The Tasty Morsels

The tasty morsels of critical care podcast is a series of bite size chunks of knowledge targeted at fellowship exam preparation.

A searchable table of all the posts and episodes exists below.

Episode	Topic	System	Link
001	Thrombotic Thrombocytopaenic Purpura	Haem	001
002	Diastolic Dysfunction	Cardiac	002
003	Diabetic Ketoacidosis DKA	Endo	003
004	Transplant drugs	Transplant	004
005	Submersion	Environmental	005
006	Chylothorax	Respiratory	006
007	Pneumocystis Jirovecii Pneumonia	Micro	007
008	Decompressive Craniectomy for Stroke	Neuro	008
009	The ESPEN 2018 Nutrition Guidelines	Nutrition	009
010	Cardiac disease in pregnancy	Obstetrics	010
011	Tumour Lysis Syndrome	Oncology	011
012	ICU Sedation	Pain and sedation	012
013	Tracheostomy - putting it in	Procedure	013
014	Tracheostomy – Taking it out	Procedure	014
015	Acute Kidney Injury	Renal	015
016	Open Lung Biopsy for ICU patients	Respiratory	016
017	Pyroglutamic acidosis	Tox	017
018	Liver Transplant Part 1	Transplant	018
019	Liver Transplant Part 2	Transplant	019
020	ICP Monitoring	Neuro	020
021	Time cycling vs flow cycling	Ventilation	021
022	Necrotising fasciitis	Micro	022
023	Cardiac Pacing	Cardiac	023
024	The aminoglycosides	Drugs	024
025	Andrenocortical insufficiency	Endocrine	025
026	Short Bowel Syndrome	Gastro	026
027	Plasmapheresis	Haem	027
028	HIV in the ICU	Micro	028
029	C. Diff	Micro	029
030	GBS Part 1	Neuro	030
031	GBS Part 2	Neuro	031
032	Nutritional requirements in ICU	Nutrition	032
033	Pre-eclampsia	Obstetrics	033
034	Chemotherapy agents and intensive care	Oncology	034
035	When to start CRRT	Renal	035
036	Oxygen	Respiratory	036
037	Serotonin Syndrome	Tox	037
038	Lung Transplantation	Respiratory	038
039	Management of raised ICP	Neuro	039
040	Respiratory Monitoring	Ventilation	040
041	Gas Emboli	Cardiac	041
042	Nitric Oxide	Ventilation	042
043	Inotropes and vasopressors	Cardiac	043
044	Calcium Disorders	Endocrine	044
045	Chemical Biological Radiological and Nuclear exposures	Environmental	045
046	Abdominal Compartment Syndrome	Gastro	046
047	Haemostatic failure	Haem	047
048	Anaphylaxis	Immunology	048
049	Candida	Micro	049
050	Spinal cord injuries	trauma	050
051	Parenteral nutrition	Nutrition	051
052	Bronchoscopy in the ICU	Respiratory	052
053	Recurrent clotting of the filter	Renal	053
054	Chest injuries	Trauma	054
055	Salicylate Poisoning	Tox	055
056	Aspergillosis	Micro	056
057	Myasthenia Gravis	Neuro	057
058	Haematological Malignancy	Haem	058
059	Dead Space	Ventilation	059
060	Post Cardiac Surgery Patient	Cardiac	060
061	Asthma	Respiratory	061
062	Diuretics	Drugs	062
063	Respiratory Compliance	Respiratory	063
064	Staph Aureus	Micro	064
065	Cerebral Protection	Neuro	064
066	Solid Tumors in Intensive Care	Oncology	065
067	The pulmonary artery catheter	Cardiac	067
068	Ventilator Triggering	Ventilation	068
069	Sub Arachnoid Haemorrhage	Neuro	069
070	CRRT Modes	Renal	070
071	Non invasive ventilation in the ICU	Ventilation	071
072	Cardiorenal syndrome	Renal	072
073	Hepatorenal syndrome	renal	073
074	Dynamic LV outflow tract obstruction	Cardiac	074
075	Vasopressin	Drugs	075
076	VV ECMO	Respiratory	076
077	Thyroid emergencies	Endocrine	077
078	Hyponatraemia – diagnostic approach	Renal	078
079	Hyponatraemia – management	Renal

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At this stage (Oct 2020), PGY17 and still in training I have done a fair number of exams and I feel that now, pushing 40 and vowing never to do another exam, I may have finally perfected my examination technique. But that’s for another post.

I have accumulated a large number of summarised and truncated notes across two specialties (three if you include the echo stuff…) and they exists as a useful compilation of information that I felt tricky enough and important enough to create a note for.

(as an aside I have migrated to Google Keep in a big way as my main repository for these notes in progress)

Like many people on t’internet, I feel it’s somewhat of a shame to keep these hidden behind my somewhat poorly secured google account and have tried to translate them to this here forum for public appreciation/scorn. In addition the transposition of said notes from brief notary form to the longer, and better hyperlinked form is an exercise in curation and improvement itself.

Ultimately I am engaged in an ongoing project to turn these notes into spoken word in the style of the great Mark Crislip’s “Gobbet of pus” to which this podcast is a humble and greatly inferior derivative of.

The Goal

The aim here is brief, <5min episodes that address a topic in hopefully just enough detail to stick in the mind in a manner that might be retrievable in a situation of extreme stress – namely a fellowship examination. The knowledge contained will hopefully be sufficient to allow you to not look completely clueless on the ICU round when the topic of PR3+ve ANCA vasculitis comes up.

They are not designed to be comprehensive coverage of a topic and the concepts included are deliberately simplified to maximise retention. As such this hopefully will occupy the niche of “exam prep/board review” in the already somewhat crowded critical care podcast scene.

While tagged and categorised on the site to some degree, I have decided to mix and match the EM with the ICM in the hopes of upholding the shared knowledge base and skill set that the two specialties enjoy. If the ortho turns off the intensivists and the antifungals turns off the emergentologists then apologies in advance and I strongly encourage the healthy use of the “skip” button on your podcatcher/player/thingamadoodle.

While not exactly a podcast of me reading aloud the LITFL or Deranged Physiology entry, it is definitely in the category of fan fiction.

Resources used in preparation for the ICM sections:

• I used Oh’s Manual of Intensive Care as the curriculum guide. It doesn’t always teach the topic the best but by covering this cover to cover I felt confident I’d covered the curriculum
• LITFL Critical Care Compendium: These are invaluable as a clinical and an exam resource and cannot be praised highly enough. My notes are frequently shorter more simplistic versions
• Deranged Physiology: I used this when I wanted detail and background. There are a lot of rabbit holes and detail that is not within the scope of an ICM exam. But it is wonderfully written and referenced and a good source of links to PDFs of important review articles.
• The IBCC: This is of course still a work in progress but it was my constant companion as I ran loops of Maynooth in 2020.
• Irwin & Rippe: Much more of a US perspective on ICM but again useful as a canonical source of detail and pathophysiology
• Tobin’s book on mechanical ventilation: I’ve still only scratched the surface of this but it’s great

Resources used in preparation of the EM sections:

• The Oxford Handbook of EM: I had a PDF version that I heavily annotated and used as a guide for curriculum coverage. If you just read trauma and resus ad stuff you’re interested in you’ll never cover the gynae emergencies…
• Rosen’s Textbook: Huge amounts of detail and breadth and generally dipped into when that’s what I needed
• Guidelines: An extensive knowledge of up to date guidelines relevant to UK EM practice is essential for the FRCEM exam. I collated and summarised a LOT of these.

If really interested the music from the intro and outro is my own and can be found here