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IBCC COVID-19 Update #2
In this episode, we right some wrongs. As we said in the beginning, given the fast pace we were bound to be wrong, and will be again.
1) New paradigm for COVID-19 patients
2) Procalcitonin: not as good as we thought
3) Malignant atelectasis and the crashing hypoxemia
4)SARS-COV-2 & DIC
5) Awake Proning / CPAP / Vent Splitting / Extubation
6) Ethical dilemmas
|Mar 30, 2020|
IBCC COVID-19 Update # 1
In this episode, we update you on:
The fall of Kaletra
Come take a listen. Know that we are all in this together.
|Mar 22, 2020|
IBCC Episode 79 - COVID-19
There is a lot of attention to this growing global health concern. Come listen for what will be a continuing update for all thing clinically pertaining to COVID-19.
|Mar 11, 2020|
IBCC Episode 78 - Vasoactive Agents
In this episode, we cover a core component of any resuscitationists tool kit: vasoactive agents.
We've got your vasopressors, your inodilators, your inopressors, you oral cheat code and some hail merry approaches. Come listen for all things pressure and flow.
|Feb 20, 2020|
IBCC Episode 77 - Anaphylaxis
In this episode, we cover one of those cardinal causes of vasodilatory shock; anaphylaxis.
Come listen to solidify your clinical diagnosis, and domination of all things epinephrine.
|Feb 17, 2020|
IBCC Episode 76 - Status Epilepticus
In this episode we cover that rapidly progressive, big stakes entity that is Status epilepticus - the unrelenting seizure. Definition, Big Benzoes and where to go after that first line. Come listen for all things Keppra, Propofol and Ketamine.
|Feb 10, 2020|
IBCC Episode 75 - Hypocalcemia
In this episode we cover the last common electrolyte derangement you'll face in the ICU; hypocalcemia. From tetany to hypotension, we've got you covered for an approach to recognition and treatment.
|Jan 31, 2020|
IBCC Episode 74 - Toxic Alcohols
In this episode we cover that rather bothersome component of your AGMA... toxic alcohols. Who is high risk, when and how to screen, and of course a tight approach to treatment. Don't forget... always call your local friendly toxicologist.
|Jan 27, 2020|
IBCC Episode 73 - Line Infection
In this episode, we cover that daily discussion point... can this line, possibly, be infected? Come refresh yourself on diagnosis, microbiology and treatment.
|Jan 14, 2020|
IBCC Episode 72 - Dominating the Diuresis
In this hallmark episode (we just hit 500k in downloads!), we cover an approach to dominating the diuresis. We cover all the major points:
-Loop diuretics and how not to screw them up
-Using thiazides to maximize ongoing diuresis
-When to add spironolactone
-How not to always just cheat and start the CRRT machine
|Jan 09, 2020|
IBCC Episode 71 - Myxedema Coma
Welcome to 2020, everyone! In this fresh new podcast we cover all things severe hypothyroidism; AKA Myxedema Coma.
Diagnosis. Treatment. Whats the deal with T4 vs T3. Who gets the roids. Come listen to it all!
|Jan 02, 2020|
IBCC Episode 70 - Non-Invasive Respiratory Support
Happy Holidays everyone! In this episode we cover the general support of those patients that are working hard to breathe. Come listen about NIPPV (BiPAP and High Flow Nasal Cannula).
|Dec 28, 2019|
IBCC Episode 69 - Acute Promyelocytic Leukemia
In this episode, we cover that rapidly progressive, easy to miss, relatively better survived leukemia: acute promyelocytic leukemia.
Come read about pathophysiology, and then listen to the summary that covers when to suspect clinical APL, the use of ATRA, and that scary hyperfibrinolysis (DIC but worse). Just to leave you with more, we cover Differentiation syndrome (aka retinoic acid syndrome).
|Dec 19, 2019|
IBCC Episode 68 - Hyponatremia
In this episode, we cover all things ICU level hyponatremia. From a mild inconvenience to a refractory seizing patient, we've got you covered for diagnosis, treatment and risk stratification.
|Dec 12, 2019|
IBCC Episode 67 - Hypokalemia
In this episode we cover that low serum potassium, aka Hypokalemia. From the minor repletion to the immediate resuscitation of a patient with VF arrest secondary to severe hypokalemia, we have you covered. So read the post, then come take a listen to review all things hypo K!
|Dec 05, 2019|
IBCC Episode 66 - Brain Death
In this episode we cover the definition and concrete way how to identify and correctly diagnose brain death. This is something we need to get right, so grab a coffee and come take a listen.
|Nov 28, 2019|
IBCC Episode 65 - Hypothermia
In this episode we cover both accidental and non-accidental hypothermia. Come listen for a good review on:
PS: Many apologies to cardiac anesthesiologists and perfusionists: core after-drop is a thing, but we don't want to cloud the issue of priorities in rewarming.
|Nov 21, 2019|
IBCC Episode 64 - Bupropion Toxicity
In this episode, we cover the 2019 version of a TCA overdose: Bupropion. AKA: Wellbutrin / Illbutrin (Shoutout to Tox & The Hound).
Read the post then get an audio summary of the clinical diagnosis, risk stratification, Activated charcoal, whole-bowel irrigation and finally all things VA-ECMO for the extreme toxicities.
|Nov 14, 2019|
IBCC Episode 63 - Acalculus Cholecystitis
In this episode, we cover that sneaky presentation of acalculus cholecystitis. When that ALP/GGT start climbing, or your chronically critically ill patient gets septic again, you need to know about this!
|Nov 12, 2019|
IBCC Episode 62 - Carbon Monoxide Poisoning
In this episode, we cover that pesky Carbon monoxide. From minor exposure to critically ill, we have you covered for:
-Bleeding Edge Therapies
|Nov 10, 2019|
IBCC Episode 61 - Post MI Complications
Just when you thought your post MI patient has made it through the woods... they start to crump! In this episode we cover the Ddx and approach to post myocardial infarction complications. Come listen to review all the greatest hits.
|Oct 24, 2019|
IBCC EP 60 - Methemoglobinemia
In this episode we cover that rare but fun element to your cyanosed patient Ddx. When your hemoglobin gets oxidized to Fe3+, badness can ensure. Enjoy this quick refresher.
|Oct 15, 2019|
IBCC EP 59 Diffuse Alveolar Hemorrhage & Pulmonary Vasculitis
In this episode, we cover one check box on your bilateral airspace opacification differential diagnosis. Come take a listen for Diffuse alveolar hemorrhage and pulmonary vasculitis in the ICU.
-What labs to order (you can't just write "vasculitis work up")
|Oct 10, 2019|
IBCC Episode 58 - Asthma
We know you all have been waiting for it! Here is one of the foundational chapters for the IBCC. All things asthma. We've got everything from physiology, to bleeding edge sedation approaches.
Come take a (longer) listen to solidify everything you read in the post:
-Presentation / patient phenotypes
-Escalation to salvage treatments
-Vent Management & ECMO
|Oct 08, 2019|
IBCC Episode 57 - Metabolic Alkalosis
In this episode, we further explore the acid-base-palooza with Metabolic Alkalosis.
We give you 10 things to treat said event with, however, sometimes its best to let sleeping dragons lie. Josh even snuck in some acid infusion!
|Sep 26, 2019|
IBCC Episode 56 - NAGMA
In this episode we have a quick little refresher on Non-Anion-Gap Metabolic Acidosis for you! Enjoy!!!
|Sep 19, 2019|
IBCC Episode 55 - AGMA
Continuing on with metabolic-palooza:
Here is the core approach to Anion-Gap Metabolic Acidosis. We've got the KULT, we've got the labs/treatment and everything in between.
|Sep 17, 2019|
IBCC Episode 54 - Approach to Acid Base Disorders
In this episode, we cover the foundations to every day clinical medicine in the ICU: Acid base. As our patients are either often too sick to regulate their own homeostasis, or what we are doing to them prevents their lungs or kidneys from doing so, we give you the approach to recognizing Acid Base disorders.
Step 1: Calculate the Anion Gap
Step 2: Look at the Bicarbonate level
Step 3: Compare the change in Anion Gap to the Change in Bicarbonate
|Sep 12, 2019|
IBCC Episode 53 - Submassive & Massive Pulmonary Embolism
In this episode we explore the controversies in how to classify the hemodynamic effects of pulmonary embolisms.
We also cover:
-The crashing & hypoxemic PE patient
|Sep 10, 2019|
IBCC Episode 52 Anticoagulation Reversal
In this episode, we cover all the big hits for anticoagulant management in your bleeding patients.
-Heparin and LMWH
|Aug 29, 2019|
IBCC Episode 51 - Tumor Lysis Syndrome
In this episode, we cover all things you need to know cold when your patient's cells are bursting all over the place.
-Life threatening Hyperkalemia
- Purine Nucleotide Management
|Aug 22, 2019|
IBCC Episode 50 - Hyper and Hypomagnesemia
In this episode, we take a break from controversial subjects and cover all thing magnesium related for critical care.
Come take a listen for diagnosis, identification, and treatment of low and high levels of magnesium.
|Aug 15, 2019|
IBCC Episode 49 - Septic Shock
Here it is, a total beast of a podcast. We cover one specific approach to patients in septic shock. We highlight all the must-know aspects:
-patient identification and risk stratification
-The Metabolic Resuscitation Protocol
We even re-leak the CITRIS-ALI trial for you... its going to be an epic Doozy. So make sure you have a proper 60+min to really take it all in.
|Aug 08, 2019|
IBCC Episode 48 Angioedema
In this episode we cover the simultaneous approach of sorting out the airway from hell, and treating both the histamine and bradykinin induced angioedema. We even snuck some novel use of TXA into the post!
|Aug 01, 2019|
IBCC Episode 47 Hyperthermia
In this episode, we follow-up on the very "heated" debate that this post sparked on the interwebs. Come listen to all things ICU level-hyperthermia. We've got the ice baths. The cold fluids. The dry air. We cover it all!
|Jul 31, 2019|
IBCC Episode 46 - Massive Hemoptysis
In this episode we go over a general approach to your patient with Massive Hemoptysis. When lungs have blood in them = badness. We give you a targeted approach to stay cool, find the bleed, and stop it in the most efficient manner possible. Come listen for discussions around securing airway, protecting the good lung, CT first, and definitive management.
|Jul 25, 2019|
IBCC Episode 45 ETOH Withdrawal
In this episode, we cover the last half of phenobarbital week! This is a long one, but we cover the Farkas manifesto on by phenobarb is superior to standard approaches to alcohol withdrawal management.
-Adjuvant therapies & more
|Jul 20, 2019|
IBCC Episode 44 - Community Acquired Biliary Sepsis
In this episode, we will cover all those pesky things that can make your patient sick from the RUQ: namely the biliary tract!
Ascending cholangitis, Cholecystitis and all the important pearly for imaging, antibiotics and source control options.
|Jul 11, 2019|
IBCC Episode 43 Clostridium Difficile
If your nursing colleagues can smell it, and you can't, fear not! We've got you covered for all things C. Diff on an ICU-level. Also, the audio quality is particularly bad on this episode, we apologize. Just the realities of recording on the road!
|Jul 05, 2019|
IBCC Episode 42 Fluid Selection & pH Guided Resuscitation
In this episode, we cover the always vexing crystalloid vs colloid debate. Farkas also brings it to the next level with a new paradigm for using large volume resuscitations to treat your patient's acid-base disturbances. Come take a listen for all things alkalinizing, acidifying and maintaining.
|Jun 27, 2019|
IBCC Episode 41 - Hypercalcemia
In this episode, we've got you covered for all things hypercalcemia. Erase those memory banks that are filled with hyper-hydration and forced diuresis and come fill them back up with appropriate fluid resuscitation, the 1-2-punch for those osteoclasts and all the rest of the pearls for hypercalcemia.
|Jun 20, 2019|
IBCC Episode 40 - Serotonin Syndrome / Toxicity
Pull those ankle socks up, and get ready for some ankle-clonus-good-times. In this episode, we cover one of those "hot and bothered" presentations of Serotonin Toxicity. Come listen to a summary of the chapter that includes, definition, clinical presentation, treatment and clinical pearls.
|Jun 13, 2019|
IBCC Episode 39 - TickBorne Illness
In this episode, we cover an often overlooked infectious cause of that ICU level patient presenting with all kinds of badness: come listen for a sound education on all things babesiosis, anaplasmosis & ehrlichiosis, and rocky mountain spotted fever (RMSF).
|Jun 06, 2019|
IBCC Episode 38 - Hepatic Encephalopathy
Either its a glaringly obvious diagnosis (because your patient is bright yellow and wont wake up) or its apart of a complex presentation, hepatic encephalopathy is one presentation you need to have down!
Come listen to consolidate your knowledge around nitrogen reduction, shunts (the good, the bad, the ugly) and all things HE!
|May 30, 2019|
IBCC Episode 37 - Rhabdomyolysis
In this episode, we help you take a more nuanced approach to those patients with "coca-cola urine." When that CK is a climbing and you don't know what to do, remember these pearls!
|May 16, 2019|
IBCC Episode 36 - All things Phosphate
In this episode, you get a two-for-one. Come for the hypophosphatemia, stay for the hyperphosphatemia.
|May 09, 2019|
IBCC Episode 35 - Contrast Induced Nephropathy
Contrast induced nephropathy is the "white walker" of critical care and emergency medicine. Come take a listen as we discuss the potential error in creating a clinically non-meaningful entity, and how we should address this in our daily clinical work.
|May 02, 2019|
IBCC Episode 34 - Endocarditis
In this episode we cover all those big highlights for infective endocarditis. Come solidify your approach to clinical presentation of both left and right sided disease, approach to imaging, and empiric therapy. We've even got the hot topic of dual coverage down!
|Apr 25, 2019|
IBCC Episode 33 - VF/VT Storm
In this episode we cover the finer points of the high stakes resuscitation of VF / VT "Storm."
Come get a solid approach to identification, resuscitation and nuanced management.
|Apr 19, 2019|
IBCC Episode 32 - Metformin Toxicity
Have you ever seen that patient with a bicarb of 6 and a lactate of 14, and they are just smiling at you and texting their spouse about taxes? In this episode, we explore the direct, indirect, and obscured role that metformin can play in your critical care patients. Come listen for all things diagnosis, classification and some special discussion around GIK, Methylene Blue and when to spin that dialysis machine.
|Apr 11, 2019|
IBCC Episode 31 - Penicillin Allergy
This often mis-understood "penicillin allergy" can have far more dire impacts on the population you would think. Come take a listen and explore the pathophysiology of R1-side chain impact on true allergy, what to do about it, and how it impacts antimicrobial selection and use.
|Apr 04, 2019|
IBCC Episode 30 - Pre-Eclampsia
In this episode, we've got you covered for this hypertensive emergency that you need to know cold. Come take a listen for all things around diagnosis, risk factors, clinical presentation, labs and treatment. We've got your magnesium. We've got your labetolol. We even have a few new tricks for hemolysis.
|Mar 30, 2019|
IBCC Episode 29 - Hypertensive Emergency
Just like when you were a kid and that science fair volcano was spewing badness everywhere... an unchecked perfusion pressure can wreak havoc on your end organs. In this podcast, we cover the true primary emergency that results from too high of perfusion pressure. Come take a listen for all things diagnosis, treatment and even a nice coverage of PRES.
|Mar 23, 2019|
IBCC Episode 28 - Abdominal Compartment Syndrome
In this episode, we cover the often missed "abdominal compartment syndrome." Lace up those shoes, get ready for your commute, and let us review for you the diagnosis and treatment of this critical care quagmire.
|Mar 14, 2019|
IBCC Episode 27 - Myasthenia Gravis Crisis
In this episode we explore this rare but commonly seen entity of NMJ caused weakness. Come listen to review the patient population, identification and management of MG CRISIS.
|Mar 07, 2019|
IBCC Episode 26 - Acetaminophen Toxicity
In this episode, we start off with all those familiar aspects of APAP toxicity that you've heard about. Then we kick it up a notch and give you new pearls around Massive ingestions and high dose NAC infusions, when to Dialyze (you read that correctly) and even more great pearls! Come take a listen.
|Feb 28, 2019|
IBCC Episode 25 - Hypernatremia
In this episode we will cover all the highlights you need to know about hypernatremia. Serum sodium... we see you yawning already! But if you want to level up your critical care skills, you need to pay attention to this often missed cause of serious morbidity in our ICUs.
|Feb 21, 2019|
IBCC Episode 24 - Salicylate intoxication
Toxicology is fun. Salicylate overdoses can be intimidating, so come take a listen to get you ready for the next patient you see, so you can keep them out of that death-spiral!
|Feb 17, 2019|
IBCC Episode 23 - Thyroid Storm
In this episode, we cover the diagnosis of this must-not-miss-unicorn. Come take a listen for a lengthy discussion around management, including the controversial use of beta-blockade.
|Feb 11, 2019|
IBCC Episode 22 - Thrombocytopenia
In this episode, we've got a great approach to low platelets in the ICU patient population. Come take a listen for approach, management, what not to miss, and all things HITT.
|Jan 31, 2019|
IBCC Episode 21 - Antibiotics
Here it is... it took a mythical amount of time to prepare, so we hope you enjoy this long format cast on the broad topic of antibiotics. We cover the highlights of all the usual suspects, beta-lactams, cephalosporins, aminoglycosides, macrolides and all the weird and wonderful.
Make sure you read the post before diving into this beast!
|Jan 27, 2019|
IBCC Episode 20 - Shock
Every resuscitationist MUST have this basic approach down cold. Come take a listen to the foundation of our specialties in what the French like to say "Reanimation."
Approach and treatment for all those SICK looking patients.
|Jan 17, 2019|
IBCC Episode 19 - Severe Influenza
ICU level Influenza. Very pertinent for this time of year. Come take a listen and explore clinical management pearls, and some bleeding edge discussion for adjuvant therapy on your hardcore viral patients.
|Jan 10, 2019|
IBCC Episode 18 - Acute Kidney Injury
Come take a listen to keep you regimented towards this must-not-mess-up presentation.
We've got classification, management and some juicy pearls. Arm yourself with the knowledge to stop ordering that FeNa!
|Jan 03, 2019|
IBCC Episode 17 - Community Acquired Urosepsis
Merry Christmas / Happy Holidays everyone!
Here is a little present for you during these cold times. For those of you who have seen this population, they can get sick, fast! However, when you've got your approach and management down, they can get better, just as fast! Come take a listen for the identification, microbiology and treatment or urosepsis.
|Dec 26, 2018|
IBCC Episode 16 - Immune Checkpoint Inhibitors
Don't know what immune checkpoint inhibitors are? Don't worry, neither did I until Farkas through some major knowledge on me. Come take a listen about what this class of drugs can do to every organ in your body!
|Dec 19, 2018|
IBCC Episode 15 Adrenal Crisis
In this short podcast, we cover the identification, workup and treatment of that often missed cause of vasodilatory shock: adrenal insufficiency.
Come take a listen for all things population, ACTH stim-test and how to manage these patients.
|Dec 12, 2018|
IBCC Episode 14 Post Cardiac Arrest Management
These patients can truly be the sickest of the sick. Come take a listen for the summary of a chapter that is bound to be one of your go-to resources.
We've got it all.
|Dec 05, 2018|
IBCC Episode 13 Meningitis
In this episode we tackle the identification & treatment of central nervous system infections, aka badness. You'll be equipped with a standard treatment regime for your patients with meningitis or that brain-melting encephalitis.
|Nov 28, 2018|
IBCC Episode 12 - Torsades De Pointes
Do those squiggly lines on the ECG monitor have you patient down in the hypotensive dumps? Don't know what to do? Well we have you covered. Identification, common causes and treatment of TDP can all be found in this one podcast.
|Nov 21, 2018|
IBCC Episode 11 Hyperkalemia
Whether its your first day seeing patients, or your last, you need to have a solid approach to hyperK. Come check out the cast for all things hyperkalemic bombs, and a plea to STOP the madness with kayexalate.
|Nov 14, 2018|
IBCC Episode 10 - Delirium
We've got you covered for identifying, evaluating and treating this all to common (and sometimes missed) syndrome. Take a listen, and go to the post to discuss the controversies of atypical antipsychotics, regular use of melatonin, and the elixir of the gods (dexmedetomidine).
|Nov 07, 2018|
IBCC Episode 9 - Anemia
Is your patient's low hemoglobin got you down? We've got you covered then. Come take a listen for all things related to diagnosis, transfusion targets and special populations. This one is sure to be a treat for halloween.
|Oct 31, 2018|
IBCC Episode 8 - Pancreatitis
In this episode, we summarize the sometimes intimidating topic of pancreatitis. We've got your education needs covered when it comes to identification, workup and treatment of this common presentation.
|Oct 25, 2018|
IBCC Episode 7 - Cardiogenic Shock & Severe LV Dysfunction
Join your regular hosts in exploring all things cardiogenic shock. Warm & Dry to Cold and Wet. We've got an approach strategy for you.
|Oct 17, 2018|
IBCC Episode 6 - Hypoglycemia
Welcome to the 6th podcast, it will not disappoint. Hypoglycemia is something you MUST know cold. So grab a coffee, and give this one a listen.
|Oct 10, 2018|
IBCC Episode 5 - Bradycardia
Bradycardia can be scary. Especially when your cardiac output is being pulled down by that slow rate. Take a listen to hone your resuscitation skills in the electrical and medical arms of the bradycardia treatment.
|Oct 03, 2018|
IBCC Episode 4 - Community Onset Pneumonia
Have you been confused with your approach to CAP/HAP/VAP? Here is a stepping stone to the approach from a new perspective: Community onset pneumonia.
Here we outline the definition, approach and management including antimicrobial selection, triaging, HFNC and so much more.
|Sep 26, 2018|
IBCC Episode 3 - Approach to the GI Bleed
In this episode we summarize the approach to the patient with a bleeding GI tract. Whether its upper, lower, or anything in between... we've got you covered.
|Sep 19, 2018|
IBCC Episode 2 - Ischemic Evaluation in the Non-Cardiac Patient
In this episode, Josh takes us through how to approach the type 1 versus type 2 acute coronary syndrome in the ICU. In other words, take a listen to find out what to do with that ECG and troponin.
|Sep 12, 2018|
IBCC Episode 1 - DKA
In this episode, we cover the anatomy of a DKA resuscitation. Check the post out for some juicy pearls.
As always, the pitfalls:
|Sep 06, 2018|