The Critical Care Commute Podcast

Hantavirus Infection: From Rodents to Cruise Ships and ICU. 26.05.2026 25min

This episode features Professor Wendy Sligl discussing hantaviruses, their transmission, clinical presentation, public health response, and prevention strategies. Aimed at healthcare professionals and public health officials, it provides critical insights into managing outbreaks and understanding zoonotic diseases.Key Topics:Hantavirus family and strainsTransmission routes and human-to-human spreadClinical presentation and severity spectrumPublic health response and quarantine protocolsPrevention and protective measures

Intubate at the Roadside? A.I Modelling that Could Save Lives, Money and Justify Resources. 12.05.2026 26min

From Intubation Dilemmas to Data-Driven Decisions: Cutting-Edge Research in Pre-Hospital Trauma Care. In this episode, we explore a study that leverages machine learning and causal modeling to improve pre-hospital trauma interventions, specifically endotracheal intubation. Experts Amy Nelson and Julian Thompson discuss how innovative data analysis can inform real-time decision-making, enhance patient outcomes, and optimize resource allocation in emergency settings.Main Topics:The long-standing debate over early pre-hospital intubation and its survival benefitsMethodological advances using machine learning and causal inference in emergency researchHow predictive models can support clinicians at the roadside and future directions for trauma careThe significance of integrating AI tools into clinical judgment without replacing human expertiseCost-effectiveness and system-wide implications of adopting data-driven protocols in trauma systems

Dr Craig Spencer: I Went to an Anti Vax Conference, So Should You! 28.04.2026 33min

In this in-depth interview, Dr. Craig Spencer discusses the anti-vaccine movement, its community dynamics, historical context, and how healthcare professionals can engage effectively. The conversation explores the psychology behind vaccine hesitancy, community engagement strategies, and the importance of understanding different perspectives.Further Reading: https://www.statnews.com/2025/11/11/childrens-health-defense-conference-pro-vaccine-doctor/Craig Spencer, MD, MPH | Center for Human Rights and Humanitarian Studies | Brown University

Antibiotic Stewardship: IV Amoxiclav with Dr George Zhanel 17.04.2026 31min

In this episode, made possible through an educational grant from Sandoz Canada, Dr. George Zhanel discusses the latest developments in antimicrobial stewardship, focusing on IV Amox Clav, its clinical applications, safety profile, and the Canadian Leadership on Antimicrobial Real-Life Usage Registry (CLEAR). Gain insights into optimizing antibiotic use and future prospects in antimicrobial development.Key Topics:IV Amox Clav clinical applicationsCanadian Leadership on Antimicrobial Usage Registry (CLEAR)Antibiotic stewardship strategiesFuture developments in antimicrobial agentsChapters: 00:00 Introduction and Guest Credibility01:47 Introduction of Dr. George Zhanel and his background02:41 The journey into IV Amox Clav and its significance03:21 Overview of the CLEAR registry and its purpose06:18 Findings from the CLEAR study on IV Amox Clav usage07:57 Clinical indications and safety profile of IV Amox Clav10:58 De-escalation and appropriate use of IV Amox Clav12:34 Use in bacteremia and various infections13:35 Side effects and safety data of IV Amox Clav15:02 Dosing strategies and renal adjustments17:29 Beta-lactamase inhibitors and future antimicrobial development20:16 Future prospects for new antibiotics in Canada23:13 Canadian Antimicrobial Resistance Alliance (CARA) and involvement25:53 Case examples and clinical decision-making in pneumonia and skin infections31:09 Closing remarks and appreciation for the audienceResources: Canadian Leadership on Antimicrobial Real-Life Usage Registry (CLEAR) - https://www.clearregistry.caCanadian Antimicrobial Resistance Alliance (CARA) - https://www.cara.caMeropenem Vaborbactam - https://www.meropenem.comCeftazidime-Avibactam - https://www.ceftazidime-avibactam.comGuest Links: LinkedIn - https://www.linkedin.com/in/george-zhanelTwitter - https://twitter.com/GeorgeZhanel

Meningitis: Implications for Critical Care 03.04.2026 51min

Young lives have sadly been lost in the 2026 Kent meningitis outbreak. An “unprecedented” cluster centred on the University of Kent, linked to a Canterbury nightclub, and rapidly spreading through student halls and social mixing.In this timely and hard-hitting podcast episode, Jonny is joined by Intensivists Martin Beed, Peter Brindley (authors of the new primer on infectious meningitis and encephalitis in the Journal of the Intensive Care Society), and Andrew Conway-Morris.They explore the UK government’s targeted MenB vaccination program for university students and affected schools, the critical importance of early clinical suspicion and prompt antibiotic administration, transmission risks in nightclubs and social settings (including behaviors like vaping), and lessons from past UK and global outbreaks.The discussion also covers practical public education, healthcare worker resources including useful infographics. The discussion stresses the need for high vigilance, rapid treatment, vaccination where appropriate, and support for public and family mental health during outbreaks.Packed with actionable clinical guidance and real-world takeaways, this episode is essential listening for healthcare professionals, students, parents, and anyone wanting to understand how to spot, treat, and prevent this devastating disease.

Dose VF: Defibrillation Done Right! With Prof. Sheldon Cheskes 25.03.2026 31min

This episode features Sheldon Cheskes discussing advanced defibrillation techniques, including double sequential defibrillation, vector change, and the importance of early intervention in refractory VF. Gain insights into recent trials, practical protocols, and the impact on neurological outcomes.Key topicsDouble sequential defibrillation (DSD)Vector change and pad positioning in defibrillationTiming and dosing of medications in VFImpact of early intervention on neurological outcomesRecent clinical trials: Dose VF and EpiDoseFurther Reading:Defibrillation Strategies for Refractory Ventricular Fibrillation

Science Communication and the Certainty Illusion - Prof Tim Caulfield 11.03.2026 38min

In this conversation, Peter Brindley and Timothy Caulfield discuss the critical importance of science communication in the face of misinformation and the challenges posed by predatory journals. They explore the societal impact of vaccines, the misuse of scientific terms for marketing purposes (scienceploitation), and the illusions surrounding science, goodness, and opinion. The discussion emphasizes the need for humility in science, the pressures researchers face, and the responsibility of all individuals to advocate for accurate scientific information.Lessons: We all have to speak up for science.Science is a process, not a list of facts.There is pressure to publish, leading to predatory journals.Vaccines are one of the most successful biomedical interventions.Science is often misused as clickbait.Terms like 'natural' have become meaningless in marketing.You can't really boost your immune system; it's about maintaining health.The wellness industry has significant conflicts of interest.The opinion illusion shows how we are manipulated by online reviews.Trillions of dollars depend on the credibility of online reviews.

Critical Care Workforce: Where We Are, And Where We're Going with Prof. Peter Kruger 24.02.2026 24min

In this conversation, Peter Brindley and Leon Byker sit down with Peter Kruger, President of the College of Intensive Care Medicine, to unpack one of the defining issues facing healthcare today: workforce reform.Against the backdrop of national workforce reviews across Australia and New Zealand, the discussion explores the tension between aspiration and reality. Governments want equitable access, rural coverage, sustainable systems, and improved wellbeing for clinicians. Colleges want standards, safety, and meaningful careers. Trainees want jobs. Communities want hospitals. Politicians want solutions.So how do we reconcile all of it?Dr. Kruger reflects on the growing engagement between specialist colleges and government, particularly around workforce maldistribution, rural and regional care, sub-specialization versus generalism, and the moral complexity of relying on internationally trained doctors. The conversation highlights a key truth: intensive care is a hospital-based, system-dependent specialty. You cannot simply “place a doctor” in a community without the supporting infrastructure.The episode also tackles uncomfortable but necessary questions:Can there be a universal standard for ICU access across vastly different hospital settings?Should governments mandate rural placements—or can communities be strengthened from within?What role should nurse practitioners and multidisciplinary teams play?Are we protecting turf, or protecting patients?And how do we better support doctors across the entire career pipeline—from medical student to senior intensivist winding down night shifts?Throughout, the tone is candid but diplomatic. There’s recognition that workforce reform is complex, long-standing, and resistant to simple solutions. Yet there is also optimism: trust, transparency, and genuine partnership between colleges and government may offer a way forward.At its core, this episode is about purpose. The shared mission between clinicians, colleges, and governments is delivering safe, effective care to the community. The challenge lies in doing so while balancing standards, sustainability, and humanity.

Steroids, Fluids, Interleukins, COVID 19 and lots of Professorial Wisdom with Prof. John Myburgh 10.02.2026 24min

In this discussion at the College of Intensive Care meeting in Tasmania 2025, Peter Brindley and Leon Byker engage with Prof. John Myburgh, who talks about his long-standing involvement in critical care research and the annual college meeting. John discusses the significance of the grad ceremony and highlights the impact of his research group at the George Institute. He reflects on the contributions of late colleague Ronaldo and praises current leading figures. The conversation delves deep into the ongoing research on steroids in critical care, focusing on genetic endotypes and precision medicine. Other topics covered include interleukin treatments, the evolution of fluid management in treating conditions like diabetic ketoacidosis, and the adaptive platform trials in sepsis. The discussion concludes with reflections on the Queensland Covid-19 vaccine and the broad implications of science, social forces, and politics in critical care advancements.00:00 Welcome and Introductions00:32 John's Involvement with the College01:47 Research and Collaborations03:29 Steroids in Critical Care04:49 Genomic Studies and Future Trials07:18 Challenges in Measuring Outcomes13:27 Interleukins and Sepsis14:18 Fluid Management in Critical Care19:31 COVID-19 and the Queensland Vaccine23:49 Closing Remarks

Are Emergency Rooms in Crisis? With Dr Paul Parks. 26.01.2026 34min

In this episode of the Critical Care Commute, hosts Peter Brindley and Leon Byker engage in a compelling discussion with Dr. Paul Parks, a prominent emergency physician and advocate for healthcare reform. Dr. Parks shares his insights on the current state of emergency room care in Alberta, emphasizing the systemic issues that have led to a crisis in emergency services. He describes the overwhelming pressures faced by emergency departments, and highlight the dire need for government acknowledgment and action to address the crisis. He also articulates the challenges of navigating the healthcare system, where patients often wait for hours or even days for care, and advocates for a coordinated response to improve patient outcomes.Takeaways'Emerge owns the sins of the system.''We are right now in a state of crisis.''It's inhumane the conditions that we're seeing.''We need a command and control structure.''We must move back to being data-driven in our decisions.''We have to have the ability to speak truth to power.''Patients are waiting for hours, even days, for care.''The system is chaotic and disorganized.''We need to advocate for transparency and accountability.'

Complaints, Courtrooms and Keeping Calm while Carrying on. 13.01.2026 38min

In this conversation, Dr. Marcus Peck shares his harrowing experience of being involved in a medical case that led to a coronial inquest and subsequent investigation by the GMC. He discusses the emotional toll of moral distress, the challenges of navigating legal scrutiny in the medical field, and the importance of community support. The conversation highlights the complexities of patient care, the impact of loss on healthcare professionals, and the lessons learned from difficult experiences in critical care.Dr Marcus Peck is a consultant in anesthesia and intensive care at Hampshire Hospitals NHS trust, and Network Lead of the Intensive Care Society's Focused Ultrasound for Intensive Care (FUSIC) committee and is joined by Dr Jonny Wilkinson, Consultant in ICU and Anesthesia from North Hampton. Takeaways:Loss is a universal experience in the medical community.Moral distress can significantly impact healthcare professionals.Legal challenges can arise from complex medical cases.Documentation is crucial in protecting healthcare providers.Emotional responses to patient outcomes are valid and important.Support from colleagues and community is essential during tough times.Investigations can feel isolating and shameful for medical professionals.Resilience is key in overcoming professional challenges.Learning from past experiences can improve future practice.Open conversations about these issues can help reduce stigma.

Acknowledgement of Country with Dr Lewis Campbell 17.12.2025 18min

In this short thoughtful episode, we highlight an important Australian tradition: the Acknowledgement of Country. This brief statement, often given at the start of meetings, gatherings, and public events, recognizes the Traditional Custodians of the land, honors their enduring cultural connection to it, and shows respect for Elders past and present. It’s a simple but meaningful way Australians acknowledge history, presence, and identity, and it reflects a national commitment to reconciliation and cultural respect.In today’s episode, we introduce Dr. Lewis Campbell, a critical care physician from Alice Springs, south of Darwin. Dr. Campbell brings his Northern Territory perspective to our clinical conversation, offering insights shaped by the unique geography, culture, and healthcare challenges of Australia’s Top End.A concise, engaging listen for your commute.

MedPod Learn: A New Era in Medical Podcasts. 02.12.2025 31min

In this conversation, Iain discusses the launch of MedPod Learn, a platform offering a searchable database of curated medical podcasts. He shares insights on the pricing strategy, including user perceptions about value and affordability, and the decision to offer a free trial to encourage subscriptions.TakeawaysMedPod Learn offers a searchable database of medical podcasts.The platform is available on both App Store and Google Play.User perceptions of pricing can vary significantly.Some users believe lower prices may lead to undervaluation.Iain's approach includes a free trial for new users.The subscription fee is set at £2.99 after the trial.Market research revealed surprising insights about pricing expectations.The founder's model aims to attract early adopters.Engagement strategies are crucial for subscription services.Understanding user psychology is key to pricing decisions.https://t.co/Jw9XUrA5nhDownload MedPod Learn from Google Play Store or Apple Store

The Obesity Paradox with Dr Rob Bevan 12.11.2025 18min

In this episode, Peter Brindley interviews Dr. Rob Bevan, past president of the CICM, about the obesity paradox in Intensive Care Units (ICUs). They discuss the surprising observation that overweight ICU patients often show better survival rates than those underweight, despite obesity's known health risks. Dr. Bevan dives into the history and the limitations of BMI as a metric and various biases that could influence the perceived obesity paradox. He also explains how classification bias, selection bias, confounding, and collider bias might skew these outcomes. The discussion touches on the importance of separating patients who are critically ill and happen to be obese from those who are in ICU primarily because of obesity-related diseases. The conversation is rooted in the upcoming textbook chapter authored by Dr. Bevan and explores obesity's broader health implications globally.

Precision Medicine - It may be easier than you think! 29.10.2025 31min

In this episode, Peter and Leon, recording at the College of Intensive Care Medicine's Conference in Tasmania, Australia, discuss advancements in precision medicine with Dr. Pratik Sinha from Washington University in St. Louis. Dr Pratik trained in both Emergency and Intensive Care Medicine, but only works clinically as an intensivist. He runs a research program that seeks to change the way we identify and classify critically ill patients, by using a combination of novel biological measurements and state of the art data science approaches. The conversation delves into how critical care medicine currently operates, emphasizing the need to shift from supportive care to more personalized approaches using biological measuring systems, big data, and novel data science techniques. They discuss identifying patient subgroups using machine learning algorithms and protein biomarkers, revealing phenotypes like hyper and hypo-inflammatory responses. The discussion covers the practical challenges of implementing these technologies, the importance of rigorous testing, and the future implications for intensive care. The speakers highlight the necessity of prospective clinical trials and broader accessibility of these advanced diagnostic tools to improve patient outcomes.00:00 Introduction and Opening Remarks00:34 Diving into Precision Medicine01:35 Elevator Pitch for Medical Research02:10 Understanding Patient Complexity04:12 Biological Measurements and Data Science10:37 Challenges in Modern Medicine17:08 Future of Medical Research and AI21:20 Concluding Thoughts and Future Prospects

Mystery Guest - Dr Smith and the future of Critical Care Medicine. 14.10.2025 43min

In this episode of the Critical Care Commute podcast, Dr. Smith discusses the multifaceted future of critical care medicine, touching on economic, political, and technological challenges. The conversation delves into the role of artificial intelligence in enhancing healthcare, the importance of clinician well-being, and the need for a human touch in medicine. The discussion also explores personal interests, travel experiences, and the ethical implications of AI in clinical practice, emphasizing the balance between technology and human interaction.Guests: Drs Marcus Peck and Jonny Wilkinson. Chapters00:00 The Future of Critical Care Medicine02:40 Artificial Intelligence in Healthcare05:38 Human Factors and Clinician Well-being08:22 Economic Challenges in Healthcare11:09 The Role of Politics in Healthcare14:13 The Turing Test and AI's Evolution16:41 Personal Interests and Travel Experiences19:57 AI's Impact on Clinical Practice22:38 Ethical Considerations of AI in Medicine25:19 The Future of AI and Human Interaction

The Power of Kindness 30.09.2025 20min

The Power of Kindness in Healthcare: A Conversation with Dr. Suzanne Crowe. In this episode, Peter Brindley and Leon Byker speaks with Dr. Suzanne Crowe, pediatric intensivist and president of the Medical College of Ireland, at the College of Intensive Care meeting in Tasmania, 2025. They explore the significant impact of kindness on patient outcomes, emphasizing its vital role in healthcare. Dr. Crow highlights the necessity of incorporating kindness as a core practice, noting that it reduces mistakes, improves diagnostic accuracy, and fosters better cooperation from patients. They discuss the effectiveness of empathy training and the importance of leadership in fostering a culture of kindness within healthcare systems. Dr. Crow also shares practical tips for healthcare professionals on how to demonstrate kindness in daily interactions, such as sitting beside patients and offering comforting gestures.00:00 Introduction and Guest Welcome00:34 The Power of Kindness in Healthcare01:24 Defining and Recognizing Kindness02:20 Microdosing Kindness in Practice03:19 Teaching and Modeling Kindness03:54 Empathy Training and Its Importance05:07 Challenges and Barriers to Kindness06:57 Kindness in Patient Interactions09:27 Systemic Kindness and Leadership17:17 Empathy Training Techniques19:00 Conclusion and Final Thoughts

Remote River Rescue: A Story of Triumph in Tasmania 16.09.2025 32min

Join Peter Brindley and Leon Byker as they host David Bertoni, an ED physician and ECMO clinical lead, and Jorian 'Joe' Kippax, a trauma specialist and reservist, for an incredible story of a remote river rescue in Tasmania. The team responds to a distress call from a trapped rafting party in the Franklin River, one of Tasmania's most remote and formidable areas. The rescue involves complex logistical challenges, a field amputation, and the use of ECMO technology amidst perilous conditions. The patient, after 20 hours trapped in frigid water, undergoes a harrowing yet successful rescue and recovery. This episode offers a gripping recount of teamwork, medical ingenuity, and human resilience.00:00 Introduction and Guest Overview00:40 Setting the Scene: Remote River Rescue01:39 The Rescue Operation Begins03:13 Challenges and Techniques in the Rescue07:25 Field Amputation and Extraction18:35 Transport and ECMO Preparation23:20 Hospital Arrival and ECMO Procedure26:18 Patient Recovery and Reflections30:45 Conclusion and Final Thoughts

Sepsis Updated: Prof Mervyn Singer, Author of Sepsis 3.0 03.09.2025 26min

In this episode, we welcome Professor Mervyn Singer, author of Sepsis 3.0. Sepsis remains one of the most complex and deadly conditions in critical care. In this conversation,Professor Singer shares his perspectives on the shifting landscape of sepsis treatment, the role of antibiotics, steroids, metabolic interventions, and the future ofprecision medicine. He also challenges some long-standing dogmas and emphasizes the importance of individualized care over rigid guidelines.Key Topics and Chapters:The Evolution of Sepsis ManagementHistorical perspectives on sepsis treatmentEarlier recognition and intervention leading to improved outcomesCurrent Challenges and Research DirectionsOrgan dysfunction and recovery in sepsisThe importance of metabolic manipulation and mitochondrial functionThe Role of the Immune System in SepsisUnderstanding hyper- and hypo-inflammatory responsesSteroid use in critical illness—when it works and when it doesn’tAntibiotics in Sepsis: How Soon, How Long, and How Much?The changing approach to antibiotic timing and durationThe impact of microbiome disruption and antibiotic toxicityRethinking the one-hour antibiotic ruleLessons from COVID-19 and Their Impact on Sepsis ResearchThe importance of phenotype-driven treatmentsMissed opportunities in clinical trials and biobankingThe Beta-Blocker Debate in SepsisPotential benefits in selected patientsThe challenge of distinguishing compensatory tachycardia from harmful sympathetic overdriveRethinking Fever ManagementIs fever protective or harmful?When to treat and when to leave it aloneGuidelines vs. Individualized CareThe balance between evidence-based medicine and clinical expertiseThe dangers of rigid mandates and protocolsThis engaging discussion provides a fresh perspective on the current state and future of sepsis management, emphasizing the need for precision medicine, nuanced clinical decision-making, and ongoing research.References:Im Y, Kang D, Ko RE, et al. Time-to-antibiotics and clinical outcomes in patients with sepsis and septic shock: a prospective nationwide multicenter cohort study. Crit Care. 2022;26(1):19. Published 2022 Jan 13. doi:10.1186/s13054-021-03883-0 HereSakkat A, Alquraini M, Aljazeeri J, Farooqi MAM, Alshamsi F, Alhazzani W. Temperature control in critically ill patients with fever: A meta-analysis of randomized controlled trials. J Crit Care. 2021;61:89-95. doi:10.1016/j.jcrc.2020.10.016 HereHasegawa D, Sato R, Prasitlumkum N, et al. Effect of Ultrashort-Acting β-Blockers on Mortality in Patients With Sepsis With Persistent Tachycardia Despite Initial Resuscitation: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Chest. 2021;159(6):2289-2300. doi:10.1016/j.chest.2021.01.009 Here

Long Term Outcomes after ICU, CPR, and Cardiogenic Shock 06.08.2025 24min

Dr. Shannon Fernando is an intensivist at Lakeridge Health and a prolific researcher with over 150 publications. Known for his work in outcomes-based research across critical care, he joins us to discuss long-term outcomes after cardiogenic shock.About the Episode:This episode is part of our cardiovascular critical care series and explores what happens after the ICU for patients who survive cardiogenic shock. We unpack quality of life, functional outcomes, mental health, and the hidden burdens on both patients and caregivers. Dr. Fernando provides key data insights from his large cohort studies and shares reflections from ICU follow-up clinics. We also dive into the challenges of prognostication and how to communicate realistic expectations to families.Topics CoveredDefining Long-Term Outcomes:Beyond survival: functional independence, mental health, cognition, and system resource use.Key Findings from Ontario Cohort42% of cardiogenic shock survivors require increased levels of care15% die within a year post-dischargeModest impact of revascularization or mechanical support on long-term outcomesMorbidity and Quality of LifeLoss of independence and inability to return to workHigh incidence of PTSD, depression, and caregiver burdenDelayed functional recovery and unmet expectationsPrognostic Factors and Predictive MarkersFrailty as a key indicatorPre-existing mental health as a predictor of post-ICU mental health outcomesIn-hospital arrest characteristics: rhythm, downtime, comorbiditiesICU Follow-Up ClinicsValue in knowledge translation and emotional supportReal-world insights on functional recovery and patient satisfactionCommon patient sentiment: gratitude mixed with traumaCommunication with FamiliesAvoiding value impositionEmphasizing trajectory over fixed timelinesBalancing hope with realismRethinking Endpoints in ResearchLimitations of 28-day mortalityNeed for patient-centered, long-term functional outcomesTrajectory-based data over snapshot metricsKnowledge Translation as the InterventionEquipping clinicians and patients with realistic expectationsNormalizing psychological responsesShaping future research directions around lived experience