PODCAST · education
Critical Care Practitioner
by Jonathan Downham
Jonathan and Bryan both have many years experience working in Critical Care and in this podcast, they share this, as well as the experience of many others in the same clinical area so that we can all learn together.Jonathan is from the Uk and Bryan is from the US so between them they can cover many of the international issues.
Episodes
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Arterial Lines: Do we always need them. A chat with Tom (Duracell Bunny)
Tom, one of my colleagues from the Critical Care Outreach Team and I discuss this paper and its findings reaching our own conclusions. Deferring Arterial Catheterisation in Patients with Septic Shock.
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Decompensated Alcohol Related Liver Disease Part 2
We return to our 48-year-old patient: jaundiced, hypotensive, drowsy, and bleeding. In decompensated cirrhosis, every treatment targets a disrupted system — splanchnic vasodilation, portal hypertension, toxin accumulation, and renal hypoperfusion. Although these patients look fluid overloaded…
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Decompensated Alcohol Related Liver Disease Part 1
In this episode, I walk through the real-world critical care management of acute decompensated alcohol-related liver disease, using a high-risk ICU case to anchor the discussion. The focus is on understanding the underlying physiology—portal hypertension, rebalanced haemostasis, hepatic...
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Non Invasive Ventilation
This episode offers a structured, bedside-focused exploration of Non-Invasive Ventilation (NIV) for acute hypercapnic respiratory failure in COPD, aligned with NICE NG115 and BTS/ICS 2016 guidance. Aimed at early-career critical care nurses, it breaks the topic down into physiology, practical...
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HHS (Hyperosmolar Hyperglycaemic State)
HHS (Hyperosmolar Hyperglycaemic State) is the quiet counterpart to DKA. It develops slowly in older type 2 diabetics with residual insulin, leading to extreme hyperglycaemia and dehydration without ketosis. In this 2-hour deep dive, Jonathan explains why HHS kills through water loss and...
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DKA- Fluids, Potassium and Insulin.
Diabetic ketoacidosis (DKA) is not just "high blood sugar" — it's a hormonal storm caused by absolute insulin deficiency and a surge of counter-regulatory hormones. The result is a triad of hyperglycaemia, dehydration, and metabolic acidosis. We follow Sophie, a 23-year-old with type 1 diabetes…
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Hypophosphatemia in Critical Care
Summary: In this episode, we spotlight a stealthy ICU disruptor — hypophosphataemia. Based on a 2024 narrative review in the Journal of Clinical Medicine, we explore why phosphate matters, how it goes missing in critically ill patients, and why you should care even when it's just "a little low."...
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DKA in Critical Care
What is DKA? – The triad of hyperglycaemia, ketonaemia, and metabolic acidosis (JBDS 2023 definitions). Pathophysiology explained – Insulin deficiency, ketone production, and why potassium is so tricky. Clinical features – Polyuria, dehydration, Kussmaul breathing, acetone breath, and red flags…
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Mobilisation in Critical Care- Barriers and Culture
Mobilisation in the ICU raises two big questions: is it safe, and will staff embrace it? In this discussion, Jonathan explores both sides of the story: Safety first: Large prevalence studies show mobilisation is happening, though often inconsistently. A systematic review of 1,800+ sessions found...
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Episode 1- Mobilisation in the ICU
Summary For much of critical care history, immobility was the norm: patients were sedated, kept still, and "protected." But decades of research have revealed the hidden costs — profound muscle wasting, delirium, and long-term disability. Jonathan explores how our understanding of mobilisation in...
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Episode 6: Guidelines and the Future of Sedation in Critical Care
Sedation practices in the ICU have evolved dramatically over the past decade — but are we truly following the evidence? In this episode of The Critical Care Practitioner Podcast, Jonathan takes you through the key milestones in sedation guidance, the persistent gap between recommendations and...
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Episode 5 — Sedation Choices: Benzos, Propofol, Dexmedetomidine
Overview In this episode we explore the three main sedatives used in critical care and how to choose the right agent for the right patient. Highlights Benzodiazepines: once the workhorse of ICU sedation, but now linked to more delirium and longer ventilation. Still useful in alcohol withdrawal…
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Episode 4: Sedation Protocols Turning knowledge into practice final
We've explored the history of sedation in ICU, the impact of daily awakening trials, and the risks of deep sedation. In this episode, we focus on how to embed that evidence into practice — through the use of structured sedation protocols. Protocols don't just provide guidance; they transform...
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Episode 3: Sedation Depth Why going too deep can hurt.
Episode 3 – Sedation Depth: How Deep Is Too Deep? In this third part of our sedation series, we explore one of the biggest game-changers in ICU practice: sedation depth. For years, the approach was "sedate and stabilise" — often to deep levels. But mounting evidence tells a different story: early...
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Episode 2 The sedation hold game changer or risky routine?
In this episode, I explore the origins and evolution of the daily sedation hold — also known as the spontaneous awakening trial (SAT) — one of the most influential shifts in ICU sedation practice. I unpack the key trials that demonstrated SATs could safely reduce ventilation time and ICU stay…
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Episode 1 A short history of sedation in ICU
In this episode, I explore how sedation practices in critical care have evolved over time — from the routine use of deep, continuous sedation to the early evidence that challenged it. You'll hear about pivotal studies that revealed the risks of over-sedation, the emergence of structured sedation...
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CCP Podcast: Whats an ITU stay like for patients families?
This is a conversation I had with Francesca Trotta, a nurse from Rome who is at the last stages in her PhD. This was at the BACCN conference in Aberdeen in 2024.
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CCP Podcast: Working in war zones and Disaster Areas
This is a chat I had with David Wightwick who is the CEO of UK Med a humanitarian medical aid charity. This happened at the BACCN 2024 conference in Aberdeen.
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Are ACCPs here to stay?
This is a conversation I had with professor Tim Buchman who is Professor of Surgery and founding director at the Emory Centre for Critical Care in the US. We discuss the advent of Advanced Practice in the US and how it will inform the same developments in the UK
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CCP Podcast: AI with Aarti Sarwal
AI is here! How will it effect us and how can we use it, or not use it to help with our work? Aarti gives some easy to understand explanations of the key concepts.
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CCP Podcast: So you want to be an ACCP?
This is a chat with Rowan Grieves who works in Belfast about her journey to become an ACCP and the hurdles she had to overcome when starting this new role.
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CCP Podcast- Patient Diaries
This was originally a Facebook livestream with an ex patient- Carol Billian, Christine representing ICU Steps, a group helping support ICU survivors and Peter Nydahl from Germany who also aims to support the same group.
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CCP Podcast- Lung Protective Ventilation- How to improve our practice.
This is a chat I had with Dr Daniel Watkin about his QI project to assess compliance with the guidelines and how they went about improving it. You can find the paper here- 'Beyond Audit: Embracing QI methodology to drive improvements in lung-protective ventilation'
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CCP Podcast- When to do the tracheostomy.
This is a chat with Tamas Szakmany about the paper 'Impact of early tracheostomy versus late or no tracheostomy in nonneurologically injured adult patients: a systematic review and meta analysis' and his editorial 'When more could mean less intervention: the tale of tracheostomy timing in…
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CCP Podcast- Weaning our patients.
This is a chat with professor John Laffey about the WEAN_SAFE study. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study
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Do Not Resuscitate- the conversations we have.
A discussion with Michelle about the recent paper she played a part in discussing the conversation s we have, or don't about Do No Resuscitate orders. The experiences of adult patients, families, and healthcare professionals of CPR decision-making conversations in the United Kingdom: A…
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ICU Acquired Weakness and Muscle Wasting with Brigitta Fazzini
Brigitta and colleagues have just published 'The rate and assessment of muscle wasting during critical illness: a systematic review and meta-analysis.' Some important and interesting discussion points.
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Nutrition management for critically and acutely unwell hospitalised patients with coronavirus disease 2019 (COVID-19) in Australia and New Zealand.
Great discussion with Dr Emma Ridley a dietitian from Australia about how they planned to look after the nutritional requirements of COVID patients. A lot of pointers about how we care for their needs when they haven't got COVID too.
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Organ Donation from the Frontline- with Vikki Howarth
Vikki has been a clinical lead for Organ Donation in the past so I spent some time picking her brains about the role of the Organ Donation team and how that affects how we look after our patients. Lots of really valuable insights.
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Proning- The PROSEVA Trial
This is an important trial to start our look at Proning and the research supporting it. https://www.nejm.org/doi/full/10.1056/nejmoa1214103 I am going to continue this series of podcasts by looking at the other evidence.
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FREE 15 Friday- End Tidal CO2
Let's get a better understanding of what that waveform is telling us!
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FREE 15 Minute Friday- Intubation- What's all that equipment?
Let's talk about the equipment we use when we decide to intubate our patients. Some understanding of their features is helpful.
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FREE 15 Minute Friday- Why have my patients sats dropped?
It could be that they have dropped quickly or slowly. Either way its sensible to have a thought process ready so that you might be able to solve it! This is what I cover in this podcast.
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FREE 15 Minute Friday- Why do we intubate?
A new series which I am hoping to provide weekly taken from the livestreams I am running across social media- this weeks topic- why do we intubate our patients?
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FREE 15 Minute Friday- Basic Ventilator Screen
A new series which I am hoping to provide weekly taken from the livestreams I am running across social media- this weeks topic- the basic ventilator screen. Lets go through some of those buttons.
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FREE 15 Minute Friday- Peak and Plateau Pressures
A new series which I am hoping to provide weekly taken from the livestreams I am running across social media- this weeks topic- Peak and Plateau Pressures. What are they and why does it matter?
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FREE 15 Minute Friday- PEEP
A new series which I am hoping to provide weekly taken from the livestreams I am running across social media- this weeks topic- PEEP
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CCP Podcast 165: Catherine White and ICUSteps
Catherine presented recently at the BACCN conference discussing some of the issues our patients have when they leave the intensive care and how we might help.
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CCP Podcast 164: Practitioners on Fire - Nathan Griffiths
Tell me who you are and where you work- Paediatric Nurse Consultant What is your background- Paediatirc nurse Why did you decide to go into advanced practice- Career options limited, spotted job opportunity What was your biggest struggle during your training- academia and developing clinical...
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CCP Podcast 163: Practitioners on Fire - Kay Murphy
Tell me who you are and where you work- Medicine/renal What is your background- Paramedic Why did you decide to go into advanced practice- Longevity for career. Opportunities limited in para medicine What was your biggest struggle during your training- Belief and role transition. Dis jointed...
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CCp Podcast 159: What Matters to Patients and Their Families During and After Critical Illness
What Matters to Patients and Their Families During and After Critical Illness: A Qualitative Study
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ABOUT THIS SHOW
Jonathan and Bryan both have many years experience working in Critical Care and in this podcast, they share this, as well as the experience of many others in the same clinical area so that we can all learn together.Jonathan is from the Uk and Bryan is from the US so between them they can cover many of the international issues.
HOSTED BY
Jonathan Downham
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Frequently Asked Questions
How many episodes does Critical Care Practitioner have?
Critical Care Practitioner currently has 186 episodes available on PodParley. New episodes are automatically indexed when they're published to the podcast feed.
What is Critical Care Practitioner about?
Jonathan and Bryan both have many years experience working in Critical Care and in this podcast, they share this, as well as the experience of many others in the same clinical area so that we can all learn together.Jonathan is from the Uk and Bryan is from the US so between them they can cover many...
How often does Critical Care Practitioner release new episodes?
Critical Care Practitioner publishes regularly with 186 episodes available. Check the episode list for the typical release schedule.
Where can I listen to Critical Care Practitioner?
You can listen to Critical Care Practitioner on PodParley by clicking any episode. We provide an embedded audio player for direct listening, and you can also subscribe via your preferred podcast app using the RSS feed.
Who hosts Critical Care Practitioner?
Critical Care Practitioner is created and hosted by Jonathan Downham.
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