Home Podcasts ICU Rounds

ICU Rounds

Jeffrey S. Guy, MD, FACS 98 episodes Latest May 11, 2026

A podcast dedicated to the teaching of critical care, targeting physicians, residents, medical students, nurses, therapists, and paramedics. Topics arise from teaching rounds in the Burn ICU at Vanderbilt Medical Center, covering a broad scope of critical care and prehospital topics, as well as recent journal articles and medical news.

Episodes

Starting Surgery Rotation: How to Pre-Round and Present on Rounds May 11, 2026 14:25 In this episode, I discuss one of the most important practical skills for medical students during the surgery clerkship: how to pre-round efficiently and deliver a concise, clinically useful patient presentation on rounds. Topics include: what surgeons actually care about during rounds how to identify important overnight events recognizing trends in vital signs and physiology organizing a 60–9

Splitting a Ventilator: Multipatient Ventilation for COVID? Apr 23, 2020 16:16 Throughout the pandemic, there has been considerable discussion about the possibility of running our of ventilators. One potential solution that was brought forward was putting multiple patients on a single ventilator. This is a lot harder than merely attaching a plastic splitter on a ventilator. In this episode, we explain safety and physiological considerations. Also, we briefly discuss specific

Prone Ventilation for ARDS (COVID-19) Apr 12, 2020 19:42 This week we have a brief conversation about prone mechanical ventilation for ARDS. Does it provide a benefit? When should we use it, and why does it work? I hope this is helpful as prone ventilation has been reported to provide benefit to patients with ARDS secondary to Coronavirus (COVID-19) infection.

ARDS and Mechanical Ventilation / COVID-19 Care Apr 5, 2020 33:29 Today we discuss the approach to oxygenating and mechanically ventilating a patient suffering from ARDS. We will cover elements relevant and essential in the management of COVID patients and all others with ARDS.

ICU Care of Coronavirus (COVID-19) Mar 29, 2020 48:34 I'm back. I plan on providing you with some useful information when caring for patients infected with COVID-19 (Coronavirus). In this episode, I will provide you an overview of the current evidence and best practices with some explanation and commentary from the recent Surviving Sepsis COVID-19 guidance.

Colloids: Details and Myths Jul 9, 2012 18:20 This episode provide some basic description of colloids as will as some myths.

Random Serum Cortisol Levels are misleading Mar 12, 2012 17:09 A physiological explanation why random cortisol levels are NOT helpful in evaluating adrenal function

EARLY use of Tranexamic Acid may improve survival from bleeding in trauma Feb 20, 2012 19:35 In this episode we talk about the results of the CRASH-2 trial published in Lancet. This trial showed that the EARLY use of Tranexamic acid may improve survivial, but delayed use may be associated with an increased mortality.

Pediatric IVC diameter determination with ultrasound Feb 9, 2012 15:52 If you are using ultrasound to evaluate IVC diamter in children, what is considered a normal IVC diameter? You can determine the IVC/Ao ratio or correct the IVC diamter based on the child's body surface area.

Takotsubo Cardiomyopathy Jan 31, 2012 12:40 This is a condition that mimics acute coronary syndrome (ACS) that may be caused by acute emotional or physical stress. Patient's may appear to have profound cardiogenic shock, but these patients have a very high survivial rate with little more than supportive care.

Necrotizing Soft Tissue Infection (NTSI) Dec 6, 2011 26:26 This episode discusses the pathophysiology, presentation, and treatment of NTSI.

Different Cardiac Output Monitors & Physiology Nov 26, 2011 31:01 This episode will discuss the physiology behind various CO output monitors such as pulmonary artery catheters, PICCO, pulse wave form analysis, and LiDCO.

Lactic Acidosis - Type B Nov 19, 2011 16:30 Now these are the types of lactic acidosis that most people are not familiar. They can be caused by medications, underlying disease, or inborn errors of metabolism.

Lactate Acidosis - Type A Nov 12, 2011 22:08 This podcast is a description of how lactate is produced and metabolized. I will discuss the role of lactate in the diagnosis and management of shock. This podcast will focus on Type A lactic acidosis.

Endotracheal tube cuff leaks and self-extubations Aug 3, 2011 24:18 A brief description on what to consider when confronted with a patient with an air leak from the ET tube or a patient that self-extubates.

Pulmonary Embolus Jul 28, 2011 33:01 A description of the risk factors, diagnosis, and treatment of PE.

Smoke Inhalation Injury Jul 6, 2011 30:53 Smoke Inhalation injuries can be deadly. This episode explains why smoke can be so deadly, and how to care for those patients with suspected smoke inhalation injuries.

Propofol Related Infusion Syndrome Jun 5, 2011 24:06 Propofol Related Infusion Syndrome is a potentially fatal complication of propofol. If you use this common ICU drug you need this information.

Wedge: Everyone elses favorite Swan number Dec 12, 2010 25:30 Wedge or PAOP is perhaps the most quoted and poorly understood variable generated by a Swan-Ganz.

SVO2 My favorite Swan Number Dec 5, 2010 18:46 The most helpful number for me on a Swan is the SvO2. This is a brief description of how I use this variable in evaluating critically ill and injured patients.

Therapeutic Hypothermia After Cardiac Arrest Oct 21, 2010 34:06 Therapeutic hypothermia after cardiac arrest is part of ACLS and is used by several EMS agencies around the US. Despite good data and improved patient outcomes, many providers fail to used this modality. This podcast will focus on a presentation of the data, methods of cooling, and potential complications.

Pancreatitis - Surgical Indications and Procedures Jul 23, 2010 26:23 This is the third in the series on severe pancreatitis and necrotizing pancreatitis. This episode reviews the indications for surgery, morbidity and mortality of surgery, and what are the surgical options.

Severe Acute Pancreatitis: Part 2 ICU Considerations Jun 2, 2010 18:04 A brief discussion of the considerations of ICU care of the patient with severe pancreatitis, fluid resuscitation, respiratory, renal, and nutrition.

Pancreatitis - Part 1 May 25, 2010 26:04 This is an initial presentation of the causes and diagnosis of acute pancreatitis.

That peripheral IV can kill you: Suppurative Thrombophlebitis Feb 25, 2010 13:44 All the recent emphasis on venous catheter infections has been on central lines. Those peripheral IVs are also dangerous.

Acute Colonic Pseudoobstruction (Ogilvie's Syndrome) Feb 15, 2010 32:12 Acute Colonic Pseudoobstruction (ACPO) is commonly called Ogilvies Syndrome. ACPO presents massive dilation in critically ill patients, and might result in invasive procedures to avoid ischemia or perforation of the colon.

Hemoglobin Based Oxygen Carriers (a.k.a. Artificial Blood) Jan 18, 2010 23:59 A brief summary of what are hemoglobin based oxygen carriers (HBOC) and where are they in development.

Catheter-Related Bloodstream Infection: Diagnosis Sep 24, 2009 18:46 Discussion of what is the difference between a CVC infection and a catheter-related blood stream infection. They are treated differently so it is important to know the difference.

Ventilator Associated Pneumonia Sep 17, 2009 34:02 A discussion on nosocomial infections and VAP.

Complications of Dwelling Central Lines Aug 4, 2009 34:28 What horrible things can happen with central lines once they have been inserted.

Central Line Insertion Complications Jul 16, 2009 32:01 A discussion of the potential problems encountered while inserting central venous catheters.

Pulmonary Physiology and General Anesthesia Jun 21, 2009 30:24 This episode discusses the effects and risks of anesthesia on patients with pulmonary disease as well as the effects of anesthesia on pulmonary physiology.

Caustic Ingestions May 13, 2009 38:46 Ingestion of caustic materials can be fatal and difficult to evaluate. These patients are often referred to our burn center.

IV Fluids (Part 1) May 3, 2009 36:31 An introduction to the basic science in fluids used to treat hypovolemia.

Arterial Blood Gases Apr 26, 2009 36:41 This episode is a discussion about how to approach an arterial blood gas result.

Pulse Oximetery Mar 30, 2009 29:45 Discussion of the technology of the pulse oximeter

Discussion on Fluids: The last Cotton lecture Mar 5, 2009 24:34 This is an interview that I did on www.medtalknetwork.com with Dr. Brian Cotton. Dr. Cotton recently left Vanderbilt to take a new position at UT Houston. He is an excellent teacher and his opinions on fluids resuscitation are cutting edge.

Refeeding Syndrome Feb 21, 2009 27:27 When and how can providing a starving patient nutrition be potentially deadly.

Hypoxia: physiological causes Feb 15, 2009 23:33 Understanding the root cause of hypoxia will allow for more appropriate treatment.

Hypernatremia Feb 12, 2009 16:16 Evaluation and treatment of elevated serum sodium is presented.

Hyponatremia: common but dangerous Feb 7, 2009 23:54 Hyponatremia or a low serum sodium is a common electrolyte problem that is dangerous if ignored or treated improperly.

Prehospital/Battlefield Tourniquet Use Feb 1, 2009 14:08 Review of a recent publication from Annals of Surgery

Environmental Hypothermia Jan 28, 2009 28:38 Following the recent crash of the US Airways in the Hudson River, it is an appropriate time to discuss the clinical manifestations and treatment of hypothermia.

Peak Inspiratory Pressure: Physiological Determinants Jan 19, 2009 27:10 Peak inspiratory pressure (PIP) the center of a great deal of discussion of ventilator management. Knowing the factors that increase or decrease PIP are important to those managing critically ill patient. This podcast is steeped in physiology and perhaps more difficult than my typical podcasts. PIP= [Tv/ (Compliance Lung & Thorax)] + (Resistance of airway + flow )

Hyperkalemia Jan 12, 2009 28:40 Hyperkalemia is a very common and potentially dangerous electrolyte disorder that commonly occurs in ICU patients.

Some Swan Stuff Dec 29, 2008 24:39 A brief discussion regarding some of the commonly used values obtained from a pulmonary artery catheter.

Therapeutic Hypothermia following Cardiac Arrest Dec 22, 2008 19:22 Therapeutic Hypothermia following cardiac arrest has been demonstrated to improve outcomes. Starting Jan 1, 2009 Ney York City EMS will dorect patients to those hospitals able to delivery such care.

Radiation Injury / Nuclear MCI Dec 12, 2008 28:50 The US government last week released a report that the threat of a nuclear device used in an act of terrorism is high in the next couple of years. In this episode we discuss the some concepts of the medical care required to those exposed to radiation as well as blast injuries. I hope this is information that none of you will ever need.

Cardiovascular Risk Reduction for Surgery Nov 20, 2008 29:57 This episode explores what is needed to make surgery safer for the patient with cardiovascular disease.

Meta-analysis of Glucose Control Nov 17, 2008 21:49 Tight glucose control has been widely introduced into critical care. This meta-analysis, recently published in JAMA, critically evaluates the effects of these trials in reduction of sepsis as well as mortality. The results might surprise you.

Myocardial Infarction: PCI and medications Oct 20, 2008 25:55 This is the second installment of this topic. In this episode we talk about the role of angioplasty and role of various medications in the treatment of the patient having an MI.

Disaster Management Oct 19, 2008 38:35 It is Sunday 8.31.08 and for hurricane Gustav is bearing down on the city of New Orleans. This podcast will discuss the basic elements of disaster planning and management. (This was reposted due to some technical problems with the server.)

Traumatic Rhabdomyolyisis / Crush Syndrome Oct 19, 2008 27:28 Crush syndrome is a common cause of death following earth quakes, mine and building collapses. Traumatic rhabdomyolysis may also be seen following electrical injury or severe trauma. (This is a reposting due to some previous technical problems with the server.)

Myocardial Infarction: Diagnosis and Thrombolytics Sep 9, 2008 28:23 Myocardial Infaction (Part 1): This episode will discuss the diagnosis of MI, STEMI, and non-STEMI. We then discuss the indications and types of thrombolytic agents.

PAIN: a four letter word Aug 21, 2008 40:18 The management of pain is a key element of the care of all patients-- ICU or not. Often providers have little understanding of the concepts and medications of pain management. This episode serves as an introduction.

Hypercalcemia Aug 14, 2008 21:05 A potentiallylife-threatening electrolyte problem that commonly finds its way into the ICU as well as on exams.

Patient-Ventilator Interactions and ventilator discontinuation Aug 7, 2008 19:53 Getting patients comfortable on the ventilator is not an easy task. This podcasts focuses on methods to make patients synchronize with the ventilator as well as a discussion of spontaneous breathing and awake trials

Ventilator Update: avoiding shear trauma Aug 3, 2008 19:49 In regards to ventilator care, all the focus has been on low tidal volume and level of peak inspiratory pressure. What level of PEEP shoud we be using to avoid shear trauma and ventilatory induced lung injury.

Abdominal Compartment Syndrome Jun 7, 2008 33:02 A discussion of the physiology and presentation of abdominal compartment syndrome.

Extremity Compartment Syndrome May 19, 2008 28:51 A limb-threatening complication that might be overlooked by the inexperienced provider.

Surviving Sepsis Campaign (part 2) May 15, 2008 34:08 We continue our discussion of the Surviving Sepsis Campaign (SSC). This includes fluids types, steroids, rhAPC (Xigris), and blood sugar control.

Surviving Sepsis Campaign (part 1) May 12, 2008 31:39 The Surviving Sepsis Campaign (SSC) is concensus document that attempts to provide the best evidence to assist in the care of the septic patient. All providers who provide care to the septic patient should be aware of the contents of the SSC.

Hemoglobin Based Blood Substitutes: Increased Morbidity and Mortality May 4, 2008 25:00 In this week's Journal of the American Medical Association a meta-analysis was published that concluded that use of hemoglobin based blood substitutes result in an increased morbidity and mortality. Included in the same journal is an editorial critical of the method the research has been regulated by the US FDA.

Glucometers in the ICU: how accurate are they? Apr 24, 2008 19:34 There is a large emphasis on intensive control of blood glucose in the ICU, but how accurate are the monitors we use to follow glucose? This episode reviews someof the limitations of deploying an instrument designed for control of outpatient diabetes management to tight control of blood glucose in the ICU.

Clostridium difficile Colitis Apr 16, 2008 24:56 Clostridium difficile colitis is a problematic complication of antibiotic theraoy in hospitalized and critically ill patients. It is increasing in frequency and can be lethal.

Traumatic Shock and Fluid Resuscitation Apr 1, 2008 42:20 Fluid resuscitation done poorly can result in significant complications to the patient. This episode will present some of the newer considerations in fluid resuscitation in traumatic shock.

Polypharmacy in the Elderly Mar 23, 2008 29:15 Patients are often admitted to the ICU with an entire list of home medications. In this episode I talk about the implications and dangers of polypharmacy.

Drug-induced QT prolongation Mar 8, 2008 26:19 Prolonged QT is the most common reason why medications are restricted or removed from the US market. This episode will explain what it is and why you should look for it in your ICU patients.

Do Steroid Improve Survivial in Sepsis? CORTICUS Trial Feb 28, 2008 23:27 The results of the CORTICUS trial are discussed.

Atrial Fibrillation Feb 20, 2008 38:40 Atrial fibrillation is a common problem in ICU patients, but it is a problem with many potential causes, and not always a well defined treatment.

Pediatric Burns Feb 13, 2008 47:31 Pediatric burns: all burns are serious, both big and small. This episode reviews the objectives of burn care to result in the best functional outcome. Also, burn is a very common method of child abuse and we detail how these children are injured and what to look for to identify possible abuse.

Pharmacology of Shock Feb 8, 2008 38:25 This is a basic introduction of some of the drugs used in various forms of shock.

Sepsis - Part 2 Feb 1, 2008 33:23 In this episode we discuss that ICU care of the patient with sepsis. This includes an introduction to various vasopressors.

Sepsis - Part 1 Dec 11, 2007 34:08 Sepsis is a common cause of death in the intensive care unit. In this episode I present some of the statistics on septic deaths, introduce the definitions, and present the basic science. Part 2 will cover fluid and drug therapy for septic shock.

HIT: Heparin Induced Thrombocytopenia Oct 27, 2007 19:40 Large numbers of patients in ICUs are on heparin and what is this complication of heparin induced thrombocytopenia?

Smoke Inhalation Injury: CO and Cyanide Toxicity Oct 15, 2007 38:38 The onset of cold weather will bring with it an increase in structure fires. The leading cause of deaths in fires is complications from the inhalation of smoke-- not burns. Learn why smoke is so deadly as well as what are the appropriate methods to treat smoke related asphyxiation.

Blood Products Oct 1, 2007 37:58 Blood products: pRBCs, fresh frozen plasma, platelets, cryoprecipitate when and how should we use it? What are the risks? You may order them like IV fluids but do you really know how these potentially deadly products are to be used.

Control of hyperglycemia improves outcomes Sep 24, 2007 33:40 A great deal is being presented and published on control of blood sugar in the ICU as well as the postoperative period. How much control is enough and what is the data?

Antibiotic Considerations in the ICU Sep 14, 2007 54:26 Why do we choose the antibiotics that we do? How long do we continue the course of therapy? Should we use some antibiotics together? These topics are covered in the episode.

Crush Syndrome Aug 20, 2007 18:42 Earthquakes are horrible natural events causing loss of lives in the thousands. Following earthquakes, building collapses, and cave-ins, large number of victims will suffer from renal failure and death following crush syndrome.

ICU Rounds

Episodes

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