Explore every episode of the podcast The Critical Care Commute Podcast

This engaging conversation explores career development, mentorship, and maintaining value throughout a medical career, with insights from experts in pediatric critical care, Drs Denise Goodman and Raj Basu.

Key Topics:

1. Career planning and transition strategies
2. Mentorship's role in professional growth
3. Maintaining motivation and feeling valuable
4. The importance of self-awareness and reflection
5. Balancing work, family, and personal fulfillment

In this "fireside" chat, recorded in front of a live audience at the Canadian Resuscitative Ultrasound Course West 2026 (CRUS WEST), Peter Brindley explores the role of point-of-care ultrasound in clinical practice, as we kick of Season 6.

Join us as Drs Brian Buchanan and Leon Byker, course directors for this year's CRUS WEST 2026, along with Dr Leo Smyth, Internist and Point of Care Ultrasound specialist, share insights on how to integrate ultrasound effectively while avoiding common pitfalls, examining its benefits, limitations, and the evidence surrounding its impact on patient outcomes.

Key Topics Discussed:

1. Ultrasound as a diagnostic and monitoring tool
2. The role of physical exam versus ultrasound
3. Evidence, (or lack thereof) on ultrasound reducing mortality
4. Risks of over-reliance on ultrasound
5. Training and competency in ultrasound use
6. Legal and medicolegal considerations
7. Ultrasound in procedural guidance
8. Impact of ultrasound on clinical workflow

Key Words:

ultrasound, point-of-care, clinical practice, diagnosis, procedure, evidence, medical education, patient safety

In this episode, Prof. Lynora Saxinger and hosts Peter Brindley and Leon Byker explore the history, impact, and public perception of vaccines. They discuss how vaccines have saved millions of lives, the challenges of vaccine hesitancy, and strategies for effective science communication.

Key topics

• The impact of vaccines on global health and mortality
• The role of vaccines as heroes in medicine
• Challenges of vaccine hesitancy and misinformation
• The importance of trust and communication in vaccination
• Strategies for effective vaccine advocacy and education

This episode was made possible by:

Pfizer - Unrestricted Educational Grant - https://www.pfizer.com/

This episode features Professor Bram Rochwerg discussing the latest guidelines on surviving sepsis, covering evidence-based practices, fluid management, vasopressor use, and emerging therapies. Gain insights into how expert panels synthesize evidence to guide critical care in sepsis management.

Key Topics Covered:

• Sepsis guideline updates 2026
• Evidence synthesis and recommendation strength
• Fluid resuscitation strategies and targets
• Vasopressor use and peripheral administration
• Emerging therapies: Methylene blue, steroids, bicarbonate
• Biomarkers and diagnostics in sepsis

Links: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026 | SCCM

Executive Summary: Surviving Sepsis Campaign:... : Critical Care Medicine

In this episode, we're joined by Sonja, RN, Nurse Educator, and host of the Sedation Vacation Radio podcast. (Full disclosure: we're big fans, so we might be just a little biased!)

Sonja shares practical, real-world advice on infection prevention and control, from getting PPE right to safely managing patients with suspected viral hemorrhagic fevers. Along the way, we explore what it takes to prepare healthcare teams and systems for these high-consequence situations, with plenty of practical tips and lessons you can apply in your own workplace.

Key topics

Infection control procedures for viral hemorrhagic fever

PPE donning and doffing protocols with step-by-step guidance

System-level response and isolation procedures for high-risk infectious cases

Role of medical officers and rapid response teams in outbreak management

Waste disposal and sample handling for contagious diseases

Aerosol-generating medical procedures and precautions

Takeaways:

Proper PPE donning and doffing is critical to prevent self-contamination.

Clear protocols and checklists improve safety during high-risk procedures.

System-level planning includes designated isolation units and inter-agency communication.

Understanding the difference between contact, droplet, and airborne precautions is essential.

Links of Interest:

https://www.canada.ca/en/public-health/services/diseases/ebola/border-measures.htmlPractical PPE:

1. Coverall PPE (this is the PPE that anyone going into the room and doing patient care or assessments will be wearing) https://youtu.be/ADosrKxfsNI

1. Buddy PPE (this is the PPE that is worn by those who assist with Coverall doffing and other tasks) https://youtu.be/RaNwdvSyrb4
2. Coverall and Buddy Doffing https://youtu.be/EjVoXmRNzWc

Sedation Vacation Podcast: https://open.spotify.com/show/15P4tJ7uW17u41bm3V7CEf?si=1ua7uXu-Sa6nQGrkur0Gow

Join us on this episode as we discuss Ebola Disease with Dr Rob Fowler, critical Care Physician, Researcher and Scientist. As a physician who experienced working with patients with Ebola Disease, there is no better person to discuss this hot topic.

Key Topics

1. Ebola virus strains and outbreaks
2. Diagnostic testing and laboratory protocols
3. Therapeutic developments and clinical trials
4. Supportive care principles in Ebola treatment
5. Infection prevention and PPE in outbreak settings
6. Case fatality rates and clinical outcomes
7. Virus immune evasion mechanisms
8. Public health response and outbreak management.

Further reading and important links:

• WHO Supportive Care Guidelines (2026 – coming soon) https://www.magicevidence.org/
• WHO Specific Therapeutic Guidelines (not Bundibugyo species specific) (2022) http://www.who.int/publications/i/item/9789240055742

• WHO Ebola and Marburg virus IPC Guidelines (2026) https://www.who.int/publications/i/item/9789240111332

This episode features Professor Wendy Sligl discussing hantaviruses, their transmission, clinical presentation, public health response, and prevention strategies. Aimed at healthcare professionals and public health officials, it provides critical insights into managing outbreaks and understanding zoonotic diseases.

Key Topics:

Hantavirus family and strains

Transmission routes and human-to-human spread

Clinical presentation and severity spectrum

Public health response and quarantine protocols

Prevention and protective measures

From Intubation Dilemmas to Data-Driven Decisions: Cutting-Edge Research in Pre-Hospital Trauma Care. In this episode, we explore a study that leverages machine learning and causal modeling to improve pre-hospital trauma interventions, specifically endotracheal intubation.

Experts Amy Nelson and Julian Thompson discuss how innovative data analysis can inform real-time decision-making, enhance patient outcomes, and optimize resource allocation in emergency settings.

Main Topics:

• The long-standing debate over early pre-hospital intubation and its survival benefits
• Methodological advances using machine learning and causal inference in emergency research
• How predictive models can support clinicians at the roadside and future directions for trauma care
• The significance of integrating AI tools into clinical judgment without replacing human expertise
• Cost-effectiveness and system-wide implications of adopting data-driven protocols in trauma systems

In this in-depth interview, Dr. Craig Spencer discusses the anti-vaccine movement, its community dynamics, historical context, and how healthcare professionals can engage effectively. The conversation explores the psychology behind vaccine hesitancy, community engagement strategies, and the importance of understanding different perspectives.

Further Reading:

https://www.statnews.com/2025/11/11/childrens-health-defense-conference-pro-vaccine-doctor/

Craig Spencer, MD, MPH | Center for Human Rights and Humanitarian Studies | Brown University

In this episode, made possible through an educational grant from Sandoz Canada, Dr. George Zhanel discusses the latest developments in antimicrobial stewardship, focusing on IV Amox Clav, its clinical applications, safety profile, and the Canadian Leadership on Antimicrobial Real-Life Usage Registry (CLEAR). Gain insights into optimizing antibiotic use and future prospects in antimicrobial development.

Key Topics:

1. IV Amox Clav clinical applications
2. Canadian Leadership on Antimicrobial Usage Registry (CLEAR)
3. Antibiotic stewardship strategies
4. Future developments in antimicrobial agents

Chapters:

00:00 Introduction and Guest Credibility

01:47 Introduction of Dr. George Zhanel and his background

02:41 The journey into IV Amox Clav and its significance

03:21 Overview of the CLEAR registry and its purpose

06:18 Findings from the CLEAR study on IV Amox Clav usage

07:57 Clinical indications and safety profile of IV Amox Clav

10:58 De-escalation and appropriate use of IV Amox Clav

12:34 Use in bacteremia and various infections

13:35 Side effects and safety data of IV Amox Clav

15:02 Dosing strategies and renal adjustments

17:29 Beta-lactamase inhibitors and future antimicrobial development

20:16 Future prospects for new antibiotics in Canada

23:13 Canadian Antimicrobial Resistance Alliance (CARA) and involvement

25:53 Case examples and clinical decision-making in pneumonia and skin infections

31:09 Closing remarks and appreciation for the audience

Resources:

Canadian Leadership on Antimicrobial Real-Life Usage Registry (CLEAR) - https://www.clearregistry.ca

Canadian Antimicrobial Resistance Alliance (CARA) - https://www.cara.ca

Meropenem Vaborbactam - https://www.meropenem.com

Ceftazidime-Avibactam - https://www.ceftazidime-avibactam.com

Guest Links:

LinkedIn - https://www.linkedin.com/in/george-zhanel

Twitter - https://twitter.com/GeorgeZhanel

Young lives have sadly been lost in the 2026 Kent meningitis outbreak. An “unprecedented” cluster centred on the University of Kent, linked to a Canterbury nightclub, and rapidly spreading through student halls and social mixing.

In this timely and hard-hitting podcast episode, Jonny is joined by Intensivists Martin Beed, Peter Brindley (authors of the new primer on infectious meningitis and encephalitis in the Journal of the Intensive Care Society), and Andrew Conway-Morris.

They explore the UK government’s targeted MenB vaccination program for university students and affected schools, the critical importance of early clinical suspicion and prompt antibiotic administration, transmission risks in nightclubs and social settings (including behaviors like vaping), and lessons from past UK and global outbreaks.

The discussion also covers practical public education, healthcare worker resources including useful infographics. The discussion stresses the need for high vigilance, rapid treatment, vaccination where appropriate, and support for public and family mental health during outbreaks.

Packed with actionable clinical guidance and real-world takeaways, this episode is essential listening for healthcare professionals, students, parents, and anyone wanting to understand how to spot, treat, and prevent this devastating disease.

This episode features Sheldon Cheskes discussing advanced defibrillation techniques, including double sequential defibrillation, vector change, and the importance of early intervention in refractory VF.

Gain insights into recent trials, practical protocols, and the impact on neurological outcomes.

Key topics

1. Double sequential defibrillation (DSD)
2. Vector change and pad positioning in defibrillation
3. Timing and dosing of medications in VF
4. Impact of early intervention on neurological outcomes
5. Recent clinical trials: Dose VF and EpiDose

Further Reading:

Defibrillation Strategies for Refractory Ventricular Fibrillation

In this conversation, Peter Brindley and Timothy Caulfield discuss the critical importance of science communication in the face of misinformation and the challenges posed by predatory journals. They explore the societal impact of vaccines, the misuse of scientific terms for marketing purposes (scienceploitation), and the illusions surrounding science, goodness, and opinion. The discussion emphasizes the need for humility in science, the pressures researchers face, and the responsibility of all individuals to advocate for accurate scientific information.

Lessons:

We all have to speak up for science.

Science is a process, not a list of facts.

There is pressure to publish, leading to predatory journals.

Vaccines are one of the most successful biomedical interventions.

Science is often misused as clickbait.

Terms like 'natural' have become meaningless in marketing.

You can't really boost your immune system; it's about maintaining health.

The wellness industry has significant conflicts of interest.

The opinion illusion shows how we are manipulated by online reviews.

Trillions of dollars depend on the credibility of online reviews.

In this conversation, Peter Brindley and Leon Byker sit down with Peter Kruger, President of the College of Intensive Care Medicine, to unpack one of the defining issues facing healthcare today: workforce reform.

Against the backdrop of national workforce reviews across Australia and New Zealand, the discussion explores the tension between aspiration and reality. Governments want equitable access, rural coverage, sustainable systems, and improved wellbeing for clinicians. Colleges want standards, safety, and meaningful careers. Trainees want jobs. Communities want hospitals. Politicians want solutions.

So how do we reconcile all of it?

Dr. Kruger reflects on the growing engagement between specialist colleges and government, particularly around workforce maldistribution, rural and regional care, sub-specialization versus generalism, and the moral complexity of relying on internationally trained doctors. The conversation highlights a key truth: intensive care is a hospital-based, system-dependent specialty. You cannot simply “place a doctor” in a community without the supporting infrastructure.

The episode also tackles uncomfortable but necessary questions:

• Can there be a universal standard for ICU access across vastly different hospital settings?

• Should governments mandate rural placements—or can communities be strengthened from within?

• What role should nurse practitioners and multidisciplinary teams play?

• Are we protecting turf, or protecting patients?

• And how do we better support doctors across the entire career pipeline—from medical student to senior intensivist winding down night shifts?

Throughout, the tone is candid but diplomatic. There’s recognition that workforce reform is complex, long-standing, and resistant to simple solutions. Yet there is also optimism: trust, transparency, and genuine partnership between colleges and government may offer a way forward.

At its core, this episode is about purpose. The shared mission between clinicians, colleges, and governments is delivering safe, effective care to the community. The challenge lies in doing so while balancing standards, sustainability, and humanity.

In this discussion at the College of Intensive Care meeting in Tasmania 2025, Peter Brindley and Leon Byker engage with Prof. John Myburgh, who talks about his long-standing involvement in critical care research and the annual college meeting. John discusses the significance of the grad ceremony and highlights the impact of his research group at the George Institute. He reflects on the contributions of late colleague Ronaldo and praises current leading figures. The conversation delves deep into the ongoing research on steroids in critical care, focusing on genetic endotypes and precision medicine. Other topics covered include interleukin treatments, the evolution of fluid management in treating conditions like diabetic ketoacidosis, and the adaptive platform trials in sepsis. The discussion concludes with reflections on the Queensland Covid-19 vaccine and the broad implications of science, social forces, and politics in critical care advancements.00:00 Welcome and Introductions00:32 John's Involvement with the College01:47 Research and Collaborations03:29 Steroids in Critical Care04:49 Genomic Studies and Future Trials07:18 Challenges in Measuring Outcomes13:27 Interleukins and Sepsis14:18 Fluid Management in Critical Care19:31 COVID-19 and the Queensland Vaccine23:49 Closing Remarks

In this episode of the Critical Care Commute, hosts Peter Brindley and Leon Byker engage in a compelling discussion with Dr. Paul Parks, a prominent emergency physician and advocate for healthcare reform.

Dr. Parks shares his insights on the current state of emergency room care in Alberta, emphasizing the systemic issues that have led to a crisis in emergency services. He describes the overwhelming pressures faced by emergency departments, and highlight the dire need for government acknowledgment and action to address the crisis. He also articulates the challenges of navigating the healthcare system, where patients often wait for hours or even days for care, and advocates for a coordinated response to improve patient outcomes.

Takeaways

1. 'Emerge owns the sins of the system.'
2. 'We are right now in a state of crisis.'
3. 'It's inhumane the conditions that we're seeing.'
4. 'We need a command and control structure.'
5. 'We must move back to being data-driven in our decisions.'
6. 'We have to have the ability to speak truth to power.'
7. 'Patients are waiting for hours, even days, for care.'
8. 'The system is chaotic and disorganized.'
9. 'We need to advocate for transparency and accountability.'

In this conversation, Dr. Marcus Peck shares his harrowing experience of being involved in a medical case that led to a coronial inquest and subsequent investigation by the GMC. He discusses the emotional toll of moral distress, the challenges of navigating legal scrutiny in the medical field, and the importance of community support. The conversation highlights the complexities of patient care, the impact of loss on healthcare professionals, and the lessons learned from difficult experiences in critical care.

Dr Marcus Peck is a consultant in anesthesia and intensive care at Hampshire Hospitals NHS trust, and Network Lead of the Intensive Care Society's Focused Ultrasound for Intensive Care (FUSIC) committee and is joined by Dr Jonny Wilkinson, Consultant in ICU and Anesthesia from North Hampton.

Takeaways:

• Loss is a universal experience in the medical community.
• Moral distress can significantly impact healthcare professionals.
• Legal challenges can arise from complex medical cases.
• Documentation is crucial in protecting healthcare providers.
• Emotional responses to patient outcomes are valid and important.
• Support from colleagues and community is essential during tough times.
• Investigations can feel isolating and shameful for medical professionals.
• Resilience is key in overcoming professional challenges.
• Learning from past experiences can improve future practice.
• Open conversations about these issues can help reduce stigma.

In this short thoughtful episode, we highlight an important Australian tradition: the Acknowledgement of Country. This brief statement, often given at the start of meetings, gatherings, and public events, recognizes the Traditional Custodians of the land, honors their enduring cultural connection to it, and shows respect for Elders past and present. It’s a simple but meaningful way Australians acknowledge history, presence, and identity, and it reflects a national commitment to reconciliation and cultural respect.

In today’s episode, we introduce Dr. Lewis Campbell, a critical care physician from Alice Springs, south of Darwin. Dr. Campbell brings his Northern Territory perspective to our clinical conversation, offering insights shaped by the unique geography, culture, and healthcare challenges of Australia’s Top End.

A concise, engaging listen for your commute.

In this conversation, Iain discusses the launch of MedPod Learn, a platform offering a searchable database of curated medical podcasts. He shares insights on the pricing strategy, including user perceptions about value and affordability, and the decision to offer a free trial to encourage subscriptions.

Takeaways

MedPod Learn offers a searchable database of medical podcasts.

The platform is available on both App Store and Google Play.

User perceptions of pricing can vary significantly.

Some users believe lower prices may lead to undervaluation.

Iain's approach includes a free trial for new users.

The subscription fee is set at £2.99 after the trial.

Market research revealed surprising insights about pricing expectations.

The founder's model aims to attract early adopters.

Engagement strategies are crucial for subscription services.

Understanding user psychology is key to pricing decisions.

https://t.co/Jw9XUrA5nh

Download MedPod Learn from Google Play Store or Apple Store

In this episode, Peter Brindley interviews Dr. Rob Bevan, past president of the CICM, about the obesity paradox in Intensive Care Units (ICUs).

They discuss the surprising observation that overweight ICU patients often show better survival rates than those underweight, despite obesity's known health risks. Dr. Bevan dives into the history and the limitations of BMI as a metric and various biases that could influence the perceived obesity paradox. He also explains how classification bias, selection bias, confounding, and collider bias might skew these outcomes. The discussion touches on the importance of separating patients who are critically ill and happen to be obese from those who are in ICU primarily because of obesity-related diseases. The conversation is rooted in the upcoming textbook chapter authored by Dr. Bevan and explores obesity's broader health implications globally.

In this episode, Peter and Leon, recording at the College of Intensive Care Medicine's Conference in Tasmania, Australia, discuss advancements in precision medicine with Dr. Pratik Sinha from Washington University in St. Louis.

Dr Pratik trained in both Emergency and Intensive Care Medicine, but only works clinically as an intensivist. He runs a research program that seeks to change the way we identify and classify critically ill patients, by using a combination of novel biological measurements and state of the art data science approaches.

The conversation delves into how critical care medicine currently operates, emphasizing the need to shift from supportive care to more personalized approaches using biological measuring systems, big data, and novel data science techniques. They discuss identifying patient subgroups using machine learning algorithms and protein biomarkers, revealing phenotypes like hyper and hypo-inflammatory responses. The discussion covers the practical challenges of implementing these technologies, the importance of rigorous testing, and the future implications for intensive care. The speakers highlight the necessity of prospective clinical trials and broader accessibility of these advanced diagnostic tools to improve patient outcomes.

00:00 Introduction and Opening Remarks

00:34 Diving into Precision Medicine

01:35 Elevator Pitch for Medical Research

02:10 Understanding Patient Complexity

04:12 Biological Measurements and Data Science

10:37 Challenges in Modern Medicine

17:08 Future of Medical Research and AI

21:20 Concluding Thoughts and Future Prospects

In this episode of the Critical Care Commute podcast, Dr. Smith discusses the multifaceted future of critical care medicine, touching on economic, political, and technological challenges.

The conversation delves into the role of artificial intelligence in enhancing healthcare, the importance of clinician well-being, and the need for a human touch in medicine.

The discussion also explores personal interests, travel experiences, and the ethical implications of AI in clinical practice, emphasizing the balance between technology and human interaction.

Guests: Drs Marcus Peck and Jonny Wilkinson.

Chapters

00:00 The Future of Critical Care Medicine

02:40 Artificial Intelligence in Healthcare

05:38 Human Factors and Clinician Well-being

08:22 Economic Challenges in Healthcare

11:09 The Role of Politics in Healthcare

14:13 The Turing Test and AI's Evolution

16:41 Personal Interests and Travel Experiences

19:57 AI's Impact on Clinical Practice

22:38 Ethical Considerations of AI in Medicine

25:19 The Future of AI and Human Interaction

The Power of Kindness in Healthcare: A Conversation with Dr. Suzanne Crowe. In this episode, Peter Brindley and Leon Byker speaks with Dr. Suzanne Crowe, pediatric intensivist and president of the Medical College of Ireland, at the College of Intensive Care meeting in Tasmania, 2025.

They explore the significant impact of kindness on patient outcomes, emphasizing its vital role in healthcare. Dr. Crow highlights the necessity of incorporating kindness as a core practice, noting that it reduces mistakes, improves diagnostic accuracy, and fosters better cooperation from patients. They discuss the effectiveness of empathy training and the importance of leadership in fostering a culture of kindness within healthcare systems. Dr. Crow also shares practical tips for healthcare professionals on how to demonstrate kindness in daily interactions, such as sitting beside patients and offering comforting gestures.00:00 Introduction and Guest Welcome00:34 The Power of Kindness in Healthcare01:24 Defining and Recognizing Kindness02:20 Microdosing Kindness in Practice03:19 Teaching and Modeling Kindness03:54 Empathy Training and Its Importance05:07 Challenges and Barriers to Kindness06:57 Kindness in Patient Interactions09:27 Systemic Kindness and Leadership17:17 Empathy Training Techniques19:00 Conclusion and Final Thoughts

Join Peter Brindley and Leon Byker as they host David Bertoni, an ED physician and ECMO clinical lead, and Jorian 'Joe' Kippax, a trauma specialist and reservist, for an incredible story of a remote river rescue in Tasmania.

The team responds to a distress call from a trapped rafting party in the Franklin River, one of Tasmania's most remote and formidable areas. The rescue involves complex logistical challenges, a field amputation, and the use of ECMO technology amidst perilous conditions. The patient, after 20 hours trapped in frigid water, undergoes a harrowing yet successful rescue and recovery. This episode offers a gripping recount of teamwork, medical ingenuity, and human resilience.00:00 Introduction and Guest Overview00:40 Setting the Scene: Remote River Rescue01:39 The Rescue Operation Begins03:13 Challenges and Techniques in the Rescue07:25 Field Amputation and Extraction18:35 Transport and ECMO Preparation23:20 Hospital Arrival and ECMO Procedure26:18 Patient Recovery and Reflections30:45 Conclusion and Final Thoughts

In this episode, we welcome Professor Mervyn Singer, author of Sepsis 3.0. Sepsis remains one of the most complex and deadly conditions in critical care. In this conversation,Professor Singer shares his perspectives on the shifting landscape of sepsis treatment, the role of antibiotics, steroids, metabolic interventions, and the future ofprecision medicine.

He also challenges some long-standing dogmas and emphasizes the importance of individualized care over rigid guidelines.

Key Topics and Chapters:

The Evolution of Sepsis Management

• Historical perspectives on sepsis treatment
• Earlier recognition and intervention leading to improved outcomes

Current Challenges and Research Directions

• Organ dysfunction and recovery in sepsis
• The importance of metabolic manipulation and mitochondrial function

The Role of the Immune System in Sepsis

• Understanding hyper- and hypo-inflammatory responses
• Steroid use in critical illness—when it works and when it doesn’t

Antibiotics in Sepsis: How Soon, How Long, and How Much?

• The changing approach to antibiotic timing and duration
• The impact of microbiome disruption and antibiotic toxicity
• Rethinking the one-hour antibiotic rule

Lessons from COVID-19 and Their Impact on Sepsis Research

• The importance of phenotype-driven treatments
• Missed opportunities in clinical trials and biobanking

The Beta-Blocker Debate in Sepsis

• Potential benefits in selected patients
• The challenge of distinguishing compensatory tachycardia from harmful sympathetic overdrive

Rethinking Fever Management

• Is fever protective or harmful?
• When to treat and when to leave it alone

Guidelines vs. Individualized Care

• The balance between evidence-based medicine and clinical expertise
• The dangers of rigid mandates and protocols

This engaging discussion provides a fresh perspective on the current state and future of sepsis management, emphasizing the need for precision medicine, nuanced clinical decision-making, and ongoing research.

References:

1. Im Y, Kang D, Ko RE, et al. Time-to-antibiotics and clinical outcomes in patients with sepsis and septic shock: a prospective nationwide multicenter cohort study. Crit Care. 2022;26(1):19. Published 2022 Jan 13. doi:10.1186/s13054-021-03883-0 Here
2. Sakkat A, Alquraini M, Aljazeeri J, Farooqi MAM, Alshamsi F, Alhazzani W. Temperature control in critically ill patients with fever: A meta-analysis of randomized controlled trials. J Crit Care. 2021;61:89-95. doi:10.1016/j.jcrc.2020.10.016 Here
3. Hasegawa D, Sato R, Prasitlumkum N, et al. Effect of Ultrashort-Acting β-Blockers on Mortality in Patients With Sepsis With Persistent Tachycardia Despite Initial Resuscitation: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Chest. 2021;159(6):2289-2300. doi:10.1016/j.chest.2021.01.009 Here

Dr. Shannon Fernando is an intensivist at Lakeridge Health and a prolific researcher with over 150 publications. Known for his work in outcomes-based research across critical care, he joins us to discuss long-term outcomes after cardiogenic shock.

About the Episode:

This episode is part of our cardiovascular critical care series and explores what happens after the ICU for patients who survive cardiogenic shock. We unpack quality of life, functional outcomes, mental health, and the hidden burdens on both patients and caregivers. Dr. Fernando provides key data insights from his large cohort studies and shares reflections from ICU follow-up clinics. We also dive into the challenges of prognostication and how to communicate realistic expectations to families.

Topics Covered

Defining Long-Term Outcomes:

• Beyond survival: functional independence, mental health, cognition, and system resource use.

Key Findings from Ontario Cohort

• 42% of cardiogenic shock survivors require increased levels of care

• 15% die within a year post-discharge

• Modest impact of revascularization or mechanical support on long-term outcomes

Morbidity and Quality of Life

• Loss of independence and inability to return to work

• High incidence of PTSD, depression, and caregiver burden

• Delayed functional recovery and unmet expectations

Prognostic Factors and Predictive Markers

• Frailty as a key indicator

• Pre-existing mental health as a predictor of post-ICU mental health outcomes

• In-hospital arrest characteristics: rhythm, downtime, comorbidities

ICU Follow-Up Clinics

• Value in knowledge translation and emotional support

• Real-world insights on functional recovery and patient satisfaction

• Common patient sentiment: gratitude mixed with trauma

• Communication with Families

• Avoiding value imposition

Emphasizing trajectory over fixed timelines

• Balancing hope with realism

Rethinking Endpoints in Research

• Limitations of 28-day mortality

• Need for patient-centered, long-term functional outcomes

• Trajectory-based data over snapshot metrics

• Knowledge Translation as the Intervention

Equipping clinicians and patients with realistic expectations

• Normalizing psychological responses

• Shaping future research directions around lived experience

In this episode, recorded live at CCCF 2024, we sit down with Dr. Emilie Belley-Côté, a cardiac intensivist, researcher, and clinical trialist from McMaster University, to unpack cardiogenic shock: the SCAI classification.

Whether you're in the ED, cath lab, or ICU, the SCAI (Society for Cardiovascular Angiography and Interventions) stages offer a common language to describe the severity of cardiogenic shock, guide escalation of care, and improve outcomes through structured assessment.

Dr. Belley-Côté walks us through:

• The five SCAI stages (A through E): what they mean and how they’re used.

• How this classification system improves communication between specialties.

• The importance of recognizing patients in pre-shock (Stage B) before they deteriorate.

• Real-world application: how SCAI staging intersects with clinical signs, biomarkers, and hemodynamic monitoring.

• Where the SCAI classification fits in research, including trials evaluating mechanical circulatory support and advanced heart failure therapies.

With Dr. Belley-Côté’s clear explanations and insights from the front lines of cardiac critical care, this episode is essential listening for anyone managing unstable cardiac patients.

In this episode, we’re joined by Dr. James Downar, a leading Canadian voice in palliative and critical care, for a wide-ranging discussion on the emerging role of psychedelics in managing psychological and existential distress.

Psychedelics have gone from fringe to forefront in recent years, and we dig into what that shift might mean for patients facing critical illness or the end of life.

What psychedelics are and how they work

• Substances like psilocybin, LSD, ketamine, and MDMA

• Key effects: altered perception, ego dissolution, and emotional insight

• Risks and benefits in vulnerable populations

Psychedelic-assisted therapy: structure and process

• The three-phase model: preparation, the session itself, and integration

• Micro dosing vs. full therapeutic sessions

• Where current evidence stands

Potential applications in critical care and palliative medicine

• Helping patients process fear, isolation, and suffering

• How psychedelics differ from traditional symptom management tools like opioids

• Limitations in advanced illness due to physiological concerns

Research and implementation challenges

• Problems with study design and placebo controls

• The importance of ‘set and setting’

• Defining success in existential or spiritual distress

Ethical considerations and clinical integration

• Balancing innovation with compassion and caution

• Avoiding reductionism: why psychedelics should complement—not replace—human care

• The future role of these therapies in ICU and palliative settings

Recorded live at the Canadian Critical Care Forum 2024 in Toronto, this episode dives into the complex world of ischemia-reperfusion syndrome — the paradox where restoring blood flow causes further injury. We explore the underlying mechanisms, clinical implications, and future directions in managing this phenomenon.

Joining us for the third time is Prof. Mervyn Singer, ICU physician, researcher, and thought leader in critical care physiology. Known for challenging dogma and making complex science accessible, Prof. Singer unpacks this important topic with clarity and insight.

Dr. Mike Christian is a critical care and pre-hospital medicine specialist with extensive experience in aeromedical transport and military medicine. His diverse career spans work as a paramedic, internal medicine and critical care training, and roles as a flight physician with London Air Ambulance and the Canadian military. He is a leading advocate for integrating interprofessional teams and advancing physician-led pre-hospital care in Canada. Currently, he is involved in the MedResponse BC initiative, which aims to enhance critical care delivery outside of hospitals.

In this episode, Peter and Leon sit down with Mike to explore the evolving landscape of pre-hospital critical care. From his unconventional career path to the integration of AI in emergency response, he shares insights on improving outcomes in pre-hospital medicine and the lessons Canada can learn from global high-performance systems.

Key Topics & Chapters

Mike’s Career Journey

• From paramedic to physician: an unconventional path

• Military and aviation medicine experience
• The shift to leadership in pre-hospital care

Pre-Hospital Critical Care: Canada vs. The World

• How Canada’s HEMS (Helicopter Emergency Medical Services) differs from global models
• Lessons from the UK, Australia, and Denmark
• The role of AI in dispatch and triage

The Role of Physicians in Pre-Hospital Medicine

• The evolving need for physician-led care outside the hospital
• The impact of interprofessional teams on survival rates
• Mentorship, coaching, and cultural change in pre-hospital systems

The Role of the Physician in Pre Hospital Medicine.

• AI-powered dispatch and GoodSAM app in improving CPR and trauma response
• Scoop and run vs. stay and play: What actually saves lives?
• Addressing Canada’s geographical challenges with rural and remote care

Future Directions in Pre-Hospital Medicine

• The rise of telemedicine and virtual ICUs
• Developing triage physicians and training programs
• MedResponse BC: A new model for interprofessional pre-hospital care

Keywords:

Pre-hospital care, critical care transport, HEMS, trauma response, paramedics, physician-led pre-hospital medicine, telemedicine, AI in emergency medicine, interprofessional teams, rural emergency care, GoodSAM app, London Air Ambulance, MedResponse BC.

Links of Interest:

1. CCCF Presentation:  https://youtu.be/MVDHaYaZRSI  (Web view)
2. Recent Publication:  https://doi.org/10.1186/s13049  (Web view)

In this episode, hosts Leon Byker and Peter Brindley are joined by Dr. Elizabeth Viglianti, an assistant professor at the University of Michigan, Pulmonologist and Critical Care Specialist, to discuss the crucial issue of gender based harassment in medicine.

Gender-Based Harassment refers to any unwelcome behavior, comment, or conduct that demeans, intimidates, or disadvantages someone based on their gender or gender identity. This can include derogatory remarks, exclusion, stereotyping, unequal treatment, or threats, whether or not the behavior is sexual in nature. In the workplace, it undermines professional dignity and contributes to a hostile or inequitable environment.

Dr. Viglianti shares her personal experience that led her to study this field, detailing the prevalence and impact of such harassment. The discussion covers key findings from the National Academies of Science, Engineering, and Medicine's framework on addressing sexual and gender based harassment, gender disparities, organizational factors contributing to harassment, and her research on the topic. Practical steps and recommendations for institutions to mitigate harassment are also explored.

00:00 Introduction and Welcome

01:08 Personal Experience with Sexual Harassment

03:06 Understanding Gender Based Harassment in Medicine

05:34 Organizational Factors and Solutions

07:50 Gender Disparities in Academic Medicine

17:42 Impact on Trainees and Reporting Challenges

24:46 Addressing Patient-Perpetrated Harassment

28:59 Practical Strategies and Training

32:26 Conclusion and Call to Action

We take another break as we are joined by Prof. Wendy Sligl, formidable ID and ICU doc, to discuss the critical topic of optimizing antibiotic prescribing in critical care settings.

The discussion covers various aspects of antibiotic use, including the importance of timely administration, the role of communication in ensuring effective treatment, and the nuances of dosing strategies such as loading doses and continuous infusions. The conversation also delves into the duration of antibiotic therapy, emphasizing the need for individualized treatment based on patient response.

Takeaways:

• Infections are common in intensive care units, and sepsis is a life-threatening condition.
• Identifying the clinical syndrome is crucial for appropriate antibiotic therapy.
• Empiric therapy is often necessary before culture data is available.
• Timely administration of antibiotics is linked to better patient outcomes.
• Communication among healthcare teams is essential for effective antibiotic delivery.
• Loading doses can help achieve therapeutic levels quickly in critically ill patients.
• Continuous infusions of certain antibiotics may improve clinical outcomes.
• Shorter courses of antibiotics can be as effective as longer ones.
• Monitoring patient response is key to adjusting antibiotic therapy.
• Consulting infectious disease specialists can enhance treatment strategies.

Chapters:

00:00

Introduction to Antibiotic Optimization

01:07

Understanding Infections and Sepsis

02:47

Emergency Room Protocols for Antibiotic Administration

04:56

Identifying Sepsis and Administering Antibiotics

06:33

Communication and Timeliness in Antibiotic Delivery

08:42

Optimizing Antibiotic Dosing Strategies

10:59

Pharmacodynamics and Continuous Infusions

12:44

Duration of Antibiotic Therapy

18:52

Monitoring and Adjusting Antibiotic Treatment

21:39

The Debate on Antibiotic Duration

26:37

Specific Infections and Treatment Duration

31:24

Practical Strategies for Antibiotic Stewardship

32:43

Rapid Fire Questions on Antibiotic Use

Following the discussion on ECLS in AMI and cardiogenic shock, we go on to discuss eCPR for cardiac arrest specifically. This episode was recorded live at the Critical Care Canada Forum 2024 as part of our special series on cardiac intensive care.

Our guest is Dr. Darryl Abrams, Associate Medical Director and Director of Research for the Medical ECMO Program at New York-Presbyterian/Columbia University. Dr. Abrams joins us for an in-depth discussion on the current state and future direction of extracorporeal cardiopulmonary resuscitation, or eCPR.

We dive into the complex world of eCPR in refractory cardiac arrest, starting with a breakdown of the three landmark trials that have shaped the field: the ARREST trial, the Prague OHCA trial, and the INCEPTION trial. Each study offers a unique perspective, from the dramatic early findings of ARREST to the pragmatic design of Prague OHCA and the sobering multicenter outcomes of INCEPTION.

A major theme throughout the episode is the role of system design. Dr. Abrams emphasizes the importance of minimizing low-flow time, rapid cannulation, and consistent team expertise—factors that can make or break the success of eCPR.

We also explore the ethical and practical considerations that come with rolling out such a resource-intensive intervention, including the balance between innovation and equity. Is it fair that access to eCPR may depend on geography or institutional resources? And how do we make meaningful improvements in survival when only a few centers can offer this advanced care?

The episode closes with a practical lens: how should clinicians approach building an ECMO program? What are the essential pieces that need to be in place before considering eCPR? And how do you select patients in a way that balances risk, benefit, and system capacity?

Chapters:

• Introduction and guest welcome

• Setting the scene: What is eCPR and why now?

• The ARREST trial: Small study, big impact

• The Prague OHCA trial: Early randomization, broader population

• The INCEPTION trial: Multicenter reality and negative results

• Comparing the evidence: Why do outcomes differ?

• Low-flow time and speed of cannulation

• The role of meta-analyses and what they do (and don’t) tell us

• Opportunity cost: What are we giving up to fund eCPR?

• Duration of support: How long is too long?

• Will there be another trial? Challenges of equipoise

• Building a responsible eCPR program

• Patient selection: Who qualifies and why?

• Cannulation techniques and adjunct devices

• System design: U.S. vs. Canada vs. U.K.

• Ethical concerns and access inequities

• Guidelines and final takeaways

In this episode, recorded live at the Critical Care Canada Forum in Toronto, we dive into extracorporeal life support (ECLS) in cardiogenic shock, with Dr Sean van Diepen.

He is an Associate Professor at the University of Alberta, Co-Director of the CCU at the Mazankowski Alberta Heart Institute, and a leading voice in cardiac critical care.

Join us as we explore the evolving landscape of mechanical circulatory support, the latest evidence from the DANGER and ECLS-SHOCK trials, and the complexities of patient selection.

Key Topics Covered:

1. The Evolution of ECLS in Cardiogenic Shock

• The 25-year gap since the last positive cardiogenic shock trial.

• How mechanical circulatory support expanded despite limited evidence.

2. The DANGER Trial – Impella in AMI-Associated Cardiogenic Shock

• Mechanism and function of the Impella device.

• Trial results: 20% mortality reduction at 180 days.

• Complications: Limb ischemia, hemolysis, and high costs.

• Real-world application: Who actually qualifies?

3. ECLS-SHOCK Trial – ECMO for Cardiogenic Shock

• A "negative" trial, but a crucial wake-up call.

• No mortality benefit but significantly higher complication rates.

• Controversies: Inclusion of cardiac arrest patients and transition to destination therapy.

• Future directions: Can patient selection improve outcomes?

4. ECPR – Extracorporeal Support in Refractory Cardiac Arrest

• Review of the ARREST, PRAGUE, and INCEPTION trials.

• Why the evidence remains unclear and institution-dependent.

• The role of high-volume ECMO centers and standardized pathways.

5. The Future of ECLS – Cost, Ethics, and Decision-Making

• How should institutions decide who gets ECMO?

• The role of cardiogenic shock teams.

• Could AI play a role in decision-making?

• The challenge of resource allocation in a single-payer system.

Key Takeaways:

✅ Impella shows promise in carefully selected AMI shock patients but is costly and high-risk.

✅ ECMO for cardiogenic shock remains controversial—patient selection is key.

✅ ECPR is promising but needs further trials and structured implementation.

✅ Cardiogenic shock management should be a team decision, not an individual one.

🔊 Listen now and join the conversation on the future of cardiac critical care!

We’re taking a break from our Cardiac Critical Care series to bring you a conversation with one of the most influential figures in medicine.

Peter had the huge privilege of interviewing Major General Tim Hodgetts, the recently retired, most senior medical advisor in the UK forces.

Hodgetts shares his remarkable journey in transforming emergency medicine from its infancy to maturity, detailing poignant experiences from his early career that steered him towards this specialty. The discussion ranges from Hodgetts' pioneering efforts in combat casualty care, the evolution of battlefield first aid, and innovative medical practices in conflict zones, to his concepts on leadership, international collaborations, and coping with trauma.

The segment also touches on Hodgetts' recent retirement and his ongoing contributions to medical and military communities through teaching, charity work, and writing.

Chapters:

00:00 Introduction and Guest Overview

02:56 Early Career and Influences

06:25 Pioneering Emergency Medicine in the Military

08:13 Revolutionizing Combat Casualty Care

17:55 International Collaboration and Cultural Insights

30:31 Leadership in Crisis

35:35 Coping with Trauma and Personal Reflections

39:43 Retirement and Legacy

42:29 Conclusion and Final Thoughts

This has been one of my absolute favorite podcasts to produce! What an honor to have Major General Tim Hodgetts join us on the Critical Care Commute!

Recorded live at the Critical Care Canada Forum 2024, this episode is part of our special Cardiac ICU Series.

Dr. Rebecca Mathew, cardiologist and critical care specialist at the University of Ottawa Heart Institute, joins us to discuss the latest refractory cardiac arrest practice updates, including antiarrhythmic drugs, defibrillation strategies, and the role of ECPR.

Chapters:

• Defining refractory cardiac arrest

• Antiarrhythmic drugs: amiodarone vs. lidocaine

• Defibrillation strategies: vector change and double sequential defibrillation

• Emerging therapies: stellate ganglion blocks and electrical storm management

• ECPR: who qualifies and what the trials say

• Equity and feasibility challenges in cardiac arrest management

• ICU recovery clinics and patient-centered outcomes

• Clinical trials: barriers to enrollment and the need for change

References:

1. ROC ALPS Trial: 1. Kudenchuk PJ, Brown SP, Daya M, et al. Resuscitation Outcomes Consortium-Amiodarone, Lidocaine or Placebo Study (ROC-ALPS): Rationale and Methodology Behind an Out-of-Hospital Cardiac Arrest Antiarrhythmic Drug Trial. American Heart Journal. 2014;167(5):653-9.e4. doi:10.1016/j.ahj.2014.02.010. PMID: 24766974.[1]

2. DOSE VF: Cheskes S, Drennan IR, Turner L, Pandit SV, Dorian P. The Impact of Alternate Defibrillation Strategies on Shock-Refractory and Recurrent Ventricular Fibrillation: A Secondary Analysis of the DOSE VF Cluster Randomized Controlled Trial. Resuscitation. 2024;198:110186. doi:10.1016/j.resuscitation.2024.110186. PMID: 38522736

3. ARREST: Yannopoulos D, Bartos J, Raveendran G, et al. Advanced Reperfusion Strategies for Patients With Out-of-Hospital Cardiac Arrest and Refractory Ventricular Fibrillation (ARREST): A Phase 2, Single Centre, Open-Label, Randomised Controlled Trial. Lancet (London, England). 2020;396(10265):1807-1816. doi:10.1016/S0140-6736(20)32338-2. PMID: 33197396

4. INCEPTION: Ubben JFH, Suverein MM, Delnoij TSR, et al. Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest - A Pre-Planned Per-Protocol Analysis of the INCEPTION-trial. Resuscitation. 2024;194:110033. doi:10.1016/j.resuscitation.2023.110033. PMID: 37923112

Disclaimer:

This episode is for educational purposes only and does not constitute medical advice. The views expressed are those of the hosts and guests and do not necessarily reflect their employers.

Welcome to our first episode in a series on Cardiac Intensive Care, recorded live at the Critical Care Canada Forum 2024. We kick off by looking at the latest Clinical Practice Update on post cardiac arrest care and refractory cardiac arrest.

The "Canadian Cardiovascular Society/Canadian Cardiovascular Critical Care Society/Canadian Association of Interventional Cardiology Clinical Practice Update on Optimal Post Cardiac Arrest and Refractory Cardiac Arrest Patient Care" CCS was published in 2024, and provides comprehensive recommendations for the management of patients following cardiac arrest.

Join us as Dr Janek Senaratne unpacks this Clinical Practice Update (CPU), and guides us through the evidence for the recommendations made.

Dr. Janek Senaratne is a dual-trained cardiologist and intensivist based in Edmonton, Alberta. He serves as an Associate Clinical Professor in the Department of Medicine at the University of Alberta. University of Alberta In his clinical roles, Dr. Senaratne practices at the University of Alberta Hospital and Grey Nuns Hospital, and is one of the Vital Heart Response physicians for the province.

Further Reading:

Recorded live at the Toronto Critical Care Canada Forum, this episode features a conversation with Prof. Derek Angus, Professor at the University of Pittsburgh, senior editor at JAMA, and Vice Chair of Innovation.

We discuss the evolution of healthcare systems, the art of decision-making, the role of AI, and how to inspire the next generation of clinicians.

Chapters:

Welcome to the Forum

• Introductions and reflections on the energy of in-person conferences post-COVID.

• Setting the stage with Dr. Angus and his storied career.

Conferences: More Than Just Science

• The dual role of conferences as spaces for rigorous science and informal discussion.

• How smaller, focused meetings like CCR foster deeper conversations.

• How We Communicate Science

Reflections on the digital age: Do we risk dumbing things down too much?

• The balance between simplicity and nuance in medical publishing.

The AI Frontier in Medicine

• Separating hype from reality: Why AI isn’t replacing doctors just yet.

• The cognitive load of decision-making and where technology fits in.

Thinking, Fast and Slow

• Exploring System One and System Two decision-making.

• The growing interest in how groups make decisions in critical care settings.

Redefining Careers in Medicine

• Moving beyond traditional roles to focus on leadership, innovation, and teamwork.

• Advice for the next generation on thinking outside the box.

Building Better Healthcare Systems

• Shifting accountability from individual outcomes to system-wide improvement.

• Transparency and trust: Why they’re essential for the future of healthcare.

Closing Thoughts

• Dr. Angus reflects on his legacy and hopes for the next wave of clinicians.

• A heartfelt thanks and a promise for more conversations ahead.

Health Economics 101: "Code Green - How the big lie in health care affects us all."

Prof. John Kellum, is a Professor of Critical Care Nephrology and now provocative author! Join us as he talks to us about his book: "Code Green - How the Big Lie in Healthcare Affects Us All."

Conflict Declaration:

The hosts and producers of this podcast declare no financial gain or conflict of interest from this episode or the promotion of Code Green. Our only goal is to share the insights and expertise of Dr. Kellum with our audience.

Episode Chapters:

1. Welcome and Introduction
2. Why Code Green? The inspiration behind the book.
3. The Evolution of U.S. Healthcare: From the 1980s to today.
4. The "Big Lie" in Healthcare: How hospitals maintain profits while claiming financial distress.
5. Trust and Its Erosion in Medicine: Exploring the misalignment between physicians, hospitals, and patient care.
6. Burnout or Moral Injury? Understanding the psychological toll of compromised care.
7. Aligning Values with Care: Dr. Kellum’s actionable solutions for a better healthcare system.
8. The Role of Patients in Reform: How patients can become advocates for systemic change.
9. Closing Thoughts and Takeaways: Dr. Kellum’s message to healthcare professionals and patients alike.

Further Resources:

• Code Green: How the Big Lie in Healthcare Affects Us All

In this episode, we dive into the fascinating world of Hyperbaric medicine with Dr. Jeff Kerrie, a Hyperbaric specialist from British Columbia, Canada.

Dr. Kerrie takes us through the science, history, and practical applications of Hyperbaric oxygen therapy (HBOT) as we explore the approved indications, physiological effects, and logistics of managing hyperbaric chambers.

Episode Chapters:

Introduction

Meet Dr. Jeff Kerrie and learn about his journey in hyperbaric medicine and the unique setup of Vancouver Island’s hyperbaric program.

History of Hyperbaric Medicine

A look at the origins of hyperbaric therapy, from 1600s pressurized chambers to its modern evolution.

The Physiology of HBOT

Understanding the effects of supra-physiologic oxygen pressures on microcirculation, angiogenesis, and inflammation.

Indications and Evidence:

Decompression Sickness

The mechanisms of treating “the bends” and why HBOT works so effectively.

Air or Gas Embolism

Insights into diagnosing and treating air embolism, including critical resuscitation tips.

Carbon Monoxide Poisoning

How HBOT prevents long-term neurological damage, with considerations for pregnant patients and associated toxins like cyanide.

Necrotizing Soft Tissue Infections

The role of HBOT in treating Fournier’s gangrene and clostridial infections alongside surgery.

Crush Injuries and Anemia

Exploring HBOT’s utility in tissue salvage and sustaining oxygenation in severe anemia.

Newer Indications: Sudden Hearing and Vision Loss

The emerging role of HBOT in sudden sensorineural hearing loss and central retinal artery occlusion.

Risks and Safety in the Chamber

Barotrauma, oxygen toxicity, fire safety, and managing emergencies during dives.

Logistics of Hyperbaric Medicine

A behind-the-scenes look at hyperbaric chamber setups, patient care protocols, and equipment considerations.

Closing Thoughts

Dr. Kerrie’s perspective on the future of hyperbaric medicine and ongoing research opportunities.

Key Indications for HBOT:

1. Decompression sickness ("The Bends")

2. Air or gas embolism

3. Carbon monoxide poisoning

4. Necrotizing soft tissue infections

5. Crush injuries and compartment syndromes

6. Severe anemia (e.g., in patients unable to receive transfusions)

7. Radiation tissue injury (e.g., osteoradionecrosis)

8. Sudden sensorineural hearing loss

Resources and Links:

• Undersea and Hyperbaric Medical Society Approved Indications for Hyperbaric Oxygen Therapy - Oceanside Hyperbaric

• Hyperbaric Medicine | © 2018 The Royal College of Physicians and Surgeons of Canada. All rights reserved.

Disclaimer:

This episode provides general information and is not a substitute for professional medical advice. Always consult with a specialist for specific clinical decisions.

In this episode, Peter Brindley and Leon Byker sit down with Dr. Rob Bevan, immediate past president of the College of Intensive Care Medicine (CICM) and Critical Care Director at Auckland City Hospital, Auckland, New Zealand.

Dr. Bevan shares his journey through leadership in intensive care, the role of intensive care colleges, and the evolution of critical care training. He also explores the political, social, and ethical dimensions of critical care, from workforce sustainability to the unique role of intensivists as brokers of care.

Episode Highlights:

The Evolution of CICM: History of the CICM and the differences between the CICM and similar organizations globally.

Training for Critical Care: The training pipeline in Australasia.

Advocacy and Political Engagement: The role of the CICM in advocating for intensive care resources.

The Value of College Convocations: Celebrating new fellows and their families and the role of meaningful ceremonies.

The Intensivist as a Broker of Care: Defining the role of the ICU specialist in complex patient care.

The Future of Critical Care Workforce: Addressing workforce challenges and it's sustainability.

The Upcoming CICM Annual Meeting: Highlights of the upcoming 2025 meeting in Tasmania.

Reflections on Leadership and Administration: Dr Bevan's Journey into administration and why it matters.

Coping with dying and saying what needs to be heard: Elliot Sprague

Introduction: In this emotional episode, Peter Brindley, Leon Byker, and Elliot Sprague revisit Elliot’s journey with metastatic cancer, a year after his initial appearance on the podcast,

Elliot reflects on the impact of living with a terminal illness, sharing life lessons, and offering insights on how he continues to thrive despite a difficult prognosis. This episode Elliot talks about acceptance, gratitude, and the importance of living each moment fully.

Topics Discussed:

1. Elliot’s cancer journey since his last appearance.
2. Transition from curative treatment to a palliative diagnosis.
3. The emotional challenges of facing terminal illness.
4. Acceptance of reality and choosing how to live each day.
5. The role of gratitude in maintaining emotional well-being.
6. Coping with the loss of professional identity.
7. Legacy-building and leaving meaningful gifts for loved ones.
8. The importance of honest conversations about death.
9. Support systems: family, friends, and the medical community.
10. Practical tools for mindfulness and mental well-being.

Timeline:

• 00:00 - 01:30: Introduction and re-welcoming Elliot Sprague to the show.
• 01:31 - 05:20: Elliot updates on his cancer journey, including treatment successes and setbacks.
• 05:21 - 10:00: The shift from a curative approach to palliative care.
• 10:01 - 15:45: Acceptance, gratitude, and how Elliot thrives with his diagnosis.
• 15:46 - 20:55: Discussing HyPEC surgery and reflecting on end-of-life realities.
• 20:56 - 25:30: Legacy-building, gratitude practice, and leaving meaningful messages for loved ones.
• 25:31 - 30:10: Coping with family grief and how Elliot's wife Danielle plays a crucial role.
• 30:11 - 35:50: The power of mindfulness in Elliot’s journey and how it changed his outlook.
• 35:51 - 40:15: The role of humor and connection in facing terminal illness.
• 40:16 - 45:00: Final reflections, messages of gratitude, and an emotional conclusion.

Thank you Elliot for joining us!

https://www.gofundme.com/f/dr-elliott-sprague-and-family?attribution_id=sl:c52d4c83-2649-4ce0-a003-651776f01205&utm_campaign=man_sharesheet_ft&utm_medium=customer&utm_source=email

In this episode, we sit down with Dr. Damon Scales and Dr. Niall Ferguson at the Canadian Critical Care Forum. We dive into a little bit of ARDS and spend a whole lot of time talking about the evolving landscape of conferences and critical care research. Tune in for insights from two leaders in the field!

Join us as Prof. Stephen Lapinski answers our questions on Obstetric critical care.

Stephen Lapinsky is Director of the Intensive Care Unit at Mount Sinai Hospital, Toronto and Professor of Medicine at the University of Toronto. He graduated from the University of the Witwatersrand, Johannesburg, and trained in Pulmonary and Critical Care Medicine. His clinical practice includes general Critical Care Medicine and ambulatory Respirology. He has a clinical and research interest in critical illness and respiratory disease in the pregnant patient. He is an officer of the North American Society of Obstetric Medicine (NASOM) and is co-Editor-in-Chief of the international journal Obstetric Medicine.

Join us as we discuss ARDS, Research and balancing life as a researcher with Professor Charlotte summers, Director of the Heart and Lung Research Institute (HLRI).

Join James Downar Head of Palliative and End of Life Care and a Critical Care Doc in Ottawa. He has walked the walk on this topic since before its introduction in Canada. Nobody is better qualified to discuss this thorny topic. 

Join Brian Buchanan, Associate Professor and ultrasound guru, for a dose of iconoclasm and provocation. Recorded at the Critical Care Canada Forum in Toronto, and following a 2024 JICS publication by Brindley et al.  

Thank you for your patience!

After a short break, we are back with a delightful interview with Dr. Jeff Drazen, the esteemed former Editor-in-Chief of the New England Journal of Medicine (NEJM).

In this episode, we explore the critical journey of transforming medical research into practical, patient-and-family centered care. We emphasize the importance of bringing humanity back into healthcare and ensuring that scientific advancements translate into meaningful outcomes for patients and families, right at the bedside. Listen as we explore modern forms of knowledge translation, the challenges they pose, and how healthcare professionals can navigate these complexities to enhance patient care.

With a distinguished career at the helm of one of the world's leading medical journals, Dr. Drazen's episode is one that you don't want to miss!

Welcome to the Critical Care Commute Podcast! In this episode, we have the honor of hosting Dr. Dan Howes. Dr. Howes is a Professor in the Departments of Critical Care Medicine and Emergency Medicine. He is the founder and director of the Kingston Resuscitation Institute and initiated the first Fellowship in Resuscitation and Reanimation through the Department of Emergency Medicine at Queen’s.

Join us as we explore how simulation in medical training is revolutionizing the way healthcare professionals prepare for high-stakes scenarios. We'll also dive into the principles of stoicism and how this ancient philosophy can enhance resilience and decision-making under pressure. Finally, we'll discuss the latest insights from cognitive science and how they can be applied to improve performance and outcomes in critical care settings.

Whether you're a healthcare professional, a student, or simply curious about these compelling topics, this episode promises to be an enlightening journey into the cutting-edge strategies that are shaping the future of medical practice.

Stay tuned, and let's get started!

We return to our Canadian Critical Care Forum series with this episode.

In this episode, we delve into the world of Extracorporeal Membrane Oxygenation (ECMO) with Dr. Eddy Fan, a leading expert in critical care and ECMO specialist.

Eddy Fan is an associate professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management, and Evaluation at the University of Toronto and a staff intensivist at the University Health Network/Mount Sinai Hospital. Dr. Fan received his undergraduate degree from the University of Toronto, his medical degree from the University of Western Ontario, and a PhD in Clinical Investigation from Johns Hopkins University. He is currently the Medical Director of the Extracorporeal Life Support Program at the Toronto General Hospital, and the Director of Critical Care Research at the University Health Network/Mount Sinai Hospital. Dr. Fan’s research has focused on advanced life support for acute respiratory failure and patient outcomes from critical illness. These include investigations on the epidemiology and use of mechanical ventilation and extracorporeal life support in patients with ARDS, as well as on the development of ICU-acquired weakness, early rehabilitation in ICU patients, and long-term outcomes in survivors of critical illness. Join us as we take on this huge topic.