Critical Care Scenarios

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Dr. Brian Cuthbertson, anesthesiologist and intensivist and lead author of the OSCAR trial, shares with us the fascinating history of high frequency oscillatory ventilation. Check out the Intensive Care Academy here! References

Theresa Human, former academic clinical pharmacist in neurocritical care and now medical liaison for a large pharmaceutical company, chats about late-career transitions and working for private industry. Check out the Intensive Care Academy here!

We step into the ring with Nick Ghionni, pulm/crit attending at MedStar Baltimore Hospital, who tries to convince us that the pressure-targeted, volume-titrated vent mode known as “PRVC” actually sucks. Check out the Intensive Care Academy here!

EM intensivist Olivia Serigano tells us about their recent publication in Anaesthesia Critical Care & Pain Medicine evaluating the use of two rules (BMI/3 or PEEP 10 in everyone) for setting PEEP in obese patients on the ventilator. Learn more at the Intensive Care Academy! Takeaway pearls

We review the basic care and workflow of caring for bread-and-butter intraparenchymal hemorrhage. Learn more at the Intensive Care Academy! Takeaway pearls

We hear a mystery tox case from Jerry Snow, director of the toxicology fellowship at Banner University Medical Center in Phoenix, and one of his med tox fellows Andrew Sheen. Learn more at the Intensive Care Academy! Takeaway pearls References PATHOPHYSIOLOGY & CLASSIFICATION 1. Lalau JD, Kajbaf F, Protti A, et al. Metformin-associated lactic acidosis … <a href="https://icuscenarios.com/episode-102-tox-files-1-with-jerry-snow-and-andrew-sheen/" class="more-link">Continue reading<span class="screen-reader-text"> "Episode 102: Tox files #1 with Andrew Sheen and Jerry Snow"</span></a>

We give our general take on IV fluids: when to use them, what to use, when to stop, how to bolus and when to use maintenance fluids, and more. Learn more at the Intensive Care Academy!

We discuss the interface between ED and ICU and why we have trouble understanding each other, with Dr. Namita Jayaprakash, dual-trained EM and critical care physician, and medical director of her ED. Learn more at the Intensive Care Academy! References

We learn about how to contribute to underserved communities abroad, with Kwame Akuamoh-Boateng, DNP, ACNP-BC, FCCM. Learn more at the Intensive Care Academy! References

Dennis Kim, trauma surgeon and surgical intensivist of the Trauma ICU Rounds podcast, weighs in on the diagnosis and management of acalculous cholecystitis. Learn more at the Intensive Care Academy! Takeaway pearls

Tammy Smith, assistant professor of neurology at the University of Utah within the division of Neuroimmunology and Autoimmune Neurology, and a clinical consultant at ARUP Laboratories, gives us the inside scoop on testing for autoimmune encephalitis syndromes. Learn more at the Intensive Care Academy! CHEST’s Procedural Skills for the Critical Care Clinician, April 23-24 2026 … <a href="https://icuscenarios.com/episode-100-autoimmune-encephalitis-testing-with-tammy-smith/" class="more-link">Continue reading<span class="screen-reader-text"> "Episode 100: Autoimmune encephalitis testing with Tammy Smith"</span></a>

Hallie Prescott, pulm/crit physician and co-chair of the recent Surviving Sepsis guideline writing committee, gives some insight into the new document, including a few interesting additions and some points of controversy. For more thoughts, especially from an EM perspective, Scott Weingart also interviewed Hallie over at EMcrit. Learn more at the Intensive Care Academy! Takeaway … <a href="https://icuscenarios.com/lightning-rounds-64-the-new-surviving-sepsis-guidelines-with-hallie-prescott/" class="more-link">Continue reading<span class="screen-reader-text"> "Lightning rounds 64: The new Surviving Sepsis guidelines with Hallie Prescott"</span></a>

Scott Weingart, ED intensivist and seminal educator from the EMCrit podcast, shares his thoughts on how we should be finding truth nowadays: how to read journals, choose experts, use AI, and resolve disagreement. Learn more at the Intensive Care Academy! Takeaway pearls

We chat about managing a complex MICU patient with RV failure in the setting of renal failure and sepsis, with Amos Dodi, nocturnal intensivist at Einstein/Montefiore and author of a recent narrative review on the RV. Learn more at the Intensive Care Academy! CHEST’s Procedural Skills for the Critical Care Clinician, April 23-24 2026 References … <a href="https://icuscenarios.com/episode-98-rv-failure-in-the-micu/" class="more-link">Continue reading<span class="screen-reader-text"> "Episode 99: RV failure in the MICU"</span></a>

We dive into the confusing rabbit hole of medical staffing, credentialing, and privileging, particularly for the critical care APP, with Chris Newman, pediatric critical care PA and Vice Chair for Clinical Performance at the University of Colorado. Check out the REVIVE conference here! Check out the CHEST Procedural Skills for the Critical Care Clinician course … <a href="https://icuscenarios.com/lightning-rounds-61-credentialing-and-privileging-with-christopher-newman/" class="more-link">Continue reading<span class="screen-reader-text"> "Lightning rounds 61: Credentialing and privileging, with Christopher Newman"</span></a>

We chat with Melissa Nestor, clinical pharmacist in neurocritical care, about tho subtleties of glucose and insulin management in the ICU. Learn more at the Intensive Care Academy!

We discuss the practicalities of running a rapid response, including crowd management, coordinating with primary services, working outside the ICU, and rapidly obtaining and synthesizing diagnostic data. Learn more at the Intensive Care Academy!

We explore the practical intricacies of nebulized medications, including timing, dosing, types of devices, and more, with Keith Lamb (@kdlamb1), RRT, RRT-ACCS, FAARC, FCCM. Learn more at the Intensive Care Academy!

We explore the practical basics of managing an elevated ICP with impending herniation, including EVD troubleshooting, hyperosmolar therapies, and the role of craniectomy. Learn more at the Intensive Care Academy! References