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Podcasts on topics relevant to intensive care medicine

Podcasts on topics relevant to intensive care medicine
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Location:

United States

Description:

Podcasts on topics relevant to intensive care medicine

Language:

English


Episodes

Metabolic mayhem in the ICU

8/26/2018
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The understanding around the metabolic response to the stress of critical illness has evolved rapidly over the past decade. This involves a neuroendocrine and an inflammatory component, which results in perturbations within the sympathetic nervous system, the hypothalamo-pituitary axis and the immune system. The clinical consequences are widespread and include changes in metabolic rate, altered use of macronutrients as energy sources, stress hyperglycaemia, muscle wasting and changes...

Duration:00:12:06

What the boss wants: getting a consultant job

8/26/2018
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What the boss wants: getting a consultant job by Dr Priya Nair & Dr Ray Raper

Duration:00:41:49

A Country Practice

8/26/2018
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The Australian population away from metropolitan areas has the same health care needs and deserves the same level of care (within available resources) as urban residents: we can and should provide it. This short talk aims to explore work in a non-tertiary centre ICU as a career option and why it’s worth considering. It will look at what life and work are really like in non-metropolitan areas and how and why working in a regional ICU can be a rewarding career. It will try and dispel some...

Duration:00:27:16

Tips and tricks for getting through the second part: Examiner’s perspective by

8/24/2018
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To pass the Second Part Exam, your performance needs to be at the expected level for a junior consultant. You need to be able to rapidly synthesise clinical information from multiple sources to reach a differential diagnosis and appropriate management decisions. (And achieve this while feeling the equivalent of standing at the top of an Olympic downhill ski-run, simultaneously suffering from a severe bout of gastro.) Some general pointers include: Get experience running the unit and...

Duration:00:19:43

Tips and tricks for getting through the first part: Examiner’s perspective

8/24/2018
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Tips and tricks for getting through the first part: Examiner’s perspective

Duration:00:18:20

Difficult conversations: uncommon death and organ donation scenarios in the ICU

8/24/2018
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10% of patients admitted to ICU die and, in some societies over 80% of people die during a hospitalization that included an ICU stay. Most deaths in ICU are predictable and the overwhelming majority of patients are comatose for the last few days of their life. Most communication by intensivists is directed at families rather than patients. This talk will cover some scenarios where this isn’t the case and give guidance on delivering bad news to and discussing organ donation with awake...

Duration:00:20:07

Paediatric ICU for the adult intensivist

8/24/2018
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According to the World Health Organization Training Package for the Health Sector (2008), ‘Children are not little adults’ and specialised care must be targeted to pediatric patients in order to optimize outcomes. In a review of Australia and New Zealand Paediatric Intensive Care (ANZPIC) Registry data from 2006 to 2016, approximately 1600 children <16 years old were admitted each year to one of 21 adult ICUs in Australia and New Zealand who voluntarily submit data. This represents at least...

Duration:00:32:12

Management of cardiac arrest post open heart surgery

8/23/2018
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You are called to see a 62-year old male now 3 hours post CABG x 4 with hypotension and escalating vasoactive requirements. As you arrive to the bedside, he arrests. How do you manage this situation? This talk outlines the management of cardiac arrest in the intensive care unit post open heart surgery, as per the CALS (Cardiac Advanced Life Support) algorithm. Key differences from the standard ALS (Advanced Life Support) algorithm are highlighted, including delaying CPR by up to 1 minute...

Duration:00:13:27

TAVI. What’s next?

8/19/2018
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The prevalence of degenerative valvular disease is increasing in the context of an increasingly ageing population, and despite advances in medical and surgical interventions, is associated with a significantly worse outcome when compared with the general population. Data from the EuroHeart Survey (2003) suggests the commonest relates to native valve disease (predominantly aortic stenosis) however, more than one quarter of patients with valve disease have undergone a previous intervention....

Duration:00:12:54

The evidence: Cardiac surgery or interventional procedure?

8/19/2018
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The title of the talk is emblematic of the binary way that we have approached structural heart disease where cardiac surgery or an interventional procedure might be required – this thinking is now transitioning to an entirely different paradigm which is that of the “Heart Team”. Remarkable advances over the last decade have led to a plethora of interventional options for both coronary and structural heart disease. In the coronary realm, as complex and high risk PCI options continue to...

Duration:00:16:24

Cardiac revascularization surgery in the elderly: An evidence-based health economic approach

8/19/2018
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CARDIAC REVASCULARIZATION SURGERY IN THE ELDERLY: AN EVIDENCE-BASED HEALTH ECONOMIC APPROACH Background: Increasing prevalence of chronic disease in the context of an ageing society has led many to question the value of cardiac revascularization surgery and associated intensive care in elderly (octogenarian) populations. However societal expectations of improved technology and its likely impact on longevity and improved quality of life suggest there is a demand for cardiac surgery in this...

Duration:00:24:24

Patient selection and functional outcomes

8/19/2018
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Introduction: Recent times have witnessed almost half, or sometimes more cardiac surgical procedures are performed in patients above 75 years of age. Traditionally, the EuroSCORE II and STS risk scoring systems have been widely used across the globe. Extensive reviews have shown that EuroSCORE II probably overestimates the perioperative risk at lower score levels while the STS score tends to underestimate the risk. Frailty is a broad term that encircles aspects of nutrition, lack of...

Duration:00:18:27

ECHO by the clinician

8/19/2018
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"The real benefit to the patient [of echocardiography] is not the technical skill, but rather the application of intellectual input... information, communication and teamwork are essential" Jos Roelandt, 1993 Of all the imaging techniques used in intensive care, echocardiography has come to the fore, in particular due to its accessibility, immediate availability and applicability as a point-of-care technique, thereby removing the risks of transportation of the critically ill. Over the...

Duration:00:16:52

Can we be intensive and non-invasive?

8/19/2018
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The goal of hemodynamic monitoring is to assess the cardiovascular state of the patient, define their reserve and monitor response to treatments and time. Resuscitation efforts are essentially aimed at restoring and sustaining tissue wellness through maintaining an adequate amount of oxygenated blood flow to the metabolically active tissues. We need to monitor pressure, flow and function. To accomplish these goals one must be able to measure arterial pressure and all its components (i.e....

Duration:00:22:11

The menagerie of monitoring tools

8/19/2018
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Many tools are nowadays available to monitor patients’ hemodynamics in the intensive care unit (ICU) and in the operating room (OR) settings. Some monitoring tools are invasive such as the pulmonary artery catheter (PAC), some others are less invasive such as transpulmonary thermodilution (TPD) systems, some others are called minimally invasive such as uncalibrated arterial pulse wave analysis (PWA) devices, and some others are non invasive such as volume-clamp method, applanation tonometry,...

Duration:00:31:18

Pulmonary hypertension and ICU therapies

8/19/2018
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With increasing survival comes morbidity. Pulmonary hypertension in the critical care population represents a secondary disease of myriad pathologies for children and adults. Whilst often cardiac failure or respiratory disease complicated by pulmonary hypertension, the exact aetiology of secondary pulmonary hypertension can be a diagnostic challenge. Yet an understanding of the pathophysiological basis for pulmonary hypertension may allow for patient guided therapy and predictions of...

Duration:00:25:17

Acute right heart failure: Adaptation, interdependence and external influences

8/19/2018
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The right ventricle (RV) is not important, until it is. Under normal conditions RV function merely keeps central venous pressure low and delivers all the venous return per beat into the pulmonary circulation under low pressure. If pulmonary artery pressures increase due to pulmonary vascular disease (embolism, ARDS, COPD), over-distention (COPD, asthma) or ischemia (embolism, pulmonary hypertension), the RV rapidly dilates decreasing left ventricular (LV) diastolic compliance via ventricular...

Duration:00:25:04

Management of acute right heart failure

8/19/2018
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The two major causes of acute right ventricular (RV) failure in ICU patients are acute cor pulmonale (ACP) during acute respiratory distress syndrome (ARDS) and ACP during acute massive pulmonary embolism (PE). The increase in pulmonary vascular resistance (PVR) in ARDS can be secondary either to « structural » mechanisms related to lung injury per se and to « functional » mechanisms related to the effects of mechanical ventilation with positive end expiratory pressure (PEEP). The latter...

Duration:00:29:28

Anticoagulation during mechanical support

8/19/2018
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The use of extracorporeal membrane oxygenation (ECMO), and ventricular assist devices (VADs) for both short-term and long-term management of advanced cardiac (and respiratory) failure is increasing. Both thrombotic and haemorrhagic complications are common in patients receiving mechanical support, and such complications are associated with increased morbidity and mortality. Risks of bleeding and of thrombosis vary over time, and according to technical and patient factors. Careful assessment...

Duration:00:18:38

How to prevent fatal pulmonary embolism

8/19/2018
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Venous thromboembolism (VTE) is one of the most preventable complications in hospitalised patients. Critically ill patients are at risk of VTE due to coexisting of multiple risk factors but, at the same time, often at risk of bleeding. Though not common, fatal pulmonary embolism (PE) continues to occur [1] – due to the alignment of failures (or ‘holes’) in each defensive layer according to the Swiss cheese model [2]. Tackling this is not easy because the pattern of the ‘holes’ in each layer...

Duration:00:16:31