Podcasts by ICU Rounds
A podcast dedicated to the teaching of critical care. The focus audience is physicians, residents, medical students, nurses, therapists, and paramedics. These are topics that arise while on teaching rounds in the Burn ICU at Vanderbilt Medical Center. A broad scope of critical care and prehospital topics are presented as well as recent journal articles and medical news.
Further podcasts by Jeffrey S. Guy, MD, FACS
Podcast on the topic Medizin
All episodes
Pulmonary Physiology and General Anesthesia from 2021-01-31T22:10:42.023393
This episode discusses the effects and risks of anesthesia on patients with pulmonary disease as well as the effects of anesthesia on pulmonary physiology.
Listen
Ventilator Update: avoiding shear trauma from 2021-01-31T22:10:42.023393
In 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 indu...
Listen
Surviving Sepsis Campaign (part 2) from 2021-01-31T22:10:42.023393
We continue our discussion of the Surviving Sepsis Campaign (SSC). This includes fluids types, steroids, rhAPC (Xigris), and blood sugar control.
Listen
Splitting a Ventilator: Multipatient Ventilation for COVID? from 2020-04-23T01:46:22
Throughout the pandemic, there has been considerable discussion about the possibility of running our of ventilators. One potential solution that was brought forward was putting multiple patients...
Listen
Prone Ventilation for ARDS (COVID-19) from 2020-04-12T20:52
This week we have a brief conversation about prone mechanical ventilation for ARDS. Does it provide a benefit? When should we use it, and why does it work? I hope this is helpful as prone ventil...
Listen
ARDS and Mechanical Ventilation / COVID-19 Care from 2020-04-05T15:13:55
Today we discuss the approach to oxygenating and mechanically ventilating a patient suffering from ARDS. We will cover elements relevant and essential in the management of COVID patients and all...
Listen
ICU Care of Coronavirus (COVID-19) from 2020-03-29T15:26:39
I'm back. I plan on providing you with some useful information when caring for patients infected with COVID-19 (Coronavirus). In this episode, I will provide you an overview of the current evide...
Listen
Colloids: Details and Myths from 2012-07-09T16:14:07
This episode provide some basic description of colloids as will as some myths.
Listen
Random Serum Cortisol Levels are misleading from 2012-03-12T18:15:39
A physiological explanation why random cortisol levels are NOT helpful in evaluating adrenal function
Listen
EARLY use of Tranexamic Acid may improve survival from bleeding in trauma from 2012-02-20T05:00
In 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 associa...
Listen
Pediatric IVC diameter determination with ultrasound from 2012-02-09T17:40:05
If 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 bo...
Listen
Takotsubo Cardiomyopathy from 2012-01-31T19:05:49
This 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 patien...
Listen
Necrotizing Soft Tissue Infection (NTSI) from 2011-12-06T18:56
This episode discusses the pathophysiology, presentation, and treatment of NTSI.
Listen
Different Cardiac Output Monitors&Physiology from 2011-11-26T05:00
This episode will discuss the physiology behind various CO output monitors such as pulmonary artery catheters, PICCO, pulse wave form analysis, and LiDCO.
Listen
Lactic Acidosis - Type B from 2011-11-19T05:00
Now 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.
Listen
Lactate Acidosis - Type A from 2011-11-12T20:09:16
This 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 ...
Listen
Endotracheal tube cuff leaks and self-extubations from 2011-08-03T04:00
A 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.
Listen
Pulmonary Embolus from 2011-07-28T02:38:13
A description of the risk factors, diagnosis, and treatment of PE.
Listen
Smoke Inhalation Injury from 2011-07-06T00:49:56
Smoke 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.
Listen
Propofol Related Infusion Syndrome from 2011-06-05T22:37:33
Propofol Related Infusion Syndrome is a potentially fatal complication of propofol. If you use this common ICU drug you need this information.
Listen
Wedge: Everyone elses favorite Swan number from 2010-12-12T21:29:43
Wedge or PAOP is perhaps the most quoted and poorly understood variable generated by a Swan-Ganz.
Listen
SVO2 My favorite Swan Number from 2010-12-05T17:57:24
The 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.
Listen
Pancreatitis - Surgical Indications and Procedures from 2010-07-23T00:53:56
This 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 surgi...
Listen
Severe Acute Pancreatitis: Part 2 ICU Considerations from 2010-06-02T00:00
A brief discussion of the considerations of ICU care of the patient with severe pancreatitis, fluid resuscitation, respiratory, renal, and nutrition.
Listen
Pancreatitis - Part 1 from 2010-05-25T18:30:21
This is an initial presentation of the causes and diagnosis of acute pancreatitis.
Listen
That peripheral IV can kill you: Suppurative Thrombophlebitis from 2010-02-25T20:40
All the recent emphasis on venous catheter infections has been on central lines. Those peripheral IVs are also dangerous.
Listen
Acute Colonic Pseudoobstruction (Ogilvie's Syndrome) from 2010-02-15T23:29
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...
Listen
Hemoglobin Based Oxygen Carriers (a.k.a. Artificial Blood) from 2010-01-18T15:41
A brief summary of what are hemoglobin based oxygen carriers (HBOC) and where are they in development.
Catheter-Related Bloodstream Infection: Diagnosis from 2009-09-24T16:34
Discussion 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.
Listen
Ventilator Associated Pneumonia from 2009-09-17T14:41
A discussion on nosocomial infections and VAP.
Complications of Dwelling Central Lines from 2009-08-04T02:20
What horrible things can happen with central lines once they have been inserted.
Listen
Central Line Insertion Complications from 2009-07-16T16:32
A discussion of the potential problems encountered while inserting central venous catheters.
Listen
Caustic Ingestions from 2009-05-13T02:50
Ingestion of caustic materials can be fatal and difficult to evaluate. These patients are often referred to our burn center.
Listen
IV Fluids (Part 1) from 2009-05-03T22:21
An introduction to the basic science in fluids used to treat hypovolemia.
Listen
Arterial Blood Gases from 2009-04-26T18:42
This episode is a discussion about how to approach an arterial blood gas result.
Listen
Discussion on Fluids: The last Cotton lecture from 2009-03-05T16:38
This 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 op...
Listen
Refeeding Syndrome from 2009-02-21T22:12
When and how can providing a starving patient nutrition be potentially deadly.
Listen
Hypoxia: physiological causes from 2009-02-15T05:01
Understanding the root cause of hypoxia will allow for more appropriate treatment.
Listen
Hypernatremia from 2009-02-12T03:04
Evaluation and treatment of elevated serum sodium is presented.
Listen
Hyponatremia: common but dangerous from 2009-02-07T05:08
Hyponatremia or a low serum sodium is a common electrolyte problem that is dangerous if ignored or treated improperly.
Listen
Prehospital/Battlefield Tourniquet Use from 2009-02-01T18:04
Review of a recent publication from Annals of Surgery
Listen
Environmental Hypothermia from 2009-01-28T20:48
Following 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.
Listen
Peak Inspiratory Pressure: Physiological Determinants from 2009-01-19T12:00
Peak 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...
Listen
Hyperkalemia from 2009-01-12T03:30
Hyperkalemia is a very common and potentially dangerous electrolyte disorder that commonly occurs in ICU patients.
Listen
Some Swan Stuff from 2008-12-29T11:30
A brief discussion regarding some of the commonly used values obtained from a pulmonary artery catheter.
Listen
Therapeutic Hypothermia following Cardiac Arrest from 2008-12-22T18:48
Therapeutic 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.
Listen
Radiation Injury / Nuclear MCI from 2008-12-12T19:28
The 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 ...
Listen
Cardiovascular Risk Reduction for Surgery from 2008-11-20T20:06
This episode explores what is needed to make surgery safer for the patient with cardiovascular disease.
Listen
Meta-analysis of Glucose Control from 2008-11-17T02:00
Tight 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 ...
Listen
Myocardial Infarction: PCI and medications from 2008-10-20T21:06
This 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.
Listen
Disaster Management from 2008-10-19T01:56
It 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 t...
Listen
Traumatic Rhabdomyolyisis / Crush Syndrome from 2008-10-19T00:48
Crush 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 rep...
Listen
Myocardial Infarction: Diagnosis and Thrombolytics from 2008-09-09T16:21
Myocardial 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.
Listen
PAIN: a four letter word from 2008-08-21T16:01
The 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 ...
Listen
Hypercalcemia from 2008-08-14T01:28
A potentiallylife-threatening electrolyte problem that commonly finds its way into the ICU as well as on exams.
Listen
Patient-Ventilator Interactions and ventilator discontinuation from 2008-08-07T16:00
Getting 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 breathi...
Listen
Abdominal Compartment Syndrome from 2008-06-07T20:00
A discussion of the physiology and presentation of abdominal compartment syndrome.
Listen
Extremity Compartment Syndrome from 2008-05-19T02:00
A limb-threatening complication that might be overlooked by the inexperienced provider.
Listen
Surviving Sepsis Campaign (part 1) from 2008-05-12T02:45
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 patie...
Listen
Hemoglobin Based Blood Substitutes: Increased Morbidity and Mortality from 2008-05-04T15:04
In 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 ...
Listen
Glucometers in the ICU: how accurate are they? from 2008-04-24T21:41
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 ...
Listen
Clostridium difficile Colitis from 2008-04-16T20:54
Clostridium difficile colitis is a problematic complication of antibiotic theraoy in hospitalized and critically ill patients. It is increasing in frequency and can be lethal.
Listen
Traumatic Shock and Fluid Resuscitation from 2008-04-01T12:16
Fluid 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.
Listen
Polypharmacy in the Elderly from 2008-03-23T21:06
Patients 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.
Listen
Drug-induced QT prolongation from 2008-03-08T23:06
Prolonged 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. ...
Listen
Do Steroid Improve Survivial in Sepsis? CORTICUS Trial from 2008-02-28T03:59
The results of the CORTICUS trial are discussed.
Listen
Atrial Fibrillation from 2008-02-20T03:05
Atrial fibrillation is a common problem in ICU patients, but it is a problem with many potential causes, and not always a well defined treatment.
Listen
Pediatric Burns from 2008-02-13T05:01
Pediatric 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...
Listen
Pharmacology of Shock from 2008-02-08T02:36
This is a basic introduction of some of the drugs used in various forms of shock.
Listen
Sepsis - Part 2 from 2008-02-01T05:01
In this episode we discuss that ICU care of the patient with sepsis. This includes an introduction to various vasopressors.
Listen
Sepsis - Part 1 from 2007-12-11T04:29
HIT: Heparin Induced Thrombocytopenia from 2007-10-27T16:02
Large numbers of patients in ICUs are on heparin and what is this complication of heparin induced thrombocytopenia?
Listen
Smoke Inhalation Injury: CO and Cyanide Toxicity from 2007-10-15T01:38
The 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 ...
Listen
Blood Products from 2007-10-01T02:46
Blood 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 pote...
Listen
Control of hyperglycemia improves outcomes from 2007-09-24T23:29
A 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?
Listen
Antibiotic Considerations in the ICU from 2007-09-14T16:03
Why 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.
Listen
Crush Syndrome from 2007-08-20T00:47
Earthquakes 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 ...
Listen
Thermal Injuries from 2007-08-13T02:59
An introduction of the biology of thermal injuries and the initial care of the patient with thermal injuries in critical condition.
Listen
Metabolic Acidosis in the ICU from 2007-07-26T02:05
A 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.
Listen
Bomb and Blast Injuries from 2007-07-06T01:06
Bomb 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 ...
Listen
Early Surgery Improves Outcomes Following Critical Burns from 2007-06-29T00:39
Early 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...
Listen
Metabolism: Starvation versus Stress from 2007-06-20T02:23
Not 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 los...
Listen
Blood Conservation in the ICU from 2007-06-14T21:55
When 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 sing...
Listen
Burns: Fluid Creep from 2007-06-07T20:17
Excessive 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 resuscitati...
Listen
Renal Replacement Therapy: SCUF, SLED, CVVH, CVVHD, IHD--what does it all mean from 2007-06-01T06:00
Renal 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 an...
Listen
Intraosseous Vascular Access: not just for the kids anymore from 2007-05-29T02:09
Intraosseous 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 sp...
Listen
Weaning (Liberating) from the mechanical ventilator from 2007-05-25T12:39
Don'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 i...
Listen
Acute RenalFailure from 2007-05-22T21:11
Acute 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.
Listen
Airway Pressure Release Ventilation (APRV) or BiVent: What the heck is this? from 2007-05-20T05:00
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...
Listen
Complications of PEEP and Auto-PEEP from 2007-05-19T03:41
Virtually 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 ar...
Listen
Glutamine In Critical Illness: what's all the fuss about? from 2007-05-18T03:24
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 o...
Listen
Lightning Injuries from 2007-05-15T02:49
Lightning 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 E...
Listen
Oxygenation&PEEP from 2007-05-13T19:59
A discussion of ventilation, oxygenation, and the role of PEEP.
Listen
Modes of Mechanical Ventilation from 2007-05-13T19:00
A 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)
Listen
What is the role of decadron in preventing post extubation stridor? from 2007-05-13T18:44
What is the role of giving an adult steroids to prevent stridor or reintubation following extubation. This epidose looks at the data.
Listen