An educational podcast presenting practical critical care scenarios. By Brandon Oto, PA-C and Bryan Boling, ACNP. New episodes weekly.
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Kali Dayton, DNP, ACNP-BC, is an ICU nurse practitioner and consultant on a mission to create Awake and Walking ICUs. She hands the microphone to ICU survivors and bedside caregivers to reveal the realities of ICU experience and patients' journeys after discharge. The big picture of sedation and immobility is discussed and we explore how to improve short and long-term patient outcomes. We shift the vision from transferring out of the ICU to walking straight home after the ICU. www.DaytonICUc ...
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"Heavy lies the crown" is a common misquote of "uneasy lies the head that wears a crown" from Shakespeare's Henry IV, Part 2. It refers to the responsibility and insecurity of governing an entire kingdom. Likewise, "heavy lies the helmet" refers to the responsibility we face as critical care transport providers working in an autonomous and often unpredictable environment. Our minds are eased with education that better prepares us for any situation that we may encounter. That is exactly what ...
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Micro-learning all things critical care medicine. The transition to practice is overwhelming. We’re here to educate, entertain, inform, and support new nurse practitioners as they cross the divide from seasoned nurse to novice nurse practitioner. Thoughts, stories, and perspectives from an expert ICU nurse practitioner, Dr. Sean P. Dent.
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Palliative Care Chat - University of MD Baltimore
Palliative Care Chat - University of MD Baltimore
Brought to you by the online Master of Science and Graduate Certificates in Palliative Care from the University of Maryland, Baltimore. graduate.umaryland.edu/palliative
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Nursing Uncensored features candid conversations with nurses about topics that range from educational to explicit, from scholarly to scatological. NU will make you laugh, make you think, and might even make you blush with our bold opinions and dark humor. At the core of our mission is the education, advocacy, and empowerment of nurses and students. We believe in creating a space that uplifts and supports all individuals, highlighting what makes them unique and interesting. We honor HIPAA but ...
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The Change of Shift Podcast offers a unique learning perspective on the nursing profession. We all learn the hard way that nursing is not easy. Each episode Sean hears from Nurses, students, educators, and professional influencers who have learned to survive the real world of nursing and its big brother the healthcare community at-large. As a profession, the “change of shift” is a moment Nurses have transformed into a malleable coping mechanism and buffering tool. A tool created to not only ...
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Episode 85: Tracheostomy basics with Vinciya Pandian
46:01
46:01
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46:01We discuss the basics of evaluation for tracheostomy placement, periprocedural care, and post-procedure complications with Vinciya Pandian, PhD, ACNP, FCCM, tracheostomy nurse practitioner and researcher. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Academy bites: You were here when we were not
15:40
15:40
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15:40Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 126 - Certification Versus Qualification
50:47
50:47
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50:47Do certifications accurately reflect an individual's qualifications? This is an ongoing argument depending on what side of the exam you are on. How much value should we on that piece of paper? And, regardless, how do we work towards obtaining and maintaining qualifications? In this podcast episode, we discuss it all including Dunning-Kruger Effect …
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Episode 84: Acute liver failure with Sergio Navarrete
56:39
56:39
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56:39We discuss assessment, monitoring, medical stabilization, and when to consider transplant of the patient with acute liver failure. We are joined by Dr. Sergio Navarrete, anesthesiologist and intensivist with fellowship training in transplant anesthesia. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway…
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Episode 188: The ICU Revolution at Mercy San Juan Medical Center - Part 7 with Dr. Coates
54:49
54:49
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54:49When the harm of “normal practices” shifts the perspective of an ICU revolutionist and medical director, what is the next course of action? Dr. Jodi Coates shares how her personal convictions inspired her to lead her trauma ICU to radically transform their sedation and mobility practices. Want to help your ICU become an Awake and Walking ICU? Sched…
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Episode 83: Cardiac arrest with Scott Weingart
1:10:15
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1:10:15We talk about the nitty-gritty details of a well-run cardiac arrest, with Scott Weingart of Emcrit (@emcrit), ED intensivist. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessons ResourcesBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 187: The ICU Revolution at Mercy San Juan Medical Center - Part 6 with Ginger Manss
32:16
32:16
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32:16What is the role of the critical care director in leading ICU teams to become Awake and Walking ICUs? How can directors use the evidence to win executive leadership support for their teams to have what they need to succeed? Ginger Manss, DNP shares with us her key role as senior director of critical care in the revolution at MSJMC. Check out their …
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Lightning rounds 48: Complete airway closure with Thomas Piraino
1:13:45
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1:13:45We talk about the phenomenon of airway closure during mechanical ventilation, with Thomas Piraino, RRT, FCSRT, FAARC, adjunct lecturer for the Department of Anesthesia at McMaster University, editor of The Centre of Excellence in Mechanical Ventilation Blog, and a member of the editorial board of Respiratory Care. Learn more at the Intensive Care A…
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Episode 125 - Breaking the Case: The Point of Ultrasound
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45:05Previously, we recorded a podcast episode about the utility surrounding Point of Care Ultrasound (POCUS). In this episode, we apply that knowledge to specific case scenarios as a continuation of our "Breaking the Case" series. We also ask the question, is POCUS really all it's cracked up to be, or should we be re-thinking our approach, particularly…
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Episodes 186: The ICU Revolution at Mercy San Juan Medical Center Part 5- Respiratory Therapy
48:04
48:04
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48:04What role do respiratory therapists play in creating Awake and Walking ICUs? How did Candace Wistrich, RRT, BSRT and Nelya Kapitula, RRT, BSRT lead their respiratory therapy department to move the revolution forward? They join us now to share their team’s journey! Vote for “Awake and Walking ICUs” as “best nurse innovation” and Kali Dayton as “best…
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Our approach to common problems and troubleshooting: Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 185: The ICU Revolution at Mercy San Juan Medical Center- Part 4 with the Trauma ICU RNs
59:00
59:00
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59:00How does the Awake and Walking ICU approach apply to the trauma ICU? How did education, training, leadership support, and deep compassion empower these experience trauma nurses to transform their ICU culture and practices? What successes have they had and how has keeping patients awake and mobile impacted their career fulfillment and team dynamics?…
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Lightning rounds 47: Post-op care transitions
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44:09We chat about the post-op transition of care from the OR to the ICU, including questions to ask, workflows, and pitfalls. Check out the Intensive Care Academy here! Bryan’s textbook: Concepts in Surgical Critical Care Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 184: The ICU Revolution at Mercy San Juan Medical Center- Part 3 with Luke Stratigates
44:29
44:29
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44:29Safe patient handling(SPH) is a fairly new and rapidly growing field. Mercy San Juan Medical Center is fortunate to have a strong SPH department and leadership. Luke Strategates, DPT shares with us the key role he plays in the ICU Revolution as the safe patient handling leader. Want to bring the revolution to your ICU? Schedule a consultation at ww…
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Episode 124 - Canine Care w/George Tarver III
56:54
56:54
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56:54Humans are easy. That's why we are able to do what we do as prehospital providers. But what happens when your patient is a canine? These working dogs are highly regarded by their handlers and require care just like anyone else that may be ill or injured. Considering that, are you equipped to care for them? If not, how can you successfully start and…
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Episode 183: The ICU Revolution at Mercy San Juan Medical Center- Part 2 with Dr. Lawrence Bistrong
37:14
37:14
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37:14What happens when a medical director really sees the reality of “normal practices” and becomes a revolutionist? Dr. Bistrong shares his personal conversion and the key role he has playing in his team’s transformation. Www.DaytonICUConsulting.com
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Episode 81: Bacterial meningitis with Casey Albin
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58:42
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58:42We talk about diagnosis, treatment, and subsequent care of the patient with bacterial meningitis, with Emory neurointensivist Casey Albin, MD (@caseyalbin). Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessons ResourcesBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 182: The ICU Revolution at Mercy San Juan Medical Center- Part 1 with Jeana Flakes
44:50
44:50
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44:50Standardized sedation and immobility are rooted in a gap in education. What is the power of a nurse educator in transforming knowledge, culture, and practice in the ICU? Jeana Flakes, MSN, RN shares how she helped lead the ICU Revolution as a nurse educator at Mercy San Juan Medical Center. Www.DaytonICUConsulting.com…
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Lightning rounds 46: Nick Ghionni on combating cognitive bias
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55:40We chat with Nick Ghionni, pulm/crit attending at MedStar Baltimore Hospital, about identifying and combating cognitive biases in our clinical decision-making. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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What do physicians understand of the ABCDEF bundle? What are their perceptions of early mobility? How are their teams practicing the ABCDEF bundle in their own units? What do physicians need to be able to lead an Awake and Walking ICU approach in their units?I interviewed physicians while attending the CHEST conference to find answers to these ques…
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Episode 123 - To Treat or Not to Treat: Hypertension
1:00:03
1:00:03
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1:00:03It can be difficult to determine whether you should treat undifferentiated hypertension or not. Many clinicians are distracted the number rather than focusing on the patient in front of them. Asymptomatic hypertension, in particular, is often benign. In fact, treating asymptomatic hypertension in a patient who a primary medical history of hypertens…
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Episode 80: Implementing the A-F bundle with Kali Dayton
58:08
58:08
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58:08We discuss the practical barriers to implementing the A-F ICU liberation bundle, with Kali Dayton, ACNP-BC (@daytonicu), host of the Walking Home from the ICU podcast, and consultant to ICUs working on these issues. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here!…
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Episode 180: Leading the ABCDEF Bundle in Bangledash
35:48
35:48
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35:48What happens when a visionary physician in a low-resource hospital in Bangledash leads his team to practice the ABCDEF bundle? How did this passionate team of ICU clinicians transform their care from automatic sedation and immobility to standardized mobility three times a day? How did they come to treat mobility as important and optional as an anti…
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Lightning rounds 45: Noelia Bischoff on transitioning nursing roles
38:55
38:55
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38:55We chat with Noelia Bischoff, recently off orientation in the medical ICU at Johns Hopkins as a nurse practitioner, about the transition from her role as a bedside ICU nurse. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 179: The Legal Liability of Failing to Practice the ABCDEF Bundle
56:24
56:24
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56:24Fear of “liabilities” is often a barrier to keeping patients awake and mobile in the ICU. Yet, we know that the ABCDEF is evidence-based best practices. So what are the legal liabilities to a hospital, leadership, and bedside clinicians of current cultural practices? Maggie Ortiz, MSN, RN joins us now to share her expert perspective. Find Maggie at…
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Episode 122 - Stay Positive When Preoxygenating (PREOXI Trial)
1:01:23
1:01:23
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1:01:23The principles of preoxygenation and passive oxygenation should be familiar to any experienced intubator. Best practice recommends the use of a nasal cannula in conjunction with either a non-rebreather mask or bag-valve mask (BVM) to prevent hypoxemia during the apneic phase of Rapid Sequence Intubation (RSI). In the PREOXI Trial, the authors pushe…
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Episode 79: Transfusion reactions with Joe Chaffin
55:54
55:54
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55:54We discuss transfusion reactions, risks, and management, including infection, consent, TRALI, TACO, and hemolytic reactions—with Dr. Joe Chaffin (@bloodbankguy), the “Blood Bank Guy” and transfusion medicine specialist. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessons…
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We dive deep into everything you need to know about Levophed. From how it works to how we use it.
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Episode 178: The Power of Nursing Leadership to Revolutionize the ICU
1:03:58
1:03:58
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1:03:58Although the ABCDEF bundle does not solely rest on the shoulders of nurses, their leadership is KEY. Andrea Silva, BSN, RN shares with his her journey to revolutionizing care in her ICU as an assistant nurse manager. Www.daytonicuconsulting.com
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Lightning rounds 44: Post-intubation sedation roundup
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32:00Experts in critical care share their approach to post-intubation sedation. Contributors: Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 177: New Grad RN Helps Lead the Revolution in His ICU
47:51
47:51
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47:51The ICU is an overwhelming and daunting environment to start a new career. While learning so many new skills from experienced mentors, how did Michael Glade, RN, BSN also see past “what is done” to “what should be done” in his ICU? Michael shares with us what led him to help lead the revolution in his ICU. Www.DaytonICUConsulting.com…
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Episode 121 - Outside the Box: Cardiac Arrest Management
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46:51
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46:51Not all cardiac arrests are created equal. Whether the presenting rhythm is asystole, ventricular fibrillation, or PEA, these patients require tailored interventions beyond "blanket" protocol and ACLS/PALS algorithms. When refractory to conventional therapy, the pulseless V-Tach/V-Fib patient, in particular, requires critical thinking "outside the …
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Episode 78: Echoing the RV with Matt Siuba
55:29
55:29
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55:29We talk the nitty-gritty of assessing the right heart using echocardiography, with our friend Matt Siuba (@msiuba), intensivist at the Cleveland Clinic and master of zentensivism. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessonsBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 176: ICU Survivor to ICU Physical Therapist- Hope’s Journey to Revolutionizing Her ICU
52:16
52:16
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52:16https://Www.daytonicuconsulting.com
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Lightning rounds 43: AI in medicine, with Nawar Shara
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56:43
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56:43We explore the fascinating world of artificial intelligence and its role in medicine, with Nawar Shara (@NawarShara), PhD, Chief of Research Data Science at Medstar Health Research Institute and cofounding director of the AI Collab between Medstar and Georgetown. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch her…
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Special episode: The Intensive Care Academy
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22:10We share our grand new project, the Intensive Care Academy, an online, video-based, subscriber-only educational platform. Check it out at icu101.com!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 175: Physiologists Leading the ECMO Revolution!
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46:54
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46:54Ilija Klipa MS, ACSM-CEP,ACSM-EP,ACSM EIM III, AACVPR-CCRP is a cardiac/pulmonary physiologist a high-acuity cardiac ICU. He shares his journey in pioneering physiology in the ICU as well as leading the revolution to create an Awake and Walking ICU. Check out Ilija's upcoming 30-credit ECMO mobility courses here: https://cme.ahn.org/content/extraco…
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Episode 77: Mastering APRV with Rory Spiegel
1:02:11
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1:02:11We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr. Rory Spiegel (@EMnerd_), emergency physician and intensivist at MedStar Washington Hospital Center (and EMNerd at Emcrit). Find us on Patreon here! Buy your merch here! Takeaway lessonsBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 174: Delirium Mismanagement for LOE Patients Exacerbate Racial Disparities in the ICU
50:37
50:37
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50:37When patients have a primary language other than English (LOE), how does this impact their access to the ABCDEF bundle? Is it standardized to provide nonverbal communication in other languages in the hospital? Emily Ahrens, MS, RN, CCRN joins us now to dive deep into her post-doctoral studies dedicated to this gap in critical care medicine. Episode…
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Lightning rounds 42: Hospital chaplains, with Christine V. Davies
47:49
47:49
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47:49We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital. Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 120 - Sorry, We Are Closed: Interfacility Transfers w/Austin Wingate
1:04:17
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1:04:17Interfacility transfers are not always indicated at the time and place of which they are being requested. Whether it's referring provider misinformation or a lack of advocacy by the transport agency, these transfers can result in unnecessary risk for crew members and patients. Specifically, weather conditions, time of day, crew fatigue, and other i…
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Episode 173: ICU Outcomes by Dose of Mobility
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56:08
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56:08We know that for each additional 10 minutes of early mobility in the ICU, hospital length of stay decreases by 1.2 days. What else do we know about the relationship between dose of mobility and time on the ventilator? Sarina Fazio, PhD, RN, shares with us her exciting discoveries in her latest research. Episode transcripts and citations at: Www.day…
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Episode 76: Rehabilitation psychology, with Megan Hosey
42:42
42:42
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42:42We discuss the field of rehabilitation psychology, and how it can help patients with persistent critical illness, with Dr. Megan Hosey (@DrMeganHoseyPhD), clinical psychologist and assistant professor at Johns Hopkins School of Medicine, where she practices in the medical ICU. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources…
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Founders, Leaders and Futurists in Palliative Care: Connie Dahlin, Jay Vanston, Mary Lynn McPherson
27:41
27:41
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27:41Constance Dahlin, MSN, ANP-BC, ACHPN®, FPCN, FAAN is a consultant to the Center to Advance Palliative Care, a palliative nurse practitioner at North Shore Medical Center and co-director of the Palliative APP Externship. Vincent Jay Vanston, MD FAAHPM HMDCB has been working in the field of Hospice and Palliative Medicine for over 25 years. His work …
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While walking the halls full of critical nurses at AACN’s NTI conference, I had get their insights and perspectives. This episode is full of interviews with anonymous ICU nurses from all over the USA. Www.DaytonICUConsulting.com
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Lightning rounds 41: Respiratory therapy with Keith Lamb
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40:14We explore the profession of respiratory therapy in the US, including their role and training and how to optimize our clinical relationships, with Keith Lamb (@kdlamb1), RRT, RRT-ACCS, FAARC, FCCM. Keith is an RT at the University of Virginia in Charlottesville, working clinically in neuro/surgical/trauma critical care, who has been active in resea…
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Responsible self-directed learning occurs in a zone between comfort and novelty. Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 171: The Power of Autonomy and Human Connection During ECMO
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29:10Check out this episode with @Christinecasiano as she shares the contrast between being sedated vs. being awake while on ECMO. Register for the monthly ICU Revolutionists zoom meetings here: https://us02web.zoom.us/meeting/register/tZ0oc-6gqzsrGNYdgMGXvVAbcjewZpNpc6PC
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Episode 75: Automatic tube compensation, with Ben Fabry
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56:54
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56:54We discuss the principles and application of automatic tube compensation (ATC) on modern ventilators, with its creator Ben Fabry. Dr. Fabry is a professor and chair of biophysics at University of Erlangen-Nuremberg, originally trained as an electrical engineer, who originally developed ATC as part of his PhD program. Find us on Patreon here! Buy yo…
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TIRBO 61: How to use POCUS (our expert consensus)
23:06
23:06
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23:06Brandon summarizes his recent publication describing best practices for performing POCUS. Read the paper open access at POCUS Journal. Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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