ICU Rounds
By Jeffrey S. Guy, MD, FACS
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Podcast Description
A podcast dedicated to the teaching of critical care. The focus audience is physicians, residents, medical students, nurses, therapists, and paramedics. These are topics that arise while on teaching rounds in the Burn ICU at Vanderbilt Medical Center. A broad scope of critical care and prehospital topics are presented as well as recent journal articles and medical news.
| Name | Description | Released | Price | ||
|---|---|---|---|---|---|
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1 |
Pediatric IVC diameter determination with ultrasound | If you are using ultrasound to evaluate IVC diamter in children, what is considered a normal IVC diameter? You can determine the IVC/Ao ratio or correct the IVC diamter based on the child's body surface area. | 2/9/12 | Free | View In iTunes |
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2 |
Takotsubo Cardiomyopathy | This is a condition that mimics acute coronary syndrome (ACS) that may be caused by acute emotional or physical stress. Patient's may appear to have profound cardiogenic shock, but these patients have a very high survivial rate with little more than supportive care. | 1/31/12 | Free | View In iTunes |
|
3 |
Necrotizing Soft Tissue Infection (NTSI) | This episode discusses the pathophysiology, presentation, and treatment of NTSI. | 12/6/11 | Free | View In iTunes |
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4 |
Different Cardiac Output Monitors & Physiology | This episode will discuss the physiology behind various CO output monitors such as pulmonary artery catheters, PICCO, pulse wave form analysis, and LiDCO. | 11/25/11 | Free | View In iTunes |
|
5 |
Lactic Acidosis - Type B | Now these are the types of lactic acidosis that most people are not familiar. They can be caused by medications, underlying disease, or inborn errors of metabolism. | 11/18/11 | Free | View In iTunes |
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6 |
Lactate Acidosis - Type A | This podcast is a description of how lactate is produced and metabolized. I will discuss the role of lactate in the diagnosis and management of shock. This podcast will focus on Type A lactic acidosis. | 11/12/11 | Free | View In iTunes |
|
7 |
Endotracheal tube cuff leaks and self-extubations | A brief description on what to consider when confronted with a patient with an air leak from the ET tube or a patient that self-extubates. | 8/2/11 | Free | View In iTunes |
|
8 |
Pulmonary Embolus | A description of the risk factors, diagnosis, and treatment of PE. | 7/27/11 | Free | View In iTunes |
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9 |
Smoke Inhalation Injury | Smoke Inhalation injuries can be deadly. This episode explains why smoke can be so deadly, and how to care for those patients with suspected smoke inhalation injuries. | 7/5/11 | Free | View In iTunes |
|
10 |
Propofol Related Infusion Syndrome | Propofol Related Infusion Syndrome is a potentially fatal complication of propofol. If you use this common ICU drug you need this information. | 6/5/11 | Free | View In iTunes |
|
11 |
Wedge: Everyone elses favorite Swan number | Wedge or PAOP is perhaps the most quoted and poorly understood variable generated by a Swan-Ganz. | 12/12/10 | Free | View In iTunes |
|
12 |
SVO2 My favorite Swan Number | The most helpful number for me on a Swan is the SvO2. This is a brief description of how I use this variable in evaluating critically ill and injured patients. | 12/5/10 | Free | View In iTunes |
|
13 |
Therapeutic Hypothermia After Cardiac Arrest | Therapeutic hypothermia after cardiac arrest is part of ACLS and is used by several EMS agencies around the US. Despite good data and improved patient outcomes, many providers fail to used this modality. This podcast will focus on a presentation of the data, methods of cooling, and potential complications. | 10/21/10 | Free | View In iTunes |
|
14 |
Pancreatitis - Surgical Indications and Procedures | This is the third in the series on severe pancreatitis and necrotizing pancreatitis. This episode reviews the indications for surgery, morbidity and mortality of surgery, and what are the surgical options. | 7/22/10 | Free | View In iTunes |
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15 |
Severe Acute Pancreatitis: Part 2 ICU Considerations | A brief discussion of the considerations of ICU care of the patient with severe pancreatitis, fluid resuscitation, respiratory, renal, and nutrition. | 6/1/10 | Free | View In iTunes |
|
16 |
Pancreatitis - Part 1 | This is an initial presentation of the causes and diagnosis of acute pancreatitis. | 5/25/10 | Free | View In iTunes |
|
17 |
That peripheral IV can kill you: Suppurative Thrombophlebitis | All the recent emphasis on venous catheter infections has been on central lines. Those peripheral IVs are also dangerous. | 2/25/10 | Free | View In iTunes |
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18 |
Acute Colonic Pseudoobstruction (Ogilvie's Syndrome) | Acute Colonic Pseudoobstruction (ACPO) is commonly called Ogilvies Syndrome. ACPO presents massive dilation in critically ill patients, and might result in invasive procedures to avoid ischemia or perforation of the colon. | 2/15/10 | Free | View In iTunes |
|
19 |
Hemoglobin Based Oxygen Carriers (a.k.a. Artificial Blood) | A brief summary of what are hemoglobin based oxygen carriers (HBOC) and where are they in development. | 1/18/10 | Free | View In iTunes |
|
20 |
Catheter-Related Bloodstream Infection: Diagnosis | Discussion of what is the difference between a CVC infection and a catheter-related blood stream infection. They are treated differently so it is important to know the difference. | 9/24/09 | Free | View In iTunes |
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21 |
Ventilator Associated Pneumonia | A discussion on nosocomial infections and VAP. | 9/17/09 | Free | View In iTunes |
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22 |
Complications of Dwelling Central Lines | What horrible things can happen with central lines once they have been inserted. | 8/3/09 | Free | View In iTunes |
|
23 |
Central Line Insertion Complications | A discussion of the potential problems encountered while inserting central venous catheters. | 7/16/09 | Free | View In iTunes |
|
24 |
Pulmonary Physiology and General Anesthesia | This episode discusses the effects and risks of anesthesia on patients with pulmonary disease as well as the effects of anesthesia on pulmonary physiology. | 6/21/09 | Free | View In iTunes |
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25 |
Caustic Ingestions | Ingestion of caustic materials can be fatal and difficult to evaluate. These patients are often referred to our burn center. | 5/12/09 | Free | View In iTunes |
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26 |
IV Fluids (Part 1) | An introduction to the basic science in fluids used to treat hypovolemia. | 5/3/09 | Free | View In iTunes |
|
27 |
Arterial Blood Gases | This episode is a discussion about how to approach an arterial blood gas result. | 4/26/09 | Free | View In iTunes |
|
28 |
Pulse Oximetery | Discussion of the technology of the pulse oximeter | 3/29/09 | Free | View In iTunes |
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29 |
Discussion on Fluids: The last Cotton lecture | This is an interview that I did on www.medtalknetwork.com with Dr. Brian Cotton. Dr. Cotton recently left Vanderbilt to take a new position at UT Houston. He is an excellent teacher and his opinions on fluids resuscitation are cutting edge. | 3/5/09 | Free | View In iTunes |
|
30 |
Refeeding Syndrome | When and how can providing a starving patient nutrition be potentially deadly. | 2/21/09 | Free | View In iTunes |
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31 |
Hypoxia: physiological causes | Understanding the root cause of hypoxia will allow for more appropriate treatment. | 2/14/09 | Free | View In iTunes |
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32 |
Hypernatremia | Evaluation and treatment of elevated serum sodium is presented. | 2/11/09 | Free | View In iTunes |
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33 |
Hyponatremia: common but dangerous | Hyponatremia or a low serum sodium is a common electrolyte problem that is dangerous if ignored or treated improperly. | 2/6/09 | Free | View In iTunes |
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34 |
Prehospital/Battlefield Tourniquet Use | Review of a recent publication from Annals of Surgery | 2/1/09 | Free | View In iTunes |
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35 |
Environmental Hypothermia | Following the recent crash of the US Airways in the Hudson River, it is an appropriate time to discuss the clinical manifestations and treatment of hypothermia. | 1/28/09 | Free | View In iTunes |
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36 |
Peak Inspiratory Pressure: Physiological Determinants | Peak inspiratory pressure (PIP) the center of a great deal of discussion of ventilator management. Knowing the factors that increase or decrease PIP are important to those managing critically ill patient. This podcast is steeped in physiology and perhaps more difficult than my typical podcasts. PIP= [Tv/ (Compliance Lung & Thorax)] + (Resistance of airway + flow ) | 1/19/09 | Free | View In iTunes |
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37 |
Hyperkalemia | Hyperkalemia is a very common and potentially dangerous electrolyte disorder that commonly occurs in ICU patients. | 1/11/09 | Free | View In iTunes |
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38 |
Some Swan Stuff | A brief discussion regarding some of the commonly used values obtained from a pulmonary artery catheter. | 12/29/08 | Free | View In iTunes |
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39 |
Therapeutic Hypothermia following Cardiac Arrest | Therapeutic Hypothermia following cardiac arrest has been demonstrated to improve outcomes. Starting Jan 1, 2009 Ney York City EMS will dorect patients to those hospitals able to delivery such care. | 12/22/08 | Free | View In iTunes |
|
40 |
Radiation Injury / Nuclear MCI | The US government last week released a report that the threat of a nuclear device used in an act of terrorism is high in the next couple of years. In this episode we discuss the some concepts of the medical care required to those exposed to radiation as well as blast injuries. I hope this is information that none of you will ever need. | 12/12/08 | Free | View In iTunes |
|
41 |
Cardiovascular Risk Reduction for Surgery | This episode explores what is needed to make surgery safer for the patient with cardiovascular disease. | 11/20/08 | Free | View In iTunes |
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42 |
Meta-analysis of Glucose Control | Tight glucose control has been widely introduced into critical care. This meta-analysis, recently published in JAMA, critically evaluates the effects of these trials in reduction of sepsis as well as mortality. The results might surprise you. | 11/16/08 | Free | View In iTunes |
|
43 |
Myocardial Infarction: PCI and medications | This is the second installment of this topic. In this episode we talk about the role of angioplasty and role of various medications in the treatment of the patient having an MI. | 10/20/08 | Free | View In iTunes |
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44 |
Disaster Management | It is Sunday 8.31.08 and for hurricane Gustav is bearing down on the city of New Orleans. This podcast will discuss the basic elements of disaster planning and management. (This was reposted due to some technical problems with the server.) | 10/18/08 | Free | View In iTunes |
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45 |
Traumatic Rhabdomyolyisis / Crush Syndrome | Crush syndrome is a common cause of death following earth quakes, mine and building collapses. Traumatic rhabdomyolysis may also be seen following electrical injury or severe trauma. (This is a reposting due to some previous technical problems with the server.) | 10/18/08 | Free | View In iTunes |
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46 |
Myocardial Infarction: Diagnosis and Thrombolytics | Myocardial Infaction (Part 1): This episode will discuss the diagnosis of MI, STEMI, and non-STEMI. We then discuss the indications and types of thrombolytic agents. | 9/9/08 | Free | View In iTunes |
|
47 |
PAIN: a four letter word | The management of pain is a key element of the care of all patients-- ICU or not. Often providers have little understanding of the concepts and medications of pain management. This episode serves as an introduction. | 8/21/08 | Free | View In iTunes |
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48 |
Hypercalcemia | A potentiallylife-threatening electrolyte problem that commonly finds its way into the ICU as well as on exams. | 8/13/08 | Free | View In iTunes |
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49 |
Patient-Ventilator Interactions and ventilator discontinuation | Getting patients comfortable on the ventilator is not an easy task. This podcasts focuses on methods to make patients synchronize with the ventilator as well as a discussion of spontaneous breathing and awake trials | 8/7/08 | Free | View In iTunes |
|
50 |
Ventilator Update: avoiding shear trauma | In regards to ventilator care, all the focus has been on low tidal volume and level of peak inspiratory pressure. What level of PEEP shoud we be using to avoid shear trauma and ventilatory induced lung injury. | 8/3/08 | Free | View In iTunes |
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51 |
Abdominal Compartment Syndrome | A discussion of the physiology and presentation of abdominal compartment syndrome. | 6/7/08 | Free | View In iTunes |
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52 |
Extremity Compartment Syndrome | A limb-threatening complication that might be overlooked by the inexperienced provider. | 5/18/08 | Free | View In iTunes |
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53 |
Surviving Sepsis Campaign (part 2) | We continue our discussion of the Surviving Sepsis Campaign (SSC). This includes fluids types, steroids, rhAPC (Xigris), and blood sugar control. | 5/15/08 | Free | View In iTunes |
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54 |
Surviving Sepsis Campaign (part 1) | The Surviving Sepsis Campaign (SSC) is concensus document that attempts to provide the best evidence to assist in the care of the septic patient. All providers who provide care to the septic patient should be aware of the contents of the SSC. | 5/11/08 | Free | View In iTunes |
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55 |
Hemoglobin Based Blood Substitutes: Increased Morbidity and Mortality | In this week's Journal of the American Medical Association a meta-analysis was published that concluded that use of hemoglobin based blood substitutes result in an increased morbidity and mortality. Included in the same journal is an editorial critical of the method the research has been regulated by the US FDA. | 5/4/08 | Free | View In iTunes |
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56 |
Glucometers in the ICU: how accurate are they? | There is a large emphasis on intensive control of blood glucose in the ICU, but how accurate are the monitors we use to follow glucose? This episode reviews someof the limitations of deploying an instrument designed for control of outpatient diabetes management to tight control of blood glucose in the ICU. | 4/24/08 | Free | View In iTunes |
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57 |
Clostridium difficile Colitis | Clostridium difficile colitis is a problematic complication of antibiotic theraoy in hospitalized and critically ill patients. It is increasing in frequency and can be lethal. | 4/16/08 | Free | View In iTunes |
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58 |
Traumatic Shock and Fluid Resuscitation | Fluid resuscitation done poorly can result in significant complications to the patient. This episode will present some of the newer considerations in fluid resuscitation in traumatic shock. | 4/1/08 | Free | View In iTunes |
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59 |
Polypharmacy in the Elderly | Patients are often admitted to the ICU with an entire list of home medications. In this episode I talk about the implications and dangers of polypharmacy. | 3/23/08 | Free | View In iTunes |
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60 |
Drug-induced QT prolongation | Prolonged QT is the most common reason why medications are restricted or removed from the US market. This episode will explain what it is and why you should look for it in your ICU patients. | 3/8/08 | Free | View In iTunes |
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61 |
Do Steroid Improve Survivial in Sepsis? CORTICUS Trial | The results of the CORTICUS trial are discussed. | 2/27/08 | Free | View In iTunes |
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62 |
Atrial Fibrillation | Atrial fibrillation is a common problem in ICU patients, but it is a problem with many potential causes, and not always a well defined treatment. | 2/19/08 | Free | View In iTunes |
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63 |
Pediatric Burns | Pediatric burns: all burns are serious, both big and small. This episode reviews the objectives of burn care to result in the best functional outcome. Also, burn is a very common method of child abuse and we detail how these children are injured and what to look for to identify possible abuse. | 2/12/08 | Free | View In iTunes |
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64 |
Pharmacology of Shock | This is a basic introduction of some of the drugs used in various forms of shock. | 2/7/08 | Free | View In iTunes |
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65 |
Sepsis - Part 2 | In this episode we discuss that ICU care of the patient with sepsis. This includes an introduction to various vasopressors. | 1/31/08 | Free | View In iTunes |
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66 |
Sepsis - Part 1 | Sepsis is a common cause of death in the intensive care unit. In this episode I present some of the statistics on septic deaths, introduce the definitions, and present the basic science. Part 2 will cover fluid and drug therapy for septic shock. | 12/10/07 | Free | View In iTunes |
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67 |
HIT: Heparin Induced Thrombocytopenia | Large numbers of patients in ICUs are on heparin and what is this complication of heparin induced thrombocytopenia? | 10/27/07 | Free | View In iTunes |
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68 |
Smoke Inhalation Injury: CO and Cyanide Toxicity | The onset of cold weather will bring with it an increase in structure fires. The leading cause of deaths in fires is complications from the inhalation of smoke-- not burns. Learn why smoke is so deadly as well as what are the appropriate methods to treat smoke related asphyxiation. | 10/14/07 | Free | View In iTunes |
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69 |
Blood Products | Blood products: pRBCs, fresh frozen plasma, platelets, cryoprecipitate when and how should we use it? What are the risks? You may order them like IV fluids but do you really know how these potentially deadly products are to be used. | 9/30/07 | Free | View In iTunes |
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70 |
Control of hyperglycemia improves outcomes | A great deal is being presented and published on control of blood sugar in the ICU as well as the postoperative period. How much control is enough and what is the data? | 9/24/07 | Free | View In iTunes |
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71 |
Antibiotic Considerations in the ICU | Why do we choose the antibiotics that we do? How long do we continue the course of therapy? Should we use some antibiotics together? These topics are covered in the episode. | 9/14/07 | Free | View In iTunes |
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72 |
Crush Syndrome | Earthquakes are horrible natural events causing loss of lives in the thousands. Following earthquakes, building collapses, and cave-ins, large number of victims will suffer from renal failure and death following crush syndrome. | 8/19/07 | Free | View In iTunes |
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73 |
Thermal Injuries | An introduction of the biology of thermal injuries and the initial care of the patient with thermal injuries in critical condition. | 8/12/07 | Free | View In iTunes |
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74 |
Metabolic Acidosis in the ICU | A common problem in the ill or injured patient is a metabolic acidosis. In this episode we will review the common etiology of a metabolic acidosis as well as some lesser known causes. | 7/25/07 | Free | View In iTunes |
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75 |
Bomb and Blast Injuries | Bomb and blast injuries: In the past blast injuries were limited to the battlefield of a rare industrial accident. The events of the past week are a reminder that civilian population centers are targets for bombing attacks. Most civilian providers has no to limited knowledge or experience treating patients with such injuries. This episode is dediacated to a discussion of some of the unique properties and injuries associated with blast injuries. In the event of a terrorist attack, like those attempted in London this past week, the injuries will be in the hundreds. | 7/5/07 | Free | View In iTunes |
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76 |
Early Surgery Improves Outcomes Following Critical Burns | Early surgical excision is likely to be the most significant individual variable to imporve the outcome of a patient (adult or child) with a critical burn. Nevertheless, many nonburn physicians still want to apply to 1970 treatment paradigms to this population of injured patients. This episode will hopefull replace these falsehoods with fact supported in the literature. | 6/28/07 | Free | View In iTunes |
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77 |
Metabolism: Starvation versus Stress | Not feeding an injured or ill patient is not that same as a normal individual who is fasting. A pound of weight loss in the stress patient is significantly different than a pound of weight loss in someone on a diet. A basic understanding of stress metabolism is needed prior to a discussion of nutrition. | 6/19/07 | Free | View In iTunes |
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78 |
Blood Conservation in the ICU | When should a patient receive a transfuse of blood? What is an acceptable hemoglobin concentration in an ICU patient and should we use EPO? Summer is a time when the blood banks often have a single day's worth of blood. Perhaps with more conservative transfusion practices we can avoid or certainly help with some of the blood shortages. Everyone wants to put patients on Epo, but does it increase the hemoglobin concentration enough to off set its high cost? | 6/14/07 | Free | View In iTunes |
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79 |
Burns: Fluid Creep | Excessive fluid resuscitations lead to horrible complications such as abdominal compartment syndrome. This article takes a critical look and challanges many of our practices in fluid resuscitation of burn patients. | 6/7/07 | Free | View In iTunes |
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80 |
Renal Replacement Therapy: SCUF, SLED, CVVH, CVVHD, IHD--what does it all mean | Renal replacement therapy (RRT) is rather a confusing topic. What do all those initials mean and why use one therapy over another? This podcast will explain the difference between intermittent and continous. What are the various forms of continuous and how do they differ? What are the concepts of ultrafiltration, diffusion, and convection? These questions will be answered in this introduction to renal replacement. | 5/31/07 | Free | View In iTunes |
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81 |
Intraosseous Vascular Access: not just for the kids anymore | Intraosseous vascular access was was developed for use in adult trauma patients over 80 years ago. Only recently has this technique regained popularity for rapid and safe access to the vascular space in patients in extremis. | 5/28/07 | Free | View In iTunes |
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82 |
Weaning (Liberating) from the mechanical ventilator | Don't wean people from their ventilators-- liberate them!! When are people ready to come off the ventilator? What are weaning parameters? How does one do a spontaneous weaning trial? What is the role of noninvasive ventilation (NIV)? | 5/25/07 | Free | View In iTunes |
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83 |
Acute RenalFailure | Acute renal failure is a dreaded complication in the ICU. This podcast will review the various types of acute renal failure, the etiology, as well as acute management. | 5/22/07 | Free | View In iTunes |
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84 |
Airway Pressure Release Ventilation (APRV) or BiVent: What the heck is this? | Airway pressure release ventilation (APRV) is not a new mode of mechanical ventilation, but it seems to be gaining a great deal of popularity lately. Many people find this mode very complicated and thick that it is reserved only for the very ill. Neither one of these assumptions are corrrect. This mode is very easy to learn and use. Furthermore, this mode is very physiological and tolerated by all types of patients. | 5/19/07 | Free | View In iTunes |
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85 |
Complications of PEEP and Auto-PEEP | Virtually all patients on ventilators are on PEEP. PEEP has several interactions with various organ systems and some can result in profound complications. An understanding of PEEP and auto-PEEP are required before we can understand modes of ventilation like APRV (Bi-Vent) | 5/18/07 | Free | View In iTunes |
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86 |
Glutamine In Critical Illness: what's all the fuss about? | All surgical residents know that glutamine is the amino acid known as the fuel for the gut. But what is all the fuss about? The episode will look at the data on glutamine. Does glutamine improve outcomes, and if so and in who? How much should we use and what are the hazards? Enteral versus parenteral. www.burndoc.com | 5/17/07 | Free | View In iTunes |
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87 |
Lightning Injuries | Lightning injuries are rare, but when you do treat a patient they can have facinating presentations. This lecture follows a patient we treated at Vanderbilt. The patient present to a local ED with stroke like symptoms following the lightning strike. Initially, physicians were confused by the presentation, but in this lecture you will learn that his presentation was near textbook. www.burndoc.com | 5/14/07 | Free | View In iTunes |
|
88 |
Oxygenation & PEEP | A discussion of ventilation, oxygenation, and the role of PEEP. | 5/13/07 | Free | View In iTunes |
|
89 |
Modes of Mechanical Ventilation | A discussion of the various types of ventilators with a focus on the various ventilator modes and types of ventilator cycles. Also presented is the topic of pressure support ventilation (PSV) | 5/13/07 | Free | View In iTunes |
|
90 |
What is the role of decadron in preventing post extubation stridor? | What is the role of giving an adult steroids to prevent stridor or reintubation following extubation. This epidose looks at the data. | 5/13/07 | Free | View In iTunes |
| Total: 90 Episodes |
Customer Reviews
Excellent Teacher!
This is absolutely wonderful. The teaching here is very, very good; he explains things in a way so that they're easy to understand. I'm an ortho resident who did an away rotation at Vanderbilt. While I never worked with Dr. Guy, the teachers there were great...Dr. Guy brings justice to the Vanderbilt name. I've now listened to 4 of the Podcasts and they've all been wonderful. I just wish that there were more of them because I listen to them on my way to work and they're running out.
Pithy, current and practical
Kudos to Dr. Guy for his generous and innovative contribution to the "audio" medical literature. This podcast is a great way for physicians to "calibrate" their own approach with that of a seasoned critical care specialist. I appreciate Dr. Guy's casual style as well... like coffee in the physician's lounge.
Amazing job
Even though im still a Sophmore in high school i love learning about medicine and this podcast is my favorite. Thank you so much for taking the time to make these. They are very in depth and always interesting, i cant wait for more!
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