Lightning rounds #5: Career development for critical care APPs

Conceiving, planning, and building your career as a critical care PA or NP. Determining if this field is for you, finding your first job, pinpointing your interests or “niche” during your early career, nurturing your growth during the mid-career period, and some thoughts on life and priorities in your late career.

Episode 34: Lightning rounds #4

Wrapping up our series on procedures with a talk about airway management. Who should manage airways in the ICU? What’s the role of intensivists, APPs, anesthesia, etc? What’s the “correct” balance of expertise, distribution of labor, and training? Our general approach to supraglottic airways, mask ventilation, intubation, cricothyrotomy, drugs, assessing airway anatomy, training, and more.

Episode 32: Lightning rounds #3

Following up from the last lightning rounds on vascular procedures, we look at non-vascular bedside procedures in the ICU: paracentesis, thoracentesis (including chest tubes), lumbar punctures, and bronchoscopy. How do we tap, what are our tricks, what’s the role of ultrasound, who needs a bronch, and more.

Episode 29: Lightning rounds #2

A vascular access roundtable, discussing our practices surrounding arterial lines, central lines, PICC lines and midlines, and PA catheters. When do we place them? When can they come out? What sites do we like? When (and how) do we use ultrasound? What’s up with the axillary site, why does Brandon hate PICCs, the age-old debate on ultrasound probe orientation… all this and more.

Episode 16: Lightning rounds #1

Quick takes on common controversies in the ICU, with Bryan and Brandon:

  1. Stress ulcer prophylaxis: drug selection, candidates, and when to discontinue
  2. Stress dose steroids: candidates, dosing, lab tests, and weaning
  3. Titrating PEEP: considering the disease process, PEEP/FiO2 tables, driving pressure trials, and pragmatic approaches