Critical Care Time

Check out our 🆕 infographic on undifferentiated shock; the perfect accompaniment to the first episode of Critical Care Time! Part 1️⃣ shows.acast.com/649181182c969b… Part 2️⃣ shows.acast.com/649181182c969b…

The Difficult Airway Course: Critical Care X (Twitter): @theairwaysite Instagram: @theairwaysite Facebook: @TheDAC.EMS LinkedIn: Airway Management Education Center (AMEC)

🔔This episode is supported by: Integration Health delivering ECMO training, simulation, and round-the-clock specialist support for critical care teams. Learn more: LinkedIn: linkedin.com/company/integr… Intsa: instagram.com/integrationhea… Website: bit.ly/IHxCCT

DKA looks straightforward on paper. In practice, it rarely is. What happens next depends on the decisions you make along the way. In our latest episode, Nick and Cyrus break down real ICU cases and the decisions that shape how DKA unfolds. Episode Link in comments👇️

Catch the Full episode

Catch the Full Episode 👇️ youtube.com/watch?v=XT5YzJ… (It’s now live on YouTube, Spotify, Apple Podcasts, and all major platforms. )

We’ve re-published our toxicology episode, this time with fixed audio. Some conversations are too good to leave behind because of bad audio. So we went back and fixed it. And yes, we even remastered the thumbnail (let us know your opinions) Episode link in the comments👇️

Atomize don’t nebulize. Nebulized lidocaine does a little for the bronchi but almost nothing for the upper airway. If you want to do an awake intubation safely you need to properly topicalize the airway, using one of these: Podcast on this topic out soon.

Another key point is that the effect size and the n required are non-linear. Detecting a 10 vs 12% difference would require an n=8,602 trial. Detecting a 10 vs 14% difference would require an n=1,930 trial: 2x the effect means 4x fewer patients required Detecting a 10 vs 16% difference would require "just" n=756; 3x the effect means 11x fewer patients required! A small difference in your estimate of effect size can make a HUGE difference in the n required for your study. 2/

How can we get to the bottom of this seeming paradox? We need to go deep into the supplement! The key is understanding how clinicians deal with discrepant information. The reduction in mortality was driven by the subset with a high NEWS score and a low procalcitonin. These are the patients that without procalcitonin clinicians could erroneously mistakenly conclude “just have sepsis.” With the extra PCT data point, they were encouraged to reevaluate. This reduced mortality in the patients who ultimately did not have infection. Conclusion: An additional test can help avoid premature closure and get you to reassess! If the data doesn’t fit reconsider! (Sidebar: it’s pretty embarrassing that @TheLancet misspelled “Medium”)

2. The Difficult Airway Course: Critical Care — practical, hands-on airway training built for real ICU scenarios. Learn more: X (Twitter): @theairwaysite Instagram: @theairwaysite Facebook: @TheDAC.EMS LinkedIn: Airway Management Education Center (AMEC)

🔔 The episode is supported by: 1. Integration Health, delivering ECMO training, simulation, and round-the-clock specialist support for critical care teams. Learn more: LinkedIn: linkedin.com/company/integr… Instagram: instagram.com/integrationhea… Website: bit.ly/IHxCCT

Toxicology Cases Often Worsen After Initial Improvement. Patients may stabilize early, while drug effects are still evolving. That’s where critical decisions begin. Here are the key principles to manage toxicology cases before patients deteriorate 🧵