Lightning rounds #14: Abdominal compartment syndrome

Brandon and Bryan discuss a practical approach to abdominal compartment syndrome: when to suspect it, confirming the diagnosis with bladder pressure or other monitoring, management, and prognosis.

Sorry for the audio on this one!

Lightning rounds #13: What’s the deal with nurses?

Brandon and Bryan reflect on the qualities that define good and bad ICU nurses, the challenges they face, and how APPs and physicians can enable them to be their best.

Lightning rounds #12: Co-managing patients in a surgical ICU

Brandon and Bryan talk about the practicalities of communication, collaboration, and compromise in a surgical ICU, when the surgical and critical care teams are both involved, one is the “primary” team on paper, but everyone needs to be heard.

Lightning rounds #11: Reflections on two years of the podcast

Bryan and Brandon look back on the two-year anniversary of the show and reflect on where it’s been, where it’s going, lessons learned, and other deep thoughts.

Lightning rounds #10: Physical examination in the ICU

Bryan and Brandon talk about the physical exam: how we apply it in the ICU, its utility and changing role in the setting of modern diagnostic modalities, and its best and most practical use-cases.


  1. McNamara LC, Kanjee Z. Counterpoint: Routine Daily Physical Exams Add Value for the Hospitalist and Patient. J Hosp Med. 2021 Aug 18. doi: 10.12788/jhm.3671. Epub ahead of print. PMID: 34424193.
  2. Rodman A, Warnock S. Point: Routine Daily Physical Exams in Hospitalized Patients Are a Waste of Time. J Hosp Med. 2021 Aug 18. doi: 10.12788/jhm.3670. Epub ahead of print. PMID: 34424194.

Lightning rounds #9: Notes and documentation

Bryan and Brandon chat about notes: what makes a good one, their many and conflicting purposes, some structures and approaches, system- versus problem-based charting, and more.

Lightning rounds #8: Five things you’re getting wrong

Bryan’s off this week, so Brandon flies solo to explain five wrong-headed notions that many people believe without thinking about them.

  1. Are diuretic infusions more effective than intermittent boluses?
  2. Are antipsychotic (neuroleptic) agents a good treatment for ICU delirium?
  3. Is pressure control or volume control a better form of assist control?
  4. Does renal failure cause chronically elevated troponin levels due to impaired troponin clearance?
  5. If a patient squeezes your hand, does that mean they heard and followed your command?

Lightning rounds #7: Operationalizing clinical skill

Discussing a pickle of a topic: outside of academic milestones, how do we recognize, acknowledge, reward, and move towards clinical excellence in medicine after one’s training is complete? In fact… do we?

Lightning rounds #6: Point of care ultrasound

We chat about focused, clinician-performed point-of-care ultrasound (POCUS) in the ICU. How do you learn it? What are our favorite applications? What are some of the particulars and caveats surrounding credentialing, documentation, and billing? All that and more…

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.