we as healthcare providers would not value living in the state this person is in? Or is it that the treatments truly cannot physiologically keep them alive or meet their stated goals? If it's the first one, that I wouldn't want to be on machines unconscious, you know, at the end of my life, well, I have to set that aside. It's really about what this patient wants. and if the family is telling you they valued every breath, every moment, and if we have care that can achieve that, we should continue to offer and recommend that care. And as healthcare providers, it is so important that we do explain when treatments are not going to be able to physiologically meet a patient's needs or achieve their goals. And that's where we can say, I'm going to continue to do everything I can, for example, to, you know, keep your loved one here for these meaningful moments. And we are at a point where performing CPR would no longer be able to restart his heart. And I just wanted to let you know that that's not something that we're going to do because I have an obligation not to provide painful medical treatments that will not work. So, my approach to futility is really different than my approach to shared decision-making because in the context of objective futility, it's not about necessarily- it's not about decision-making, it's not about shared decision-making as much as it is explaining why something is simply not going to work. Does that make sense? Dr Monteith: Absolutely. And what I love in your article is that, you know, you go beyond the skills, but also potential communication challenges---for example, patients' neurologic status, their ability to understand complex communication, or even cultural differences. So, can you speak about that briefly? Dr Besbris: Absolutely. In the world of neurological serious illness, it is incredibly common for our patients to face challenges in communication. That might be because they are aphasic, because they have a motor speech deficit, it might be because they're intubated, it might be because their capacity is diminished or absent. And so, there are a lot of challenges to keeping patients in these conversations. And in the article, I summarize what those challenges can look like and some strategies that we can use to continue to engage our patients in these conversations to the greatest extent possible and also turn to their surrogate decision makers where the patients themselves are no longer able to participate or participate fully. In terms of cultural considerations, I mean, there could be an entire article or an entire Continuum just on cultural considerations in neurology and in serious illness communication. And so, the key points that I really tried to focus on were exploring from a place of cultural humility what the beliefs and practices of a particular patient and family are in their cultural context, to ask questions to help you understand how those cultural differences may impact the way you approach these conversations. And being sensitive to folks with limited English proficiency, to ensure that we are using medical interpreters whenever possible. Dr Monteith: Excellent. Well, there's so much in the article. There's already so much that we just discussed, but our listeners are going to have to go to the article to get the rest of this. I do want to ask you to just kind of reflect on, you know, all the different cases and experiences that you have, and just, if you can give us a final remark? Dr Besbris: I can think of a number of cases that I've seen in my work as both an inpatient and outpatient neuropalliative provider where I've seen patients after strokes in the hospital with uncertain prognosis, whose families were struggling with a decision around feeding tubes. And where we have made a determination based on goals; for example, to pursue what's called a time-limited trial, to say let's place a feeding tube, let's meet again in the clinic in a few months after some rehab and let's just see, is this meeting this patient 's goals and expectations? I have been pleasantly surprised by the number of patients who have walked into my office after a period of rehabilitation who have regained the ability to eat, who are living an acceptable quality of life, and who have expressed gratitude for the work that I did in eliciting their goals, helping support their families. And some of whom have even come in and said, now that I'm doing better, I'd really like to do an advance directive to better guide my family in the future. People asking for more goals of care discussions, having seen how successful and helpful these conversations have been. Dr Monteith: Great. That's really life-altering for that patient, the family, so many people. Thank you so much for the work you do and for writing this great article and sharing all of this that we really need to learn more about. Dr Besbris: It's been a privilege. Thank you so much for talking with me today. Dr Monteith: Today I've been interviewing Dr Jessica Besbris about her article on the approach to serious illness conversation, which is found in the December 2025 Continuum issue on neuropalliative care. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Send us a text In this episode of The Incubator Podcast, recorded live at Hot Topics in Neonatology in Washington, DC, we sit down with Dr. Daniele De Luca, Chief of Pediatric and Neonatal Critical Care at AP-HP Paris-Saclay University and leader of one of Europe's largest NICUs. Dr. De Luca discusses the groundbreaking Lancet Child & Adolescent Health Commission on the Future of Neonatology, a three-year initiative involving over 100 global key opinion leaders addressing the critical innovation gap in our specialty. He explores why neonatal medicine has experienced a slowdown in therapeutic advances since the 1990s, despite treating patients who will become citizens for decades ahead. The conversation covers the multifactorial barriers to innovation—from regulatory challenges to funding constraints—and the Commission's comprehensive recommendations for industry, regulators, academic centers, and patient representatives. Dr. De Luca emphasizes the urgent need to avoid treating babies in 20 years the same way we did 20 years ago, highlighting specific examples like the decades-long journey from drug development to registration and the paradox of FDA-approved equipment. He calls for a united approach to elevate neonatology's profile, establish formal specialty recognition, and accelerate the translation of research into bedside care.  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!

When Shannon's 7-year-old daughter, Raelynn, went from gymnastics practice to the ICU in DKA within 48 hours, her family's world flipped overnight. In this episode, Shannon shares the real story behind their viral TikTok family: the trauma of diagnosis, the mental load of T1D parenting, the role of their diabetic alert dog Spy, and how she and her husband found a rhythm that gives their daughter both safety and independence. If you're a parent navigating Type 1 — or worried about your other kids' risk — this conversation will make you feel less alone and more equipped.What we cover:The day a “virus” turned into an ICU DKA diagnosisHow Shannon and her husband divide T1D responsibilitiesThe impact of T1D on siblings and family dynamicsWhat their diabetic alert dog Spy actually does day-to-dayHow their TikTok community started and what it means to themThe emotional weight of screening another child for T1DKey takeaways:1️⃣ You don't have to be fearless as a T1D parent — you just have to keep showing up.2️⃣ Kids with T1D often grow up faster, and that maturity can become a powerful advantage later in life.3️⃣ Community, tools, and support make the mental load of T1D lighter and your decisions clearer.What's next:

Can a digital replica of your heart save your life? In CXOTalk episode 902, Michael Krigsman talks with Dr. Joe Alexander, Director of the Medical and Health Informatics Lab at NTT Research, to explore the revolutionary world of Bio-Digital Twins.Discover how researchers are using mathematical modeling to build "computational replicas" of the human cardiovascular system. Dr. Alexander explains how these digital twins can predict heart failure, automate critical care in the ICU through closed-loop intervention systems, and pave the way for a future where personalized medicine is accessible to everyone.We dive deep into the science of treating the heart as an electrical circuit, the ethics of AI in medicine, and the "moonshot" goal of eliminating cardiovascular disease..

What does it truly mean to protect life — and have we forgotten how? This week onThe Feds, we are airing a thought-provoking and deeply personal speech by Irene Mavrakakis, MD, recorded at the Medical Freedom and the Constitution Summit 2025. Dr. Mavrakakis, a physician and medical freedom advocate, challenges us to rethink the role of medicine, government, and society in safeguarding the most fundamental human right: the right to life.Drawing on powerful real-life stories from her medical career and unflinching honesty about her own experiences, Dr. Mavrakakis explores how far modern medicine and public policy have drifted from their original purpose. From the meaning of the Hippocratic Oath to the failures of informed consent, from debates on abortion, organ donation, and euthanasia to the emerging threat of AI and human identity, she asks the hard questions that most avoid — and demands that we redefine what it means to be human before it's too late.Irene Mavrakakis, MD is a physician in a private practice and a Clinical Assistant Professor in the Department of Surgery at the Philadelphia College of Osteopathic Medicine. She is the host of the podcast Liberty Speaks w/ Dr. Mav. She lectures on medical freedom and its Constitutional basis, and is the author of the Medical Freedom chapter in the book "A Gold New Deal." Dr. Mavrakakis is also the author of the recent peer reviewed published paper entitledIgE-mediated Cytokine Storm in Vaccinated Populations: Call for Further Investigation and Caution.Follow Dr. Mav's Twitter:https://x.com/IreneMavrakakisListen toLiberty Speaks w/ Dr. Mav: https://rumble.com/c/c-6838563Timestamps:00:00 – Introduction and the meaning of “life”03:00 – A powerful story from the ICU that changed everything08:00 – Physicians' duty: “First, do no harm”14:00 – Informed consent and the COVID era20:00 – Abortion: redefining life and medical ethics27:00 – Brain death, organ donation, and the definition of consciousness33:00 – Euthanasia and the value of suffering40:00 – AI, humanity, and the case for a 28th Amendment45:00 – Have we forgotten what life means?

What does a man raised in a country where women are legally second-class citizens become one of the strongest male allies in American medicine?In Part 1 of this two-part Echo Episode, Dr. Mehrdad  Soleimani pulls back the curtain on his improbable journey: fleeing Iran at 16, putting himself through nursing school as a first-generation immigrant, defending his female nursing colleagues from an abusive surgeon and then deciding that very night to become a doctor, switching specialties mid-residency, and ultimately landing in emergency medicine, where he now champions wellness, debriefing, and the “human factor.”Mehrdad and Andrea explore why stoicism and perfectionism are killing physicians, why it's actually strength (not weakness) to feel deeply in the resuscitation room, and how small acts of allyship, from checking in on a new female colleague to calling consultants on her behalf, change culture one shift at a time. This episode is a love letter to every physician humanity and a masterclass in what authentic male allyship feels like on the ground.You'll Hear How They:Trace the roots of fierce gender-equity beliefs to a mother who refused to accept second-class status in IranReveal the night a cardiothoracic surgeon's tantrum pushed a male ICU nurse to apply to medical schoolDiscuss why switching residencies even after years invested, can be the bravest and best career decision Unpack the hidden curriculum of medicine: stoicism, perfectionism, and competition,  and why it's failing usChampion debriefing, emotional processing, and the power of the “feeling doctor” who still gets the job done Model everyday allyship that makes women physicians feel seen, supported, and safer in the workplaceAbout the Guest“Just because I was born a man doesn't mean I'm better than anybody else.” — Dr. Mehrdad SoleimaniDr. Mehrdad Soleimani is a board-certified emergency physician, Assistant Director of the Emergency Department at Temecula Valley Hospital, and Chair of the hospital's Physician Wellness Committee. A former critical-care nurse, general surgery resident, proud girl-dad of three, and co-owner/medical director of NeoMed Spa, Mehrdad brings a rare blend of clinical expertise, emotional intelligence, and lived experience as an immigrant to his passionate advocacy for physician wellness and gender equity.Website: https://neomedicalspa.comResources + Mentions・ Debriefing after critical cases (including pediatric codes)・ Hidden curriculum of medicine: stoicism, perfectionism, competition・ Emotional regulation vs. emotional suppression・ The power of 45-second empathy moments with patientsTop 3 Key TakeawaysAllyship isn't a poster,  it's action: Checking in, offering to call consultants, making new colleagues feel welcome, and using your privilege to smooth someone else's path.Feeling deeply is not weakness, it's strength: The best physicians are “feeling doctors” who process emotion, debrief, and still lead the code with clarity.Your career is allowed to evolve: Switching specialties even years in, is not failure; it's choosing a life where you wake up excited to go to work. 

🧭 REBEL Rundown 🗝️ Key Points ❌ Don’t chase perfect numbers: Adequate and safe is often better than “perfect but harmful.”💨 Oxygenation levers: Start with FiO₂ and PEEP, but remember MAP is the true driver.🫁 Ventilation levers: Adjust RR and TV, tailored to underlying physiology.🚫 Watch your obstructive patients: Sometimes less RR is more. Click here for Direct Download of the Podcast. 📝 Introduction Ventilator management can feel overwhelming—there are so many knobs to turn, numbers to watch, and changes to make. But before adjusting any settings, it’s crucial to understand why the patient is in distress in the first place, because the right strategy depends on the underlying cause. In this episode, we’ll walk through three different cases to see how the approach changes depending on the problem at hand. ️ The 4 Main Ventilator Settings Tidal Volume (Vt) 🌬️ Amount of air delivered with each breath Typically set based on ideal body weight (6–8 mL/kg for lung protection) Respiratory Rate (RR) ⏱️ Number of breaths delivered per minute Adjusted to control minute ventilation and manage CO₂ FiO₂ (Fraction of Inspired Oxygen) ⛽ Percentage of oxygen delivered Adjusted to maintain adequate oxygenation (goal SpO₂ 92–96%, PaO₂ 55–80 mmHg). PEEP (Positive End-Expiratory Pressure) 🎈 Pressure maintained in the lungs at the end of exhalation to prevent alveolar collapse and improve oxygenation 🧮 Modes of Ventilation AC/VC (Assist Control – Volume Control)How it Works: Delivers a set tidal volume with each breath (whether patient- or machine-triggered).When It’s Used / Pros: Most common initial mode; guarantees minute ventilation; good for patients with variable effort.Limitations / Cons: May cause patient–ventilator dyssynchrony if set volumes don’t match patient’s demand.AC/PC (Assist Control – Pressure Control)How it Works: Delivers a set inspiratory pressure for each breath; tidal volume varies depending on lung compliance/resistance.When It’s Used / Pros: Useful in ARDS (lung-protective strategy), limits peak airway pressures.Limitations / Cons: Tidal volume not guaranteed; must closely monitor volumes and minute ventilation.PRVC (Pressure-Regulated Volume Control)How it Works: Hybrid: set target tidal volume, ventilator adjusts inspiratory pressure breath-to-breath to achieve it (within limits).When It’s Used / Pros: Common default mode on newer vents; combines benefits of VC (guaranteed volume) + PC (pressure limitation).Limitations / Cons: Can increase pressures if compliance worsens.SIMV (Synchronized Intermittent Mandatory Ventilation)How it Works: Delivers set breaths, but allows spontaneous patient breaths in between (without guaranteed volume).When It’s Used / Pros: Used for weaning; allows patient effort.Limitations / Cons: Risk of increased work of breathing if spontaneous breaths are inadequate.PSV (Pressure Support Ventilation)How it Works: Every breath is patient-initiated; ventilator provides preset pressure support to overcome airway resistance.When It’s Used / Pros: Weaning trials; patients with intact drive who just need assistance.Limitations / Cons: Not a full-support mode; not for unstable patients without spontaneous drive. ♟️ Ventilation Strategies Airway ProtectionLow GCS, seizure, strokeLoss of gag/cough reflexHigh aspiration risk (vomiting, GI bleed, poor mental status)Hypoxemic Respiratory FailureSevere pneumoniaARDSPulmonary edemaInhalation injuryVentilatory (Hypercapnic) Failure / Increased Ventilation DemandSevere metabolic acidosis (DKA, sepsis, renal failure) → need high minute ventilationCOPD, asthma (if decompensating)Neuromuscular weakness (myasthenia, Guillain–Barré, spinal cord injury)Airway Obstruction / Anticipated Loss of AirwayTumor, anaphylaxis, angioedemaFacial or airway traumaPre-op / anticipated deterioration Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Priyanka Ramesh, MD PGY 1 Internal Medicine Resident Cape Fear Valley Internal Medicine Residency Program Fayetteville NC Aspiring Pulmonary Critical Care Fellow 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator When you take the airway, you take the wheel and ... Thoracic and Respiratory Read More REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes Mechanical ventilation can feel overwhelming, especially when faced with a ... Thoracic and Respiratory Read More REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes For many medical residents, the ICU can feel like stepping ... Thoracic and Respiratory Read More REBEL Core Cast 140.0: The Power and Limitations of Intraosseous Lines in Emergency Medicine The sicker the patient, the more likely an IO line ... Procedures and Skills Read More REBEL Core Cast 139.0: Pneumothorax Decompression On this episode of the Rebel Core Cast, Swami takes ... Procedures and Skills Read More The post REBEL Core Cast 146.0–Ventilators Part 4: Setting up the Ventilator appeared first on REBEL EM - Emergency Medicine Blog.

In this episode of the Atomic Anesthesia Podcast, we're talking to future nurse anesthetists who've just crushed the biggest milestone yet — getting accepted into CRNA school. Between acceptance and day one, there's often a long waiting period, and this episode is your roadmap for using that time strategically. From tackling financial readiness and creating a solid academic foundation to preparing your family, refining your clinical skills in the ICU, and strengthening your mindset, we cover every step of the “Pre‑CRNA School Survival Checklist.” You'll learn how to simplify your finances, refresh your physiology and pharmacology knowledge, set up realistic support systems, and mentally prepare for the demands ahead. Whether you start in a few months or next year, this episode gives you a clear, actionable plan to transition smoothly from RN to SRNA with confidence and focus.Want to learn more? Grab our Cardiac Pharm Course --> [HERE]⚛️ CONNECT:

Send us a textEp 264 -- Real Housewives of Salt Lake City Season 6 Ep16 Gossip, I tell you what I discussed with Whitney Rose regarding her MLM - those MLM business partners allegedly destroyed Whitney Rose's Beauty and she's losing respect for Justin Rose for a reason she hints at but doesn't fully reveal. Bronwyn Newport's Boston Tea Party spirals when Angie Katsanevas questions if Lisa Barlow actually bought that horse, and more. Plus why this season's authenticity is crumbling and what Heather's really feeling about her daughters leaving. Then Jen Shah's shocking early release is discussed with her friend Princess Sammy. Plus Princess Sammy returns with the most explosive interview of the year about Miss Universe - Sammy knows where the dead bodies are buried...wait until you hear which transgender billionaire allegedly stole $200 million and is now on the run in Mexico with a family member set up to take the fall. She reveals her personal connection to someone who sold half the pageant to a man allegedly linked to Mexican cartels who once did something horrific involving 52 people and fire, and is now facing arrest warrants for crimes you won't believe. The 2025 Miss Universe competition was allegedly rigged from the start - Miss Mexico's win involves her father's shady business deals, Miss Jamaica's mysterious stage fall that put her in ICU has disturbing undertones, a judge allegedly bought 2 million votes for someone he's romantically involved with, and another judge resigned three days before the finale exposing it as a complete setup. Sammy spills on why someone she used to date threw a pageant director in Thai prison, the cryptic message Miss USA wrote spelling out "I was silenced" after not getting paid by a woman with a buried scandalous past, why a legendary pageant figure dramatically quit while calling out the corruption, and Donald Trump's role in Miss Universe. Full episode only available at Dishing Drama Dana Patreon: https://www.patreon.com/cw/DishingDramaWithDanaWilkeyTIME CODE HIGHLIGHTS:

Rural nursing is anything but simple. They have limited resources, fewer specialists, and often have to send patients hours away from their families for a higher level of care. But all that is changing as new tech like Zeto brings monitoring right to the bedside and keeps more patients close to home.In this episode, ICU nurse leader Kristen RN shares how point-of-care EEG has empowered her team to catch subclinical seizures sooner and make faster, more informed clinical decisions. From buy-in to implementation, you'll hear how she advocated for her community and successfully integrated this technology into a small ICU. If you work in a rural or resource-limited facility, don't miss this one!Topics discussed in this episode:The unique challenges rural nurses and hospitals faceWhy keeping patients close to home mattersHow telemedicine and new tech are transforming rural healthcareWhy subclinical seizures are hard to recognizeHow Zeto's spot EEG helps nurses keep more patients close to homeThe positive impact on team confidence and patient careHow you can advocate for the tools your community needsLearn more about Zeto here:https://zeto-inc.com/Mentioned in this episode:CONNECT

You've probably been earning CEUs and studying way harder than you need to. In this episode, we walk through the Core Anesthesia app and show you how to turn your commute, dog walks, and dishwashing sessions into Class A credits, smarter studying, and less stress. If you're a CRNA, SRNA, or ICU nurse thinking about CRNA school, this walkthrough will show you how to make your studying and CEUs fit into your real life, not the other way around.Support the showTo access all of our content, download the CORE Anesthesia App available here on the App Store and here on Google Play. Want to connect? Check out our instagram or email us at info@coreanesthesia.com

Jim's List: Top 10 Large Rockers, Gary Ho-Ho-Hoey joins the show, Flagrant podcast jumps the shark, Sydney Sweeney's new failure, Matthew Perry doctor sentenced, Thomas Markle in ICU, the Robocop statue arrives, and 30% of college kids are "disabled". Gary Hoey is in the building (aka on Zoom). Check out his new Christmas album, Ho Ho Hoey: Christmas Time Is Here! Also, make sure to check him out at The Magic Bag on December 14. Matthew Perry's doctor was sentenced. Quentin Tarantino's Top 20 Movies since 2000. Sydney Sweeney and her boobs have a new movie out soon that's going to bomb. Thomas Markle is in the ICU. Meghan must be so worried. Luke Nowacki brings you a new Bonerline. What is the actual definition of a three piece band? The new Flagrant Podcast is out. And Akaash AND the guys look to be taking a massive L. Sean Combs: The Reckoning is much watch Netflix. We catch Tom Mazawey before he gets his hair did. The Detroit Lions are on thin ice and BETTER win this week. College Football championship weekend talk...Michigan sucks...Drew is going to love James Franklin...Penn State is falling apart. Guess how many college kids are "disabled." Cindy Crawford's nepo-kid is having mental health issues. J Lo is trying to pump up sales for her new tour. Robocop is installed! Jim's Picks: Top 10 Fat Musicians. If you'd like to help support the show… consider subscribing to our YouTube Channel, Facebook, Instagram and Twitter (Drew Lane, Marc Fellhauer, Trudi Daniels, Jim Bentley and BranDon).

In this episode of Skin Anarchy, Dr. Ekta Yadav sits down with Jordan Harper, board-certified nurse practitioner and founder of Barefaced, to explore the movement toward simplicity, integrity, and long-term skin health. With nearly a decade in aesthetic medicine, Harper brings a refreshing, clinically grounded perspective to a beauty landscape overwhelmed by trends, noise, and overcomplicated routines.Harper shares how her early career in the ICU shaped her detail-oriented, problem-solving mindset — and how she carried that discipline into aesthetics. What she noticed immediately was a disconnect: patients would invest heavily in treatments but neglect the daily routine that actually sustains results. That realization became the foundation of Barefaced's “less but better” philosophy, anchored by her Core Four essentials: exfoliant, vitamin C, retinoid, and SPF.Throughout the conversation, Harper reframes skincare as prevention, not correction — a longevity-based approach that prioritizes the barrier, cellular health, and consistency over quick fixes. She also dives into the meaning of true “medical grade”: thoughtful formulations, meaningful concentrations, and uncompromising standards. It's the reason she once pulled a product at a $200,000 loss — integrity outweighs profit.From the cult-favorite Toning Pads that sparked the brand's cult following to Barefaced's commitment to education and honest guidance, Harper emphasizes serving the consumer, not selling to them.Tune in to hear how Jordan Harper is redefining modern skincare through clinical rigor, simplicity, and unwavering authenticity — and why the future of skin health is built on foundations, not fads.SHOP BAREFACED and learn more on social media!CHAPTERS:(0:02) - Introduction & Guest Welcome(0:40) - From ICU to Aesthetics: The Turning Point(2:34) - The 80/20 Rule: At-Home vs In-Office Results(4:39) - Common Routine Mistakes & Barrier Damage(7:16) - “Less, But Better” and The Core Four(9:28) - Longevity vs Anti-Aging(12:12) - What “Medical Grade” Really Means(17:28) - Scaling with Integrity & Brand Discipline(20:35) - Cult Favorites, Toning Pads & Community-Centered CarePlease fill out this survey to give us feedback on the show!Don't forget to subscribe to Skin Anarchy on Apple Podcasts, Spotify, or your preferred platform.Reach out to us through email with any questions.Sign up for our newsletter!Shop all our episodes and products mentioned through our ShopMy Shelf!*This is a paid collaboration Hosted on Acast. See acast.com/privacy for more information.