Critical Care Education …

On Your Terms.

“Change is inevitable, but transformation is by conscious choice.”
— Heather Ash Amara
The Acute Care Lab
$89.00
One time

✓ Access to 24 Video Lectures
✓ Downloads To Slides For All Lectures
✓ Downloads For 6 Templates, Visual Aids, Charts

Educational material dedicated to helping you level up your ICU skills.

  • What It Is:

    • A library of 24 educational videos with associated lecture slides and adjunct templates/visual aids teaching provider management of the acute patient.

  • How It Is Different:

    • Teaching style begins with a brief review of pathophysiology so that you can understand the why before the how. Most lectures include a case study and focus on application.

    • Presentation style is dynamic and casual - I despise attending lectures where an academic reads words from a power point.

    • Evidence based with reference links as well as a focus on the most helpful resources to add to your arsenal.

  • Who It Is For:

    • Ideal for anyone new to ICU level of care. The content is focused on patho-physiology and management and is intended to train new ICU providers.

    • Members have included nurses, respiratory therapists, nurse practitioners, physician assistants, EMS providers, even a medical resident.

Now converted to a vault containing instant access to 24 video lectures, PDF slides, templates, visual aids. At this time there are no live lectures.

Featured
Managing Hypo/Hypernatremia In The ICU
Managing Hypo/Hypernatremia In The ICU

  • Case Study

  • Favorite adjunctive resources

  • Brief physiology review

  • S/S of high and low sodium levels and assigning severity

  • Diagnosing the type of derangement

  • Narrowing the etiology differentials

  • When to treat and when to leave them alone

  • How to treat

  • Pitfalls to avoid in management

  • When to consult nephrology

Managing Arrhythmia
Managing Arrhythmia

  • The limitations of a typical non-cardiac ICU nurse practitioner

  • Case Study

  • Rhythm review including diagnosis, handling emergencies, when to get a 12 lead and what to do with it, cardioversion, anti-coagulation, other medical/device management, and when to phone a friend.

    • ST

    • SVT

    • AVNRT

    • AVRT

    • AT

    • Afib

    • Aflutter

    • Bradycardia / Sick Sinus Syndrome

    • VT & VT storm

    • PVCs and other intermittent irregular beats

  • Best resources

This is not a 12 lead interpretation lecture. Instead, this is designed to teach the non cardiac NP how to handle urgent and emergent arrhythmias including rapid/generalized interpretation, forming diagnoses, identifying likely etiologies, and management.

IV Fluids
IV Fluids

  • How To Choose The Right Fluid Type, Rate, & Site of Administration By Diagnosis

    • Resuscitation ≠ Maintenance

  • Case Study

  • How Fluids Move

    • ECF vs ICF

    • Oncotic/Hydrostatic Pressures

    • Electrolyte Impact

  • Crystalloid vs Colloid

  • Each Fluid Type & Their Effect On ECF/ICF Electrolytes & Volume Shifts

    • Indications v Contraindications

  • A Bit About Access

Complete Guide To CPAP/BPAP
Complete Guide To CPAP/BPAP

  • Case study

  • Understanding the mechanism of action with CPAP and Bipap devices

  • Breakdown of the interface variables and what they mean

  • Discussion of indications for and limitations of use

  • Absolute and relative contraindications

  • Delineation of modes, deciding what mode to use for initial set up

  • How to perform the follow up evaluation

  • When hypercarbia is expected and how to handle it

  • Evaluating pt response and knowing when to intubate

ETOH Withdrawal
ETOH Withdrawal

  • The progression of pathophysiology in acute alcohol ingestion -> alcohol dependency -> alcohol withdrawal

  • Case Study

  • Guidelines

  • How to diagnose ETOH w/d and assign severity

  • Disposition - where your pt. will be best served/safest

  • Management

    • Neurotransmitter targeted approach

    • Adjuncts

    • Supportive Care

    • Why CIWA protocols suck

    • Airway concerns

  • The progression of pathophysiology in acute alcohol ingestion -> alcohol dependency -> alcohol withdrawal

  • Case Study

  • Guidelines

  • How to diagnose ETOH w/d and assign severity

  • Disposition - where your pt. will be best served/safest

  • Management

    • Neurotransmitter targeted approach

    • Adjuncts

    • Supportive Care

    • Why CIWA protocols suck

    • Airway concerns

Managing The Critically Ill GIB
Managing The Critically Ill GIB

  • Identifying The Source (Upper v Lower)

  • Quality of bleeding and degree of concern

  • Hematologic considerations

    • Limitations of H/H results - how to interpret with clinical context

    • Coagulopathy reversal

    • TEG guided resuscitation

  • Diagnosing etiology

  • Risk Stratification: Ok for floor admission | ICU admit | All hands on deck emergency

  • Pillars of Mgt

    • Emergent Steps

    • Medical Management

    • Interventions for source control and who does what

  • Identifying The Source (Upper v Lower)

  • Quality of bleeding and degree of concern

  • Hematologic considerations

    • Limitations of H/H results - how to interpret with clinical context

    • Coagulopathy reversal

    • TEG guided resuscitation

  • Diagnosing etiology

  • Risk Stratification: Ok for floor admission | ICU admit | All hands on deck emergency

  • Pillars of Mgt

    • Emergent Steps

    • Medical Management

    • Interventions for source control and who does what

Treating Sepsis In The ICU
Treating Sepsis In The ICU

This lecture will discuss THE MOST COMMON problem we treat in any ICU: The dreaded sepsis. Antibiotics are complicated and rely heavily on an individualized approach. For me, understanding proper coverage became easier once I took a reverse engineering approach. Starting with identifying the common problems we treat (PNA, UTI…), what organisms tend to cause these infections, the resistance profiles we need to be cognizant of covering, and pt co-morbidites that impact drug selection.

  • Case study

  • Pathophysiology and complications

  • How to work up and identify a patient with sepsis

  • Common etiologies

  • Risk factors for hard to treat organisms: MRSA, Pseudomonas, anaerobes, fungal organisms

  • How to choose an antimicrobial agent

  • When medication alone won’t cut it

  • A bit about shock

  • The BEST resources to have on hand to help you make decisions

Cardiogenic Shock
Cardiogenic Shock

  • How to identify when de-compensated HF has progressed to cardiogenic shock

  • Why cardiogenic shock is a self-perpetuating cycle of badness (brief pathophys review)

  • Hemodynamics

  • Delineation of the two(-ish) categories of cardiogenic shock

  • How it differs from other forms of shock

  • Management Steps 1-5

  • Inotropes / Mechanical support

Decompensated Heart Failure
Decompensated Heart Failure

  • Types of HF: Left v Right, Systolic v Diastolic

  • Common causes

  • When to hold goal directed medical therapy

  • How to evaluate severity from an organ system approach

  • Management pillars

  • Cardiogenic shock and mechanical support will be covered in the lecture following this

What To Do If Your Intubated Pt Becomes Hypoxic
What To Do If Your Intubated Pt Becomes Hypoxic

  • Brief review of pathophysiology and causes

  • ARDS discussion

  • Step1-3: Assessment of patient, medications, recent events, or changes in plan of care that have impacted this decline

  • Step 4: Assessment of imaging (POCUS, XR, CT)

  • Step 5: Assessment of ventilator and other equipment, what the data on the vent can elucidate. Alarms, peak/plateau pressures

  • Step 6: Chart review/further narrowing of differentials

  • Step 7-8: Developing an action plan and reevaluating

The goal is to help reduce a problem with vast etiologies down to a more easily traversed workup with actionable steps for treatment. This lecture picks up where the respiratory failure lecture left off and drills deeper into the unique pathophysiology experienced by patients who are on a ventilator. Often this is an acute issue that demands rapid establishment of a (pretty darn) good idea of the likely problem and more importantly, the solution. Objectives for this lecture are as follows:

  • Brief review of pathophysiology

  • Common causes

  • ARDS discussion with strategy and treatment options including the associated risk of complications that comes with each

  • Step1-3: Assessment of patient, medications, recent events, or changes in plan of care that have impacted this decline

  • Step 4: Assessment of imaging (POCUS, XR, CT)

  • Step 5: Assessment of ventilator and other equipment, what the data on the vent can elucidate. Alarms, peak/plateau pressures

  • Step 6: Chart review/further narrowing of differentials

  • Step 7-8: Developing an action plan and reevaluating

    This lecture include sa ventilator assessment mind map to help aid you in diagnosing the cause of hypoxia.

Pressors 101
Pressors 101

  • What constitutes a pressor, an inotrope, and other medical agents used to treat hypotension

  • Shock vs hypotension with basic physiology review

  • Breakdown of adrenergic receptors

  • Classification, MOA, indications, dose, pros, cons, and tips for each of these drugs:

    • Levophed, Epinephrine, Vasopressin, Neosynephrine, Milrinone, Dobutamine, Dopamine, Isuprel, Angiotensin II

  • This lecture includes a visual aid download under the PDF archives section.

The goal is to familiarize you with the medical agents used to support your pt’s low blood pressure. It requires some discussion about the nature of shock versus hypotension; a review of adrenergic receptors and the varying affinity of catecholamines for these receptors so that you have a more firm grasp on when to treat, how to treat, and what to treat with to optimize management, limit side effects, and prevent a paradoxical worsening of the problem. Objectives for this lecture are as follows:

  • What constitutes a pressor, an inotrope, and other medical agents used to treat hypotension

  • Shock vs hypotension with basic physiology review

  • Breakdown of adrenergic receptors

  • Classification, mechanism of action, indications, dose, pros, cons, and tips for each of these drugs:

    • Levophed, Epinephrine, Vasopressin, Neosynephrine, Milrinone, Dobutamine, Dopamine, Isuprel, Angiotensin II

  • This lecture includes visual aid downloads for

    • Drugs and their effects by comparison to one another for quick reference

    • Adrenergic receptors

    • Shock overview

Post Arrest Managment
Post Arrest Managment

  • Discussion of the 5 phases of post cardiac arrest syndrome to help you anticipate the “what comes next when” plan.

  • Focusing on etiology of the arrest, which tests still need to be ordered, and what you should do about common causes.

  • Post-stabilization fall out: which organs are going to fail when and how do you handle this.

  • TTM discussion: current evidence and pros/cons of cooling.

  • When and how to prognosticate.

  • Tips for handling the family/POA.

You got them back, yipee! Now what 🤔? Believe it or not this is fairly predictable and standard management. While all patients face differing severity, the problems they encounter are straight forward. This lecture will focus on the common problems patients encounter and the timing of these issues so you know when to BOLO.

  • Discussion of the 5 phases of post cardiac arrest syndrome to help you anticipate the “what comes next when” plan.

  • Focusing on etiology of the arrest, which tests still need to be ordered, and what you should do about common causes.

  • Post-stabilization fall out: which organs are going to fail when and how do you handle this.

  • TTM discussion: current evidence and pros/cons of cooling.

  • When and how to prognosticate.

  • Tips for handling the family/POA.

IF Your Pt Is Coding THEN Do This
IF Your Pt Is Coding THEN Do This

As a provider you have many roles to fill in a cardiac arrest situation, which when you are new, can feel overwhelming in the heat of the moment. This lecture will walk you through the step-wise approach to organizing your thoughts, interventions, and management of the coding patient.

  • How your role as the provider is different

  • Pros/Cons and timing of procedures you may need to perform

  • How to command the room and limit the chaos

  • How to determine etiology

  • Immediate management

Red Herrings: The Scary Pieces Of Data You Don't Want To Get Wrong
Red Herrings: The Scary Pieces Of Data You Don't Want To Get Wrong

The key to teasing out what to do or not do is to understand the difference between the normal-abnormal state and the abnormal-normal state. In this lecture we will talk about the following conditions in regards to establishing etiology, steps to take for treatment, when to leave them alone, when to worry, and when to panic:

  • Tachycardia

  • Tachypnea

  • Hemoglobin

  • Hypercarbia

  • Sodium Derangements

Often the most common calls you will get from bedside staff in the ICU are for concerns about labs, vital signs, and exam findings which reflect a compensatory state. Do not cave to the pressure of needing to treat a number without fully understanding why the data exists and if it is a good thing or a bad thing. You will, at best, just be chasing your tail and have to continuously temporize things, or at worst, kill them. The key to teasing out what to do or not do is to understand the difference between the normal-abnormal state and the abnormal-normal state. In this lecture we will talk about the following conditions in regards to establishing etiology, steps to take for treatment, when to leave them alone, when to worry, and when to panic:

Tachycardia
Tachypnea
Hypercarbia
Hemoglobin
Sodium derangements

IF Your Pt Needs To Be Intubated THEN Do THis
IF Your Pt Needs To Be Intubated THEN Do THis

  • Learn the proper way to set up your room/equipment.

  • Define the steps involved with establishing multiple plans and creating a team approach.

  • Discuss drug selection.

  • Identify the common high risk intubation situations, and what you can do to mitigate complications/prevent cardiac arrest.

    • GIB

    • Hypoxemia

    • Hypotension

    • Metabolic Acidosis

    • Asthma/COPD

  • Learn the proper way to set up your room/equipment.

  • Define the steps involved with establishing multiple plans and creating a team approach.

  • Discuss drug selection.

  • Identify the common high risk intubation situations, and what you can do to mitigate complications/prevent cardiac arrest.

    • GIB

    • Hypoxemia

    • Hypotension

    • Metabolic Acidosis

    • Asthma/COPD

    • Pulmonary HTN / RV failure

How To Decide When It Is Time To Intubate
How To Decide When It Is Time To Intubate

  • Determining the diagnostic class of respiratory failure.

  • Disease states and a brief review of which phase of ventilation and impaired gas exchange is affected.

  • Review of the pertinent data/exam used. Do you need an ABG? What invalidates a VBG?

  • Determining etiology and why this is the cornerstone to developing a plan.

  • Options which could defer intubation.

  • CPAP/Bipap

  • Global perspective on diagnosis + prognosis in conjunction with pt GOC to establish what actions need to happen and in what order.

IF Your Non-Intubated Pt Is Agitated THEN Do This
IF Your Non-Intubated Pt Is Agitated THEN Do This

  • A brief review of the types of agitation.

  • Emotional vs physical causes, common etiologies andhow to differentiate your problem.

  • Step 1: Identifying and managing emergencies.

  • System based exam, review of recent events, labs, diagnostics, and vital signs data and how these narrow the differential.

  • Focused/ideal management for your specific patient.

  • The goal: evidence based; focused selection of the most appropriate plan of care for what you are combating.

IF Your Non-Intubated Pt Is Agitated THEN Do This

  • Designed to be action oriented, these IF…THEN lectures teach step wise approach to managing specific problems. You can walk into a room prepared to come to the most likely diagnosis AND provide a plan of care for the team with confidence.

  • Agitation is likely the #1 call you will receive as an ICU provider. Beware the blanket order for sedation - there is a decent chance you could make your pt worse.

  • This lecture will consist of:

  • A brief review of the types of agitation.

  • Emotional vs physical causes, common etiologies and how to differentiate your problem.

  • Step 1: Identifying and managing emergencies.

  • System based exam, review of recent events, labs, diagnostics, and vital signs data and how these narrow the differential.

  • Focused/ideal management for your specific patient.

  • The goal: evidence based; focused selection of the most appropriate plan of care for what you are combating.

Sedatives In The ICU
Sedatives In The ICU

  • A discussion on the nature of agitation.

  • Analysis of the neurotransmitters/receptors involved in agitation.

  • Drugs presented: Precedex, Propofol, Versed, Phenobarbital, Ketamine, Typical and Atypical Anti-psychotic options, PRN options.

  • Indications, mechanism of action, dosage, adverse reactions, considerations for use, benefits.

  • The goal: Evidence based; focused selection of the most appropriate medication regimen for what you are combating.

ABG Case Studies
ABG Case Studies

  • Brief ABG review.

  • Case studies involving HPI, vitals, labs, imaging, ventilator interfaces, and other info.

  • ID primary disturbance

  • Discuss expected compensation

  • What is the diagnosis driving the ABG derangement

  • What is your plan

  • The goal here is illustrating application of ABG mastery. Ultimately an ABG is just a tool to point us in the right direction.

ABG Mastery AND Application
ABG Mastery AND Application

ABG Mastery AND Application

  • Interpretation overview - made super fast.

  • Why the data you’re looking at may not be accurate.

  • Focus on compensatory mechanisms, how to determine if the pt is doing so on their own; if they need support and how urgently.

  • Differential diagnosis development and how ABG’s assist.

  • What to do about the acid base disturbance. APPLICATION is the key.

  • Case studies including lots of ABG print outs. Our goal is to speed up the assessment and plan process related to ABG’s.

Ventilator Modes
Ventilator Modes

  • Deep overview of how to relate similar modes regardless of what manufacturer your institution uses.

  • Suggested resources for those who want to go a little deeper in understanding mechanisms, asynchrony and pt complications while on vent.

  • Mode Taxonomy

  • Control Variable

  • Breath Sequence

  • Target Scheme

    • Do we want the machine to adapt to pt feedback?

  • Pros/Cons to each mode.

  • The four main classifications of modes: PCV vs VCV, IMV, Pressure Support/CPAP, and adaptive modes.

Interpreting The Ventilator
Interpreting The Ventilator

  • Why is it so confusing?

  • Best way to learn - step by step approach

  • Suggested resources

  • Vent scavenger hunt

  • Breaking down the components you see - machine (set/independent variables) and pt (dependent variables) + numerical vs graphic display

  • Intro to waveforms and what they represent

  • Intro to pressures

  • Our own vent scavenger hunt

CXR Interpretation
CXR Interpretation

  • Review of chest anatomy and physiology

  • When your film is trash and how to shift your interpretation

  • ABCDEF approach…

  • Common pathology and what to do about it

  • Case Studies presentation

Learning to read chest xrays in the hospital or ICU is a very right brained process. The more you look at with guidance the easier it becomes. In this lecture we review the systematic approach. In time you will be performing the review of all these systems simultaneously.

Shock
Shock

  • Pathophysiology Review

  • Suggested Resources / Recommended Pocket Guides

  • Hemodynamics Overview of Shock States

  • Case Studies

Recent Lectures…

Templates Created For The Lectures

Pressors 101 Visual Aid
Quick View
Pressors 101 Visual Aid
$5.00

Two sided 8.5x11 PDF with an overview of shock physiology, the adrenergic receptors with associated effects & agonist/antagonists from each class on one side. The reverse side contains a chart and a graph with all the common drugs used and their intended receptor targets yielding a net effect all in one place so you can quickly make decisions regarding which agent would be ideal in your patient’s situation.

Guide For Hypoxia While On A Vent Visual Aid
Quick View
Guide For Hypoxia While On A Vent Visual Aid
$5.00

This data is a mindmap for working through the etiology and solution to managing hypoxia while a patient is ventilated. It includes differentials for acute versus progressive onset, common ventilator alarms and what concerns they raise, and a quick action ABC approach to mitigate the panic factor.

This is a downloadable PDF file which will be accessible to you immediately upon purchase.

ICU Sepsis 101 Visual Aid
Quick View
ICU Sepsis 101 Visual Aid
$5.00

This is a quick reference guide for sepsis. Publication date 2/2024. Bearing in mind many regional and timeline changes will vary the data presented here. This is designed to act as a place to start for quick reminders of the pathophysiology, the common risk factors to consider, and on the reverse is a think chart for antimicrobial selection as well as resource recommendations.

Shock Template
Shop For Visual Aids
Shop For Visual Aids
BPAP Guide Visual Aid
Quick View
BPAP Guide Visual Aid
$5.00

Two sided guide for use as a quick reference to understanding and managing Bilevel Positive Airway Pressure. Page one: breaking down the components you see on the interface + strategy for common problems encountered in ICU. Page two: walks you through how to correct properly for acidosis via BPAP settings.

ICU patient workup template

Learning to write notes is a difficult trajectory.

Watch this quick video to see how mastering your own EMR’s built in technology will serve you well in regards to gaining traction with your growth.

These books are a how-to for H&P note writing. But they are so much more than that. They include a copy/paste ready dotphrase for the most commonly encountered problems in critical care as well as a teaching section for each problem. A “behind-the-scenes” if you will, sharing what I teach NP students about the pathophysiology, forming a differential diagnosis, and developing an evidence-based treatment plan.

Purchase
Purchase

The Ultimate H&P Cheatsheet

The newly written 2nd edition includes expanded details.

The newly written 2nd edition includes expanded details.

Truly the most common diagnoses you will see.

Truly the most common diagnoses you will see.

Each problem/diagnosis begins with some teaching pages.

Each problem/diagnosis begins with some teaching pages.

A thorough; evidence based plan is presented.

A thorough; evidence based plan is presented.

The sample, which applies to the fictitious patient presented is a great copy/paste to use in your EMR. You simply edit to suit your population/protocols.

The sample, which applies to the fictitious patient presented is a great copy/paste to use in your EMR. You simply edit to suit your population/protocols.

There is a reference sheet including what I consider to be the MOST helpful resources in learning these diagnoses.

There is a reference sheet including what I consider to be the MOST helpful resources in learning these diagnoses.

The Ultimate H&P Cheatsheet Companion

Volume 2 is now available!

Volume 2 is now available!

11 of the next most common diagnoses.

11 of the next most common diagnoses.

A new patient scenario with a set of associated problems. I do include some bonus diagnoses at the end which are variations of a few diagnoses introduced in the first book.

A new patient scenario with a set of associated problems. I do include some bonus diagnoses at the end which are variations of a few diagnoses introduced in the first book.

Same presentation format as the first book: a few pages of teaching followed by a sample.

Same presentation format as the first book: a few pages of teaching followed by a sample.

Months of research combined with my years of experience were poured into this book so that you can fast track your learning.

Months of research combined with my years of experience were poured into this book so that you can fast track your learning.

These dot phrase samples are ready to go for you so all you have to do is load them in your EMR and get busy seeing patients.

These dot phrase samples are ready to go for you so all you have to do is load them in your EMR and get busy seeing patients.

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The Ultimate H&P Cheatsheet

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