On this week's episode of Critical Care Time, Cyrus & Nick go all-in on DKA and spend a little time talking about alcoholic and starvation ketosis too! In this jam-packed, clinically robust episode, the guys discuss the importance and pathophysiology of DKA before discussing all things treatment. After listening to this - and perusing the show notes - you'll be a DKA master! Check it out and let us know what you think. Special thanks to Integration Health and The Difficult Airway Course: Critical Care for supporting the production of this episode! Hosted on Acast. See acast.com/privacy for more information.

On this week, Cyrus & Nick are joined again by intensivist extraordinaire, Dr. Adam Mora, for a long overdue episode on ICU Toxicology! Together, the three of us embark on a case-based journey covering some of the more common ICU toxidromes as well as some of the more unusual, but can't-miss diagnoses. This is a bit of a longer one but it's super high-yield and very practical for anyone who is studying for their boards and/or participating in the care of the critically ill! Thanks to our tag-team of sponsors for this episode: The Difficult Airway Course: Critical Care and our newest sponsor, Integration Health!Integration Health Website: https://bit.ly/IHxCCTLinkedIn: https://www.linkedin.com/company/integration-health/Instagram: https://www.instagram.com/integrationhealth_eclsThe Difficult Airway Course: Critical CareX (Twitter): @theairwaysiteInstagram: @theairwaysiteFacebook: @TheDAC.EMSLinkedIn: Airway Management Education Center (AMEC) Hosted on Acast. See acast.com/privacy for more information.

We've been teasing this one for a while and now it's finally ready! This week we've released our first LIVE podcast from Chest 2025 where we cover cases in cardiogenic shock with our amazing panel of incredible clinicians. Nick & Cyrus moderate a discussion using a choose-your-own-adventure format, leveraging the expertise of our panelists in an hour long, fun-filled and practical discussion where we put some of our earlier CCT content to practice in some real world cases. Check out the YouTube channel or the website if you want to follow along with the slides. Please let us know how you like this!! Hosted on Acast. See acast.com/privacy for more information.

Buckle up because on this week's episode of Critical Care Time we are treated to a master class on Right Heart Failure with world-class educator Dr. Matt Siuba. We are taking a deep dive on diagnosis, management and of course, sharing our love for the PAC! Make sure you clear your schedule and take notes for this one because as far as we are concerned, this is required listening for anyone who cares for the critically ill! Hosted on Acast. See acast.com/privacy for more information.

Folks this right here is a JAM PACKED episode of CCT goodness for you guys to enjoy! In this show for the ages we take a deep dive into the world of Mechanical Circulatory Support (MCS) and Cardiopulmonary Critical Care with one of the best in the biz, Dr. Bindu Akkanti! We will go through several fictional patients illustrating use cases, pitfalls and pearls of tools such as the balloon pump, ECMO and the microaxial flow devices used in ICUs all over the globe to help care for the sickest of the sick. If these tools ring a bell or if you are just interested in how we optimize care for these types of patients, give us a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

On this week’s BONUS episode of Critical Care Time, Cyrus & Nick flip the coin on sleep and discuss the importance of sleep for those of us that have to work nights. We also discuss how to find ways to still get rest even when your whole world is flipped upside down! Be prepared to keep taking excellent care of your patients using some of the tricks we review here. Give it a listen - or a watch and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

On this episode of Critical Care Time we delve into the fascinating world of sleep with a focus on the importance of sleep in our ICU patients and how we can promote good quality sleep in the sickest patients in the hospital. Try not to sleep through this one as we provide some valuable insights and high quality pearls to get you geared up and ready to be a champion for sleep in your ICU! As always, listen and let us know what you think. Special thanks to The Difficult Airway Course: Critical Care, for sponsoring this episode! Hosted on Acast. See acast.com/privacy for more information.

On this episode of Critical Care Time, we tackle the enigma - shrouded in mystery and caped in uncertainty - know as rheumatologic emergencies in the critically ill patient! We sit down with Dr. Marcela Ferrada - a QUADRUPLE boarded intensivist/rheumatologist/ID specialist and internist - who guides us through her approach to rheumatologic emergencies in the sickest of the sick. As we often do, we approach this via a pragmatic, cased-based journey for your listening pleasure. Please check it out, learn all you can, and as always - let us know your thoughts and leave a review!Special thanks to returning sponsor, Seastar Medical for supporting us with this production!  Hosted on Acast. See acast.com/privacy for more information.

This Critical Care Time bonus is our ode to RSI... that is the RSI Trial! In this episode, we'll unpack all the important elements of the recently released RSI Trial by the Pragmatic Critical Care Research Group exploring whether there is a signal favoring etomidate vs ketamine for tracheal intubation of critically ill adults. Does one drug reign supreme? Is this practice changing, practice affirming or perhaps the devil's in the details? Listen, learn and let us know YOUR thoughts! Hosted on Acast. See acast.com/privacy for more information.

This week we drop a journal club extravaganza! Should we do away with the A-Line? Is Bicarb a sure-fire way to treat metabolic acidosis in the setting of AKI? What about selective decontamination and all that capillary refill business!? We tackle all these topics through thoughtful journal discussion, provide our $0.02 and a little witty repartee, of course! Check it out and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

The importance of leadership in the hospital setting is critically important yet often overlooked. It’s even more important to have sound leaders and adhere to well-founded leadership practices when taking care of the critically ill. Join us as we sit down with Dr. Josh Hartzell - internist, infectious disease physician, author, veteran and physician-leader - as we discuss Leading in the ICU and Beyond!As always, please leave us feedback and let us know what you think!  Hosted on Acast. See acast.com/privacy for more information.

For those who work in an ICU - or with any patients for that matter -the concepts of burnout and moral injury are no stranger. In order to mitigate the effects of these forces, it’s important to understand them. Join Nick and Cyrus, as they sit down with an incredible guest, Dr. Venktesh Ramnath, with the hopes of doing just that. On this episode we step away from the pressors and central lines and focus on the contributors to burn out and moral injury in the medical field while developing some strategies to combat them. Listen, watch, learn and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

Join Cyrus & Nick as the FINALLY tackle mechanical ventilation. In this episode - first of many we suspect - we lay the foundations for mechanical ventilation. If you stick with us through this one you'll come away with a great introduction to vents to include why we use them, what we adjust, and about a number of the primary vent modes you'll likely seen in your ICU. We've got something for everyone with this episode so please give it a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

Join Nick and Cyrus as they teach a master class on hypoxemia for everyone and anyone who is ICU adjacent! We discuss why oxygen is so crucial, share some very interesting animal physiology and - perhaps most importantly- discuss the 6 causes of hypoxemia you MUST know… and what you can do about them! Take a listen, let us know what you think, and leave us a review! Hosted on Acast. See acast.com/privacy for more information.

This week on Critical Care Time, Nick & Cyrus discuss the recent article in the Journal of Critical Care titled “Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications.” Is this bunk or is this practice changing? Did they select the right population for this study or is the question they asked and answered... maybe not such a great question? We'll cover all this and more during this week's episode! Please take a listen, react, reach out & as always - don't forget to leave a review! Hosted on Acast. See acast.com/privacy for more information.

Join us this week on Critical Care Time as we take on Airway Controversies with Dr. Jarrod Mosier - course director for The Difficult Airway Course: Critical Care! We talk induction agents, pre-oxygenation and cover so much more in this episode!If you love this - consider attending the upcoming Difficult Airway Course at the Manchester Grand Hyatt in sunny San Diego, California from November 14th to the 16th and use our Discount Code CCTIME25 at checkout and save $250! Hosted on Acast. See acast.com/privacy for more information.

On this mini-sode, Cyrus & Nick are once again joined by Dr. Prager as they follow up on last week's episode with some cases & practical pearls to really hammer home some of the points previously discussed. Here we look at practical uses for the volume assessment tools discussed in our prior show, along with some commentary on when such assessments may or may not be warranted. This is a great, practical, rubber-meets-the-road episode for folks looking for a quick review/refresher. Listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

What is the microcirculation? How are terms like volume-status and fluid-responsiveness misleading? Join us as we sit down with Dr. Ross Prager to unpack and de-mystify the concepts of congestion and volume tolerance along with our survey of the tools of the trade as it relates to these terms. On this Critical Care Time episode we really get into the weeds on this stuff and even get theoretical at some points so it's NOT for the faint of heart! However, if you listen to us for the deep dives into physiology and if you want to level-up your ICU patient care, this is the episode for you! Listen, leave us some feedback and drop us a review! Hosted on Acast. See acast.com/privacy for more information.

This week, Nick & Cyrus try something a little different with Tales from the ICU. Here, we explore clinical reasoning in the ICU in the context of a mystery case! Don't worry, we'll reveal the diagnosis and go through all the pitfalls, pearls and pathophysiology! This way, you get to play along for a while AND learn some cool medicine. As this is a new episode format, PLEASE leave us feedback and let us know if you like it or if we should send this one to the crypt! Hosted on Acast. See acast.com/privacy for more information.

On this week's episode of Critical Care Time, Dr. David Dulaney rounds out GI bleeds in the ICU by taking on cirrhosis & variceal bleeds! During this show we discuss the unique challenge associated with managing a patient with cirrhosis - specifically focusing on the coagulopathy of advanced liver disease. We then delve into the nuances associated with managing a variceal bleed, both in terms of the unique critical care elements but also the challenges faced by the endoscopist when trying to saves these patients in extremis. Tune in, leave us a review and most importantly - leave us some feedback! Hosted on Acast. See acast.com/privacy for more information.

Join us on this week's episode of Critical Care Time as we embrace blood-and-guts with Dr. David T. Dulaney, gastroenterologist-extraordinaire! Nick & Cyrus host David for a pearl-laden discussion on non-variceal GI bleeds where we talk guidelines, expert opinion and so much more. Who needs a scope? When do you scope them? Why is stabilizing your patient SO important before GI comes in to save the day? How can we work together effectively with our colleagues in GI to ensure the best outcomes for our patient? We tackle a ton of content on this episode so you'll definitely want to tune in... and maybe even take some notes! Make sure to leave us feedback and let us know what you think! Oh... and spoiler alert: cirrhosis and variceal bleeds is on deck for our next installment so keep your eyes peeled for that one too! Hosted on Acast. See acast.com/privacy for more information.

On this episode of Critical Care Time, Nick & Cyrus embark on a deep dive into the world of lactic acidosis! As it is the beginning of the academic year, we figured this would be a great topic to demystify and disambiguate for our listeners. We discuss why lactic acidosis matters, and deconstruct all the clinically relevant elements from diagnosis to management, so that you are fully equipped with the tools necessary to conquer your next case of lactic acidosis - or maybe your first!! Ring in this new season of CCT with a banger of an episode and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

This week on Critical Care Time, we’re turning the mic over to you, our brilliant listeners!  In this special Q&A episode, Nick and Cyrus read your comments, tackle your toughest clinical questions, and share how your insights have sent them diving back into PubMed, Reddit, and beyond. Whether you’re commuting, charting, or on break in the ICU, this episode is packed with practical pearls, literature deep-dives, and the human stories that make critical care so rewarding. Thank you for helping us learn and grow—let’s jump right in! Hosted on Acast. See acast.com/privacy for more information.

On this week's episode of Critical Care Time, Cyrus & Nick take a deep dive into the wide world of sepsis! This one has been a long time in the making so buckle up for a journey through the history of sepsis and critical care, culminating in a review of our approach to diagnosis and management in 2025 complete with some hot topics and controversies. Please give us a listen or a watch, leave us some feedback and share our show with your friends and colleagues! Hosted on Acast. See acast.com/privacy for more information.

We see fever every day in the ICU but what’s the best approach to diagnosis and when do we need to go on a Zebra hunt? In this episode, we’re joined by Dr. Luis Tatem, a physician triple-boarded in Internal Medicine, Infectious Diseases, and Critical Care — plus certified in Tropical Medicine from the London School of Hygiene & Tropical Medicine. We explore the diagnostic and therapeutic approach to fever in the ICU, including practical pearls for evaluating fevers in patients returning from global travel. We then walk through high-yield case vignettes that illustrate diseases like malaria, dengue, typhoid, leptospirosis, and more. Hosted on Acast. See acast.com/privacy for more information.

On this week's episode of Critical Care Time, we revisit ARDS... sort of! We are joined again by Dr. Whittney Warren & for the first time by Denitza Blagev for a dynamic discussion on ARDS imitators: Things that looks like ARDS but aren't technically ARDS - or are they? It's a bit of a confusing landscape as you'll see, where the lines are blurred and things get a bit murky. We'll unpack diagnoses like EVALI, DAH, AIP and more in the context of ARDS and help you guys come up with a framework for the "ARDS" patient who doesn't seem to respond to the tried and true approaches we discussed earlier this year on our ARDS Epic-sode!. As always, give it a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

In this episode of Critical Care Time, Dr. Joshua Boster joins Cyrus and Nick to explore how interventional pulmonary (IP) skills can be life-saving in the ICU. From managing malignant central airway obstruction with rigid bronchoscopy to navigating pleural disease, persistent air leaks, and even life-threatening hemoptysis, Dr. Boster shares practical insights from the front lines. Listeners will learn how IP tools can transform critical care decision-making and offer meaningful interventions when time and options are limited. Whether you're an intensivist, a trainee, or just IP-curious, this episode highlights procedures that not only restore patency—but restore hope. Give it a listen, leave us a review and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

On this week's episode of Critical Care Time, Nick & Cyrus tackle extubation. Join them for a pragmatic, soup-to-nuts approach on liberation from mechanical ventilation. You'll learn about the pre-extubation assessment, pitfalls and pears of the RSBI, who benefits from extubation to positive-pressure support and so much more! Give us a listen and let us know what you think! Be sure to head over to www.criticalcaretime.com for show notes on this episode and many of our other recordings!We are also happy to introduce our new, limited sponsorship with Airway Management Education Center: The Difficult Airway Course who is joining our Season 2 Platinum Sponsor Seastar Medical as an Executive Sponsor for a few episodes this season and next! Hosted on Acast. See acast.com/privacy for more information.

It’s well known that many of the problems we encounter on a daily basis in medicine are related to ineffective communication. When caring for the critically ill, it’s vital that such lapses in communication are minimized. Join us along with Genae Christensen- a current MS-2, active critical care flight nurse and prior ECMO program coordinator as we delve into some important communication pitfalls and pearls. We will cover topics such as the authority gradient and how to navigate that, where misunderstandings may stem from, and how using structured communication systems may help you stay out of trouble. Give us a listen, let us know YOUR thoughts, share the show with your friends, and leave us a review! Hosted on Acast. See acast.com/privacy for more information.

On Critical Care Time we are no strangers to topics that make us uncomfortable. There may be no topic in the world of critical care more stress provoking than OB emergencies! Now… We didn’t say we are tackling this alone! Join us as we explore the wide world obstetrics in the ICU with Drs. Stephanie Levine and Adam Mora! Together we review the physiologic changes in pregnancy, unique considerations when it comes to general ICU management of the OB patient and then we delve into some OB cases where we tackle things like postpartum hemorrhage, cardiac arrest and more! Give us a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

The critical care landscape is a dynamic one, filled with team members with all sorts of backgrounds who have various skill sets and experiences to bring to the table. In this episode of Critical Care Time we focus on the role NPs & PAs - sometimes referred to collectively as APPs - play in the ICU. To help us explore this we sat down with Gary Macy of Duke University a Critical Care NP in their Neuroscience ICU who has many years of experience working as an ICU NP. During our discussion we explored numerous topics such as the concerns regarding education, "turf wars" and what integrative models might best serve our patients. Give us a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

The idea that movement is medicine doesn’t stop with the critically ill. On this week’s episode of Critical Care Time we sit down with Kali Dayton, a critical care NP with a passion for ICU mobility. We talk all things mobility in the critically ill: The roles of bedside nurses and clinicians, how we can implement best mobility practices with our patients, the financial and patient-care benefits of fostering a culture of movement in your ICU and what it means to be an “ICU Revolutionist” - along with so much more! If you truly care for the critically ill you cannot miss this episode! Hosted on Acast. See acast.com/privacy for more information.

On this week’s episode of Critical Care Time, we sit down with two brilliant early-career ECMOlogists for an “intro-plus” to VV and VA ECMO. Not only do we cover the basics, but we couldn’t help ourselves and went on some deep dives along the way that you guys will hopefully find interesting! With the help of our good friends Nick Villalobos and Kha Dinh, we review indications for ECMO, approaches to configuration and management, touch on some of the complications and… even spend some time demystifying the European unit for girth! We hope you guys will have as much fun listening to this as we did producing it. If so, leave us a review and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

If you thought ARDS was a long episode... get ready for a marathon! This week on Critical Care Time, Cyrus and Nick take on the unenviable task of trying to cover everything you need to know about cardiogenic shock - at least in broad strokes - in ONE episode! That's right, this is your one-stop-shop for all things cardiogenic shock. While we will have some deep dives on RV and LV failure, as well as ECMO and other mechanical circulatory support options - this episode has a little bit of it all to wet your whistle and then some! We deconstruct the epidemiology of cardiogenic shock, do a deep dive on the SCAI classes of cardiogenic shock, talk pathophysiology (duh!) and then move on to treatment considerations - both medical and mechanical - followed finally by some cases to cement all the learning. We know this is a long one so feel free to listen/watch in chunks. However you decide to enjoy it, we are certain you will walk away from it ready to conquer the next CGS case you come across! Once you've finished this epic - leave us a review and let us know how we did! Hosted on Acast. See acast.com/privacy for more information.

In anticipation of some exciting new content where we take deep dives into shock physiology and treatment modalities, we wanted to wet appetites, prime engines and get any of our new listeners up to speed by rebooting some of our heavy hitters from Season 1.We've already discussed how to identify shock, or how to assess a patient whom you are worried may be in shock... but what's next? Listen as Nick & Cyrus discuss the Pump, Pipe & Tank framework for determining the type of shock your patient is suffering from. In this episode we discuss the pathophysiology of the different types of shock, the tools you can use to help differentiate one type of shock from another, and scratch the surface on some initial treatment considerations. Hosted on Acast. See acast.com/privacy for more information.

In anticipation of some exciting new content where we take deep dives into shock physiology and treatment modalities, we wanted to wet appetites, prime engines and get any of our new listeners up to speed by rebooting some of our heavy hitters from Season 1.In critical care medicine - it's not just a priority, but it's critical that you know how to identify, assess and stratify shock. Join Nick & Cyrus in Part 1 of a 2-part, deep-dive into undifferentiated shock. On this episode we discuss how we define and assess a patient in shock; laying down the foundation for our shock framework. Hosted on Acast. See acast.com/privacy for more information.

On this end-of-year episode, Nick & Cyrus boldly go where no Critical Care Podcasters have gone before - into space! Join us, as we adventure into the great beyond with astronaut extraordinaire, Dr. Shawna Pandya - the first female Canadian commercial astronaut, who also happens to be a rural emergency medicine physician among SO many other things. We spend an hour with her discussing space physiology, medical applications of space tech, chatting about ICU corollaries, her experiences training for her upcoming mission, and exploring the challenges facing space exploration in 2025 and beyond. Hop aboard and and enjoy this exciting content and let us know what you think. This super accessible episode is loads of fun for ICU junkies and space-nerds alike so kick back, give it a listen, and as always, let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

On this week's episode of Critical Care Time, Cyrus & Nick sit down with Dr. Alin Gragossian - intensivist, patient advocate, acclaimed blogger and heart transplant recipient and Dr. Paul Wischmeyer - a prior guest on CCT who is a world-renowned intensive care nutrition expert, tenured professor and no stranger to prolonged bouts with critical illness and life-threatening disease. These two incredible people share their stories and perspectives as physicians who have spent considerable time both behind the drape and beneath the drape: Being on the receiving end of countless procedures and life-saving interventions. They share with us their thoughts on where we are succeeding as a healthcare team, and where we can strive to improve at the bedside. Join us as we embark on this emotional and thoughtful journey with Alin & Paul. We hope you will listen to their stories and come away with a new appreciation for the patient experience and how privileged we are to care for the patients we care for.Please be sure to check out Alin's blog www.achangeofthe.art and follow her on Instagram (@a_change_of_heart_blog). Give Paul some follows where he's most active on Instagram (@paulwischmeyermd), X (Paul_Wischmeyer) and LinkedIn (Paul Wischmeyer). As always, listen and let us know what you think, and make sure to leave us a 5-star review on your favorite podcast app!  Hosted on Acast. See acast.com/privacy for more information.

On this week's episode of Critical Care Time, Cyrus & Nick are honored to be joined by palliative care expert, Dr. Anand Iyer. Together they explore the intricacies of palliation in the ICU, exploring the challenge and nuances of addressing this critical element of care amongst the sickest patients in the hospital. How do you begin these discussions? How do you ensure your patients and families feel heard? How do you help them realize palliation is part of the care process and not that you are giving up on a loved one? What terms should we avoid using? We cover all of this and more with Dr. Iyer so make sure to give this episode a listen and leave us some feedback! Hosted on Acast. See acast.com/privacy for more information.

On this week’s episode, Cyrus & Nick tackle one of their biggest challenges yet: Acute Respiratory Distress Syndrome, more commonly known as ARDS.***WARNING*** this is no shorty! We cover all things ARDS from pathophysiology, diagnosis, treatments and things NOT to do. Dare we say, this is the definitive FOAM-ARDS experience for anyone and everyone who cares for people suffering from ARDS. Give it a listen and as always, send us your feedback!! Hosted on Acast. See acast.com/privacy for more information.

Get excited for a new episode jam-packed with Critical Care goodness! Nick & Cyrus deconstruct, demystify and unpack inotropes. These medications are essential in the world of critical care when we have to manage cardiogenic shock. What are the different inotropes? How can you decide which one is right for your patient? And... what's the difference between an Inotropic and an Ionotropic agent? You'll learn all this and so much more on this week's episode of Critical Care Time: The Podcast for Everyone Who Cares for the Critically Ill! Hosted on Acast. See acast.com/privacy for more information.

In this REBOOTED episodes of Critical Care Time, Cyrus and Nick go beyond the basics of vasopressor management. This thing is jam-packed with high-yield pearls, where we discuss important topics such as how to titrate vasopressors, what can be done when vasopressors seem to be failing and how to wean patients from vasopressors in order to successfully get them out of the ICU and ultimately home. Sit back, relax, and enjoy this hour long master-class on Vasopressors - Beyond the Basics! Hosted on Acast. See acast.com/privacy for more information.

In this REBOOTED episodes of Critical Care Time, Cyrus and Nick explore the basic in’s and out’s of vasopressors, providing a framework for understanding them and recommendations for the who, what, when, where and why as it pertains to their use! If you are new to the ICU or work anywhere that vasopressors may be used to treat your patients, this is the episode for you! Hosted on Acast. See acast.com/privacy for more information.

On this week's release, Cyrus and Nick revisit one of their favorite topics: Pulmonary Embolism! In this episode - a follow up to our two-parter from season 1 - we sit down with Dr. Rick Channick of UCLA to talk about his approach to PE management with a focus on catheter directed therapies & PE response teams. This episode is packed full of expert insights and practical clinical pearls. Give it a listen and let us know what you think!Risk Stratification MethodologiesWhat is the landscape of risk stratification in Pulmonary Embolism (PE)?Broadly, what interventions does each risk category group warrant?Rule of Thumb: The greater the risk to the patient, the more likely aggressive interventions will be considered.Most patients with PE are low risk:Typically treated with systemic anticoagulationExcellent prognosis High risk PE patients typically have hemodynamic involvement and can present in shock requiring emergent management :No contraindications + shock due to PE systemic thrombolysisAbsolute contraindications:Prior history of ICHKnown cerebrovascular lesionKnown malignant intracranial neoplasmNon-acute ischemic stroke, within the last 3 monthsSuspect aortic dissectionIntermediate risk patients:Management options exist and are tailored to each specific patient.Most, but not all, patients with PE deemed to be at intermediate risk will do well with systemic anticoagulation.Some patients are good candidates for catheter directed therapies such as thrombectomy or thrombolysis.Who? We don’t really know with a high degree of certainty. Considerations should be made for those with numerous risk factors for poor PE-related outcomes OR those with significant cardiopulmonary reserve / excellent functional status who theoretically could benefit from more brisk reversal of their acute pulmonary hypertension.See more in depth show notes at criticalcaretime.com Hosted on Acast. See acast.com/privacy for more information.

In this week's episode of Critical Care Time, Cyrus & Nick close out their discussion (for now anyway!) on difficult airways! Here we build upon episode 33 by working through some scenarios we've seen where we've needed to implement some of the strategies previously discussed. We close out by covering 10 pitfalls and pearls when it comes to anatomically difficult airways. As always, give us a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

On this week’s episode of Critical Care Time, Nick & Cyrus return to talk about airway management in the ICU. In season 1 we focused on the physiologically difficult airway. Now we will begin to unravel the anatomically difficult airway. Today we will break things down by covering foundational concepts, discussing some of the physical and cognitive tools you can use to address an airway, and basically set the stage for part II where we will go through some case studies and leave you with our pitfall and pearls for anatomically difficult airways. This episode is packed with clinical pearls that will empower you to take on even the  spiciest  of airways!As always - give us a watch or a listen and let us know what you think! Don’t forget those    reviews!! Hosted on Acast. See acast.com/privacy for more information.

On this week’s episode of Critical Care Time, Nick & Cyrus have the honor of hosting Dr. Thanh Neville, MD, MSHS (X @thanh_neville) the director of the 3 Wishes Program out of UCLA. In this moving discussion we explore the importance of dying with dignity when curative intent is no longer a realistic option. We dovetail this with an impassioned exploration Dr. Neville’s incredible work with 3WP which relies on modest funding and the power of humanism to grant priceless gifts - Wishes, if you will - to dying patients and their loved ones in their 11th hour. Please give us a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

Tele-health is blowing up in 2024 and that is as true for critical care as it is for other fields of medicine! On this episode of Critical Care Time, Nick and Cyrus interview Drs. Bill Beninati and David Guidry: Two experts in the world of tele critical care. We cover all the in’s and out’s of delivering critical care service from afar with a focus on implementation, logistics, benefits and challenges. Give this a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

Join Nick and Cyrus as they teach a master class on hypoxemia for everyone and anyone who is ICU adjacent! We discuss why oxygen is so crucial, share some very interesting animal physiology and - perhaps most importantly- discuss the 6 causes of hypoxemia you MUST know… and what you can do about them! Take a listen, let us know what you think, and leave us a review! Hosted on Acast. See acast.com/privacy for more information.

On this episode - part 2/2 if you will - we continue our discussion of pleural disease with a focus on hemothorax & management of bronchopleural fistulas. Small tube or large tube? When do you call in the reinforcements? What about endobronchial valves for persistent air leaks? Learn the answers to these questions - and so much more -n with Dr. Mike Sobieszczyk our expert interventionalist! Hosted on Acast. See acast.com/privacy for more information.

On this episode of Critical Care Time, Nick & Cyrus revisit the pleural space! We had SO much great content we opted to split the episode into two parts. We also figured it would be nice to get an interventionalists take on this and we thus recruited Dr. Mike Sobieszczyk to help navigate this complex topic! Here we discuss things like hepatic hydrothorax, indwelling pleural catheters and all things parapneumonic effusion. Check it out and leave us a review! If you missed our first episode on pleural disease, head on back to episode 10 and get caught up. If you like what you heard here, make sure to come back in 2 weeks for the second part! Hosted on Acast. See acast.com/privacy for more information.

Join Cyrus and Nick as they review listener questions and feedback from season one of Critical Care Time! Where did we goof up? Where did we hit the "Mark"? Give this episode a listen as we investigate a potpourri of clinically relevant topics courtesy of YOU - our incredible audience whom we are so thankful for. Hosted on Acast. See acast.com/privacy for more information.

Extra Extra - Read All About It!! It is our pleasure to bring to you - hot off the presses - the results from the PREOXI Trial which looks at whether or not preoxygenation with non-invasive positive pressure ventilation results in better peri-intubation outcomes versus non-pressurized preoxygenation strategies. Joining us is the primary author on this paper, Dr. Kevin Gibbs, MD of Wake Forest University School of Medicine. Practice changing? Practice affirming? Does it even matter?! Check out our interview with Dr. Gibbs and see what you think! Leave us a comment and let us know if this is going to impact your practice in the ICU and beyond! Hosted on Acast. See acast.com/privacy for more information.

Diuretics are essential tools used by clinicians to manage volume status in ambulatory patients and in the critically ill… but are we using them correctly? Join Nick & Cyrus as they explore principles of fluid balance and teach a masterclass on how to approach diuresis in the critically ill patient. You won’t want to miss this high-yield episode discussing an evergreen topic in the world of critical care medicine! Hosted on Acast. See acast.com/privacy for more information.

Thrombocytopenia is a puzzling, yet common problem in the ambulatory setting, on the wards and certainly in critically ill patients! Having an understanding of why it matters, why it can happen and what we should do about it, is of paramount importance to you if you are committed to excellent patient care.Given that patient care is first and foremost for us at Critical Care Time, we’ve teamed up - once again - with hematologist extraordinaire Matthew Rendo (X: RendOncology) to help us develop a pragmatic approach to managing the patient with thrombocytopenia. Please give it a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

On Critical Care Time we are - of course - HUGE fans of POCUS. On this episode, Nick and Cyrus take this love for POCUS to the next level with our discussion on Resuscitative Transesophageal Echocardiography (Resus-TEE) with Canadian intensivist, Dr. Ross Prager (@ross_prager), Resus-TEE expert aficionado! On this show, we discuss the basics of Resus-TEE including indications, pitfalls and pearls, the practicality of implementing this modality at your hospital and some of the medico-legal considerations. We had a ton of fun recording this with Ross and hope you enjoy listening to it! Hosted on Acast. See acast.com/privacy for more information.

Like that time the Jetsons met the Flintstones or the more recent colab between Lululemon and Peloton, join us for an epic pairing between Critical Care Time hosts Cyrus & Nick and the PulmPEEPS - Drs. Dave Furfaro and Kristina Montemayor. On this show we use a case based approach to answer the question: How can a bronchoscope save your @$$ in the ICU and beyond? We take a practical look at airway bleeds, trach emergencies and so much more with our friends from PulmPEEPs! Make sure to give this a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

On this MEGAsode of Critical Care Time, Cyrus & Nick are joined by world-renowned expert in ICU nutrition, Dr. Paul Wischmeyer (X: Paul_Wischmeyer & IG: paul_wischmeyermd) to discuss all things ICU nutrition. This episode is highly fortified with practice changing pearls from soup to nuts! In addition to getting to know who Paul is and why he does what he does, we demystify metabolic carts, talk about protein needs and metabolism in the critically ill, discuss steroids and other supplements - all while dispelling some major ICU myths regarding gastric residuals, TPN and more. Grab a healthy snack, sit back and get ready to enjoy some remarkable content in an oft overlooked field in medicine! Hosted on Acast. See acast.com/privacy for more information.

On this week’s episode of Critical Care Time, Nick and Cyrus discuss continuous renal replacement (or kidney replacement) therapy and acute kidney injury with master intensivist and extra corporeal aficionado, Dr. Kevin Chung. Dr. Chung is a retired colonel in the United States Army, the principal force behind an intensivist-run renal replacement program in San Antonio, and is currently the Chief Medical Officer for our season one sponsor, Seastar Medical.In this episode, we discuss an approach to acute kidney injury, demystify elements of continuous renal replacement therapy, and then discuss various applications to include blood purification technology in 2024. Give us a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

In this Critical Care Time x Neph Madness colab, Nick & Cyrus host Drs. Tim Yau and Jeff Kott for a comprehensive discussion of metabolic acidosis with a focus on critically ill patients. We start by outlining a pragmatic approach to acid/base derangements peppered with some fact finding and myth busting, CCT style! We then turn our attention to working up and treating metabolic acidosis in the ICU. If you are looking for a one stop shop when it comes to metabolic acidosis in the ICU - look no further. You may even figure out what Spanx & sodium bicarb have in common! Hosted on Acast. See acast.com/privacy for more information.

On this week’s installment of Critical Care Time, Nick & Cyrus tackle the recent multicenter, randomized control DEVICE Trial, which compared direct to video laryngoscopy in 17 American ICUs & EDs with the primary outcome of interest being successful intubation on first attempt. During this episode, we’ll take a deep dive into the paper, discuss other literature, and weigh-in ourselves based upon our own experiences and the data that’s available. Give it a listen and let us know what YOU think! Hosted on Acast. See acast.com/privacy for more information.

Sit back and grab some salty treats as you enjoy the mindful musings of master nephrologist Dr. Joel Topf (X: @Kidney_Boy) who joins Nick & Cyrus to chat about hyponatremia in critical illness - a very common condition. Here we discuss diagnosis and management of hyponatremia with special attention to those in the intensive care unit. Of course, no discussion is complete without plenty of time dedicated to osmotic demyelination syndrome (aka: central pontine myelinolysis) which gets plenty of face-time during this episode. Give it a listen and leave feeling confident in your ability to diagnose and manage a very prevalent condition in our patient population! Hosted on Acast. See acast.com/privacy for more information.

In Part II of our discussion of PE, Nick & Cyrus discuss the Pillars of PE Management! We review the literature behind lytics in non-massive PEs, talk about airway management, hemodynamics and more! Make sure you listen to Part I if you missed it as it sets the stage for this fantastic, treatment focused discussion. Hosted on Acast. See acast.com/privacy for more information.

There are few things in medicine Nick & Cyrus enjoy talking about more than PE! Join the guys from Critical Care Time as they tackle this massive topic via a two part epic that’ll prove to be the best saga since The Lord of The Rings! In part one they talk about diagnosis, clinical decision support tools and demystify the pathophysiology behind pulmonary emboli. Check it out, and be sure to catch the second half in two weeks! We promise you’ll get your money’s worth! Hosted on Acast. See acast.com/privacy for more information.

Hemoptysis can be a scary thing to encounter in medicine and massive hemoptysis - i.e. life threatening hemoptysis - is a serious emergency that often requires cognitive agility and technical prowess. Join Nick & Cyrus as they talk with Dr. Whittney Warren - an intensivist and interventional pulmonologist - who walks us through her pragmatic approach to life-threatening hemoptysis. What medications can we use to stabilize these patients? How would we go about intubating such a patient? What bronchoscopic tools do we have at our disposal? Listen to this first CCT episode of 2024 and find out!  Hosted on Acast. See acast.com/privacy for more information.

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Every time we admit or care for a critically ill patient, we must consider their risk for deep venous thrombosis, or DVT. Many of our patients are at higher risk for DVT than the general population, but anticoagulants are not wholly benign drugs. What do we do? How do we decide who to treat medically, who to treat with mechanical compressive devices and identify patients who may NOT need anything? When do risks outweigh benefits? What agent is best?Join Nick and Cyrus as they interview hematologist & oncologist Dr. Matthew Rendo (Twitter/X: Rendoncology) as they do a deep dive into managing DVT prophylaxis in the critically ill patient!  Hosted on Acast. See acast.com/privacy for more information.

Airway management in the critically ill can be one of the most challenging, stressful and rewarding elements of critical care medicine. While the anatomically challenging airway is often the first place our minds go when discussing difficult airways, the physiologically difficult airway is both more common and often requires more savvy to overcome. Join Cyrus & Nick as they take a pragmatic, case-based approach to this topic with the hopes of equipping you with the tools you need to successfully take a physiologically difficult airway, or support an airway operator charged with this task! Hosted on Acast. See acast.com/privacy for more information.

Whether you work in the ICU, on the medicine wards or in the prehospital setting, you've got to be familiar with the unsung hero of the thorax - the pleura! On this episode of Critical Care Time, Cyrus & Nick extol the virtues of this humble structure, cover a little comparative physiology and spend the latter half of their chat discussing all things pneumothorax. Sit back, relax and enjoy this episode packed with pulmonary and critical care pearls that will take your breath away! Hosted on Acast. See acast.com/privacy for more information.

Running a code is a stressful proposition. The code team leader is responsible for conducting an orchestra in a most austere environment, with the goal of guiding the team towards success - defined hopefully by a successful resuscitation. The code team leader needs to have the presence of mind to lead, but also needs to know how to delegate responsibilities and quickly cultivate a shared mental-model between the various team members. Join Nick and Cyrus as they try to demystify some of the elements of leading a code by providing practical pearls and shedding light on potential pitfalls during this episode on Cardiac Arrest and Running a Code. Hosted on Acast. See acast.com/privacy for more information.

The intersection between patient care and the legal system can be a tricky one to navigate. Our duty as members of the healthcare team - irrespective of a patient’s social history - is to provide the best care we can, while protecting a patient’s privacy. Unfortunately, this can sometimes be easier said than done, and traveling such choppy waters can be challenging! Join Nick & Cyrus as they host Drs. Erin DeMartino & Matthew Griffith of Scopes and Shields for a case-based discussion which will hopefully equip you with some knowledge and tools for the next time you have a patient who is in custody or otherwise involved with the legal system. Hosted on Acast. See acast.com/privacy for more information.

On this episode of Critical Care Time, Cyrus and Nick go beyond the basics of vasopressor management. This thing is jam-packed with high-yield pearls, where we discuss important topics such as how to titrate vasopressors, what can be done when vasopressors seem to be failing and how to wean patients from vasopressors in order to successfully get them out of the ICU and ultimately home. Sit back, relax, and enjoy this hour long master-class on Vasopressors - Beyond the Basics! Hosted on Acast. See acast.com/privacy for more information.

On this episode of Critical Care Time, Cyrus and Nick explore the basic in’s and out’s of vasopressors, providing a framework for understanding them and recommendations for the who, what, when, where and why as it pertains to their use! If you are new to the ICU or work anywhere that vasopressors may be used to treat your patients, this is the episode for you! Whether you are ordering them, titrating them or looking out for complications associated with their use, Nick & Cyrus have got your back!  Hosted on Acast. See acast.com/privacy for more information.

They say that when you hear hoofbeats, you should look for horses. This age-old medical adage makes sense in many circumstances, but what do you do when the paradigm is flawed? What if what we generally accept as a common entity, is actually rare? What about the reverse? In this first episode of Zorses & Hebras, Nick & Cyrus will discuss some of these very entities in the context of critical illness, shed some light on them, and explain why focusing on the Horses & Zebras model may bite you on the tail! Hosted on Acast. See acast.com/privacy for more information.

Delirium is a common but serious complication of critical illness. Nick and Cyrus discuss this important topic with Dr. Wes Ely, MD. They cover prevention, diagnosis, and treatment of delirium; Dr. Ely's award-winning book "Every Deep Drawn Breath", and how his life story led him to become a world expert in brain dysfunction in the ICU.Go to https://criticalcaretime.com for more information Hosted on Acast. See acast.com/privacy for more information.

Join Nick & Cyrus as they take on their first journal club episode! This week the duo provides their take on the NEJM paper from van Baarle and colleagues entitled Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia. They also provide some of their tips and tricks for safe central line placement. Give it a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

We've already discussed how to identify shock, or how to assess a patient whom you are worried may be in shock... but what's next? Listen as Nick & Cyrus discuss the Pump, Pipe & Tank framework for determining the type of shock your patient is suffering from. In this episode we discuss the pathophysiology of the different types of shock, the tools you can use to help differentiate one type of shock from another, and scratch the surface on some initial treatment considerations. Hosted on Acast. See acast.com/privacy for more information.

In critical care medicine - it's not just a priority, but it's critical that you know how to identify, assess and stratify shock. Join Nick & Cyrus in Part 1 of a 2-part, deep-dive into undifferentiated shock. On this episode we discuss how we define and assess a patient in shock; laying down the foundation for our shock framework.Go to https://criticalcaretime.com for more information Hosted on Acast. See acast.com/privacy for more information.

Cyrus Askin & Nick Mark are two intensivists with a passion for education and a penchant for taking care of the sickest patients in the hospital. Join the two of them as they embark on a journey through the world of critical medicine - leaving no stone unturned.In this episode, Nick & Cyrus share a little about themselves and a lot about what Critical Care Time is... and isn't!"Go to https://criticalcaretime.com for more information Hosted on Acast. See acast.com/privacy for more information.

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. They are triple board-certified intensivists who love patient care and teaching. Journey with them through deep dives into physiology and practical pearls, leaving no stone unturned in the world of critical care medicine. Through their own insights, expert interviews and targeted reviews of the literature, Nick and Cyrus provide practical, relevant critical care pearls. If you bill for critical care time, you must make time for Critical Care Time! Hosted on Acast. See acast.com/privacy for more information.