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PODCAST

Critical Care Scenarios

Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM

An educational podcast presenting practical critical care scenarios. By Brandon Oto, PA-C and Bryan Boling, ACNP. New episodes weekly.

health & fitness medicine

All Episodes

15:55

TIRBO #6: The many varieties of subclavian line

Critical Care Scenarios ·

2022/04/03

Reviewing the different approaches to placing central venous catheters in the subclavian vein.

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47:23

Episode 45: Amniotic fluid embolism with Stephanie...

Critical Care Scenarios ·

2022/03/27

We discuss the clinical presentation and management of AFE with guests Dr. Stephanie Martin (Twitter: @OBCriticalCare, Instagram: @criticalcareob), medical director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist in Scottsdale, Arizona with expertise in critical care obstetrics. She is also co-host of the Critical Care Obstetrics podcast. We’re also joined for a … Continue reading "Episode 45: Amniotic fluid embolism with Stephanie Martin"

en-US

1:09:02

Episode 44: Physical therapy with Heidi Engel

Critical Care Scenarios ·

2022/03/20

A look at rehabilitation and mobility in the critically ill, from the perspective of our skilled therapists—with Heidi Engel, PT, DPT of UC San Francisco, long-term provider of acute care therapy, researcher in ICU rehabilitation, and founding member of the SCCM’s ICU Liberation program. Takeaway lessons Tolerance of pressure support ventilation is often a good … Continue reading "Episode 44: Physical therapy with Heidi Engel"

en-US

9:53

TIRBO #5: Tracheoinnominate fistulas

Critical Care Scenarios ·

2022/03/13

A quick review of tracheoinnominate fistulas: how they happen, what they look like, and most importantly, what you’ll need to do.

en-US

53:40

Lightning rounds #13: What’s the deal with nurses?

Critical Care Scenarios ·

2022/03/06

Brandon and Bryan reflect on the qualities that define good and bad ICU nurses, the challenges they face, and how APPs and physicians can enable them to be their best.

en-US

10:42

TIRBO #4: Hope

Critical Care Scenarios ·

2022/02/27

Why an assumption in your training should be to call for assistance, but expect it will never arrive. Plan to manage problems yourself. Let help surprise you—otherwise hope becomes your plan.

en-US

56:21

Episode 43: Resuscitative TEE with Felipe Teran

Critical Care Scenarios ·

2022/02/20

The hows, whys, logistics, and applications of focused, bedside transesophageal echocardiography performed by critical care and EM providers, with Felipe Teran, assistant professor of emergency medicine at Weill Cornell and director of the Resuscitative TEE Project. Takeaway lessons As a rule, resuscitative TEE is performed in patients with a secured airway. TEE views are not … Continue reading "Episode 43: Resuscitative TEE with Felipe Teran"

en-US

9:07

TIRBO #3: Weaning vs Titration

Critical Care Scenarios ·

2022/02/14

When do interventions need to be “weaned”? Stop using this word when you don’t mean it! Titrate, target to effect, but only wean when there is a physiologic dependence.

en-US

37:09

Lightning rounds #12: Co-managing patients in a...

Critical Care Scenarios ·

2022/02/06

Brandon and Bryan talk about the practicalities of communication, collaboration, and compromise in a surgical ICU, when the surgical and critical care teams are both involved, one is the “primary” team on paper, but everyone needs to be heard.

en-US

9:03

TIRBO #2: Procedural handedness

Critical Care Scenarios ·

2022/02/02

When should you place a line or perform other procedures using your left (or non-dominant) hand? Brandon reflects on a few situations.

en-US

20:11

TIRBO #1: Toughness

Critical Care Scenarios ·

2022/01/27

The first episode of Brandon’s intermittent solo rants, in this case discussing toughness, stress tolerance, and flexibility in clinical medicine.

en-US

50:14

Episode 42: Clinical pharmacists with Laura Means Ebbitt

Critical Care Scenarios ·

2022/01/23

An overview of the role and contributions of a clinical pharmacist in the ICU, with Laura Means Ebbitt of the University of Kentucky, a clinical pharmacist specializing in colorectal/ENT surgery and critical care. Takeaway lessons A clinical pharmacist is a “knowledge pharmacist,” dispensing advice rather than medications. They round with the team to review meds … Continue reading "Episode 42: Clinical pharmacists with Laura Means Ebbitt"

en-US

39:31

Lightning rounds #11: Reflections on two years of the...

Critical Care Scenarios ·

2022/01/09

Bryan and Brandon look back on the two-year anniversary of the show and reflect on where it’s been, where it’s going, lessons learned, and other deep thoughts.

en-US

55:35

Episode 41: Preventing and managing complications...

Critical Care Scenarios ·

2021/12/26

Part two of our discussion with fan favorite Matt Siuba (@msiuba), Cleveland Clinic intensivist, on complications in critical care and how to prevent and manage them. Today we focus on respiratory failure after extubation, and unintentional self-extubation. Takeaway lessons When considering extubation of borderline patients, extubating to high flow nasal cannula or CPAP/BiPAP is often a good … Continue reading "Episode 41: Preventing and managing complications (part 2) with Matt Siuba"

en-US

52:57

Lightning rounds #10: Physical examination in the ICU

Critical Care Scenarios ·

2021/12/12

Bryan and Brandon talk about the physical exam: how we apply it in the ICU, its utility and changing role in the setting of modern diagnostic modalities, and its best and most practical use-cases. References McNamara LC, Kanjee Z. Counterpoint: Routine Daily Physical Exams Add Value for the Hospitalist and Patient. J Hosp Med. 2021 … Continue reading "Lightning rounds #10: Physical examination in the ICU"

en-US

1:10:10

Episode 40: Making the diagnosis with André Mansoor

Critical Care Scenarios ·

2021/11/28

Dr. André Mansoor (@AndreMansoor), associate professor of medicine in Portland, Oregon, author of the excellent Frameworks for Internal Medicine, and contributor to Physical Diagnosis PDX, talks us through a complex case of encephalopathy and respiratory failure to illustrate some principles of diagnostic reasoning. Takeaway lessons The hardest part of treating most diseases is making the … Continue reading "Episode 40: Making the diagnosis with André Mansoor"

en-US

57:04

Lightning rounds #9: Notes and documentation

Critical Care Scenarios ·

2021/11/14

Bryan and Brandon chat about notes: what makes a good one, their many and conflicting purposes, some structures and approaches, system- versus problem-based charting, and more.

en-US

58:13

Episode 39: ECMO for COVID-19 with Kim Boswell

Critical Care Scenarios ·

2021/10/31

An overview of VV ECMO with a focus on COVID-19, with Dr. Kimberly A. Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. We discuss evaluating for candidacy, induction, maintenance, weaning, and general approaches to the COVID patient. Takeaway lessons The limited amount of ECMO … Continue reading "Episode 39: ECMO for COVID-19 with Kim Boswell"

en-US

11:57

Lightning rounds #8: Five things you’re getting wrong

Critical Care Scenarios ·

2021/10/17

Bryan’s off this week, so Brandon flies solo to explain five wrong-headed notions that many people believe without thinking about them. Are diuretic infusions more effective than intermittent boluses? Are antipsychotic (neuroleptic) agents a good treatment for ICU delirium? Is pressure control or volume control a better form of assist control? Does renal failure cause … Continue reading "Lightning rounds #8: Five things you’re getting wrong"

en-US

49:31

Episode 38: GI bleeding with Elliot Tapper

Critical Care Scenarios ·

2021/10/03

Back with returning guest Dr. Elliot Tapper (@ebtapper), gastroenterologist, transplant hepatologist, and director of the cirrhosis program at the University of Michigan in Ann Arbor, to talk about critical GI bleeding. Takeaway lessons Consider the Glasgow-Blatchford score to stratify risk and need for admission, GI consultation, etc. Octreotide (or terlipressin) is indicated in every cirrhotic … Continue reading "Episode 38: GI bleeding with Elliot Tapper"

en-US

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