Critical Care Time is the podcast for everyone who cares for the critically Ill. Whether you work in an ICU, a Med-Surg unit, an ED, a PACU or the back of an ambulance - Dr. Cyrus Askin & Dr. Nick Mark provide practical insights and useful tips to enhance your skillset.
Updated pulmonary embolism guidance separates diagnostic probability from clinical severity and emphasises recognising poor perfusion before hypotension develops. The discussion examines limitations of reperfusion evidence, multidisciplinary escalation, anticoagulation duration and investigation of persistent symptoms.
ICU survivors may remember delirium and frightening experiences vividly even when physical recovery appears good. Clear explanations during care, attention to family burden and realistic discharge planning recognise that psychological and practical recovery continues beyond critical care.
Inotrope choice should follow the physiology: assess perfusion, heart rate, ventricular function, vascular resistance, beta-blocker exposure and renal function rather than blood pressure alone. Dobutamine, epinephrine and milrinone produce importantly different cardiac and vascular effects.
US brain death assessment requires a known catastrophic brain injury, exclusion of physiological and drug confounders, absent brainstem responses and appropriate apnoea testing, with cerebral blood-flow studies used when clinical testing cannot be completed reliably.
A normal bicarbonate can conceal more than one metabolic process. A state–process–story approach uses pH, anion gap, strong ion difference and clinical context to distinguish respiratory failure or sedation from shock, bleeding or postoperative abdominal pathology.
A displayed oxygen saturation is only as reliable as pulsatile perfusion, probe position and signal quality. Delayed peripheral readings, pigmentation-related bias and hyperoxia limit interpretation, while suspected carbon monoxide poisoning or methaemoglobinaemia requires co-oximetry.
Critical-care and respiratory clinicians get an ARDS refresher covering alveolar-capillary leak, shunt, V/Q mismatch and reduced lung compliance. Practical management includes predicted-body-weight ventilation, plateau and driving-pressure review, early proning, dexamethasone, conservative fluid management, rescue therapies and palliative care alongside active treatment.
Critical-care, emergency and respiratory teams get a physiology-led airway strategy for refractory hypoxaemia, shock, severe metabolic acidosis and right ventricular failure. It links limited safe apnoea time with awake flexible endoscopic intubation, careful topicalisation, continued high-flow nasal oxygen and a prepared rescue plan.
Emergency and critical-care clinicians get a physiology-led approach to intubation in haemorrhagic shock, severe metabolic acidosis, hypoxaemic respiratory failure, pulmonary embolism and traumatic brain injury. It connects induction-related hypotension, apnoea, positive-pressure ventilation and right ventricular failure with preoxygenation, haemodynamic preparation, drug selection and team roles.
Critical-care, emergency and acute medicine clinicians get a detailed arterial-line update for shock, vasoactive titration, severe hypoxaemia, cardiac arrest and VA ECMO. It links decision-critical monitoring, ultrasound-guided insertion, site choice, securement, levelling, zeroing, damping checks and waveform interpretation to safer bedside decisions.
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