Podcast 100 – What is Critical Care and What is EMCrit?

whiskey-still

Thanks for joining me on the wild ride of these first 100 episodes!

This was the opening lecture of SMACC 2013. Chris Nickson assigned me the lecture: What is the essence of critical care? In ruminating on that topic what I really came to is the essence of this blog and podcast. The video is here:

but I think I agree with Brother Minh that it works even better as a podcast.

smacc-620

Now on to the Podcast…

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Comments

  1. Lakshay says:

    Hey Scott..
    this was one of your best vodcasts.. jus love it !! amazing work…

    Lakshay
    INDIA

  2. suja mohan says:

    Dr.Scott,
    Emergency medicine is more Critical care
    than Critical care itself.I am in total agreement with you and manage to train Hybrid nurses
    who are Emergency Critical Care nurses in our department.Now the concern is, are they giving the down stairs care upstairs ?
    Love your presentation and is very proud to be a part of the Network.
    Suja,QHC ED

  3. Loved this when it first live streamed from SMACC13. Glad that it is on-line now. Proof that the lecture can be alive and well!

  4. Matt S says:

    Thanks for this, Scott. I’ve never had anyone so eloquently put into words why we need EM-CC (or just more resuscitationsists) in this country. I’ll be trotting out some of your thoughts a great deal this week as I graduate residency and prepare to go onto my fellowship. The biggest question I’ve got over the last year is: why bother with CC when you can go and get a great job in EM somewhere. Something like: “Why are you wasting more of your time in training?”, especially when I already spent 5 years in a combined residency. I’ve been trying to defend it and myself for the last several months and never had the right words; thank you for that. As an aside, those are three of the most inspiring stories I’ve heard regarding critical care and outcomes. I’ve shared this with a few people already and I think everyone ends up with a little dust in their eyes by that last story. Great, great work.

  5. Great talk Scott!

    It really helped put to rest my uneasiness with signing on for my critical care fellowship. I have a feeling that I’ll be watching this a few times in the call room when things get tough…

    Thank you,
    ~Luke

  6. Jeff Siewert says:

    Dr Weingart,
    That was one of the best presentations I’ve ever seen, keep up the great work!!

  7. Peter Weimersheimer says:

    Great talk. The intro of no one assuming responsibility for a patient seems less about upstairs care downstairs versus providers being too lazy and myopic to do their job. I’m EM-only trained but wouldnt set foot in my shop if I couldnt manage critical patients for as long as a period of time as they were in my care. Whether trained in EM, CC, or both, any “title” doesn’t preclude a lack of professionalism or competency.

  8. Joe Bellezzo says:

    …just watched this VodCast. A great epitomization of what we do every day.

  9. Justin says:

    Nice podcast but I want to clarify a statement made about Houston and not doing critical care. This by no means represents all emergency departments in Houston. The main hospital at our program, Memorial Hermann Hospital, also the busiest level one trauma center does plenty of critical care in the ED. We have a 45% admission rate and an 11% critical care admission rate. We are generally expected to do the all of the resuscitation, EGDT, procedures (CVC, A.line, ETT, chest tube), stabilization necessary before going to the ICU. Even over my three years as a resident, there has been a more and more of an expectation of keeping patients in the ED longer until the patient is “ready” for the ICU. We also have a large boarding problem, like most other hospitals, and end up taking care of ICU patients anywhere from 4-30+ hours. I don’t think that you meant it to be generalizable to Houston, I just didn’t want there to be any misconceptions. Thanks for doing what you do.

    • Great addition Justin; sounds like you folks are doing it right. I know of at least 3 other EDs in the Houston area that are also kicking ass at critical care in the ED.

  10. Scott,

    I want everyone who listens to your podcast to know that at the University of Texas Health Sciences CTR at Houston, which staffs Memorial Hermann (the largest trauma ctr in the United States) and LBJ Hospital (one of our two county hospitals in Houston), we pride ourselves on providing exemplary critical care. We have two boarded EM Critical Care physicians and five other docs who work in the ER critical care area of our county hospital. Our residents also rotate through a mandatory month long ED critical care rotation where they see and manage only the critically ill patients in our ER critical care pod. Residents on that rotation get special lectures in crit care to supplement our monthly critical care conference that all our residents attend as part of their regular didactic education. The large majority of us here in Houston, TX and at the All Houston Comference love critical care.

    Andy

  11. Dear sir, these past several months of listening to your podcasts have been some of the greatest learning events I’ve ever encountered in 25 years of EMS and EMS education. I listened to ‘What is Critical Care” 3X today before teaching PALS to a class of residents. I think this was a grand slam on your part and need now to sit with it and a notepad to dissect and metabolize your words. So much I’d like to say but I’ll respect your time.

    Steve in NJ – Paramedic and Resuscitationist

  12. Sarah B. says:

    Thank you for the nursing shout-out! I love your podcast!!

  13. Steve Young says:

    Fantastic Podcast like Cliff Reed said, in the UK we need more inspirational stuff to encourage more EM docs, this is exactly the stuff I needed to hear in med school. I’m spreading the EMCRIT word in the UK!

    Steve
    EM Doc
    Swansea
    UK

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