In this episode of the Critical Care Commute, hosts Peter Brindley and Leon Byker engage in a compelling discussion with Dr. Paul Parks, a prominent emergency physician and advocate for healthcare reform.

Dr. Parks shares his insights on the current state of emergency room care in Alberta, emphasizing the systemic issues that have led to a crisis in emergency services. He describes the overwhelming pressures faced by emergency departments, and highlight the dire need for government acknowledgment and action to address the crisis. He also articulates the challenges of navigating the healthcare system, where patients often wait for hours or even days for care, and advocates for a coordinated response to improve patient outcomes.

Takeaways

1. 'Emerge owns the sins of the system.'
2. 'We are right now in a state of crisis.'
3. 'It's inhumane the conditions that we're seeing.'
4. 'We need a command and control structure.'
5. 'We must move back to being data-driven in our decisions.'
6. 'We have to have the ability to speak truth to power.'
7. 'Patients are waiting for hours, even days, for care.'
8. 'The system is chaotic and disorganized.'
9. 'We need to advocate for transparency and accountability.'

In this conversation, Dr. Marcus Peck shares his harrowing experience of being involved in a medical case that led to a coronial inquest and subsequent investigation by the GMC. He discusses the emotional toll of moral distress, the challenges of navigating legal scrutiny in the medical field, and the importance of community support. The conversation highlights the complexities of patient care, the impact of loss on healthcare professionals, and the lessons learned from difficult experiences in critical care.

Dr Marcus Peck is a consultant in anesthesia and intensive care at Hampshire Hospitals NHS trust, and Network Lead of the Intensive Care Society's Focused Ultrasound for Intensive Care (FUSIC) committee and is joined by Dr Jonny Wilkinson, Consultant in ICU and Anesthesia from North Hampton.

Takeaways:

• Loss is a universal experience in the medical community.
• Moral distress can significantly impact healthcare professionals.
• Legal challenges can arise from complex medical cases.
• Documentation is crucial in protecting healthcare providers.
• Emotional responses to patient outcomes are valid and important.
• Support from colleagues and community is essential during tough times.
• Investigations can feel isolating and shameful for medical professionals.
• Resilience is key in overcoming professional challenges.
• Learning from past experiences can improve future practice.
• Open conversations about these issues can help reduce stigma.

In this short thoughtful episode, we highlight an important Australian tradition: the Acknowledgement of Country. This brief statement, often given at the start of meetings, gatherings, and public events, recognizes the Traditional Custodians of the land, honors their enduring cultural connection to it, and shows respect for Elders past and present. It’s a simple but meaningful way Australians acknowledge history, presence, and identity, and it reflects a national commitment to reconciliation and cultural respect.

In today’s episode, we introduce Dr. Lewis Campbell, a critical care physician from Alice Springs, south of Darwin. Dr. Campbell brings his Northern Territory perspective to our clinical conversation, offering insights shaped by the unique geography, culture, and healthcare challenges of Australia’s Top End.

A concise, engaging listen for your commute.

In this conversation, Iain discusses the launch of MedPod Learn, a platform offering a searchable database of curated medical podcasts. He shares insights on the pricing strategy, including user perceptions about value and affordability, and the decision to offer a free trial to encourage subscriptions.

Takeaways

MedPod Learn offers a searchable database of medical podcasts.

The platform is available on both App Store and Google Play.

User perceptions of pricing can vary significantly.

Some users believe lower prices may lead to undervaluation.

Iain's approach includes a free trial for new users.

The subscription fee is set at £2.99 after the trial.

Market research revealed surprising insights about pricing expectations.

The founder's model aims to attract early adopters.

Engagement strategies are crucial for subscription services.

Understanding user psychology is key to pricing decisions.

https://t.co/Jw9XUrA5nh

Download MedPod Learn from Google Play Store or Apple Store

In this episode, Peter Brindley interviews Dr. Rob Bevan, past president of the CICM, about the obesity paradox in Intensive Care Units (ICUs).

They discuss the surprising observation that overweight ICU patients often show better survival rates than those underweight, despite obesity's known health risks. Dr. Bevan dives into the history and the limitations of BMI as a metric and various biases that could influence the perceived obesity paradox. He also explains how classification bias, selection bias, confounding, and collider bias might skew these outcomes. The discussion touches on the importance of separating patients who are critically ill and happen to be obese from those who are in ICU primarily because of obesity-related diseases. The conversation is rooted in the upcoming textbook chapter authored by Dr. Bevan and explores obesity's broader health implications globally.

In this episode, Peter and Leon, recording at the College of Intensive Care Medicine's Conference in Tasmania, Australia, discuss advancements in precision medicine with Dr. Pratik Sinha from Washington University in St. Louis.

Dr Pratik trained in both Emergency and Intensive Care Medicine, but only works clinically as an intensivist. He runs a research program that seeks to change the way we identify and classify critically ill patients, by using a combination of novel biological measurements and state of the art data science approaches.

The conversation delves into how critical care medicine currently operates, emphasizing the need to shift from supportive care to more personalized approaches using biological measuring systems, big data, and novel data science techniques. They discuss identifying patient subgroups using machine learning algorithms and protein biomarkers, revealing phenotypes like hyper and hypo-inflammatory responses. The discussion covers the practical challenges of implementing these technologies, the importance of rigorous testing, and the future implications for intensive care. The speakers highlight the necessity of prospective clinical trials and broader accessibility of these advanced diagnostic tools to improve patient outcomes.

00:00 Introduction and Opening Remarks

00:34 Diving into Precision Medicine

01:35 Elevator Pitch for Medical Research

02:10 Understanding Patient Complexity

04:12 Biological Measurements and Data Science

10:37 Challenges in Modern Medicine

17:08 Future of Medical Research and AI

21:20 Concluding Thoughts and Future Prospects

In this episode of the Critical Care Commute podcast, Dr. Smith discusses the multifaceted future of critical care medicine, touching on economic, political, and technological challenges.

The conversation delves into the role of artificial intelligence in enhancing healthcare, the importance of clinician well-being, and the need for a human touch in medicine.

The discussion also explores personal interests, travel experiences, and the ethical implications of AI in clinical practice, emphasizing the balance between technology and human interaction.

Guests: Drs Marcus Peck and Jonny Wilkinson.

Chapters

00:00 The Future of Critical Care Medicine

02:40 Artificial Intelligence in Healthcare

05:38 Human Factors and Clinician Well-being

08:22 Economic Challenges in Healthcare

11:09 The Role of Politics in Healthcare

14:13 The Turing Test and AI's Evolution

16:41 Personal Interests and Travel Experiences

19:57 AI's Impact on Clinical Practice

22:38 Ethical Considerations of AI in Medicine

25:19 The Future of AI and Human Interaction

The Power of Kindness in Healthcare: A Conversation with Dr. Suzanne Crowe. In this episode, Peter Brindley and Leon Byker speaks with Dr. Suzanne Crowe, pediatric intensivist and president of the Medical College of Ireland, at the College of Intensive Care meeting in Tasmania, 2025.

They explore the significant impact of kindness on patient outcomes, emphasizing its vital role in healthcare. Dr. Crow highlights the necessity of incorporating kindness as a core practice, noting that it reduces mistakes, improves diagnostic accuracy, and fosters better cooperation from patients. They discuss the effectiveness of empathy training and the importance of leadership in fostering a culture of kindness within healthcare systems. Dr. Crow also shares practical tips for healthcare professionals on how to demonstrate kindness in daily interactions, such as sitting beside patients and offering comforting gestures.00:00 Introduction and Guest Welcome00:34 The Power of Kindness in Healthcare01:24 Defining and Recognizing Kindness02:20 Microdosing Kindness in Practice03:19 Teaching and Modeling Kindness03:54 Empathy Training and Its Importance05:07 Challenges and Barriers to Kindness06:57 Kindness in Patient Interactions09:27 Systemic Kindness and Leadership17:17 Empathy Training Techniques19:00 Conclusion and Final Thoughts

Join Peter Brindley and Leon Byker as they host David Bertoni, an ED physician and ECMO clinical lead, and Jorian 'Joe' Kippax, a trauma specialist and reservist, for an incredible story of a remote river rescue in Tasmania.

The team responds to a distress call from a trapped rafting party in the Franklin River, one of Tasmania's most remote and formidable areas. The rescue involves complex logistical challenges, a field amputation, and the use of ECMO technology amidst perilous conditions. The patient, after 20 hours trapped in frigid water, undergoes a harrowing yet successful rescue and recovery. This episode offers a gripping recount of teamwork, medical ingenuity, and human resilience.00:00 Introduction and Guest Overview00:40 Setting the Scene: Remote River Rescue01:39 The Rescue Operation Begins03:13 Challenges and Techniques in the Rescue07:25 Field Amputation and Extraction18:35 Transport and ECMO Preparation23:20 Hospital Arrival and ECMO Procedure26:18 Patient Recovery and Reflections30:45 Conclusion and Final Thoughts

In this episode, we welcome Professor Mervyn Singer, author of Sepsis 3.0. Sepsis remains one of the most complex and deadly conditions in critical care. In this conversation,Professor Singer shares his perspectives on the shifting landscape of sepsis treatment, the role of antibiotics, steroids, metabolic interventions, and the future ofprecision medicine.

He also challenges some long-standing dogmas and emphasizes the importance of individualized care over rigid guidelines.

Key Topics and Chapters:

The Evolution of Sepsis Management

• Historical perspectives on sepsis treatment
• Earlier recognition and intervention leading to improved outcomes

Current Challenges and Research Directions

• Organ dysfunction and recovery in sepsis
• The importance of metabolic manipulation and mitochondrial function

The Role of the Immune System in Sepsis

• Understanding hyper- and hypo-inflammatory responses
• Steroid use in critical illness—when it works and when it doesn’t

Antibiotics in Sepsis: How Soon, How Long, and How Much?

• The changing approach to antibiotic timing and duration
• The impact of microbiome disruption and antibiotic toxicity
• Rethinking the one-hour antibiotic rule

Lessons from COVID-19 and Their Impact on Sepsis Research

• The importance of phenotype-driven treatments
• Missed opportunities in clinical trials and biobanking

The Beta-Blocker Debate in Sepsis

• Potential benefits in selected patients
• The challenge of distinguishing compensatory tachycardia from harmful sympathetic overdrive

Rethinking Fever Management

• Is fever protective or harmful?
• When to treat and when to leave it alone

Guidelines vs. Individualized Care

• The balance between evidence-based medicine and clinical expertise
• The dangers of rigid mandates and protocols

This engaging discussion provides a fresh perspective on the current state and future of sepsis management, emphasizing the need for precision medicine, nuanced clinical decision-making, and ongoing research.

References:

1. Im Y, Kang D, Ko RE, et al. Time-to-antibiotics and clinical outcomes in patients with sepsis and septic shock: a prospective nationwide multicenter cohort study. Crit Care. 2022;26(1):19. Published 2022 Jan 13. doi:10.1186/s13054-021-03883-0 Here
2. Sakkat A, Alquraini M, Aljazeeri J, Farooqi MAM, Alshamsi F, Alhazzani W. Temperature control in critically ill patients with fever: A meta-analysis of randomized controlled trials. J Crit Care. 2021;61:89-95. doi:10.1016/j.jcrc.2020.10.016 Here
3. Hasegawa D, Sato R, Prasitlumkum N, et al. Effect of Ultrashort-Acting β-Blockers on Mortality in Patients With Sepsis With Persistent Tachycardia Despite Initial Resuscitation: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Chest. 2021;159(6):2289-2300. doi:10.1016/j.chest.2021.01.009 Here