An educational podcast presenting practical critical care scenarios. By Brandon Oto, PA-C and Bryan Boling, ACNP. New episodes weekly.
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Episode 78: Echoing the RV with Matt Siuba
55:29
55:29
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We 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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Lightning rounds 43: AI in medicine, with Nawar Shara
56:43
56:43
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We 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
22:10
22:10
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We 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 77: Mastering APRV with Rory Spiegel
1:02:11
1:02:11
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We 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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Lightning rounds 42: Hospital chaplains, with Christine V. Davies
47:49
47:49
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We 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 76: Rehabilitation psychology, with Megan Hosey
42:42
42:42
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42:42
We 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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Lightning rounds 41: Respiratory therapy with Keith Lamb
40:14
40:14
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We 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 75: Automatic tube compensation, with Ben Fabry
56:54
56:54
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We 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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Brandon 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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Episode 74: Obstructive shock, with Sarah Lorenzini (Nurses’ Podcrawl 2024)
49:54
49:54
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Our collaboration with Sarah Lorenzini of the Rapid Response RN podcast, discussing a case and general principles for diagnosing and managing obstructive shock. Check out the other episodes on shock in the Nurses’ Podcrawl 2024! 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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Lightning rounds 40: Critical care medicine fellowships with Nicholas Ghionni
39:10
39:10
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We chat about pulmonary/critical care medicine fellowship with recent graduate Nicholas Ghionni (@pulmtoilet), a first-year attending at the MedStar Baltimore Hospital system. He completed PCCM fellowship at MedStar Washington Hospital Center where he also served as chief fellow. Find us on Patreon here! Buy your merch here!…
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The difference between people and institutions. 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 73: POCUS for nephrology, with Abhilash Koratala
53:51
53:51
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53:51
We discuss the role of point-of-care ultrasound in evaluating the patient with kidney injury and assessing volume status, with Abhilash Koratala (@nephroP), nephrologist, Director of Clinical Imaging for Nephrology at the Medical College of Wisconsin, and champion of nephrology-focused ultrasound. Find us on Patreon here! Buy your merch here! Takea…
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The nuts and bolts of how we produce the show. 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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Lightning rounds 39: Understanding flight medicine with Jace Mullen
52:09
52:09
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We explore critical care transport medicine from both a clinical and career perspective, including helicopters (HEMS), fixed wing jet, and ground ambulance transports, with Jace Mullen, flight paramedic and airway educator out of Denver. 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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When do patients deaths bother us?By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 72: CPR-induced consciousness with Jack Howard
41:21
41:21
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Find us on Patreon here! Buy your merch here! We discuss the phenomenon of CPR-induced consciousness (i.e. patients demonstrating awakeness during resuscitation) with Jack Howard, Intensive Care Paramedic at Ambulance Victoria in the northern suburbs of Melbourne, Australia, and first author on a recent literature review and Delphi-derived expert g…
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Should you use volume or pressure control ventilation? 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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Lightning rounds 38: Working in APP leadership, with Jason Wieland
46:47
46:47
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We talk about working in critical care APP leadership positions, with Jason Wieland, PA, Lead Pulmonary & Critical Care APP at WakeMed Health System in Raleigh, NC. 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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You poked through the deep wall of a vessel. Now what? 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 71: Transplant medications with Olivia Philippart
54:52
54:52
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We discuss the medications typically used after organ transplant, their impact on critical illness, and how to manage them when these patients show up sick—with Olivia Philippart, transplant clinical pharmacist specializing in liver and kidney transplant at University of Kentucky HealthCare. Find us on Patreon here! Buy your merch here! Takeaway le…
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How I make patients poop. 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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Lightning rounds 37: Weaning the deliriosedated patient (SCCM roundup)
9:13
9:13
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A roundup of opinions from attendees at SCCM’s 2024 Critical Care Congress in Phoenix on strategies for rescuing the patient stuck in a loop of deep sedation and agitation. Thanks to Pat Posa, Martha Roberts, Juliana Barr, Kelly Drumright, and Ben Lassow for their input. ResourcesBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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How to document your ultrasound findings. 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 70: Airway evaluation for non-anesthesiologists, with Jed Wolpaw
58:25
58:25
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We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr. Jed Wolpaw, anesthesiologist and intensivist from Johns Hopkins, anesthesiology residency program director, and host of the ACCRAC podcast. Find us on Patreon here! Buy your merch here! Takeaway lessons Referenc…
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Arterial lines are resuscitative tools.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Lightning rounds 36: Nurses are from Venus
43:04
43:04
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Bedside nurses and providers (physicians, PAs, NPs) tend to see the world differently, much of it driven by their training and the systems they work within. We chat about reconciling this and how to best function as a team.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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TIRBO 52: Reliable is better than perfect
10:01
10:01
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In general, medical decisions that avoid error are better than those that optimize care.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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We discuss head and neck surgery with Dr. Alexandra Kejner, otolaryngologist at the Medical University of South Carolina specializing in transoral robotic surgery, reconstructive surgery including microvascular free tissue transfer, salivary neoplasms, and sialoendoscopic procedures. Find us on Patreon here! Buy your merch here! Takeaway lessons Re…
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TIRBO 51: Critical care problems are syndromes
8:05
8:05
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The core disorders of critical care are mostly syndromes, not diseases. What should this mean to us?By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Lightning rounds #35: Brain death updates, with Ariane Lewis and Matthew Kirschen
46:03
46:03
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46:03
Discussing the new 2023 AAN/AAP/CNS/SCCM Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline, with the joint first authors: Dr. Ariane Lewis, neurointensivist, professor of neurology and neurosurgery at NYU Langone, director of neurocritical care, and chair of the Langone ethics committee, and Dr. Matthew Kirsc…
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If you produce academic work, use the research to produce multiple products. Once is a waste.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 68: Liver transplant with Meera Gupta
46:11
46:11
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We learn about liver transplant with Dr. Meera Gupta, transplant surgeon at the University of Kentucky Healthcare Transplant Center, and surgical director of the Kidney and Pancreas Transplant Program. We discuss eligibility, triage, the peri-operative course, and important post-op complications. Find us on Patreon here! Buy your merch here! Takeaw…
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Explaining the ultimate expression of prognosis: Morbidity = (Severity x Duration)/ReversibilityBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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When should you…By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Which site should you select for your central line placement? A discussion of some considerations.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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We learn about pancreaticoduodenectomy (the Whipple) with Michael Cavnar (@DrMikeCavnar), surgical oncologist at University of Kentucky, with a fellowship in Complex General Surgical Oncology from Sloan Kettering. He specializes in GI surgical oncology (liver, pancreas, stomach, etc), with ongoing research in GI stromal tumors and hepatic artery in…
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A review of the physiological and practical reasons to position patients with ARDS in the prone position.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Lightning rounds #33: Transitioning to academics with Janelle Bludorn
54:19
54:19
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We chat with Janelle Bludorn (@JanelleRBlu), former emergency medicine PA, Assistant Professor and Academic Coordinator at the Duke PA program, about transitioning from clinical work into teaching and academia. Find us on Patreon here! Buy your merch here! ResourcesBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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The value of being curious about practice differences, not judgmental.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 66: Aortic dissection with Travis Hughes
52:54
52:54
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We explore aortic dissection with Travis Hughes, vascular surgery fellow from the University of Kentucky, including classification, medical management, and nuances of the surgical perspective. 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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What are the ways that patients fail breathing trials, and what can they tell us about how to optimize them for next time?By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Lightning rounds #32: Creating a POCUS system with Leon Chen
1:04:44
1:04:44
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We chat with Leon Chen about his work setting up infrastructure for clinical POCUS at Memorial Sloan Kettering. Leon is an Adult/Gerontology Acute Care Nurse Practitioner in the ICU, Clinical Program Manager of Research and Simulated Learning, and an Associate Professor at Columbia University School of Nursing. Find us on Patreon here! Buy your mer…
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A brief discussion of the stuff in your pockets as you practice medicine.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 65: Obstructive UTI with Ashley Winter
41:17
41:17
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We discuss the nuts and bolts of urinary infection with an obstructing stone with Ashley Winter (@AshleyGWinter), board certified urologist with a fellowship in male and female sexual medicine, and chief medical officer of Odela Health. 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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TIRBO #43: Lying to ourselves (the clinician’s perspective on end-of-life care)
18:49
18:49
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From the Critical Concepts blog, thoughts on our personal biases and lack of humility when contemplating end-of-life decision making.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Lightning rounds #31: How to not get fired
49:13
49:13
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Bryan and Brandon chat about holding down jobs, conflict resolution and interpersonal skills, and how to protect yourself as an employee.By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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When are patient outcomes your fault?By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Episode 64: Neurologic POCUS with Aarti Sarwal
43:50
43:50
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We explore the cutting edge practice of point-of-care ultrasound of the brain, including optic nerve sheath measurement, transcranial doppler, assessing midline shift, and more, with Aarti Sarwal, neurologist and neurointensivist, director of the neurocritical care unit at Wake Forest, and director of their neurovascular lab and ultrasound courses.…
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