The Synapse Critical Care & Emergency Medicine Podcast
The Synapse is a Critical Care and Emergency Medicine podcast breaking down topics and case studies into simple easy-to-digest segments to help build paramedic, nurse, and other pre-hospital and hospital clinicians into more robust providers. This podcast is open to any and all Emergency Medicine and Critical Care healthcare providers both in and out-of-hospital. Every effort is made to put out as many various topics to cater to everyone's interests and levels. Leave your technician hat outside, put on your clinician hat, and join us!
**Disclosures:
1) This is a non-monetary podcast, created and edited for free for your enjoyment and learning purposes.
2) The opinions and information presented in these podcast episodes is based off of up-to-date research, the latest evidence-based-guidelines, and/or anecdotal experience/opinions of the author.
3) Under no circumstances does this podcast or the information presented within each episode serve as authorization to work outside your guidelines, protocols, or workplace rules otherwise. When in doubt, contact Medical Control for guidance.
Episodes
279 episodes
The Synapse Season 4 Episode 5 - The Shock Indices
Shock is not just about BP. In fact, in adults in hemorrhagic shock, we typically need to lose at least 1.5L of blood before BP changes, which is stage III shock. In kids? That can vary but is much more on the occult side. You can be in shock w...
The Synapse Season 4 Episode 3 - Sodium Channel Blocker Toxicity Review
Sodium channel blockers can cause a host of nasty effects in the body, and the heart unfortunately can take the brunt of a lot of it. We will examine this in today's episode with what to look for, signs and symptoms, treatments, etc.
The Synapse Season 4 Episode 2 - The OXY-PICU Trial Said to do What??
For those who aren't aware, there really isn't much benefit to SpO2 >94%. We have talked about this ad nauseum in other episodes before. The AHA tells us 94-99% for an SpO2 range for various reasons. However a recently-released trial, the Ox...
The Synapse Season 4 Episode 1 - Bye-Bye, Orthostatics!
Welcome to Episode 1 of our 4th Season! I can't express how grateful I am for the continued support from around the world as this podcast continues to grow! We are now hosted on multiple streaming sites and have listeners regularly tuning in fr...
The Synapse Season 4 Episode 4 - Aortic Dissections and Rupture
This episode brings a review of the appropriate diagnostics and care for patients with aortic dissections and rupture as well as a review of the pathophysiology and classification types. Are you familiar with the newer HR and BP goals? Why is t...
The Synapse Season 3 Episode 100 - Ultrasound of the IVC is NOT a Stand-alone Assessment Tool
Thank you for tuning into the last episode of Season 3! This episode dissects the highs and lows of ultrasound of the IVC for volume status. Where does it excel? Where does it let us down, and how do we add other components of assessments in to...
The Synapse Season 3 Episode 99 - Autonomic Nervous System Exercise Map
This seems to be an area many people struggle with, trying to figure out sympathetic vs parasympathetic, muscarinic vs nicotinic, and how these all relate. Who has what for primary transmitters? How do we navigate this? I am showing you a quick...
The Synapse Season 3 Episode 98 - Occlusion of the LVOT in CPR
Is hand placement on the sternum mid-line halfway up the breastbone really the best place for compressions? What does the evidence show? How can we use POCUS in and out of the hospital to determine where hand placement is most effective, and ho...
The Synapse Season 3 Episode 97 - Antibiotic Infusions...Not All Are Rapid in 30 Minutes!
There are certain aspects of Pharmacology and Pharmacokinetics that are non-negotiable. One of those is the aspect of time in relation to antibiotic effectiveness. How much time is the antibiotic in the system for, vs how long does it take to r...
The Synapse Season 3 Episode 96 - Calcium Does NOT "Stabilize the Cardiac Cell Membrane" in Hyperkalemia
Ok...I get it. We were and still are often told that Calcium's role in the treatment of hyperkalemia is to "stabilize the cell membrane walls." In the most simplistic of explanations, this is still not entirely correct. This episode brings actu...
The Synapse Season 3 Episode 95 - CPAP and the Failing Heart...Why PPV Can *Sometimes* Increase Cardiac Output
PPV is notorious for dropping cardiac output by changing intrathoracic pressures and decreasing preload return by forcing lung tissue against major vessels and alveoli compression. However, is there ever a circumstance when PPV can actually imp...
The Synapse Season 3 Episode 94 - ECG Precordial Lead Placement in Men & Women with Large Breasts
Many of us were taught to place ECG precordial "V" leads under large breast tissue, replace/set down the tissue after, and then obtain the image. However, did you ever stop to think about how much large breast tissue can displace the ECG leads ...
The Synapse Season 3 Episode 93 - Cord Syndromes, Spinal vs Neurogenic Shock, and SCIWORA
Today is a review of most things having to do with spinal injuries. Anterior, posterior, and Brown-Sequard syndromes...Spinal vs Neurogenic shock differentiation (yes they are different!), and SCIWORA. We will examine each of these and what you...
The Synapse Season 3 Episode 92 - The Loop Diuretic Paradox...CO2 Retention
How does giving a loop diuretic actually cause the body to retain CO2??? What does that have to do with fluid management?! Surprise, quite a bit actually. Tune in and find out!
The Synapse Season 3 Episode 91 - Reduction of Hemolysis in PIV Draws
We have most likely all had the phone call from the lab before, asking for a re-draw on our patient due to lab hemolysis. Have you ever thought about why that happens and how we can reduce it? It is not just the desire of a larger-bore IV cathe...
The Synapse Season 3 Episode 90 - Mitral Valve Stenosis Causes Dysphagia
Similar to the Aortic Stenosis and head-bobbing, Mitral stenosis can also cause a peculiar side effect, that being Dysphagia. Can you figure out how this might happen before listening? See if you were right!
The Synapse Season 3 Episode 89 - Heparin-Induced Thrombocytopenia
Thrombocytopenia and Heparin aren't usually thought of together, at least Heparin not as being a potential cause. This episode will look at how that can be possible!
The Synapse Season 3 Episode 88 - Aortic Regurgitation...the Physics of a Bounding Pulse and a Bobbing Head
There are some things in medicine that, when you learn the mechanics behind it, are just, well,...cool! Unfortunate, but cool to see. One wouldn't initially think something like aortic regurgitation would be that, but this episode looks at how ...
The Synapse Season 3 Episode 87 - CO2 Narcosis...When Ventilation Fails the Brain
We have heard about O2 and CO2 in patients like COPD'ers...but what happens truly when CO2 builds up to dangerous levels in the body? How does ventilation actually shut down? What do we do about it?
The Synapse Season 3 Episode 85 - New DKA Criteria
DKA is a wild animal. Taming it in our sick patients can be incredibly challenging. The newest criteria are out for diagnosis of DKA, and there have been a few bigger changes. Tune in to keep up!
The Synapse Season 3 Episode 84 - Pediatric Fluid and Electrolyte Rates
We are all most likely pretty adept at initial fluid resuscitation and repletion rates for pediatrics. What happens after the patient is more stable-ish? In that time period where we must now maintain the patient? How do we calculate appropriat...
The Synapse Season 3 Episode 86 - Phenylephrine Review
This episode is a review on the pharmacology behind Phenylephrine, a very potent alpha vasopressor, its uses, cautions, and more!
The Synapse Season 3 Episode 83 - Poor Lab Interpretation Traps
If you interpret lab values, you have most assuredly fallen into the same trap I have in the past of taking something at face value and not reasoning against trends or in conjunction with other lab values. In medicine this can cause dangerous c...
The Synapse Season 3 Episode 82 - S3 and S4 Simplification
If you are like me, you probably have trouble remembering the difference between heart murmur grades, whether S4 comes before S1, S3 after S2, and why it even matters. This episode breaks this down as simple as I think it can possibly be broken...
The Synapse Season 3 Episode 81 - Isolated Diastolic Hypotension
Who are you more concerned about, the patient with a blood pressure of 96/70 or the patient with a blood pressure of 200/35? Besides the fact that this episode is titled Isolated Diastolic Hypotension, can you figure out why option B is more co...