Critical Care Scenarios

Lightning rounds 73: How to use AI in medicine, with Harvey Castro

Lightning rounds 72: How to teach POCUS

Academy bites: Is lung POCUS dumb?

AI safety requires urgent, coordinated federal and international regulation to manage risks associated with rapid technological development. Beyond this, point-of-care lung ultrasound in critical care serves specific, high-value functions but remains limited for broader diagnostic tasks. While ultrasound effectively id...

Lightning rounds 71: The story of HFOV, with Brian Cuthbertson

Lightning rounds 70: Jumping ship for private industry, with Theresa Human

Lightning rounds 69: Does PRVC suck? with Nick Ghionni

Lightning rounds 68: Setting PEEP in the obese with Olivia Serigano

Setting optimal PEEP for obese patients requires balancing extrinsic chest wall pressure against alveolar recruitment to prevent atelectasis. While esophageal manometry serves as the gold standard for measuring transpulmonary pressure, its limited clinical availability necessitates practical alternatives. Using a simpl...

Episode 103: Basic intracranial hemorrhage

Intracranial hemorrhage (ICH) management requires a nuanced, patient-specific approach focused on preventing hematoma expansion and secondary complications. While clinical workflows vary by institution, initial management centers on stabilizing blood pressure—often targeting systolic levels below 140–150 mmHg—and timel...

Episode 102: Tox files #1 with Andrew Sheen and Jerry Snow

Lightning rounds 67: IV fluids

Clinical management of IV fluids in critical care has shifted from routine maintenance toward intentional, goal-directed administration. Resuscitation requires rapid boluses—often utilizing pressure bags—rather than slow, continuous infusions, which frequently fail to achieve intravascular volume goals. While balanced ...

Lightning rounds 66: ED vs ICU with Namita Jayaprakash

Lightning rounds 65: Global health with Kwame Boateng

Episode 101: Acalculous cholecystitis with Dennis Kim

Acute acalculous cholecystitis presents a diagnostic challenge in the ICU, particularly in patients with sepsis or prolonged NPO status. Dr. Dennis Kim emphasizes that while imaging findings like gallbladder distension and wall thickening are common, they often lack specificity in critically ill populations. A comprehe...

Episode 100: Autoimmune encephalitis testing with Tammy Smith

Autoimmune encephalitis testing requires a strategic, phenotype-driven approach rather than a broad, indiscriminate diagnostic method. Because these tests are expensive and prone to false positives, clinicians must first identify the patient's specific clinical phenotype—such as epilepsy, movement disorders, or encepha...

Lightning rounds 64: The new Surviving Sepsis guidelines with Hallie Prescott

The podcast explores the updated Surviving Sepsis Campaign guidelines, addressing both their content and the controversies surrounding their implementation. Hallie Prescott, co-chair of the writing committee, clarifies new recommendations, including pre-hospital antibiotic administration for hypotensive patients with p...

Lightning rounds 63: How to be right, with Scott Weingart

The podcast explores the challenges of discerning truth in medicine amid information overload and the rise of experts and AI. It questions the traditional reliance on journals, given the difficulty in assessing methodologies and the lack of definitive answers in critical care. Scott Weingart shares his approach to stay...

Episode 98: RV failure in the MICU

The podcast explores the complexities of managing right heart failure in critically ill patients, particularly focusing on the challenges of diagnosis and treatment in patients with multiple comorbidities. Amos Dodi, a nocturnal intensivist, provides insights into using point-of-care ultrasound to differentiate between...

Lightning rounds 61: Credentialing and privileging, with Christopher Newman

The podcast episode explores the complexities of medical credentialing and privileging, clarifying the definitions, processes, and implications for healthcare professionals. It distinguishes between credentialing, which verifies qualifications, and privileging, which determines the scope of practice within an instituti...

Lightning rounds 60: The nuances of insulin, with Melissa Nestor

The podcast explores insulin usage in the ICU, questioning when and why it's administered, even to non-diabetic patients. It highlights the role of hyperglycemia as a stress response and the impact of medications like steroids and altered feeding patterns. The speakers advocate for A1c tests to differentiate between ac...

Episode 98: Running rapid responses