Jonathan Downham: Advanced Critical Care Practitioner, Teaching, Sharing and Interviewing.
203 episodes
4 days ago
Jonathan Downham is an Advanced Critical Care Practitioner, in the UK and Bryan Boling is a Critical Care Nurse Practitioner in the US. both of whom have a desire to share with like-minded people. Discover new resources in the physical and virtual worlds to help improve your practice, from websites with direct links to critical care and intensive care to those websites which make your life as an internet learner easier. Social media as a powerful learning and networking tool, using Twitter, YouTube and Linkedin to their maximum potential. Current research and the discussions about that research happening amongst practitioners on the internet and how that research can be implemented. News from current conferences and interviews with others practising in critical care. A site for a variety of people from those working in the critical care field to paramedics and physiotherapists, to practitioners working in specialties other than critical care.
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Jonathan Downham is an Advanced Critical Care Practitioner, in the UK and Bryan Boling is a Critical Care Nurse Practitioner in the US. both of whom have a desire to share with like-minded people. Discover new resources in the physical and virtual worlds to help improve your practice, from websites with direct links to critical care and intensive care to those websites which make your life as an internet learner easier. Social media as a powerful learning and networking tool, using Twitter, YouTube and Linkedin to their maximum potential. Current research and the discussions about that research happening amongst practitioners on the internet and how that research can be implemented. News from current conferences and interviews with others practising in critical care. A site for a variety of people from those working in the critical care field to paramedics and physiotherapists, to practitioners working in specialties other than critical care.
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 setup, monitoring, and escalation.Key Topics CoveredMechanisms behind acute-on-chronic hypercapnic respiratory failure in COPD.How NIV improves […]
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 hyperviscosity rather than acid, and how to manage it safely.Key Learning Points:· Pathophysiology: Relative […]
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.”What’s Covered:The vital role of phosphate in energy, […]
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 serious adverse events in only 0.6% — most minor and short-lived.Even patients on CRRT can safely mobilise […]
SummaryFor 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 ICU has evolved — from the recognition of harm caused by bedrest, to the […]
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 real-world practice, and the emerging shift toward human-centered, wakeful care.What You’ll […]
OverviewIn this episode we explore the three main sedatives used in critical care and how to choose the right agent for the right patient.HighlightsBenzodiazepines: once the workhorse of ICU sedation, but now linked to more delirium and longer ventilation. Still useful in alcohol withdrawal and seizures.Propofol: rapid on/off, easy to titrate, helpful for daily sedation […]
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, and examines how these findings became standard care. But it's […]
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 protocols, and the beginnings of a culture shift […]
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.
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.
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
AI is here! How will it effect us and how can we use it to make learning fun with AI, or not use it to help with our work? Aarti gives some easy to understand explanations of the key concepts.
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.
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.
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'
Jonathan Downham is an Advanced Critical Care Practitioner, in the UK and Bryan Boling is a Critical Care Nurse Practitioner in the US. both of whom have a desire to share with like-minded people. Discover new resources in the physical and virtual worlds to help improve your practice, from websites with direct links to critical care and intensive care to those websites which make your life as an internet learner easier. Social media as a powerful learning and networking tool, using Twitter, YouTube and Linkedin to their maximum potential. Current research and the discussions about that research happening amongst practitioners on the internet and how that research can be implemented. News from current conferences and interviews with others practising in critical care. A site for a variety of people from those working in the critical care field to paramedics and physiotherapists, to practitioners working in specialties other than critical care.
