The Peak Inspiration Podcast

Former ICU nurse and palliative care APP Courtnee Stagner shares the words clinicians can use to help families face what’s happening, understand their options, and make decisions grounded in what the patient would want. An honest, practical conversation about ICU care, palliative care, and saying the hard things with compassion.

Everyone thinks ventilator waveforms are confusing, but when you understand the physiology you can dissect them much easier!!!

In this lecutre, I go over core concepts in ventilator waveform physiology :

💨 Flow occurs when there’s a pressure gradient.
📈 Know what normal looks like → recognize when the patient–ventilator interaction changes.
🧠 Waveforms show you how pressure, flow, and volume are interacting in real time.

This is a shortened version of the whole lecture which could be found on my patreon along with the slides at

https://patreon.com/Pulmtoilet?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink

Click below for a free month !

Attendings

Critical Access

CRNA

APPs, PharmD, and Rehab Services

Medics/RNs/RTs/Flight Crew

All Trainees & First Responders

In this episode, we move beyond normal waveforms and break down the abnormal patterns you’ll actually encounter at the bedside.

Learn how changes in pressure, flow, and volume can reveal problems with resistance, compliance, flow delivery, air trapping--lets move beyond just sedating!!

Full video and powerpoint on patreon!

Click your job below for a free month!

Attendings

Critical Access

CRNA

APPs, PharmD, and Rehab Services

Medics/RNs/RTs/Flight Crew

All Trainees & First Responders

🫁 MAKE THE DRIVING PRESSURE < 15

We all hear it: “Keep driving pressure <15.”

Cool… HOW?

There’s no driving pressure button on the ventilator.

In this webinar, we break down the physiology and the practical bedside approach to actually lowering driving pressure—using tidal volume, PEEP, recruitment, compliance, ventilator modes, and waveform interpretation.

The goal isn’t just to memorize DP <15. It’s to understand WHY the driving pressure is high and what you can actually do about it.

🎥 Full webinar + slides available on Patreon:

Patreon.com/cw/Pulmtoilet

Click the link for your specialty to sign up and get a free month!!!!!

Attending

CRNA

APPs/PharmD/Rehab Services

RTs/RNs/Medics/Flight

All Trainees and First Responders

Critical access healthcare workers

I go over 4 waveforms sent to me from followers! They quite bad so take a listen and let me know what you think!

Only 2/4 are here-- go to my patreon (@pulmtoilet) for the full 4 waveforms and the accompanying PDF to download and annoate along!

https://www.patreon.com/Pulmtoilet/posts/waveform-video-2-167832507?utm_medium=clipboard_copy&utm_source=copyLink&utm_campaign=postshare_creator&utm_content=join_link

Bridging the Gap in Critical Care Education

In this episode, I sit down with Karen Battistoni, a CVICU educator from the Texas Medical Center, to discuss one of the biggest challenges in critical care: the gap between classroom education and bedside practice.

We explore why many clinicians feel underprepared for complex ICU patients, how social media has become a powerful educational tool, and why teaching practical physiology matters. Karen also shares her perspective on fast-track cardiac surgery protocols, emphasizing that patient assessment and clinical judgment should always come before rigid protocol adherence.

Finally, we discuss the importance of collaboration between nurses, respiratory therapists, and physicians, and how shared decision-making leads to better patient outcomes.

Key takeaways:

• Practical education is essential for building ICU confidence.

• Protocols should support—not replace—clinical judgment.

• Teamwork is critical for delivering high-quality patient care.

Whether you're a nurse, RT, APP, resident, fellow, or attending, this conversation offers practical insights you can apply at the bedside.

In this episode, I break down the same framework I teach in my Ventilator Dyssynchrony Bootcamp.

Rather than memorizing a long list of named dyssynchronies, I focus on understanding what a normal breath should look like first.

From there, we compare expectation to reality and systematically work through each phase of the breath—trigger, flow, cycle, and expiration—to identify where the patient and ventilator have fallen out of sync.

This approach helps make waveform interpretation more intuitive, more reproducible, and ultimately more useful at the bedside for anyone caring for mechanically ventilated patients!

A clip of my webinar that I did on PRVC and why adaptive modes are generally bad in the ICU.

Want full webinar? Email ME!

[email protected]

Running back my talk from ResusX about ventilating severe acidosis!

I try to approach this from a pragmatic perspective! Nothing will work great so just do the least bad thing!!

We all know SIMV sucks, but what exactly is the difference between SIMV and AC?