In this episode of At The Bedside, Vicki with her guest Becky Bolkovac, dive into the complex ethical dilemmas faced in nursing and ECMO care. From balancing patient autonomy with life-saving interventions to navigating medical futility, resource allocation, and conflicting communication from care teams, this conversation highlights the real-world challenges clinicians face when there are no clear answers—only difficult decisions.

In this episode of At The Bedside, Vicki Carlisle and perfusionist Dr. Samir Patel break down post-operative bleeding in CABG patients. They explore the difference between surgical and medical causes, the role of cardiopulmonary bypass, and the dangerous “lethal triad” of hypothermia, acidosis, and coagulopathy. With real-world insights from both the ICU and the OR, this episode highlights how early detection and targeted intervention can make all the difference in patient outcomes.

Welcome to the very first episode of At the Bedside, where nursing knowledge meets real-world clinical practice.

In this episode, host Vicki Carlisle, an ICU nurse and adult ECMO specialist, is joined by perfusionist Samir Patel for an in-depth discussion on Cold Agglutinin Disease (CAD) — a rare but critical autoimmune hemolytic anemia that can have serious implications in the ICU, operating room, and cardiac surgery.

🔍 What you’ll learn in this episode:

• What Cold Agglutinin Disease is and how it affects red blood cells
• The step-by-step pathophysiology behind cold-triggered hemolysis
• Differences between primary CAD and secondary cold agglutinin syndrome
• Common triggers include infections like Mycoplasma pneumonia
• ICU signs and symptoms: anemia, Raynaud’s phenomenon, acrocyanosis, renal injury, and thrombosis
• Bedside clues nurses may notice during routine blood draws
• Why temperature management is critical for these patients
• Medication, plasmapheresis, and treatment considerations
• Surgical and perfusion challenges during cardiopulmonary bypass
• A real-world cardiac surgery case illustrating how devastating CAD can be when undiagnosed

This episode blends clinical science, bedside nursing insight, and real OR experience, making it essential listening for ICU nurses, perfusionists, CRNAs, and anyone caring for critically ill patients.

🎧 Whether you’re on shift, commuting, or winding down, this episode will sharpen your clinical awareness and deepen your understanding of a rare but high-risk condition.

👉 Subscribe for upcoming episodes, including our next discussion on post-operative bleeding after cardiac surgery.

💬 Have a question or a case you’d like featured on the show? Drop a comment or reach out — we’d love to hear from you.

Hosted by Vicki Carlisle

See you At the Bedside.