Episodes
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Welcome back to the tasty morsels of critical care podcast. For the next couple of posts we’re going to focus on infective endocarditis. We have had something of a run of these over the past few months with every other cardiac surgery seemingly being done for IE. Not all of this will be relevant to every intensive care unit but as I work in an ICU with lots of cardiac surgery we will be covering the relevant aspects. This episode we’ll look at the diagnostic process and next time we’ll look at management. IE is a common consideration in patients with infection being admitted to the hospital. B
Welcome back to the tasty morsels of critical care podcast. Today we look at blunt cerebrovascular injury or BCVI. I added this to my list to cover for unclear reasons as when i looked back at my notes i had about 8 bullet points and a couple of referenced articles. So this will be shorter than usual I suspect. Effectively this refers to injuries to the carotids and vertebral arteries in the context of trauma. The pathology here is typically a pinch, twist or stretch of the vessel leading to an intimal tear in the vessel. The exposed endothelium then is a nidus for thrombus formation. The main
Welcome back to the tasty morsels of critical care podcast. Today we’re going to look at the red stuff – blood, and when to give it. This will cover some of Oh’s Manual chapter 97 covering blood transfusion. But we’ll have a focus on transfusion targets. There’s a nice narrative of evidence here over the past 20 years that has given us a relatively robust evidence base for practice in this area, something quite novel in critical care. Blood is expensive and unlike fossil fuels currently remains a renewable resource in the healthy population, it is obviously quite limited and nations frequently
Welcome back to the tasty morsels of critical care podcast. Today we look at something we do fairly frequently in ICU, especially in the post COVID era: prone positioning or to use its preferred technical term: adult tummy time. This has been around for a long time but was uncommonly done in the pre COVID days and was always a talking point when it did happen. But then 2020 came and you’d spend significant portions of the day proning and supinating patients in the unit. Fair to say it’s something we should have a keen understanding of. Firstly we’ll talk about the physiology and potential mech
Welcome back to the tasty morsels of critical care podcast. Today we’re going to have a quick overview of the oesophageal balloon. If you’re directed to a patient in your long case who has an oesophageal balloon in, then you’re probably having a bad day. It would seem very unfair to have too many questions on this but an awareness of their existence and some cliff notes on their basic use might come in handy especially if you’re doing well and you’re in the medal type territory of the exam. Exams aside they’re a useful gateway drug into some important respiratory mechanics that are relevant to
Welcome back to the tasty morsels of critical care podcast. This is the second of 2 parts on PE in critical care. The first focused on risk stratification and this one will focus on management. There is a link to a transcript of a more comprehensive talk with references on emergencymedicineireland.com for those keen enough to dive a little deeper. As noted in the last podcast this one leans very heavily on “in the my experience” level of the evidence pyramid and should be weighted as such. For this discussion I’m going to assume your patient is in the ESC High risk category, ie hypotensive wit
Welcome back to the tasty morsels of critical care podcast. I haven’t managed to cover PE on the podcast yet. I have been involved in lots of small PE projects over the years and have developed something of an interest in it. I got invited to give a talk to the national EM conference this year and these podcasts are sort of the cliff notes version of that lecture. The full talk is linked to on the emergencymedicineireland.com website for those interested. I would emphasise that beyond the mention of the ESC guidelines this is an evidence lite podcast and more than usual represents opinions rat
Welcome back to the tasty morsels of critical care podcast. Hypertriglyceridaemua induced pancreatitis came up at a recent trainee presentation and I thought despite it being pretty niche and rare, it’s still common enough that it might be fair game for an SAQ or perhaps a side bar in a viva discussion. Pancreatitis is of course a common presentation to the ICU and can range from the straightforward to the never ending complication fest that carries a not insubstantial mortality rate. This is not the post that will cover the full gammut of pancreatitis. So what is the deal with the cumbersomel
Welcome back to the tasty morsels of critical care podcast. Today we’re going to try and cover the not insubstantial topic of acute liver failure from Oh’s Manual chapter 44. As you can imagine this will be a superficial skim of the topic so set your expectations appropriately. First point is differentiating acute from acute on chronic liver failure. This has a massive impact on presentation, diagnosis and management and I must confess for many years as a trainee my understanding of the distinction between the two was a little cloudy and it was only really in fellowship that it became clear to
Welcome back to the tasty morsels of critical care podcast. Today we look at the other diabetes. We are of course all familiar with the sweet urine of diabetes mellitus but this time we will look at the tasteless or insipid urine of diabetes insipidus. This will as always be a critical care type primer on the topic designed to help you survive a critical care fellowship exam. I would certainly not claim endocrine as my strong suit. There are 2 forms we’re likely to encounter in the ICU. The first is a deficiency or absence of antidiuretic hormone.The second is an resistance to ADH. You’ll noti
Welcome back to the tasty morsels of critical care podcast. Following on from the recent post on Heparin, today we’re going to talk about one of its more significant complications – Heparin Induced Thromboyctopaenia or HIT for short. In my ... Read More »
Welcome back to the tasty morsels of critical care podcast. Following on from our initial post in this entirely accidental series on “things you don’t want to find in the chest drain” we turn our eyes (if not our noses) ... Read More »
Welcome back to the tasty morsels of critical care podcast. Today we look at quite a niche topic, that of chylothorax. We are used to many things in the pleural space, like simple fluid or blood or air but the ... Read More »
Welcome back to the tasty morsels of critical care podcast. We’re going to cover a bit of an environmental/tox topic today and look at carbon monoxide poisoning from Oh’s manual chapter 83 on burns. I have previously covered this on ... Read More »
Welcome back to the tasty morsels of critical care podcast. We’ve been talking about pulmonary hypertension, last time we had a pretty broad overview with a focus on group 1 or pulmonary arterial hypertension. This time we’re going to go ... Read More »
Welcome back to the tasty morsels of critical care podcast. This time we’re looking at pulmonary hypertension. Mainly cause I recently had to give a talk on it so it’s fresh in my rapidly diminishing brain cells and thought I ... Read More »
Welcome back to the tasty morsels of critical care podcast. Last time i was butchering my way through a diagnostic approach to hyponatraemia, particularly the forms likely to end up in the critical care end of the hospital. This time ... Read More »
Welcome back to the tasty morsels of critical care podcast. Today we cover an incredibly common inpatient issue – hypnatraemia. We’ll often find 1 or 2 of these in our high dependency unit at any given time, mainly due to ... Read More »
Welcome back to the tasty morsels of critical care podcast. Today we’ll cover some key exam content, all be it not something you’re likely to run into in the ICU too often. The thyroid is a deceptive little organ, tucked ... Read More »
Welcome back to the tasty morsels of critical care podcast. Today we’ll talk about one of the niche and shall I say “advanced” in inverted commas therapies in intensive care practice. ECMO. And to be precise we’ll be talking about ... Read More »
Welcome back to the tasty morsels of critical care podcast. Way back in the way back in tasty morsel number 43 we discussed inotropes and vasopressors but there was a noticeable AHD analogue shaped hole in that post that i ... Read More »
Welcome back to the tasty morsels of critical care podcast. Today we’re going to verge into challenging territory for an audio podcast in that we’re going to the discuss the very visual topic of dynamic LV outflow tract obstruction. This ... Read More »
Welcome back to the tasty morsels of critical care podcast. Following hot on the heels of tasty morsel number 72 on cardio renal syndrome is its partner in nephron injury: hepatorenal syndrome. This gets covered in a sub section of ... Read More »
Welcome back to the tasty morsels of critical care podcast. Today we tackle a somewhat nebulous syndrome. Something we throw around with a few hand wavy explanations but often light on detail. Hopefully in a few minutes you’ll at least ... Read More »
Welcome back to the tasty morsels of critical care podcast. Oh Chapter 37 is dedicated to NIV in the ICU and is probably worth some time given that this is a common respiratory support both in the ICU and throughout ... Read More »
