Critical Care Scenarios

By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM

What's Critical Care Scenarios about?

An educational podcast presenting practical critical care scenarios. By Brandon Oto, PA-C and Bryan Boling, ACNP. New episodes weekly.

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Critical Care Scenarios episodes:

04.17.2024
TIRBO 59: How we make the podcast
The nuts and bolts of how we produce the show. Find us on Patreon here! Buy your merch here!
04.10.2024
Lightning rounds 39: Understanding flight medicine with Jace Mullen
We explore critical care transport medicine from both a clinical and career perspective, including helicopters (HEMS), fixed wing jet, and ground ambulance transports, with Jace Mullen, flight paramedic and airway educator out of Denver. Find us on Patreon here! Buy your merch...
04.03.2024
TIRBO 58: Difficult cases
When do patients deaths bother us?
03.27.2024
Episode 72: CPR-induced consciousness with Jack Howard
Find us on Patreon here! Buy your merch here! We discuss the phenomenon of CPR-induced consciousness (i.e. patients demonstrating awakeness during resuscitation) with Jack Howard, Intensive Care Paramedic at Ambulance Victoria in the northern suburbs of Melbourne, Australia, and first author on...
03.20.2024
TIRBO 57: Volume vs pressure control
Should you use volume or pressure control ventilation? Find us on Patreon here! Buy your merch here!
03.13.2024
Lightning rounds 38: Working in APP leadership, with Jason Wieland
We talk about working in critical care APP leadership positions, with Jason Wieland, PA, Lead Pulmonary & Critical Care APP at WakeMed Health System in Raleigh, NC. Find us on Patreon here! Buy your merch here!
03.06.2024
TIRBO 56: Transfixing vessels
You poked through the deep wall of a vessel. Now what? Find us on Patreon here! Buy your merch here!
02.28.2024
Episode 71: Transplant medications with Olivia Philippart
Photo by Tim Webb We discuss the medications typically used after organ transplant, their impact on critical illness, and how to manage them when these patients show up sick—with Olivia Philippart, transplant clinical pharmacist specializing in liver and kidney transplant at...
02.21.2024
TIRBO 55: Bowel regimens
How I make patients poop. Find us on Patreon here! Buy your merch here!
02.14.2024
Lightning rounds 37: Weaning the deliriosedated patient (SCCM roundup)
A roundup of opinions from attendees at SCCM’s 2024 Critical Care Congress in Phoenix on strategies for rescuing the patient stuck in a loop of deep sedation and agitation. Thanks to Pat Posa, Martha Roberts, Juliana Barr, Kelly Drumright, and Ben...
02.07.2024
TIRBO 54: Documenting POCUS studies
How to document your ultrasound findings. Find us on Patreon here! Buy your merch here!
01.31.2024
Episode 70: Airway evaluation for non-anesthesiologists, with Jed Wolpaw
We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr. Jed Wolpaw, anesthesiologist and intensivist from Johns Hopkins, anesthesiology residency program director, and host of the ACCRAC podcast. Find us on Patreon...
01.24.2024
TIRBO 53: Who needs an arterial line?
Arterial lines are resuscitative tools.
01.17.2024
Lightning rounds 36: Nurses are from Venus
Bedside nurses and providers (physicians, PAs, NPs) tend to see the world differently, much of it driven by their training and the systems they work within. We chat about reconciling this and how to best function as a team.
01.10.2024
TIRBO 52: Reliable is better than perfect
In general, medical decisions that avoid error are better than those that optimize care.
01.03.2024
Episode 69: Head and neck surgery with Alexandra Kejner
We discuss head and neck surgery with Dr. Alexandra Kejner, otolaryngologist at the Medical University of South Carolina specializing in transoral robotic surgery, reconstructive surgery including microvascular free tissue transfer, salivary neoplasms, and sialoendoscopic procedures. Find us on Patreon here! Buy your...
12.27.2023
TIRBO 51: Critical care problems are syndromes
The core disorders of critical care are mostly syndromes, not diseases. What should this mean to us?
12.20.2023
Lightning rounds #35: Brain death updates, with Ariane Lewis and Matthew Kirschen
Discussing the new 2023 AAN/AAP/CNS/SCCM Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline, with the joint first authors: Dr. Ariane Lewis, neurointensivist, professor of neurology and neurosurgery at NYU Langone, director of neurocritical care, and chair of...
12.13.2023
TIRBO #50: Never do anything once
If you produce academic work, use the research to produce multiple products. Once is a waste.
12.06.2023
Episode 68: Liver transplant with Meera Gupta
We learn about liver transplant with Dr. Meera Gupta, transplant surgeon at the University of Kentucky Healthcare Transplant Center, and surgical director of the Kidney and Pancreas Transplant Program. We discuss eligibility, triage, the peri-operative course, and important post-op complications. Find...
11.29.2023
TIRBO #49: The universal acuity equation
Explaining the ultimate expression of prognosis: Morbidity = (Severity x Duration)/Reversibility
11.22.2023
Lightning rounds #34: … When?
When should you… * Update family on clinical changes * Call a consult * Notify a nurse about new orders * Communicate with an attending
11.15.2023
TIRBO #48: Choosing a line site
Which site should you select for your central line placement? A discussion of some considerations.
11.08.2023
Episode 67: Whipples with Michael Cavnar
We learn about pancreaticoduodenectomy (the Whipple) with Michael Cavnar (@DrMikeCavnar), surgical oncologist at University of Kentucky, with a fellowship in Complex General Surgical Oncology from Sloan Kettering. He specializes in GI surgical oncology (liver, pancreas, stomach, etc), with ongoing research...
11.01.2023
TIRBO #47: Why do we prone?
A review of the physiological and practical reasons to position patients with ARDS in the prone position.
10.25.2023
Lightning rounds #33: Transitioning to academics with Janelle Bludorn
We chat with Janelle Bludorn (@JanelleRBlu), former emergency medicine PA, Assistant Professor and Academic Coordinator at the Duke PA program, about transitioning from clinical work into teaching and academia. Find us on Patreon here! Buy your merch here! Resources * Harvard Macy Institute * Duke...
10.18.2023
TIRBO #46: Being curious
The value of being curious about practice differences, not judgmental.
10.11.2023
Episode 66: Aortic dissection with Travis Hughes
We explore aortic dissection with Travis Hughes, vascular surgery fellow from the University of Kentucky, including classification, medical management, and nuances of the surgical perspective. Find us on Patreon here! Buy your merch here! Takeaway lessons * Type B dissections do not involve the...
10.04.2023
TIRBO #45: SBT failure phenotypes
What are the ways that patients fail breathing trials, and what can they tell us about how to optimize them for next time?
09.27.2023
Lightning rounds #32: Creating a POCUS system with Leon Chen
We chat with Leon Chen about his work setting up infrastructure for clinical POCUS at Memorial Sloan Kettering. Leon is an Adult/Gerontology Acute Care Nurse Practitioner in the ICU, Clinical Program Manager of Research and Simulated Learning, and an Associate...
09.20.2023
TIRBO #44: The things I carry
A brief discussion of the stuff in your pockets as you practice medicine.
09.13.2023
Episode 65: Obstructive UTI with Ashley Winter
We discuss the nuts and bolts of urinary infection with an obstructing stone with Ashley Winter (@AshleyGWinter), board certified urologist with a fellowship in male and female sexual medicine, and chief medical officer of Odela Health. Find us on Patreon here! Buy...
09.06.2023
TIRBO #43: Lying to ourselves (the clinician’s perspective on end-of-life care)
From the Critical Concepts blog, thoughts on our personal biases and lack of humility when contemplating end-of-life decision making.
08.30.2023
Lightning rounds #31: How to not get fired
Bryan and Brandon chat about holding down jobs, conflict resolution and interpersonal skills, and how to protect yourself as an employee.
08.23.2023
TIRBO #42: The mobile locus of control
When are patient outcomes your fault?
08.16.2023
Episode 64: Neurologic POCUS with Aarti Sarwal
We explore the cutting edge practice of point-of-care ultrasound of the brain, including optic nerve sheath measurement, transcranial doppler, assessing midline shift, and more, with Aarti Sarwal, neurologist and neurointensivist, director of the neurocritical care unit at Wake Forest, and...
08.09.2023
TIRBO #41: Tissue compression and elasticity during procedures
Dealing with the good and bad aspects of tissue mobility during percutaneous procedures.
08.02.2023
Lightning rounds #29: Making APP and physician collaboration work, with Matt Siuba
We chat with friend of the podcast Matt Siuba (@msiuba), Mr. Zentensivist, to share our distinct perspectives on the relationship between APPs (PAs or NPs) and the intensivists we work alongside.
07.26.2023
TIRBO #40: Ventilating the breathing patient
The dilemma of lung-protective ventilation in patients with strong spontaneous breathing.
07.19.2023
Episode 63: Understanding dialysis, with Paul Adams
We dive into when to initiate renal replacement therapy, the modalities, settings, and physics involved, troubleshooting problems, and more, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky. Find us on Patreon here! Buy your merch here! Takeaway...
07.12.2023
TIRBO #39: 5 rules for clinical excellence
5 things you pretty much must be doing if you want to be excellent at critical care. See also on the blog: The ten laws of critical care Practicing medicine like an adult
07.05.2023
Lightning rounds #28: Online learning with Callie Tennyson
Bluejacket_headshotDownload We chat with Callie Tennyson, DNP, ACNP-BC, AACC, CHSE, assistant professor from the Duke University School of Nursing, about the use of the internet and social media for medical education: trends, challenges, and principles for doing it right.
06.28.2023
TIRBO #38: Why you should follow up
The value of performing chart checks to see how your patients are doing after your care.
06.21.2023
Episode 62: Running a cardiac arrest
Bryan puts Brandon through the paces, discussing the nuts and bolts of managing a code. Find us on Patreon here! Buy your merch here! Takeaway lessons * Managing a room is less about asserting authority and more about leading by example. Cardiac arrest is...
06.14.2023
TIRBO #37: Remote brains
The importance of using an app to keep notes and establish a second, more reliable medical memory.
06.07.2023
Lightning rounds #27: Burnout and career satisfaction
We chat about why people get burned out in medicine, how to weigh the pros and cons of our work, and the right perspective on job satisfaction.
05.31.2023
TIRBO #36: Liberty or death
A brief overview and call to arms around the key concepts of ICU liberation.
05.24.2023
Episode 61: ECPR with Scott Weingart
We chat with Scott Weingart of Emcrit about the use of crash VA ECMO for the cardiac arrest patient. Check out the REANIMATE course here! Listen to the ED ECMO podcast on ECPR here Find us on Patreon here! Buy your merch here! Takeaway lessons *...
05.17.2023
TIRBO #35: Vent double-triggering
Understanding the causes of doubled vent breaths, including premature/short cycling and reverse triggering, plus a basic approach to managing them.
05.10.2023
Lightning rounds #27: Our favorite FOAM
Bryan and Brandon share their favorite podcasts, blogs, social media, and other online channels for medical education. Podcasts * CORE IM * EMcrit * Gobbet ‘o Pus * Simulcast * Intensive Care Network * ACCRAC * Blood Bank Guy Essentials * Traumacast * Maryland Critical Care Project * PulmPEEPS * IBCC podcast *...

What's Critical Care Scenarios about?

Download our free app to listen on your phone

Critical Care Scenarios episodes:

TIRBO 59: How we make the podcast

Lightning rounds 39: Understanding flight medicine with Jace Mullen

TIRBO 58: Difficult cases

Episode 72: CPR-induced consciousness with Jack Howard

TIRBO 57: Volume vs pressure control

Lightning rounds 38: Working in APP leadership, with Jason Wieland

TIRBO 56: Transfixing vessels

Episode 71: Transplant medications with Olivia Philippart

TIRBO 55: Bowel regimens

Lightning rounds 37: Weaning the deliriosedated patient (SCCM roundup)

TIRBO 54: Documenting POCUS studies

Episode 70: Airway evaluation for non-anesthesiologists, with Jed Wolpaw

TIRBO 53: Who needs an arterial line?

Lightning rounds 36: Nurses are from Venus

TIRBO 52: Reliable is better than perfect

Episode 69: Head and neck surgery with Alexandra Kejner

TIRBO 51: Critical care problems are syndromes

Lightning rounds #35: Brain death updates, with Ariane Lewis and Matthew Kirschen

TIRBO #50: Never do anything once

Episode 68: Liver transplant with Meera Gupta

TIRBO #49: The universal acuity equation

Lightning rounds #34: … When?

TIRBO #48: Choosing a line site

Episode 67: Whipples with Michael Cavnar

TIRBO #47: Why do we prone?

Lightning rounds #33: Transitioning to academics with Janelle Bludorn

TIRBO #46: Being curious

Episode 66: Aortic dissection with Travis Hughes

TIRBO #45: SBT failure phenotypes

Lightning rounds #32: Creating a POCUS system with Leon Chen

TIRBO #44: The things I carry

Episode 65: Obstructive UTI with Ashley Winter

TIRBO #43: Lying to ourselves (the clinician’s perspective on end-of-life care)

Lightning rounds #31: How to not get fired

TIRBO #42: The mobile locus of control

Episode 64: Neurologic POCUS with Aarti Sarwal

TIRBO #41: Tissue compression and elasticity during procedures

Lightning rounds #29: Making APP and physician collaboration work, with Matt Siuba

TIRBO #40: Ventilating the breathing patient

Episode 63: Understanding dialysis, with Paul Adams

TIRBO #39: 5 rules for clinical excellence

Lightning rounds #28: Online learning with Callie Tennyson

TIRBO #38: Why you should follow up

Episode 62: Running a cardiac arrest

TIRBO #37: Remote brains

Lightning rounds #27: Burnout and career satisfaction

TIRBO #36: Liberty or death

Episode 61: ECPR with Scott Weingart

TIRBO #35: Vent double-triggering

Lightning rounds #27: Our favorite FOAM