The Critical Care Commute Podcast (Critical Care Commute)

Dr Rob Mac Sweeney is an Intensivist at the Royal Victoria Hospital in Belfast, and the lead organizer for the Critical Care Review, both the website and conference. 2023's conference is June 14-16, and streamed from the Titanic Centre in Belfast. Join us as Dr. Mac Sweeney explains what makes this meeting one of the top conferences in Critical Care.

Follow this link for the 20223 meeting: CCR23 (criticalcarereviews.com)

Welcome back to the Critical Care Commute as we continue our “State of the Art 2023” series. In today's episode, we have a distinguished guest who needs no introduction in the field of Advanced Cardiac Life Support (ACLS).

Joining us today is Professor Jerry Nolan, a renowned expert and thought leader in resuscitation science and ACLS guidelines. Join us for an insightful and informative conversation with Professor Jerry Nolan as we delve deep into the world of ACLS guidelines, resuscitation science, and the critical role they play in saving lives.

Whether you're a healthcare professional or simply interested in the field, this episode is a must-listen.

Thank you for tuning in to the Critical Care Commute. If you enjoyed this episode, please consider leaving a review and sharing it with your colleagues and friends. Stay tuned for more fascinating discussions in the world of healthcare and medicine.

[Disclaimer: The information provided in this podcast is for educational and informational purposes only and should not be considered as medical advice. Consult with a qualified healthcare professional for any medical concerns or questions.]

Join us as we take a brief break from our State of the Art series as we speak to Dr. Blair Bigham about death and the complexities that life sustaining therapies bring when there is dwindling hope.

Blair is an award-winning journalist, scientist and physician who trained in emergency and critical care medicine at McMaster and Stanford Universities. He was a Global Journalism Fellow at the Munk School of Global Affairs and Associate Scientist at St Michael’s Hospital.  His work has appeared in newspapers, magazines, newscasts, podcasts and medical journals. He is co-host of the CMAJ Podcast.

He witnesses the relationship between wealth and health on a daily basis, and reports on the undertold stories of patients, healthcare providers, and the systems that help or fail them.

His first book, Death Interrupted: How modern medicine is complicating the way we die became a best-seller.

https://youtu.be/CxdDaFoBYXA

We take a quick break from our Canada Critical Care Forum series, for a special episode. We had the privilege of hosting Dr. Rob Fowler, visiting professor at the University of Alberta as part of the Dr. Noel Gibney lecture series.

Dr. Fowler is a critical care physician and Tory Trauma Program Chief at Sunnybrook Hospital and Chair of the Canadian Critical Care Trials Group. Rob’s academic interests include access and outcomes of care for critically ill patients and those near the end of life – in a global context. He has assisted or worked with national and international health care organizations during SARS, pandemic and avian influenza, Middle East Respiratory Syndrome, Ebola and COVID-19. Dr. Fowler shared invaluable insights into the concept of "Critical Care Without Borders," emphasizing the universal principles and challenges inherent in critical care medicine. Throughout the episode, Dr. Fowler's passion for improving patient care and his commitment to advancing critical care education and research were evident.

Tune in to this enlightening conversation as we explore the boundless possibilities and inherent responsibilities of providing Critical Care Without Borders.

Tim Caulfield (professor, best selling author, Netflix presenter and Order of Canada recipient) joins us for a spirited discussion of so much that matters to so many: COVID, vaccines, masks, science, tribalism and public debate. Informative provocative and (surprisingly?) upbeat.

Further Reading: 

On the harm of misinformation: https://cca-reports.ca/reports/the-socioeconomic-impacts-of-health-and-science-misinformation/

Debunking sudden death https://www.thestar.com/news/canada/2022/11/07/why-wont-a-debunked-conspiracy-theory-about-doctors-harmed-by-the-covid-vaccine-go-away.html

And a recent study that is relevant: https://www.nature.com/articles/s41467-022-35653-z

Welcome to our first episode in a series on Cardiac Intensive Care, recorded live at the Critical Care Canada Forum 2024. We kick off by looking at the latest Clinical Practice Update on post cardiac arrest care and refractory cardiac arrest.

The "Canadian Cardiovascular Society/Canadian Cardiovascular Critical Care Society/Canadian Association of Interventional Cardiology Clinical Practice Update on Optimal Post Cardiac Arrest and Refractory Cardiac Arrest Patient Care" CCS was published in 2024, and provides comprehensive recommendations for the management of patients following cardiac arrest.

Join us as Dr Janek Senaratne unpacks this Clinical Practice Update (CPU), and guides us through the evidence for the recommendations made.

Dr. Janek Senaratne is a dual-trained cardiologist and intensivist based in Edmonton, Alberta. He serves as an Associate Clinical Professor in the Department of Medicine at the University of Alberta. University of Alberta In his clinical roles, Dr. Senaratne practices at the University of Alberta Hospital and Grey Nuns Hospital, and is one of the Vital Heart Response physicians for the province.

Further Reading:

Welcome back to our second podcast from sunny San Diego! Stay classy, San Diego! Peter and Leon are again joined by Matteo, Jarrod, and Calvin for rapid fire cases! In this episode they discuss approaches to:

Rapid Fire Scenario 1 - Tracheostomy tube displacement.

Rapid Fire Scenario 2 - Hypoxemic patient going into Cardiac arrest

Topicalization Techniques

Handling the Soiled Airway - Video Laryngoscopy vs. Direct Laryngoscopy.

Join us as the team reflects on the benefits of spending time immersed in difficult airway scenarios. Airway management goes beyond mere intubation and involves cognitive skills, team management, and situational awareness. The Difficult Airway Course is a valuable experience for those interested in enhancing their airway management skills.

Recorded live at the Toronto Critical Care Canada Forum, this episode features a conversation with Prof. Derek Angus, Professor at the University of Pittsburgh, senior editor at JAMA, and Vice Chair of Innovation.

We discuss the evolution of healthcare systems, the art of decision-making, the role of AI, and how to inspire the next generation of clinicians.

Chapters:

Welcome to the Forum

• Introductions and reflections on the energy of in-person conferences post-COVID.

• Setting the stage with Dr. Angus and his storied career.

Conferences: More Than Just Science

• The dual role of conferences as spaces for rigorous science and informal discussion.

• How smaller, focused meetings like CCR foster deeper conversations.

• How We Communicate Science

Reflections on the digital age: Do we risk dumbing things down too much?

• The balance between simplicity and nuance in medical publishing.

The AI Frontier in Medicine

• Separating hype from reality: Why AI isn’t replacing doctors just yet.

• The cognitive load of decision-making and where technology fits in.

Thinking, Fast and Slow

• Exploring System One and System Two decision-making.

• The growing interest in how groups make decisions in critical care settings.

Redefining Careers in Medicine

• Moving beyond traditional roles to focus on leadership, innovation, and teamwork.

• Advice for the next generation on thinking outside the box.

Building Better Healthcare Systems

• Shifting accountability from individual outcomes to system-wide improvement.

• Transparency and trust: Why they’re essential for the future of healthcare.

Closing Thoughts

• Dr. Angus reflects on his legacy and hopes for the next wave of clinicians.

• A heartfelt thanks and a promise for more conversations ahead.

Join Brian Buchanan, Associate Professor and ultrasound guru, for a dose of iconoclasm and provocation. Recorded at the Critical Care Canada Forum in Toronto, and following a 2024 JICS publication by Brindley et al.  

In this episode we welcome back good friend, Dr. Matt Morgan.

Dr. Morgan is a Consultant in Intensive Care Medicine at the University Hospital of Wales, UK and The Royal Perth Hospital, Australia. He is an adjunct Clinical Professor at Curtin University, an Honorary Senior Research Fellow at Cardiff University and regular columnist at the BMJ. In his off time, he has penned 2 books thus far. In his is first book “Critical" he tells the remarkable stories of patients he has met as a guide through the intensive care unit. His second book, "One Medicine", explores how understanding the lives of animals can help treat human disease.

In this episode, recorded remotely from Perth, Australia, Matt highlights animal physiology to help understand respiratory therapies in the ICU.

Join Dr. Leon Byker as he talks to Dr Peter Brindley about CRM on the telephone. Yes, the hunter becomes the hunted! 

Dr. Brindley is an Intensive Care Doctor, Professor of Critical Care, Adjunct Professor of Anesthesiology and Adjunct Professor of Medical Ethics at the University of Alberta, Edmonton, Canada. He has special interest in Human Factors, Crisis Resource Management, Medical Communication, Airway Management, Resuscitation Prognostication, End of life care, and lastly Resilience and wellbeing in healthcare workers. 

In this episode we discuss the importance of isolating oneself when taking a call, "conserving bandwidth", building a relationship on the phone, triaging patients as red, orange or green to assist in decision making, avoiding technical language and recognizing discomfort with end-of-life matters some health care workers may experience. 

Further reading:

Brindley PG, Cardinal P. Optimizing crisis resource management to improve patient safety and team performance: a handbook for all acute care health professionals. Royal College of Physicians and Surgeons of Canada. Collège Royal des médecins et chirurgiens du Canada; 2017.

In this episode, we are joined by Professor Hugh Montgomery, leading expert in intensive care medicine, and Dr Jessica Sullivan, Anaesthetic/ITU Registrar. Listen as they share their insights on a challenging clinical scenario: hypoxemia with a normal chest X-ray. What are the pitfalls and pearls of managing hypoxemia with a normal chest X-ray? How has COVID-19 changed our understanding of this phenomenon?

Professor Montgomery practices as a consultant in intensive care at the Whittington hospital in North London. His interest has been in the use of environmental stressors in the exploration of human (patho)physiology – often using a genetic approach. He was the first to discover a 'gene for human fitness'. He has published over 450 articles. He also has a strong interest in environmental impacts on health, and in climate change in particular.

Dr Jessica Sullivan's most recent position was as an Anesthetic/ITU Registrar at the Whittingtoin Hospital, where she worked alongside Prof Montgomery. She is on the organizing committee for the North Thames Anaesthetic Meeting (NTAM) conference. Medicine is not her only passion, she is a keen sportswoman and an ex competitive gymnast. She is currently undertaking training in acrobatics.

Learn more here:

1. Hugh Montgomery (physician) - Wikipedia
2. AirCraft Circus Academy aerial circus & studio hire, Greenwich, London – AirCraft Circus Academy Performance & Circus Training in London

Welcome to the inaugural episode of our podcast series, recorded live at the Critical Care Canada Forum meeting of 2023.

In our first episode, we are again joined by the esteemed Dr. Hannah Wunsch, expert in critical care medicine with a keen interest in the historical lessons we can glean from medical breakthroughs of the past.

Today, we will continue exploring the lessons from the fight against polio and they shaped modern critical care practices.

This is just the beginning, so buckle up and get ready to be inspired as we interview Dr. Hannah Wunsch and many more Canadian Critical Care luminaries, recorded live at the Critical Care Canada Forum meeting of 2023.

Health Economics 101: "Code Green - How the big lie in health care affects us all."

Prof. John Kellum, is a Professor of Critical Care Nephrology and now provocative author! Join us as he talks to us about his book: "Code Green - How the Big Lie in Healthcare Affects Us All."

Conflict Declaration:

The hosts and producers of this podcast declare no financial gain or conflict of interest from this episode or the promotion of Code Green. Our only goal is to share the insights and expertise of Dr. Kellum with our audience.

Episode Chapters:

1. Welcome and Introduction
2. Why Code Green? The inspiration behind the book.
3. The Evolution of U.S. Healthcare: From the 1980s to today.
4. The "Big Lie" in Healthcare: How hospitals maintain profits while claiming financial distress.
5. Trust and Its Erosion in Medicine: Exploring the misalignment between physicians, hospitals, and patient care.
6. Burnout or Moral Injury? Understanding the psychological toll of compromised care.
7. Aligning Values with Care: Dr. Kellum’s actionable solutions for a better healthcare system.
8. The Role of Patients in Reform: How patients can become advocates for systemic change.
9. Closing Thoughts and Takeaways: Dr. Kellum’s message to healthcare professionals and patients alike.

Further Resources:

• Code Green: How the Big Lie in Healthcare Affects Us All

Welcome to the Critical Care Commute Podcast! In today's episode, we delve into the field medical education. Joining us is Dr. Chris Nickson, to explore the question: "Are we training intensivists for the future?"

As advancements in medical technology and our understanding of critical care continue to evolve, it's essential to assess whether our current training programs adequately equip intensivists with the skills and knowledge needed for the challenges ahead. Dr. Chris Nickson, with his wealth of experience and insights, provides a deep dive into the current state of intensive care training, identifies potential gaps, and offers valuable perspectives on how we can better prepare the next generation of intensivists.

Whether you're a healthcare professional, a medical student, or someone interested in the future of critical care, this episode promises to be enlightening and thought-provoking. Tune in as we navigate the landscape of intensive care training and explore the measures needed to ensure that intensivists are well-prepared to meet the demands of the ever-evolving healthcare landscape.

In this episode, Peter Brindley and Leon Byker sit down with Dr. Rob Bevan, immediate past president of the College of Intensive Care Medicine (CICM) and Critical Care Director at Auckland City Hospital, Auckland, New Zealand.

Dr. Bevan shares his journey through leadership in intensive care, the role of intensive care colleges, and the evolution of critical care training. He also explores the political, social, and ethical dimensions of critical care, from workforce sustainability to the unique role of intensivists as brokers of care.

Episode Highlights:

The Evolution of CICM: History of the CICM and the differences between the CICM and similar organizations globally.

Training for Critical Care: The training pipeline in Australasia.

Advocacy and Political Engagement: The role of the CICM in advocating for intensive care resources.

The Value of College Convocations: Celebrating new fellows and their families and the role of meaningful ceremonies.

The Intensivist as a Broker of Care: Defining the role of the ICU specialist in complex patient care.

The Future of Critical Care Workforce: Addressing workforce challenges and it's sustainability.

The Upcoming CICM Annual Meeting: Highlights of the upcoming 2025 meeting in Tasmania.

Reflections on Leadership and Administration: Dr Bevan's Journey into administration and why it matters.

This podcast was a little different and, hence, so are the show notes. What follows is the books mentioned during the recording. The list is neither comprehensive nor to suggest we’re especially literate: we’re not.

Instead, we’re merely encouraging people to explore books about the wider world of medicine and to bolster your courage when you come to write your own! Feel free to share your favorites, especially those that we missed, via our Twitter or Instagram accounts.

Matt Morgan

Critical 2019 (history of ICU, personal reflection)

One Medicine, 2023 (popular science, comparative physiology)

James Maskalyk

Life on the Ground Floor, 2017 (emergency medicine in both developed and developing world, personal reflection)

Kevin Fong

Extreme Medicine, 2014 (popular science, physiology)

Rachel Clarke

Your Life in My Hands, 2017 (life as a junior doctor, personal reflection)

David Nott

War Doctor, 2019 (surgery in developing world and war zones), personal reflection)

Aoife Abbey

Seven Signs of Life, 2019 (ICU physician, personal reflections)

Henry Marsh

Do no harm, 2014 (neurosurgeon, personal reflections

Admissions, 2017

Adam Kay

This is Going to Hurt 2017 (obstetrics, personal reflections, diary)

Undoctored (2022)

Kathryn Mannix

With the End in Mind 2017 (end of life, palliative care, insights)

Michael Bliss

The Discovery of Insulin 1982 (medical history)

William Osler: a life in medicine, 1999

Harvey Cushing, 2005

Rose George

The Big Necessity, 2008 (the story of human waste)

Nine Pints, 2019 (blood and transfusion)

Mary Roach

Stiff: the curious life of human cadavers, 2021 (self explanatory)

Caitlan Doughty

Smoke gets in your eyes, 2015 (working in the funeral and cremation business)

Sam Keens

The tale of the dueling neurosurgeons, 2014 (popular science, neuroanatomy)

The Icepick Surgeon, 2021 (the awful things done in the name of medical science)

Roy Porter

Medicine, a history of healing, 1997 (medical history)

The greatest benefit to mankind, 1999

And one we didn’t mention but should have

Wendy Moore

The Knife Man, 2005 (biography of John Hunter and the history of surgery and Victorian medicine)

In the grand finale of our "State of the Art 2023" series, we delve into the field of Neuro Critical Care research. We had the privilege of sitting down with renowned Professor David Menon, a leading authority in Neuro Intensive Care.

Don't miss this final episode in our series, where we journey into learning lessons from large collaborations. This episode is a must-listen.

Dr. Sam Shemie is a highly respected expert in the field of critical care medicine. He is a pediatric critical care physician (our first peaditric critical care specialist on the podcast) and a professor of Pediatrics at McGill University in Montreal, Canada. Dr. Shemie has dedicated his career to improving the care of critically ill patients, particularly children. He has a special interest in organ donation and transplantation, and has made significant contributions to the development of donation policies and practices in Canada and around the world. 

In this podcast, Dr. Shemie shares his extensive knowledge and experience in the field critical care medicine, as he takes us on a journey of "Life, Death and the Bridges in Between."

In this episode, we sit down with Dr. Damon Scales and Dr. Niall Ferguson at the Canadian Critical Care Forum. We dive into a little bit of ARDS and spend a whole lot of time talking about the evolving landscape of conferences and critical care research. Tune in for insights from two leaders in the field!

Join us on our next podcast in the "State of the Art" series, as we delve into the realm of sustainability and climate change, guided by the wisdom and insights of Professor Hugh Montgomery.

In this podcast, Professor Hugh Montgomery challenge us to think critically, act responsibly, and embrace the urgent imperative of creating a sustainable and resilient future for all.

Who is Professor Hugh Montgomery? Read here: Hugh Montgomery (physician) - Wikipedia

Welcome to the Critical Care Commute Podcast! In this episode, we have the honor of hosting Dr. Dan Howes. Dr. Howes is a Professor in the Departments of Critical Care Medicine and Emergency Medicine. He is the founder and director of the Kingston Resuscitation Institute and initiated the first Fellowship in Resuscitation and Reanimation through the Department of Emergency Medicine at Queen’s.

Join us as we explore how simulation in medical training is revolutionizing the way healthcare professionals prepare for high-stakes scenarios. We'll also dive into the principles of stoicism and how this ancient philosophy can enhance resilience and decision-making under pressure. Finally, we'll discuss the latest insights from cognitive science and how they can be applied to improve performance and outcomes in critical care settings.

Whether you're a healthcare professional, a student, or simply curious about these compelling topics, this episode promises to be an enlightening journey into the cutting-edge strategies that are shaping the future of medical practice.

Stay tuned, and let's get started!

Dr. Sam Shemie is a world-renowned expert in the field of critical care and the determination of brain death. He is a pediatric critical care physician and a professor of Pediatrics and Critical Care Medicine at McGill University in Montreal, Canada. Dr. Shemie is also the founder and director of the Canadian Donation and Transplantation Research Program, a national research program focused on improving organ donation and transplantation in Canada.Throughout his distinguished career, Dr. Shemie has made significant contributions to the understanding and practice of brain death determination, which is a critical component of organ donation and transplantation. He has published numerous scholarly articles on the subject, and he has served as an advisor to the World Health Organization, the Canadian Blood Services, and other organizations on issues related to organ donation and transplantation.In this podcast, Dr. Shemie shares his expertise on brain death determination and the ethical considerations that surround this complex topic.

Listeners will gain valuable insights into the science of brain death determination, as well as the challenges that clinicians and families face in making these difficult decisions. Dr. Shemie's thoughtful and compassionate approach to this topic will leave listeners with a deeper understanding of the critical role that organ donation and transplantation play in saving lives.

As health care providers, we are often called on to manage patients with chronic pain. In the acute setting, how do we manage them well? Join us on this podcast with Dr Saifee Rashiq, as we unravel chronic pain secrets well beyond opioids and other medications.

Dr. Saifee Rashiq is an Anesthesiologist and Pain Medicine Specialist at the University of Alberta in Edmonton and a Professor in its Faculty of Medicine and Dentistry. He studied medicine at University of Nottingham, anesthesia training at the University of Alberta, fellowship in Pain Medicine in Seattle, and a Master’s Degree in Clinical Epidemiology from the Harvard School of Public Health.

His clinical practice combines anesthesia and treating chronic pain patients in a Multidisciplinary Pain Clinic, where his clinical interest is in medically and psychosocially complex patients and non-organic pain syndromes.

He is a loving husband and father of 3 and cycles to work when the weather is fine.

Note that this was an earlier recording and the sound quality is not what we are hoping to achieve. 

Further Reading:

1. Beyond nociception: the imprecision hypothesis of chronic pain. G. Lorimer Moseleya, Johan W. S. Vlaeyen. Painjournalonline January 2015, Vol 156, Nr 1. http://dx.doi.org/10.1016/j.pain.0000000000000014

2. Injuries of the Nervous System: On Railway and Other Injuries of the Nervous System. London, Walton and Moberly 17-23.4349,1866.

3. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain. The SPACE Randomized Clinical Trial. Erin E. Krebs, MD, MPH; Amy Gravely, MA; Sean Nugent, BA; Agnes C. Jensen, MPH; Beth DeRonne, PharmD; Elizabeth S. Goldsmith, MD, MS; Kurt Kroenke, MD; Matthew J. Bair; Siamak Noorbaloochi, PhD. JAMA. 2018;319(9):872-882. doi:10.1001/jama.2018.0899

Welcome to our "State of the Art 2023 Congress Series," recorded live in Birmingham, UK!

We are absolutely thrilled to bring you the first installment of our podcast series, where we dive deep into groundbreaking topics and innovations discussed right here at this conference.

As we embark on this podcast series, we aim to bring you captivating conversations, enlightening interviews, and thought-provoking discussions straight from the conference floor, background chatter, laughter and tea trolly clanging included!

Our first guest is Dr. Dan Harvey, Professor of Intensive Care Medicine at Nottingham University Hospitals and University of Nottingham. He is Chair of the UK Intensive Care Societies Legal & Ethical Advisory Group, and an author of multiple ICS & FICM guidance documents. Dan has an active research interest with roles including National Lead for Innovation & Research in Organ Donation for NHS Blood and Transplant, Vice Chair of the NIHR’s National Critical Care Group, and is joint Chief Investigator for the SIGNET study, the world’s largest interventional study in organ donation (https://ics.ac.uk/soa23/speakers.html#:~:text=Dr%20Dan%20Harvey,in%20organ%20donation.)

Join us as we talk about devastating brain injury and what it means for patients, health care workers and families.

Welcome to our first episode of season three! We are kicking off with what is probably one of the most important topics to be discussed in modern medicine today: The rational use of antibiotics.

In this episode, we have the honor of hosting Dame Sally Davies, a renowned figure in global public health and former Chief Medical Officer for England. Dame Sally has been a leading voice in advocating for the rational use of antibiotics to combat antimicrobial resistance. Join us as we sit down with Dame Sally Davies to explore the intricacies of antibiotic stewardship and the urgent need for global action.

Throughout our conversation, we'll delve into the complexities surrounding antibiotic use, discussing the challenges of over prescribing, the rise of drug-resistant infections, and the implications for both human and animal health. This is a conversation you won't want to miss.

Dr. Robert Arntfield is an esteemed physician and researcher based in Canada who has made significant contributions to the field of critical care medicine. His expertise in cardiorespiratory physiology and resuscitation has led him to develop innovative approaches to patient care, including the use of artificial intelligence (AI) in healthcare. In this podcast, Dr. Arntfield will share his insights and experiences on how AI is transforming the healthcare landscape, from its potential to improve patient outcomes to its impact on the healthcare workforce. With his vast knowledge and experience, listeners can expect to gain valuable insights into the future of AI in healthcare and its potential to revolutionize the way we approach patient care.

Further Reading:

Deep Breathe - Artificially Intelligent Lung Ultrasound

We are back with our "State of the Art" series! Join us as we talk to Dr. Nandy Gautam on the COVID experience in Birmingham, UK, and the Post-COVID syndrome.

Dr. Gautam is a specialist physician and ICU consultant at the Queen Elizabeth Hospital, Birmingham, UK. In this episode, he takes us through his COVID experience working in this very busy Centre during the pandemic, and highlights the Post COVID syndrome experienced in their follow up clinic.

Further Reading:

www.postcovidsyndromebsol.nhs.uk

www.yourcovidrecovery.nhs.uk

www.physiotherapyforbpd.org.uk

Stockley, James & Alhuthail, Eyas & Coney, Andrew & Parekh, Dhruv & Geberhiwot, Tarekegn & Gautam, Nandan & Madathil, Sc & Cooper, Brendan. (2021). Lung function and breathing patterns in hospitalised COVID-19 survivors: a review of post-COVID-19 Clinics. Respiratory Research. 22. 10.1186/s12931-021-01834-5.

Welcome to another episode in our "State of the Art" series. We are joined by Dr Ronan O'Leary, Consultant and Specialty Lead in Neurosciences and Trauma Critical Care at Cambridge University. Dr. O'Leary brings a wealth of knowledge and experience to the table, making him the perfect guide for our journey through this fascinating and often life-changing field.

In our latest episode, we sat down with Dr. Neil Spenceley, pediatric intensivist and Safety expert.

Listen as Dr. Spenceley unpacks safety and proposes a shift from a binary safety approach (safety 1 and safety 2) to resilient engineering and system performance. Dr. Neil emphasizes the holistic view encompassing efficiency, efficacy, safety, and staff well-being.

Drawing from incidents like Three Mile Island, he emphasizes the role of human factors in identifying and resolving issues, understanding work as work is done and the importance of understanding frontline work realities to bridge gaps between protocols and real-world scenarios, advocating for system redesign to reduce complexity.

We hope you enjoy this episode!

In this episode, recorded live at the Critical Care Canada Forum in Toronto, we dive into extracorporeal life support (ECLS) in cardiogenic shock, with Dr Sean van Diepen.

He is an Associate Professor at the University of Alberta, Co-Director of the CCU at the Mazankowski Alberta Heart Institute, and a leading voice in cardiac critical care.

Join us as we explore the evolving landscape of mechanical circulatory support, the latest evidence from the DANGER and ECLS-SHOCK trials, and the complexities of patient selection.

Key Topics Covered:

1. The Evolution of ECLS in Cardiogenic Shock

• The 25-year gap since the last positive cardiogenic shock trial.

• How mechanical circulatory support expanded despite limited evidence.

2. The DANGER Trial – Impella in AMI-Associated Cardiogenic Shock

• Mechanism and function of the Impella device.

• Trial results: 20% mortality reduction at 180 days.

• Complications: Limb ischemia, hemolysis, and high costs.

• Real-world application: Who actually qualifies?

3. ECLS-SHOCK Trial – ECMO for Cardiogenic Shock

• A "negative" trial, but a crucial wake-up call.

• No mortality benefit but significantly higher complication rates.

• Controversies: Inclusion of cardiac arrest patients and transition to destination therapy.

• Future directions: Can patient selection improve outcomes?

4. ECPR – Extracorporeal Support in Refractory Cardiac Arrest

• Review of the ARREST, PRAGUE, and INCEPTION trials.

• Why the evidence remains unclear and institution-dependent.

• The role of high-volume ECMO centers and standardized pathways.

5. The Future of ECLS – Cost, Ethics, and Decision-Making

• How should institutions decide who gets ECMO?

• The role of cardiogenic shock teams.

• Could AI play a role in decision-making?

• The challenge of resource allocation in a single-payer system.

Key Takeaways:

✅ Impella shows promise in carefully selected AMI shock patients but is costly and high-risk.

✅ ECMO for cardiogenic shock remains controversial—patient selection is key.

✅ ECPR is promising but needs further trials and structured implementation.

✅ Cardiogenic shock management should be a team decision, not an individual one.

🔊 Listen now and join the conversation on the future of cardiac critical care!

We take another break as we are joined by Prof. Wendy Sligl, formidable ID and ICU doc, to discuss the critical topic of optimizing antibiotic prescribing in critical care settings.

The discussion covers various aspects of antibiotic use, including the importance of timely administration, the role of communication in ensuring effective treatment, and the nuances of dosing strategies such as loading doses and continuous infusions. The conversation also delves into the duration of antibiotic therapy, emphasizing the need for individualized treatment based on patient response.

Takeaways:

• Infections are common in intensive care units, and sepsis is a life-threatening condition.
• Identifying the clinical syndrome is crucial for appropriate antibiotic therapy.
• Empiric therapy is often necessary before culture data is available.
• Timely administration of antibiotics is linked to better patient outcomes.
• Communication among healthcare teams is essential for effective antibiotic delivery.
• Loading doses can help achieve therapeutic levels quickly in critically ill patients.
• Continuous infusions of certain antibiotics may improve clinical outcomes.
• Shorter courses of antibiotics can be as effective as longer ones.
• Monitoring patient response is key to adjusting antibiotic therapy.
• Consulting infectious disease specialists can enhance treatment strategies.

Chapters:

00:00

Introduction to Antibiotic Optimization

01:07

Understanding Infections and Sepsis

02:47

Emergency Room Protocols for Antibiotic Administration

04:56

Identifying Sepsis and Administering Antibiotics

06:33

Communication and Timeliness in Antibiotic Delivery

08:42

Optimizing Antibiotic Dosing Strategies

10:59

Pharmacodynamics and Continuous Infusions

12:44

Duration of Antibiotic Therapy

18:52

Monitoring and Adjusting Antibiotic Treatment

21:39

The Debate on Antibiotic Duration

26:37

Specific Infections and Treatment Duration

31:24

Practical Strategies for Antibiotic Stewardship

32:43

Rapid Fire Questions on Antibiotic Use

Welcome to our second episode in our "State of the Art 2023" series, recorded live in Birmingham, UK. In this episode, Dr Dale Gardiner shares his experience in leading UK ICU teaching in breaking bad news - including a structured approach which they call ‘Breaking bad news as a Shakespearean tragedy’.

Dr Dale Gardiner is the Associate Medical Director – Deceased Organ Donation, at NHS Blood and Transplant and a Consultant in Adult Intensive Care Medicine at Nottingham University Hospitals NHS Trust. Take-home message: https://www.youtube.com/watch?v=zxtec2TAV1g

Lecture link (Paywall): Continulus | Breaking Bad News in the ICU: Part A

Mervyn Singer is a ludicrously busy and accomplished intensivist and professor at University College London. He is a prolific and provocative publisher, researcher and innovator, and our go to guy for all things Sepsis, Syndromes and (basic) Science. This is a fun and informative chat: many thanks Merv!   Further Reading: 1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287 2. Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):775-787. doi:10.1001/jama.2016.0289 3. Póvoa P, Coelho L, Dal-Pizzol F, et al. How to use biomarkers of infection or sepsis at the bedside: guide to clinicians. Intensive Care Med. 2023;49(2):142-153. doi:10.1007/s00134-022-06956-y 4. Singer M. Personalizing Sepsis Care. Crit Care Clin. 2018;34(1):153-160. doi:10.1016/j.ccc.2017.08.011 5. Singer M. Sepsis: personalization v protocolization?. Crit Care. 2019;23(Suppl 1):127. Published 2019 Jun 14. doi:10.1186/s13054-019-2398-5 6. Morelli A, Ertmer C, Westphal M, et al. Effect of heart rate control with esmolol on hemodynamic and clinical outcomes in patients with septic shock: a randomized clinical trial. JAMA. 2013;310(16):1683-1691. doi:10.1001/jama.2013.278477 7. Singer M, Shipley R, Baker T, Cowell A, Brealey D, Lomas D. The UCL Ventura CPAP device for COVID-19. Lancet Respir Med. 2020;8(11):1076-1078. doi:10.1016/S2213-2600(20)30422-7

Dr Mark Wilson is one clever, busy and productive chap. His day job is as Neurosurgeon, Pre Hospital Resuscitation Doc and a Professor at Imperial College London. Most relevant to our podcast he is co-founder of GoodSAM (http://www.goodsamapp.org/), a platform that alerts doctors, nurses, paramedic and those trained in basic life support to emergencies around them. Listen, learn, and sign up for GoodSam.   Link to BBC show: https://www.bbc.co.uk/sounds/play/m0018x4p Link to GoodSAM evidence: GoodSAM (goodsamapp.org)

Join us on this episode as Dr. Laura Vincent discusses what a good day looks like , for ICU staff.

Dr. Vincent is a Consultant in Critical Care and Anaesthesia at Oxford University Hospitals (OUH). She is the simulation and education lead for critical care at OUH and is passionate about multi-disciplinary medical education, with particular focus on human factors, patient safety and the link to staff wellbeing. She is an active faculty member of OxSTaR simulation centre, University of Oxford and delivers human factors and patient safety training.

Welcome to our next episode! In this episode, we again delve into the world of neuroprognostication with none other than Dr. Julie Kromm. Dr Kromm is a neurointensivist, who brings a wealth of expertise to the table and was one of the authors on the Canadian Position Statement for Neuro Prognostication after cardiac arrest.

Neuroprognostication is a field that combines the precision of neurology with the nuances of predicting outcomes in patients with severe neurological injury after cardiac arrest. Join us as Dr. Kromm guides us through looking behind the fog, using the physical examination appropriately and what to make of special testing.

Further Reading: 1. Neuroprognostication in the Post Cardiac Arrest Patient: A Canadian Cardiovascular Society Position Statemen. https://doi.org/10.1016/j.cjca.2022.12.014

Here it is! The penultimate episode in our "State of the Art" series. Join Peter and distinguished guests, Prof. Mervyn Singer and Dr. Martin Beed as they discuss the world of sepsis and the impact of COVID-19 on ICU trials.

Doctor Jarrod Mosier is a bit of a polymath, and we were delighted he could squeeze us into his busy life. His day jobs include Intensive Care Medicine and Emergency medicine in Tucson, where he is a professor (at the other UofA: Arizona).He is an expert in all aspects of airway management, ranging from the physiologically difficult airway, through the importance of first pass success, including how to optimize for intubation, the roles of ultrasound and extracorporeal support, and all the way to safe extubation. This was the focus of our wide-ranging entertaining conversation. When away from work Jarrod throws a mean football, dotes on his two kids, and loves getting up into the mountains to snap superb nature photographs.

Further reading:

1. Mosier JM, Sakles JC, Law JA, Brown CA 3rd, Brindley PG. Tracheal Intubation in the Critically Ill. Where We Came from and Where We Should Go. Am J Respir Crit Care Med. 2020;201(7):775-788. doi:10.1164/rccm.201908-1636CI

2. Mosier JM. Physiologically difficult airway in critically ill patients: winning the race between haemoglobin desaturation and tracheal intubation. Br J Anaesth. 2020;125(1):e1-e4. doi:10.1016/j.bja.2019.12.001

Join us on this podcast for a case-based discussion on Human Factors and Patient Safety with Dr Jocelyn Slemko, an Intesivist Internist from Edmonton, Canada and rising star in the area of Human Factors and Patient Safety. Dr Slemko completed medical school in Calgary, followed by Residency in both Internal Medicine and Critical Care Medicine in Edmonton, Canada. She is a published author and recently contributed to a chapter in the Textbook of Acute Trauma Care (2022). She is currently completing a MSc degree in Patient Safety and Clinical Human Factors at the University of Edinburgh and works as an Intensivist in the Edmonton Zone. She is navigating life as a busy mom. Important discussion points from this episode: 1. Introduction of the Safety Engineering Initiative for Patient Safety (SEIPS) model as an alternative to the classic “Swiss Cheese” model as a framework to analyse adverse events. 2. The pillars of team communication. 3. Team leadership, especially in “Flash or Ad Hoc” teams. 4. Equipment design. 5. Situational awareness. Hope you enjoy this one! Further Reading: 1. Brindley, Peter & Slemko, Jocelyn. (2022). Human Factors in Trauma Care: Why the Human Factor Is Always a Factor. 10.1007/978-3-030-83628-3_1. Here 2. Holden RJ, Carayon P  SEIPS 101 and seven simple SEIPS tools  BMJ Quality & Safety 2021;30:901-910. Here

Following the discussion on ECLS in AMI and cardiogenic shock, we go on to discuss eCPR for cardiac arrest specifically. This episode was recorded live at the Critical Care Canada Forum 2024 as part of our special series on cardiac intensive care.

Our guest is Dr. Darryl Abrams, Associate Medical Director and Director of Research for the Medical ECMO Program at New York-Presbyterian/Columbia University. Dr. Abrams joins us for an in-depth discussion on the current state and future direction of extracorporeal cardiopulmonary resuscitation, or eCPR.

We dive into the complex world of eCPR in refractory cardiac arrest, starting with a breakdown of the three landmark trials that have shaped the field: the ARREST trial, the Prague OHCA trial, and the INCEPTION trial. Each study offers a unique perspective, from the dramatic early findings of ARREST to the pragmatic design of Prague OHCA and the sobering multicenter outcomes of INCEPTION.

A major theme throughout the episode is the role of system design. Dr. Abrams emphasizes the importance of minimizing low-flow time, rapid cannulation, and consistent team expertise—factors that can make or break the success of eCPR.

We also explore the ethical and practical considerations that come with rolling out such a resource-intensive intervention, including the balance between innovation and equity. Is it fair that access to eCPR may depend on geography or institutional resources? And how do we make meaningful improvements in survival when only a few centers can offer this advanced care?

The episode closes with a practical lens: how should clinicians approach building an ECMO program? What are the essential pieces that need to be in place before considering eCPR? And how do you select patients in a way that balances risk, benefit, and system capacity?

Chapters:

• Introduction and guest welcome

• Setting the scene: What is eCPR and why now?

• The ARREST trial: Small study, big impact

• The Prague OHCA trial: Early randomization, broader population

• The INCEPTION trial: Multicenter reality and negative results

• Comparing the evidence: Why do outcomes differ?

• Low-flow time and speed of cannulation

• The role of meta-analyses and what they do (and don’t) tell us

• Opportunity cost: What are we giving up to fund eCPR?

• Duration of support: How long is too long?

• Will there be another trial? Challenges of equipoise

• Building a responsible eCPR program

• Patient selection: Who qualifies and why?

• Cannulation techniques and adjunct devices

• System design: U.S. vs. Canada vs. U.K.

• Ethical concerns and access inequities

• Guidelines and final takeaways

Join James Downar Head of Palliative and End of Life Care and a Critical Care Doc in Ottawa. He has walked the walk on this topic since before its introduction in Canada. Nobody is better qualified to discuss this thorny topic. 

Welcome to another episode of "The Critical Care Commute" podcast! In this episode, Peter Brindley and Leon Byker sit down with special guest Elliot Sprague.

Elliot Sprague is an internist known for his unique perspective on healthcare and his remarkable journey through a recent health challenge.

In this episode, Elliot reflects on the shock of being diagnosed with a metastatic malignancy and how it changed his life. He discusses the impact of being present, engaged, and honest with patients, and how it has positively influenced his own well-being.

Elliot also delves into the emotional side of life, sharing how he encourages his son to express and deal with his feelings, describes the importance of naming and acknowledging emotions thus fostering a healthy approach to fear and anxiety.

Tune in to this episode for a profound conversation about life, medicine, and finding joy in the face of adversity. Elliot Sprague's unique perspective serves as an inspiration to both healthcare professionals and listeners navigating their own journeys.

Thank you for joining "The Critical Care Commute" podcast!

Join us as Prof. Stephen Lapinski answers our questions on Obstetric critical care.

Stephen Lapinsky is Director of the Intensive Care Unit at Mount Sinai Hospital, Toronto and Professor of Medicine at the University of Toronto. He graduated from the University of the Witwatersrand, Johannesburg, and trained in Pulmonary and Critical Care Medicine. His clinical practice includes general Critical Care Medicine and ambulatory Respirology. He has a clinical and research interest in critical illness and respiratory disease in the pregnant patient. He is an officer of the North American Society of Obstetric Medicine (NASOM) and is co-Editor-in-Chief of the international journal Obstetric Medicine.

Join us as we discuss early burns resuscitation with Dr. Dennis Djogovic. 

Dennis Djogovic is an emergency physician, trauma team leader and intensivist at the University of Alberta Hospital in Edmonton Alberta. He is the medical director for the HOPE organ donation organization, medical director for the Garner King General Systems Intensive Care Unit, and medical director for the Biggs and Allen Neurosciences Intensive Care Unit. The Garner King GSICU also incorporates the Edmonton Firefighters Burn Treatment unit, an American Burn Association verified burn centre and is a major burn referral centre in Western Canada, where Dennis is an instructor and course director for the Advanced Burn Life Support course.

The following make up the major learning points in this episode:

1. Ignore the burn. Burns patients are trauma patients with thermal traumas. Primary survey first!

2. Early on, only note extent as more than, or less than 20% BSA. 

3. Airway decompensation is usually slow. Outward appearance may not indicate the presence of an airway injury, if in doubt, intubate.  

4. If you are unsure of the exact extent of burns, start with Ringers Lactate at 500cc per hour for all patients who have more than 20% BSA burns and who are older than 14 years of age. If you are sure of extent, use the ABLS formula in place of the traditional (and old) Parkland formula, which is 2cc/kg/BSA divided by 2 and then by 8 for the first hour's starting rate. Changes to fluid administration rate then gets made in accordance to urine output and hemodynamic parameters. 

5. Hypotension in the burns patient, especially early on, is usually not due to the burn. Seek other etiologies to explain hypotension early on. 

6. Referral criteria include: More than 10% BSA involvement, involvement of special areas like hand, genitals and face, all pediatric burns, burns involving the joints and patients with major comorbidities. 

Further reading:

State of the Art: An Update on Adult Burn Resuscitation. Causbie, J.M.; Sattler, L.A.; Basel, A.P.; Britton, G.W.; Cancio, L.C. . Eur. Burn J. 2021, 2, 152–167. https://doi.org/10.3390/ ebj2030012. Here

Nebulized heparin for inhalation injury in burn patients: a systematic review and meta-analysis Xiaodong Lan1, Zhiyong Huang, Ziming Tan, Zhenjia Huang1, Dehuai Wang, and Yuesheng Huang. Here

The Physiologic Basis of Burn Shock and the Need for Aggressive Fluid Resuscitation Lisa Rae, Philip Fidler, Nicole Gibran. Here

Welcome to our next podcast in the "State of the Art 23" series. Listen as we talk POCUS and all things Focused Ultrasound for Intensive Care (FUSIC). In this episode, we hare joined by awesome guests: Dr. Marcus Peck, a consultant in anaesthesia and intensive care medicine at Frimley Park Hospital and sits on the board of the Intensive Care Society (ICS)’s Focused Ultrasound for Intensive Care (FUSIC) committee; and Dr. Jonny Wilkinson, a consultant in intensive care medicine and anaesthesia at Northampton General Hospital. So sit back, relax, and enjoy the show!" Further reading: 1. SONO-Olympiad - CAEP Conference 2. FUSIC HD. Comprehensive haemodynamic assessment with ultrasound - Ashley Miller, Marcus Peck, Tom Clark, Hannah Conway, Segun Olusanya, Nick Fletcher, Nick Coleman, Prashant Parulekar, Jonathan Aron, Justin Kirk-Bayley, Jonathan Nicholas Wilkinson, Adrian Wong, Jennie Stephens, Antonio Rubino, Ben Attwood, Andrew Walden, Andrew Breen, Manprit Waraich, Catherine Nix, Simon Hayward, 2022 (sagepub.com)

Welcome to another episode in our "State of the Art Series". In this episode, we have the privilege of delving into the world of ARDS with a true pioneer in the field. Join us as we sit down with Professor Danny McAuley to unravel the complexities of ARDS – from its underlying mechanisms to the latest advancements in diagnosis and treatment. Professor McAuley's major interest is Acute Respiratory Distress Syndrome (ARDS). His research strategy in ARDS is to investigate potential novel therapeutic agents in ARDS in vitro, in vivo in human models of ARDS and in phase 2 clinical trials to inform subsequent phase 3 clinical trials. He is currently investigating the role of MSCs, statins and ECCO2R in ARDS.

In this episode, join us for an in-depth conversation with Dr. Andrew Baker, as he reflects on his time as the incident Commander of the Ontario Critical Care COVID Command Centre, during the COVID pandemic.

Dr. Baker offers a firsthand account of the establishment and operation of this crucial hub in the battle against the pandemic, highlighting the collaborative efforts of healthcare professionals, policymakers, and community leaders.

Dr. Andrew Baker is the Chief of the Departments of Critical Care and of Anesthesia, and the Medical Director of the Surgery and Critical Care Program at St. Michael’s Hospital, Unity Health Toronto.

Tune in as we uncover the dedication, innovation, and resilience driving our collective response to this unprecedented crisis.

Recorded live at the Critical Care Canada Forum 2024, this episode is part of our special Cardiac ICU Series.

Dr. Rebecca Mathew, cardiologist and critical care specialist at the University of Ottawa Heart Institute, joins us to discuss the latest refractory cardiac arrest practice updates, including antiarrhythmic drugs, defibrillation strategies, and the role of ECPR.

Chapters:

• Defining refractory cardiac arrest

• Antiarrhythmic drugs: amiodarone vs. lidocaine

• Defibrillation strategies: vector change and double sequential defibrillation

• Emerging therapies: stellate ganglion blocks and electrical storm management

• ECPR: who qualifies and what the trials say

• Equity and feasibility challenges in cardiac arrest management

• ICU recovery clinics and patient-centered outcomes

• Clinical trials: barriers to enrollment and the need for change

References:

1. ROC ALPS Trial: 1. Kudenchuk PJ, Brown SP, Daya M, et al. Resuscitation Outcomes Consortium-Amiodarone, Lidocaine or Placebo Study (ROC-ALPS): Rationale and Methodology Behind an Out-of-Hospital Cardiac Arrest Antiarrhythmic Drug Trial. American Heart Journal. 2014;167(5):653-9.e4. doi:10.1016/j.ahj.2014.02.010. PMID: 24766974.[1]

2. DOSE VF: Cheskes S, Drennan IR, Turner L, Pandit SV, Dorian P. The Impact of Alternate Defibrillation Strategies on Shock-Refractory and Recurrent Ventricular Fibrillation: A Secondary Analysis of the DOSE VF Cluster Randomized Controlled Trial. Resuscitation. 2024;198:110186. doi:10.1016/j.resuscitation.2024.110186. PMID: 38522736

3. ARREST: Yannopoulos D, Bartos J, Raveendran G, et al. Advanced Reperfusion Strategies for Patients With Out-of-Hospital Cardiac Arrest and Refractory Ventricular Fibrillation (ARREST): A Phase 2, Single Centre, Open-Label, Randomised Controlled Trial. Lancet (London, England). 2020;396(10265):1807-1816. doi:10.1016/S0140-6736(20)32338-2. PMID: 33197396

4. INCEPTION: Ubben JFH, Suverein MM, Delnoij TSR, et al. Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest - A Pre-Planned Per-Protocol Analysis of the INCEPTION-trial. Resuscitation. 2024;194:110033. doi:10.1016/j.resuscitation.2023.110033. PMID: 37923112

Disclaimer:

This episode is for educational purposes only and does not constitute medical advice. The views expressed are those of the hosts and guests and do not necessarily reflect their employers.

Join us as we discuss Neuroprognostication after Cardiac Arrest with Clinician-Scientist, Dr Gord Boyd. Dr Boyd has dual certification in Neurology and Critical Care Medicine and is a Clinician Scientist at Queens University, Kingston, Canada. He works at the Kingston General Hospital as an Intensivist and heads a research program aimed at understanding the relationship between cerebral perfusion, delirium, and long-term neurological outcomes for ICU survivors.

He received his undergraduate degree (Psychology) from Lakehead University in his hometown of Thunder Bay, Ontario. That was followed by his PhD in Neuroscience from the University of Alberta, where he studied the role of growth factors in peripheral nerve regeneration. In 2001 he moved to Kingston to do a post-doctoral fellowship in the Queen’s Department of Anatomy and Cell biology, examining the potential of glial cell transplantation to treat spinal cord injury. He stayed in Kingston to do his undergraduate degree in Medicine, which was followed by his residency in Neurology and fellowship in Adult Critical Care. He is an active musician and plays the drums in an all-physician band.

In this episode we discuss the importance of admitting uncertainty when it comes to neuroprognostication following cardiac arrest, allowing enough time to pass, some of the best and worst tests for clinical prognostication, usefulness of biomarkers, EEG, seizure treatment and the risk of persistent neurovegetative states.

Further Reading:

1. Nakstad ER, Stær-Jensen H, Wimmer H, et al. Late awakening, prognostic factors and long-term outcome in out-of-hospital cardiac arrest - results of the prospective Norwegian Cardio-Respiratory Arrest Study (NORCAST). Resuscitation. 2020;149:170-179. doi:10.1016/j.resuscitation.2019.12.031 https://pubmed.ncbi.nlm.nih.gov/31926258/

2. Nolan JP, Sandroni C, Böttiger BW, et al. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Intensive Care Med. 2021;47(4):369-421. doi:10.1007/s00134-021-06368-4 https://pubmed.ncbi.nlm.nih.gov/33765189/

3. Sandroni C, D'Arrigo S, Cacciola S, et al. Prediction of good neurological outcome in comatose survivors of cardiac arrest: a systematic review. Intensive Care Med. 2022;48(4):389-413. doi:10.1007/s00134-022-06618-z https://pubmed.ncbi.nlm.nih.gov/35244745/

4. Beuchat I, Novy J, Barbella G, Oddo M, Rossetti AO. EEG patterns associated with present cortical SSEP after cardiac arrest. Acta Neurol Scand. 2020;142(2):181-185. doi:10.1111/ane.13264 EEG patterns associated with present cortical SSEP after cardiac arrest - PubMed (nih.gov)

In brief, “it’s okay to not feel okay” and “to do well we ought to feel well”. The problem is that many of us don’t feel okay, hence this candid, caring and common-sense podcast. We timed it to coincide with what is- statistically at least- the most depressing day of the year, namely the third Monday of January. Otherwise known as “Blue Monday” it’s a day to take a moment, to reach out, to acknowledge that the job can be tough, and to be reminded that we need to care for the carers. There is nobody better than Dr. Shelly Dev to highlight the importance of burnout, wellness and medical culture. Thank you for your time and for the work you do. Take care of yourself.

Dr. Dev has been a Staff Intensivist at Sunnybrook Health Sciences Centre in Toronto since 2006, after completing her Internal Medicine residency and Critical Care Fellowship at The University of Toronto, followed by a Fellowship in Multimedia Education at the New England Journal of Medicine.  She is a Clinician Educator and Associate Professor of Medicine, Director of Education in the Department of Critical Care Medicine at Sunnybrook and lead for Mentorship and Wellness in the Interdepartmental Division of Critical Care Medicine at the University of Toronto. She is an award-winning medical educator of undergraduate, postgraduate and continuing medical education audiences.

In addition to nearly 300 lectures given to national and international audiences about healthcare worker mental health, burnout, resilience and medical culture, Dr. Dev has written and spoken extensively on these topics in the wider media.

But, if asked, she would say her most significant accomplishment to date is continuing to convince 14-year-old Nathan and 12-year-old Jack that it is beyond cool to be seen with your mother in public.

Welcome to the Critical Care Commute, the podcast where we explore the ever-evolving world of critical care medicine, one conversation at a time. In this episode, we're honored to have a distinguished guest who has dedicated her career to getting it right the first time in critical care. Joining us is Dr. Anna Batchelor, an expert in the field with a wealth of experience and insights to share. Join us for an enlightening conversation, as we explore the art and science of "Getting it Right the First Time" . Whether you're a healthcare professional, a student, or someone passionate about healthcare, this episode is bound to provide valuable insights. Thank you for tuning in to the Critical Care Commute. If you enjoyed this episode, please consider leaving a review and sharing it with your colleagues and friends. Stay tuned for more thought-provoking discussions in the realm of critical care medicine.

[Disclaimer: The information provided in this podcast is for educational and informational purposes only and should not be considered as medical advice. Consult with a qualified healthcare professional for any medical concerns or questions.]

Thank you for your patience!

After a short break, we are back with a delightful interview with Dr. Jeff Drazen, the esteemed former Editor-in-Chief of the New England Journal of Medicine (NEJM).

In this episode, we explore the critical journey of transforming medical research into practical, patient-and-family centered care. We emphasize the importance of bringing humanity back into healthcare and ensuring that scientific advancements translate into meaningful outcomes for patients and families, right at the bedside. Listen as we explore modern forms of knowledge translation, the challenges they pose, and how healthcare professionals can navigate these complexities to enhance patient care.

With a distinguished career at the helm of one of the world's leading medical journals, Dr. Drazen's episode is one that you don't want to miss!

We’re taking a break from our Cardiac Critical Care series to bring you a conversation with one of the most influential figures in medicine.

Peter had the huge privilege of interviewing Major General Tim Hodgetts, the recently retired, most senior medical advisor in the UK forces.

Hodgetts shares his remarkable journey in transforming emergency medicine from its infancy to maturity, detailing poignant experiences from his early career that steered him towards this specialty. The discussion ranges from Hodgetts' pioneering efforts in combat casualty care, the evolution of battlefield first aid, and innovative medical practices in conflict zones, to his concepts on leadership, international collaborations, and coping with trauma.

The segment also touches on Hodgetts' recent retirement and his ongoing contributions to medical and military communities through teaching, charity work, and writing.

Chapters:

00:00 Introduction and Guest Overview

02:56 Early Career and Influences

06:25 Pioneering Emergency Medicine in the Military

08:13 Revolutionizing Combat Casualty Care

17:55 International Collaboration and Cultural Insights

30:31 Leadership in Crisis

35:35 Coping with Trauma and Personal Reflections

39:43 Retirement and Legacy

42:29 Conclusion and Final Thoughts

This has been one of my absolute favorite podcasts to produce! What an honor to have Major General Tim Hodgetts join us on the Critical Care Commute!

In this episode, we have the privilege of hosting three luminaries in the field of airway management: Drs. Jarrod Mosier, Calvin Brown, and Matteo Parotto.

As distinguished leaders from the Difficult Airway Course, they bring incredible insights to managing the acute care airway. Whether you're a seasoned practitioner or a healthcare enthusiast, their collective knowledge promises to deepen your understanding and appreciation for the art and science of airway management. Tune in as they share their experiences, innovations, and vision for the future of airway management.

https://www.theairwaysite.com/

Putting the trial on trial? Not really, but join us and the ludicrously accomplished Prof Simon Finfer (with special guest appearances by his beloved dogs) for this review of all things Clinical Trial. Why we need them, how to design them, what they tell us and what they don't.   Professor Simon Finfer works at Sydney's George Institute, Royal North Shore Hospital and University New South Wales. He has led/co-led many of the last two decade's  landmark clinical trials in icu (fluid administration, glycemic control, steroid use...you name it).  

Welcome to our latest episode, recorded live at the Critical Care Forum in Canada. We're joined by Dr. Stephanie Sibley and Dr. Michal Cwhalek, a Critical Care Trainee, to discuss Atrial Fibrillation, the most commonly sustained cardiac arrhythmia in critical care.

Dr Stephanie Sibley is an Assistant Professor in the Department of Critical Care Medicine at Queens University, Kingston, Canada. Her research interests include new onset atrial fibrillation in critically ill patients where she is developing methods for better quantifying atrial fibrillation burden using electronic monitoring, prevention and treatment strategies and determination of long-term atrial fibrillation outcomes. 

Join us as we delve into the clinical importance, management approaches, and potential complications of AF in critically ill patients.

Professor Dan Martin is one busy, productive, chap. This Consultant in anaesthesia and intensive care is also the Editor-in-chief for the journal JICS. His research focuses on how we adapt to low oxygen and the harm from excessive oxygen. This has included several expeditions with the Xtreme Everest team. He is the chief investigator for the UK-ROX trial and EXAKT study. He also studies how exercise can improve clinical outcomes (including liver transplantation; the EXALT trial). He was awarded an OBE for prevention of infectious diseases and caring for those with Ebola. https://www.plymouth.ac.uk/alumni/invenite/the-big-interview-professor-daniel-martin-obe

Join us as we discuss ARDS, Research and balancing life as a researcher with Professor Charlotte summers, Director of the Heart and Lung Research Institute (HLRI).

Welcome to the Critical Care Commute Podcast! In this episode, we are delighted to be joined by Dr. Alika Lafontaine, a trailblazing physician, advocate, and leader in Canadian healthcare.

Dr. Lafontaine is not only a prominent anesthesiologist and physician leader, but also an influential voice in championing Indigenous perspectives within the broader healthcare system. His journey is one of dedication and overcoming, both characteristics that shaped his career into one of sheer brilliance. Dr. Lafontaine has been at the forefront of initiatives aimed at bridging gaps in Indigenous health outcomes. He is currently the immediate past-President of the Canadian Medical Association.

Join us in this enlightening conversation as we delve into what matters to Dr. Lafontaine. His insights are sure to inspire, educate, and challenge our understanding of what it means to provide truly inclusive and effective healthcare for all.

So, without further ado, let's dive into this interview with Dr. Alika Lafontaine!

Welcome to the 2nd episode in our Critical Care Forum Canada 2023 podcast series, where we interview leading Canadian experts.

In this episode, we explore the intersection of artificial intelligence and critical care medicine with Dr. Shelly Dev and David Maslove, recorded after a panel discussion held at the Conference in Toronto.

Dr Dev is no stranger to our podcast and is a staff intensivist at Sunnybrook Health Sciences Centre, Toronto, Canada, where she serves as the director of education for Critical Care Medicine.

Dr Maslove is a Clinician Scientist and Intensivist at Queen’s University, Kingston, Canada. His research focuses on the use of physiologic and genomic data to advance precision medicine in the ICU.

Dr Robyn Harrison is a clinical professor in infectious diseases at the University of Alberta, Canada, and the vice-chair of NACI (the National Advisory Committee on Immunization). She joins us for a topical chat to coincide with new guidelines, and to explore what we can ALL do to keep our patients safer from one of the ICUs biggest issues: that dastardly bacterium Streptococcus Pneumoniae. Many thanks, Robyn; go adult vaccines!  

Further Reading:

1. Sprague E, Reynolds S, Brindley P. Patient Isolation Precautions: Are They Worth It?. Can Respir J. 2016;2016:5352625. doi:10.1155/2016/5352625

2. https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/public-health-level-recommendations-use-pneumococcal-vaccines-adults-including-use-15-valent-20-valent-conjugate-vaccines/summary-february-2023.html

3. https://www.cdc.gov/vaccines/adults/index.html

Join us as we talk to the ridiculously talented Dr. Dustin Anderson, Neurointensivist from the University Hospital in Edmonton, Canada, as he unpacks anti-NMDA encephalitis and the EEG in the ICU.

Dr. Anderson completed his undergraduate training in electrical engineering (UBC) and biochemistry (SFU). Thereafter, he completed the MD/PhD program at the University of Calgary. Dr. Anderson went on to complete neurology training at the University of Alberta, also obtaining certification as an electro-encephalographer (CSCN Diplomate) and neuro-sonologist (ASN Diplomate), followed by Critical Care training and a fellowship in Neurocritical Care at Johns Hopkins. His research focuses on non-invasive neurocritical care monitoring, specifically, evaluating the role of non-invasive ultrasound (ocular ultrasonography and transcranial doppler) in patients with acute liver failure and the clinical utility of continuous EEG versus spot EEG in various clinical scenarios. Not only is he well accomplished in the world of medicine, he is also a musician and plays in a band called "the Heart Failure Research Institute".

Further Reading:

Sonicbids

Anderson D, Nathoo N, McCombe JA, Smyth P, Brindley PG. Anti-N-methyl-d-aspartate receptor encephalitis: A primer for acute care healthcare professionals. J Intensive Care Soc. 2021;22(2):95-101. doi:10.1177/1751143720914181 Nathoo N, Anderson D, Jirsch J. Extreme Delta Brush in Anti-NMDAR Encephalitis Correlates With Poor Functional Outcome and Death. Front Neurol. 2021;12:686521. Published 2021 Jul 9. doi:10.3389/fneur.2021.686521

Welcome to the Critical Care Commute "Liver" podcast, where we explore all things liver with leading expert, Professor Dean Karvellas, Professor of Medicine,
Division of Gastroenterology (Liver Unit) and the Department of Critical Care at the University of Alberta, Canada. In this podcast, he shares his insights and expertise on a wide range of ICU liver-related topics, including ACLF, extracorporeal support, liver transplantation, liver scores and Acetaminophen (Paracetamol). Join us as we discuss all things liver in the ICU.

Join us on this episode as we talk to Dr Oleksa Rewa, who along with Professor J Kutsogiannis (Department of Critical Care Medicine, University of Alberta, Canada), were authors on the recently published LOVIT paper.

Dr. Oleksa Rewa is an Assistant Professor and an Associate Chair for Research & Innovation in the Department of Critical Care Medicine and has a Masters of Clinical Epidemiology from the University of Alberta. He completed his M.D. and Internal Medicine Residency at Queen’s University followed by his Critical Care Medicine Fellowship at the University of Toronto. Dr. Rewa’s research focuses on Critical Care Nephrology with a specific interest in evaluating the quality of healthcare delivery for critically ill patients.

Vitamin C administration in Septic Shock has been a hot topic over the last few years. It’s role as a powerful anti-oxidant and possible therapy to minimize tissue damage in Septic Shock gained traction after the publicized paper by Marik et al (link below).

Listen as we tease apart the LOVIT trial and discuss the following learning points:

1. Vitamin C is not associated with any improvement in clinical outcomes in critically ill patients.

2. Death or persistent organ dysfunction seems higher in the Vitamin C group.

3. Translation of scientific data can be accelerated improving knowledge translation where it is needed the most, next to the bedside.

Further reading:

LOVIT paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2200644

VITAMINS paper: https://jamanetwork.com/journals/jama/fullarticle/2759414

ATESS paper: https://link.springer.com/content/pdf/10.1007/s00134-020-06191-3.pdf

Marik paper: http://journal.publications.chestnet.org/article.aspx?articleid=2593508

Meta Analysis on Vitamin C in Septic shock: https://link.springer.com/article/10.1007/s00134-021-06558-0

Dr Sandy Widder is a Trauma Surgeon, Intensivist and overall amazing human being. She works as an associate professor in the departments of critical care and surgery at the University of Alberta, and is the Assistant Zone Director on Integrated Quality Management for the Edmonton zone in Alberta, Canada. She is passionate about Quality Improvement/Patient Safety and somehow finds time for Health administration in her busy schedule. We were lucky to get her on our podcast! 

Join us as she talks about what the general intensivist needs to know about the trauma patient. 

Further reading:

1. ABC assessment: Early prediction of massive transfusion in trauma: simple as ABC (assessment of blood consumption)?  Nunez TC, Voskresensky IV, Dossett LA, Dutton WD, Cotton BA.  J. Trauma.  2009.  Feb 66 (2): 346-52.
2. TXA: Effects of transexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant hemorrhage (CRASH-2): a randomized, placebo-controlled trial.  Lancet.  2010.  376: 23-32.
3. Fibrinogen: Reversal of trauma-induced coagulopathy using first-line coagulation factor concentrates or fresh frozen plasma (RETIC): a single-centre, parallel-group, open label, randomized trial.  Innerhofer P, Fries D, Mittermayer M, Innerhofer N, von Langen D, Hell T et al.  Lancet Haematology.  2017.  4 (6): 258-271.
4. Stop the bleed:  www.stopthebleed.org
5. VTE Prophylaxis: Updated guidelines to reduce venous thromboembolism in trauma patients: a Western Trauma Association critical decisions algorithm.  Let EJ, Brown C, Moore E, et al.  The Journal of Trauma and Acute Care Surgery.  2020.  89 (5): 971-981.
6. Geriatric trauma: ACS TQIP Geriatric Trauma Management Guidelines.  HTTPS:\\www.facs.org/media/314or1oq/geriatric_guidelines.pdf
7. Rib fractures: Western Trauma Association Critical Decisions in Trauma: Management of rib fractures.  Brasel KJ, Moore E, Albrecht RA et al.  2017.   Journal of Trauma and Acute Care Surgery.  82 (1): 200 - 203.

In this episode, we dive into the fascinating world of Hyperbaric medicine with Dr. Jeff Kerrie, a Hyperbaric specialist from British Columbia, Canada.

Dr. Kerrie takes us through the science, history, and practical applications of Hyperbaric oxygen therapy (HBOT) as we explore the approved indications, physiological effects, and logistics of managing hyperbaric chambers.

Episode Chapters:

Introduction

Meet Dr. Jeff Kerrie and learn about his journey in hyperbaric medicine and the unique setup of Vancouver Island’s hyperbaric program.

History of Hyperbaric Medicine

A look at the origins of hyperbaric therapy, from 1600s pressurized chambers to its modern evolution.

The Physiology of HBOT

Understanding the effects of supra-physiologic oxygen pressures on microcirculation, angiogenesis, and inflammation.

Indications and Evidence:

Decompression Sickness

The mechanisms of treating “the bends” and why HBOT works so effectively.

Air or Gas Embolism

Insights into diagnosing and treating air embolism, including critical resuscitation tips.

Carbon Monoxide Poisoning

How HBOT prevents long-term neurological damage, with considerations for pregnant patients and associated toxins like cyanide.

Necrotizing Soft Tissue Infections

The role of HBOT in treating Fournier’s gangrene and clostridial infections alongside surgery.

Crush Injuries and Anemia

Exploring HBOT’s utility in tissue salvage and sustaining oxygenation in severe anemia.

Newer Indications: Sudden Hearing and Vision Loss

The emerging role of HBOT in sudden sensorineural hearing loss and central retinal artery occlusion.

Risks and Safety in the Chamber

Barotrauma, oxygen toxicity, fire safety, and managing emergencies during dives.

Logistics of Hyperbaric Medicine

A behind-the-scenes look at hyperbaric chamber setups, patient care protocols, and equipment considerations.

Closing Thoughts

Dr. Kerrie’s perspective on the future of hyperbaric medicine and ongoing research opportunities.

Key Indications for HBOT:

1. Decompression sickness ("The Bends")

2. Air or gas embolism

3. Carbon monoxide poisoning

4. Necrotizing soft tissue infections

5. Crush injuries and compartment syndromes

6. Severe anemia (e.g., in patients unable to receive transfusions)

7. Radiation tissue injury (e.g., osteoradionecrosis)

8. Sudden sensorineural hearing loss

Resources and Links:

• Undersea and Hyperbaric Medical Society Approved Indications for Hyperbaric Oxygen Therapy - Oceanside Hyperbaric

• Hyperbaric Medicine | © 2018 The Royal College of Physicians and Surgeons of Canada. All rights reserved.

Disclaimer:

This episode provides general information and is not a substitute for professional medical advice. Always consult with a specialist for specific clinical decisions.

Every department, that uses clinical pharmacists on their team has one: A pharmacy whiteboard! A whiteboard for education. These take tons of work before a single note is written, and great care is taken to ensure accuracy and relevance. Join us on this new short segment called "the Pharmacy Whiteboard" as we learn from pharmacists using their whiteboard ideas. In this his first one, we are joined by Dr Jonathan Mailman, a clinical pharmacist from Victoria BC, Canada, as he discusses the value of clinical pharmacists in the ED. No better time than now as pharmacy appreciation month draws to a close. Further reading: Here's the short selection Pharmacy Practice literature (in PMID) by category:Sepsis PMID: 24904184 PMID: 27503060 Trauma PMID: 23943183 PMID: 25797938 PMID: 25768964PMID: 29079370 Resuscitation PMID: 29276268 PMID: 21665406PMID: 18349308 PMID: 22095821 Stroke PMID: 28759998 PMID: 29623155 Cost saving: PMID: 29276268PMID: 30079985PMID: 35158260 BPMH:PMID: 17381374

Join us on this podcast as we discuss Renal Replacement Therapy with Professor Sean Bagshaw from the University of Alberta Hospital, Edmonton, Canada. Dr. Bagshaw is Professor and Chair for the Department of Critical Care Medicine at the University of Alberta in Edmonton, Canada. He completed medical school and residency training at the University of Calgary (Doctor of Medicine – 2000; Internal Medicine – 2003; Critical Care Medicine – 2005; Master of Science in Epidemiology – 2005) prior to completing a Critical Care Nephrology fellowship in the Department of Intensive Care Medicine, at the Austin Hospital in Melbourne, Australia. Dr. Bagshaw works as a full-time staff intensivist in two of the busiest and highest acuity intensive care units in Alberta – the General Systems ICU at the University of Alberta Hospital and the Cardiovascular Surgical ICU at the Mazankowski Alberta Health Institute. Dr. Bagshaw has expertise in acute kidney injury, renal replacement therapy, frailty and vulnerable patients and end-of-life care in ICU settings. He has published over 400 peer-reviewed articles and it was our absolute privilege to have him on the show. In this episode we talk about timing of replacement therapy, data around continuous and intermittent therapy, intensity of dialysis, fluid management, anticoagulation and weaning of renal replacement therapy. Articles of Interest: 1. Timing of Initiation of  Renal-Replacement Therapy in Acute Kidney Injury. New England Journal of  Medicine. 2020 Jul 16;383(3):240–51. 2. Zarbock A, Kellum JA, Schmidt C, van  Aken H, Wempe C, Pavenstädt H, et al. Effect of Early vs Delayed Initiation of  Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute  Kidney Injury. JAMA. 2016 May 24;315(20):2190. 3. Barbar SD, Clere-Jehl R, Bourredjem A,  Hernu R, Montini F, Bruyère R, et al. Timing of Renal-Replacement Therapy in  Patients with Acute Kidney Injury and Sepsis. New England Journal of Medicine.  2018 Oct 11;379(15):1431–42. 4. Gaudry S, Hajage D, Schortgen F,  Martin-Lefevre L, Pons B, Boulet E, et al. Initiation Strategies for  Renal-Replacement Therapy in the Intensive Care Unit. New England Journal of  Medicine. 2016 Jul 14;375(2):122–33. 5. Jaber S, Paugam C, Futier E, Lefrant  JY, Lasocki S, Lescot T, et al. Sodium bicarbonate therapy for patients with  severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a  multicentre, open-label, randomised controlled, phase 3 trial. The Lancet.  2018 Jul;392(10141):31–40. 6. Intensity of Continuous  Renal-Replacement Therapy in Critically Ill Patients. New England Journal of  Medicine. 2009 Oct 22;361(17):1627–38. 7. Intensity of Renal Support in  Critically Ill Patients with Acute Kidney Injury. New England Journal of  Medicine. 2008 Jul 3;359(1):7–20.

We return to our Canadian Critical Care Forum series with this episode.

In this episode, we delve into the world of Extracorporeal Membrane Oxygenation (ECMO) with Dr. Eddy Fan, a leading expert in critical care and ECMO specialist.

Eddy Fan is an associate professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management, and Evaluation at the University of Toronto and a staff intensivist at the University Health Network/Mount Sinai Hospital. Dr. Fan received his undergraduate degree from the University of Toronto, his medical degree from the University of Western Ontario, and a PhD in Clinical Investigation from Johns Hopkins University. He is currently the Medical Director of the Extracorporeal Life Support Program at the Toronto General Hospital, and the Director of Critical Care Research at the University Health Network/Mount Sinai Hospital. Dr. Fan’s research has focused on advanced life support for acute respiratory failure and patient outcomes from critical illness. These include investigations on the epidemiology and use of mechanical ventilation and extracorporeal life support in patients with ARDS, as well as on the development of ICU-acquired weakness, early rehabilitation in ICU patients, and long-term outcomes in survivors of critical illness. Join us as we take on this huge topic.

Welcome to the Critical Care Commute Podcast, as we delve into the world of healthcare communication with one of the most esteemed voices in the field – Andre Picard.

Andre Picard, a renowned health columnist for The Globe and Mail, brings his wealth of knowledge and experience, providing insights into the vital role that effective communication plays in the world of healthcare. From doctor-patient interactions to public health messaging, Picard offers a unique perspective on how communication shapes our understanding of health issues and influences decision-making at both individual and societal levels.

In this episode, we explore the impact of media on healthcare perceptions, the role of social media in shaping health narratives, and the challenges of conveying accurate information in an era of misinformation. Join us for a thoughtful exploration of the nuances in healthcare communication, as we seek to enhance our understanding of the crucial link between effective communication and the overall well-being of individuals and communities.

Coping with dying and saying what needs to be heard: Elliot Sprague

Introduction: In this emotional episode, Peter Brindley, Leon Byker, and Elliot Sprague revisit Elliot’s journey with metastatic cancer, a year after his initial appearance on the podcast,

Elliot reflects on the impact of living with a terminal illness, sharing life lessons, and offering insights on how he continues to thrive despite a difficult prognosis. This episode Elliot talks about acceptance, gratitude, and the importance of living each moment fully.

Topics Discussed:

1. Elliot’s cancer journey since his last appearance.
2. Transition from curative treatment to a palliative diagnosis.
3. The emotional challenges of facing terminal illness.
4. Acceptance of reality and choosing how to live each day.
5. The role of gratitude in maintaining emotional well-being.
6. Coping with the loss of professional identity.
7. Legacy-building and leaving meaningful gifts for loved ones.
8. The importance of honest conversations about death.
9. Support systems: family, friends, and the medical community.
10. Practical tools for mindfulness and mental well-being.

Timeline:

• 00:00 - 01:30: Introduction and re-welcoming Elliot Sprague to the show.
• 01:31 - 05:20: Elliot updates on his cancer journey, including treatment successes and setbacks.
• 05:21 - 10:00: The shift from a curative approach to palliative care.
• 10:01 - 15:45: Acceptance, gratitude, and how Elliot thrives with his diagnosis.
• 15:46 - 20:55: Discussing HyPEC surgery and reflecting on end-of-life realities.
• 20:56 - 25:30: Legacy-building, gratitude practice, and leaving meaningful messages for loved ones.
• 25:31 - 30:10: Coping with family grief and how Elliot's wife Danielle plays a crucial role.
• 30:11 - 35:50: The power of mindfulness in Elliot’s journey and how it changed his outlook.
• 35:51 - 40:15: The role of humor and connection in facing terminal illness.
• 40:16 - 45:00: Final reflections, messages of gratitude, and an emotional conclusion.

Thank you Elliot for joining us!

https://www.gofundme.com/f/dr-elliott-sprague-and-family?attribution_id=sl:c52d4c83-2649-4ce0-a003-651776f01205&utm_campaign=man_sharesheet_ft&utm_medium=customer&utm_source=email

In this episode, we have the honor of speaking with Professor John Myburgh, a former South African physician and researcher who has dedicated his life to improving the field of critical care medicine. Professor Myburgh has made significant contributions to the field of fluid resuscitation, catecholamines, and microbiomes. In this episode, we will be discussing his early years in medicine, some reflections on medicine in South Africa and how his experiences have shaped his research interests. We will also delve into the latest research on fluid resuscitation, catecholamines, and microbiomes. So sit back, relax, and enjoy this fascinating conversation with Professor John Myburgh. Further Reading: SAFE TBI: Cooper DJ, Myburgh J, Heritier S, et al. Albumin resuscitation for traumatic brain injury: is intracranial hypertension the cause of increased mortality?. J Neurotrauma. 2013;30(7):512-518. doi:10.1089/neu.2012.2573 SAFE Study: Finfer S, Norton R, Bellomo R, Boyce N, French J, Myburgh J. The SAFE study: saline vs. albumin for fluid resuscitation in the critically ill [retracted in: Mayr W, Prowse C. Vox Sang. 2004 Aug;87(2):142]. Vox Sang. 2004;87 Suppl 2:123-131. doi:10.1111/j.1741-6892.2004.00468.x CHEST Study: Myburgh JA, Finfer S, Bellomo R, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care [published correction appears in N Engl J Med. 2016 Mar 31;374(13):1298]. N Engl J Med. 2012;367(20):1901-1911. doi:10.1056/NEJMoa1209759 PLUS study: Finfer, S., Micallef, S., Hammond, N., Navarra, L., Bellomo, R., Billot, L., ... & Myburgh, J. (2022). Balanced multielectrolyte solution versus saline in critically ill adults. New England Journal of Medicine, 386(9), 815-826. CAT study: Myburgh JA, Higgins A, Jovanovska A, Lipman J, Ramakrishnan N, Santamaria J, CAT Study Investigators. A comparison of epinephrine and norepinephrine in critically ill patients. Intensive care medicine. 2008 Dec;34:2226-34. SOAP II Trial: De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL. Comparison of dopamine and norepinephrine in the treatment of shock. New England Journal of Medicine. 2010 Mar 4;362(9):779-89. Prof. Myburg on Catecholamines at SMACC/CODA: https://youtu.be/90ru25QuGFI

This one is a biggie! Join us as we chat with Drs. Roger Harris and Oli Flower, the gurus behind the SMACC and CODA conferences. The topic is, naturally enough, the past and future of the medical conference.

Welcome to this episode featuring Dr. Hannah Wunsch, Professor of Anaesthesia and Critical Care Medicine and now published author of her debut book, The Autumn Ghost. In this episode, we explore the story behind Dr. Wunsch's book, the inspiration for its creation, and the message she hopes to convey to readers. The Autumn Ghost is a captivating literary work that delves deep into the origin story of Critical Care Medicine, the fragility of life, and the importance of cherishing the moments we have with our loved ones. Join us as we dive into the pages of Autumn Ghost and explore the profound themes that Dr. Wunsch explores in her writing.