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Jean & Mike Do The New York Times CrosswordThursday, March 13, 2025 - ESSIE, the preferred nail polish for 9 out of 10 mythical Scottish loch monsters 🙄The consensus at JAMDTNYTC HQ is that this was a terrific Thursday crossword, and a limbering up, as it were, in preparation for the grueling Friday and Saturday crosswords yet to come. We were pleased to see OCCAM make an appearance in the grid, as well as a smattering of frqtly. sn. txt. msg. abbrs., including DMED, OTOH, IRL and IPAS (ok, we're not sure about that last one, but the rest most definitely are frequently seen text message abbreviations).Show note imagery: ATOMICDOGWe love feedback! Send us a text...Contact I...2025-03-1419 min
The Review 614Jake Paul vs. Mike Tyson & Jon Jones vs Stipe MiocicWelcome back to The Review 614, we were joined by our friend Woot. This has been an exciting fight weekend. Friday 11/15 Jake Paul “defeated” Mike Tyson via unanimous decision & Saturday 11/16 Jon “Bones” Jones defeated Stipe Miocic via TKO to retain his UFC Heavyweight Championship. If you didn’t watch then you missed out on some treats (besides the continuous buffering). Listen to our thoughts regarding the fights. Also go connect with Woot on Instagram @sliz4l . Give us a like, comment, & follow.Â
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#614 #TheReview614 #SocialClub #SexyXmas #NoDiddy #MeanGirls #ABCParty #MeatToMeat #WootToow #OPP #FIETTS #AtomicDog #DoTheTongueThing #2Chainz #FightingInDaClub #JakePaul #Mi...2024-11-1940 min
ICU RoundsWhat is the role of decadron in preventing post extubation stridor?What is the role of giving an adult steroids to prevent stridor or reintubation following extubation. This epidose looks at the data.2014-03-3008 minICU RoundsModes of Mechanical VentilationA discussion of the various types of ventilators with a focus on the various ventilator modes and types of ventilator cycles. Also presented is the topic of pressure support ventilation (PSV)2014-03-3023 minICU RoundsOxygenation & PEEPA discussion of ventilation, oxygenation, and the role of PEEP.2014-03-3026 minICU RoundsLightning InjuriesLightning injuries are rare, but when you do treat a patient they can have facinating presentations. This lecture follows a patient we treated at Vanderbilt. The patient present to a local ED with stroke like symptoms following the lightning strike. Initially, physicians were confused by the presentation, but in this lecture you will learn that his presentation was near textbook. www.burndoc.com
2014-03-3010 minICU RoundsGlutamine In Critical Illness: what's all the fuss about?All surgical residents know that glutamine is the amino acid known as the fuel for the gut. But what is all the fuss about? The episode will look at the data on glutamine. Does glutamine improve outcomes, and if so and in who? How much should we use and what are the hazards? Enteral versus parenteral. www.burndoc.com2014-03-3011 minICU RoundsComplications of PEEP and Auto-PEEPVirtually all patients on ventilators are on PEEP. PEEP has several interactions with various organ systems and some can result in profound complications. An understanding of PEEP and auto-PEEP are required before we can understand modes of ventilation like APRV (Bi-Vent)2014-03-3018 minICU RoundsAirway Pressure Release Ventilation (APRV) or BiVent: What the heck is this?Airway pressure release ventilation (APRV) is not a new mode of mechanical ventilation, but it seems to be gaining a great deal of popularity lately. Many people find this mode very complicated and thick that it is reserved only for the very ill. Neither one of these assumptions are corrrect. This mode is very easy to learn and use. Furthermore, this mode is very physiological and tolerated by all types of patients. 2014-03-3022 minICU RoundsAcute RenalFailureAcute renal failure is a dreaded complication in the ICU. This podcast will review the various types of acute renal failure, the etiology, as well as acute management. 2014-03-3042 minICU RoundsWeaning (Liberating) from the mechanical ventilatorDon't wean people from their ventilators-- liberate them!! When are people ready to come off the ventilator? What are weaning parameters? How does one do a spontaneous weaning trial? What is the role of noninvasive ventilation (NIV)?2014-03-3026 minICU RoundsIntraosseous Vascular Access: not just for the kids anymoreIntraosseous vascular access was was developed for use in adult trauma patients over 80 years ago. Only recently has this technique regained popularity for rapid and safe access to the vascular space in patients in extremis. 2014-03-3017 minICU RoundsRenal Replacement Therapy: SCUF, SLED, CVVH, CVVHD, IHD--what does it all meanRenal replacement therapy (RRT) is rather a confusing topic. What do all those initials mean and why use one therapy over another? This podcast will explain the difference between intermittent and continous. What are the various forms of continuous and how do they differ? What are the concepts of ultrafiltration, diffusion, and convection? These questions will be answered in this introduction to renal replacement. 2014-03-3031 minICU RoundsBurns: Fluid CreepExcessive fluid resuscitations lead to horrible complications such as abdominal compartment syndrome. This article takes a critical look and challanges many of our practices in fluid resuscitation of burn patients. 2014-03-3021 minICU RoundsBlood Conservation in the ICUWhen should a patient receive a transfuse of blood? What is an acceptable hemoglobin concentration in an ICU patient and should we use EPO? Summer is a time when the blood banks often have a single day's worth of blood. Perhaps with more conservative transfusion practices we can avoid or certainly help with some of the blood shortages. Everyone wants to put patients on Epo, but does it increase the hemoglobin concentration enough to off set its high cost?2014-03-3028 minICU RoundsMetabolism: Starvation versus StressNot feeding an injured or ill patient is not that same as a normal individual who is fasting. A pound of weight loss in the stress patient is significantly different than a pound of weight loss in someone on a diet. A basic understanding of stress metabolism is needed prior to a discussion of nutrition. 2014-03-3028 minICU RoundsEarly Surgery Improves Outcomes Following Critical BurnsEarly surgical excision is likely to be the most significant individual variable to imporve the outcome of a patient (adult or child) with a critical burn. Nevertheless, many nonburn physicians still want to apply to 1970 treatment paradigms to this population of injured patients. This episode will hopefull replace these falsehoods with fact supported in the literature. 2014-03-3024 minICU RoundsBomb and Blast InjuriesBomb and blast injuries: In the past blast injuries were limited to the battlefield of a rare industrial accident. The events of the past week are a reminder that civilian population centers are targets for bombing attacks. Most civilian providers has no to limited knowledge or experience treating patients with such injuries. This episode is dediacated to a discussion of some of the unique properties and injuries associated with blast injuries. In the event of a terrorist attack, like those attempted in London this past week, the injuries will be in the hundreds...2014-03-3032 minICU RoundsMetabolic Acidosis in the ICUA common problem in the ill or injured patient is a metabolic acidosis. In this episode we will review the common etiology of a metabolic acidosis as well as some lesser known causes. 2014-03-3036 minICU RoundsThermal InjuriesAn introduction of the biology of thermal injuries and the initial care of the patient with thermal injuries in critical condition.2014-03-3040 minICU RoundsCrush SyndromeEarthquakes are horrible natural events causing loss of lives in the thousands. Following earthquakes, building collapses, and cave-ins, large number of victims will suffer from renal failure and death following crush syndrome. 2014-03-3018 minICU RoundsAntibiotic Considerations in the ICUWhy do we choose the antibiotics that we do? How long do we continue the course of therapy? Should we use some antibiotics together? These topics are covered in the episode. 2014-03-3054 minICU RoundsControl of hyperglycemia improves outcomesA great deal is being presented and published on control of blood sugar in the ICU as well as the postoperative period. How much control is enough and what is the data?2014-03-3033 minICU RoundsBlood ProductsBlood products: pRBCs, fresh frozen plasma, platelets, cryoprecipitate when and how should we use it? What are the risks? You may order them like IV fluids but do you really know how these potentially deadly products are to be used. 2014-03-3037 minICU RoundsSmoke Inhalation Injury: CO and Cyanide ToxicityThe onset of cold weather will bring with it an increase in structure fires. The leading cause of deaths in fires is complications from the inhalation of smoke-- not burns. Learn why smoke is so deadly as well as what are the appropriate methods to treat smoke related asphyxiation. 2014-03-3038 minICU RoundsHIT: Heparin Induced ThrombocytopeniaLarge numbers of patients in ICUs are on heparin and what is this complication of heparin induced thrombocytopenia? 2014-03-3019 minICU RoundsSepsis - Part 1Sepsis is a common cause of death in the intensive care unit. In this episode I present some of the statistics on septic deaths, introduce the definitions, and present the basic science. Part 2 will cover fluid and drug therapy for septic shock. 2014-03-3034 minICU RoundsSepsis - Part 2In this episode we discuss that ICU care of the patient with sepsis. This includes an introduction to various vasopressors.2014-03-3033 minICU RoundsPharmacology of ShockThis is a basic introduction of some of the drugs used in various forms of shock. 2014-03-3038 minICU RoundsPediatric BurnsPediatric burns: all burns are serious, both big and small. This episode reviews the objectives of burn care to result in the best functional outcome. Also, burn is a very common method of child abuse and we detail how these children are injured and what to look for to identify possible abuse.2014-03-3047 minICU RoundsAtrial FibrillationAtrial fibrillation is a common problem in ICU patients, but it is a problem with many potential causes, and not always a well defined treatment. 2014-03-3038 minICU RoundsDo Steroid Improve Survivial in Sepsis? CORTICUS TrialThe results of the CORTICUS trial are discussed. 2014-03-3023 minICU RoundsDrug-induced QT prolongationProlonged QT is the most common reason why medications are restricted or removed from the US market. This episode will explain what it is and why you should look for it in your ICU patients. 2014-03-3026 minICU RoundsPolypharmacy in the ElderlyPatients are often admitted to the ICU with an entire list of home medications. In this episode I talk about the implications and dangers of polypharmacy. 2014-03-3029 minICU RoundsTraumatic Shock and Fluid ResuscitationFluid resuscitation done poorly can result in significant complications to the patient. This episode will present some of the newer considerations in fluid resuscitation in traumatic shock. 2014-03-3042 minICU RoundsClostridium difficile ColitisClostridium difficile colitis is a problematic complication of antibiotic theraoy in hospitalized and critically ill patients. It is increasing in frequency and can be lethal. 2014-03-3024 minICU RoundsGlucometers in the ICU: how accurate are they?There is a large emphasis on intensive control of blood glucose in the ICU, but how accurate are the monitors we use to follow glucose? This episode reviews someof the limitations of deploying an instrument designed for control of outpatient diabetes management to tight control of blood glucose in the ICU. 2014-03-3019 minICU RoundsHemoglobin Based Blood Substitutes: Increased Morbidity and MortalityIn this week's Journal of the American Medical Association a meta-analysis was published that concluded that use of hemoglobin based blood substitutes result in an increased morbidity and mortality. Included in the same journal is an editorial critical of the method the research has been regulated by the US FDA. 2014-03-3025 minICU RoundsSurviving Sepsis Campaign (part 1)The Surviving Sepsis Campaign (SSC) is concensus document that attempts to provide the best evidence to assist in the care of the septic patient. All providers who provide care to the septic patient should be aware of the contents of the SSC. 2014-03-3031 minICU RoundsSurviving Sepsis Campaign (part 2)We continue our discussion of the Surviving Sepsis Campaign (SSC). This includes fluids types, steroids, rhAPC (Xigris), and blood sugar control.2014-03-3034 minICU RoundsExtremity Compartment SyndromeA limb-threatening complication that might be overlooked by the inexperienced provider. 2014-03-3028 minICU RoundsAbdominal Compartment SyndromeA discussion of the physiology and presentation of abdominal compartment syndrome.2014-03-3033 minICU RoundsVentilator Update: avoiding shear traumaIn regards to ventilator care, all the focus has been on low tidal volume and level of peak inspiratory pressure. What level of PEEP shoud we be using to avoid shear trauma and ventilatory induced lung injury.2014-03-3019 minICU RoundsPatient-Ventilator Interactions and ventilator discontinuationGetting patients comfortable on the ventilator is not an easy task. This podcasts focuses on methods to make patients synchronize with the ventilator as well as a discussion of spontaneous breathing and awake trials2014-03-3019 minICU RoundsHypercalcemiaA potentiallylife-threatening electrolyte problem that commonly finds its way into the ICU as well as on exams.2014-03-3021 minICU RoundsPAIN: a four letter wordThe management of pain is a key element of the care of all patients-- ICU or not. Often providers have little understanding of the concepts and medications of pain management. This episode serves as an introduction. 2014-03-3040 minICU RoundsMyocardial Infarction: Diagnosis and ThrombolyticsMyocardial Infaction (Part 1): This episode will discuss the diagnosis of MI, STEMI, and non-STEMI. We then discuss the indications and types of thrombolytic agents.2014-03-3028 minICU RoundsTraumatic Rhabdomyolyisis / Crush SyndromeCrush syndrome is a common cause of death following earth quakes, mine and building collapses. Traumatic rhabdomyolysis may also be seen following electrical injury or severe trauma. (This is a reposting due to some previous technical problems with the server.)2014-03-3027 minICU RoundsDisaster ManagementIt is Sunday 8.31.08 and for hurricane Gustav is bearing down on the city of New Orleans. This podcast will discuss the basic elements of disaster planning and management. (This was reposted due to some technical problems with the server.)2014-03-3038 minICU RoundsMyocardial Infarction: PCI and medicationsThis is the second installment of this topic. In this episode we talk about the role of angioplasty and role of various medications in the treatment of the patient having an MI.2014-03-3025 minICU RoundsMeta-analysis of Glucose ControlTight glucose control has been widely introduced into critical care.
This meta-analysis, recently published in JAMA, critically evaluates
the effects of these trials in reduction of sepsis as well as
mortality. The results might surprise you.2014-03-3021 minICU RoundsCardiovascular Risk Reduction for SurgeryThis episode explores what is needed to make surgery safer for the patient with cardiovascular disease. 2014-03-3029 minICU RoundsRadiation Injury / Nuclear MCIThe US government last week released a report that the threat of a nuclear device used in an act of terrorism is high in the next couple of years. In this episode we discuss the some concepts of the medical care required to those exposed to radiation as well as blast injuries. I hope this is information that none of you will ever need.2014-03-3028 minICU RoundsTherapeutic Hypothermia following Cardiac ArrestTherapeutic Hypothermia following cardiac arrest has been demonstrated to improve outcomes. Starting Jan 1, 2009 Ney York City EMS will dorect patients to those hospitals able to delivery such care. 2014-03-3019 minICU RoundsSome Swan StuffA brief discussion regarding some of the commonly used values obtained from a pulmonary artery catheter. 2014-03-3024 minICU RoundsHyperkalemiaHyperkalemia is a very common and potentially dangerous electrolyte disorder that commonly occurs in ICU patients.2014-03-3028 minICU RoundsPeak Inspiratory Pressure: Physiological DeterminantsPeak inspiratory pressure (PIP) the center of a great deal of discussion of ventilator management. Knowing the factors that increase or decrease PIP are important to those managing critically ill patient. This podcast is steeped in physiology and perhaps more difficult than my typical podcasts. PIP= [Tv/ (Compliance Lung & Thorax)] + (Resistance of airway + flow )2014-03-3027 minICU RoundsEnvironmental HypothermiaFollowing the recent crash of the US Airways in the Hudson River, it is an appropriate time to discuss the clinical manifestations and treatment of hypothermia.2014-03-3028 minICU RoundsPrehospital/Battlefield Tourniquet UseReview of a recent publication from Annals of Surgery2014-03-3014 minICU RoundsHyponatremia: common but dangerousHyponatremia or a low serum sodium is a common electrolyte problem that is dangerous if ignored or treated improperly.2014-03-3023 minICU RoundsHypernatremiaEvaluation and treatment of elevated serum sodium is presented.2014-03-3016 minICU RoundsHypoxia: physiological causesUnderstanding the root cause of hypoxia will allow for more appropriate treatment.2014-03-3023 minICU RoundsRefeeding SyndromeWhen and how can providing a starving patient nutrition be potentially deadly.2014-03-3027 minICU RoundsDiscussion on Fluids: The last Cotton lectureThis is an interview that I did on www.medtalknetwork.com with Dr. Brian Cotton. Dr. Cotton recently left Vanderbilt to take a new position at UT Houston. He is an excellent teacher and his opinions on fluids resuscitation are cutting edge.2014-03-3024 minICU RoundsPulse OximeteryDiscussion of the technology of the pulse oximeter2014-03-3029 minICU RoundsArterial Blood GasesThis episode is a discussion about how to approach an arterial blood gas result.2014-03-3036 minICU RoundsIV Fluids (Part 1)An introduction to the basic science in fluids used to treat hypovolemia.2014-03-3036 minICU RoundsCaustic IngestionsIngestion of caustic materials can be fatal and difficult to evaluate. These patients are often referred to our burn center.2014-03-3038 minICU RoundsPulmonary Physiology and General AnesthesiaThis episode discusses the effects and risks of anesthesia on patients with pulmonary disease as well as the effects of anesthesia on pulmonary physiology.2014-03-3030 minICU RoundsCentral Line Insertion ComplicationsA discussion of the potential problems encountered while inserting central venous catheters.2014-03-3032 minICU RoundsComplications of Dwelling Central LinesWhat horrible things can happen with central lines once they have been inserted.2014-03-3034 minICU RoundsVentilator Associated PneumoniaA discussion on nosocomial infections and VAP.2014-03-3034 minICU RoundsCatheter-Related Bloodstream Infection: DiagnosisDiscussion of what is the difference between a CVC infection and a catheter-related blood stream infection. They are treated differently so it is important to know the difference.2014-03-3018 minICU RoundsHemoglobin Based Oxygen Carriers (a.k.a. Artificial Blood)A brief summary of what are hemoglobin based oxygen carriers (HBOC) and where are they in development.2014-03-3024 minICU RoundsAcute Colonic Pseudoobstruction (Ogilvie's Syndrome)Acute Colonic Pseudoobstruction (ACPO) is commonly called Ogilvies Syndrome. ACPO presents massive dilation in critically ill patients, and might result in invasive procedures to avoid ischemia or perforation of the colon.2014-03-3032 minICU RoundsThat peripheral IV can kill you: Suppurative ThrombophlebitisAll the recent emphasis on venous catheter infections has been on central lines. Those peripheral IVs are also dangerous. 2014-03-3013 minICU RoundsPancreatitis - Part 1This is an initial presentation of the causes and diagnosis of acute pancreatitis. 2014-03-3026 min
ICU RoundsSevere Acute Pancreatitis: Part 2 ICU ConsiderationsA brief discussion of the considerations of ICU care of the patient with severe pancreatitis, fluid resuscitation, respiratory, renal, and nutrition.2014-03-3018 minICU RoundsPancreatitis - Surgical Indications and ProceduresThis is the third in the series on severe pancreatitis and necrotizing pancreatitis. This episode reviews the indications for surgery, morbidity and mortality of surgery, and what are the surgical options. 2014-03-3026 minICU RoundsTherapeutic Hypothermia After Cardiac Arrest
Therapeutic hypothermia after cardiac arrest is part of ACLS and is used by several EMS agencies around the US. Despite good data and improved patient outcomes, many providers fail to used this modality. This podcast will focus on a presentation of the data, methods of cooling, and potential complications.
2014-03-3034 minICU RoundsSVO2 My favorite Swan NumberThe most helpful number for me on a Swan is the SvO2. This is a brief description of how I use this variable in evaluating critically ill and injured patients. 2014-03-3018 minICU RoundsWedge: Everyone elses favorite Swan numberWedge or PAOP is perhaps the most quoted and poorly understood variable generated by a Swan-Ganz.2014-03-3025 minICU RoundsPropofol Related Infusion SyndromePropofol Related Infusion Syndrome is a potentially fatal complication of propofol. If you use this common ICU drug you need this information.2014-03-3024 minICU RoundsSmoke Inhalation InjurySmoke Inhalation injuries can be deadly. This episode explains why smoke can be so deadly, and how to care for those patients with suspected smoke inhalation injuries.2014-03-3030 minICU RoundsPulmonary EmbolusA description of the risk factors, diagnosis, and treatment of PE.2014-03-3033 minICU RoundsEndotracheal tube cuff leaks and self-extubationsA brief description on what to consider when confronted with a patient with an air leak from the ET tube or a patient that self-extubates.2014-03-3024 min
ICU RoundsLactate Acidosis - Type AThis podcast is a description of how lactate is produced and metabolized. I will discuss the role of lactate in the diagnosis and management of shock. This podcast will focus on Type A lactic acidosis.2014-03-3022 minICU RoundsLactic Acidosis - Type BNow these are the types of lactic acidosis that most people are not familiar. They can be caused by medications, underlying disease, or inborn errors of metabolism. 2014-03-3016 minICU RoundsDifferent Cardiac Output Monitors & PhysiologyThis episode will discuss the physiology behind various CO output monitors such as pulmonary artery catheters, PICCO, pulse wave form analysis, and LiDCO. 2014-03-3031 minICU RoundsNecrotizing Soft Tissue Infection (NTSI)This episode discusses the pathophysiology, presentation, and treatment of NTSI.2014-03-3026 minICU RoundsTakotsubo CardiomyopathyThis is a condition that mimics acute coronary syndrome (ACS) that may be caused by acute emotional or physical stress. Patient's may appear to have profound cardiogenic shock, but these patients have a very high survivial rate with little more than supportive care. 2014-03-3012 minICU RoundsPediatric IVC diameter determination with ultrasoundIf you are using ultrasound to evaluate IVC diamter in children, what is considered a normal IVC diameter? You can determine the IVC/Ao ratio or correct the IVC diamter based on the child's body surface area. 2014-03-3015 minICU RoundsEARLY use of Tranexamic Acid may improve survival from bleeding in traumaIn this episode we talk about the results of the CRASH-2 trial published in Lancet. This trial showed that the EARLY use of Tranexamic acid may improve survivial, but delayed use may be associated with an increased mortality. 2014-03-3019 minICU RoundsRandom Serum Cortisol Levels are misleadingA physiological explanation why random cortisol levels are NOT helpful in evaluating adrenal function2014-03-3017 minICU RoundsColloids: Details and MythsThis episode provide some basic description of colloids as will as some myths. 2014-03-3018 min