Having hard conversations is an uncomfortable part of working in healthcare—and living life! Inspired by an article April wrote for the Sound Op-Med blog, she and Alicia dive into the realities of navigating tough talks and dissect what they’ve learned from having them with patients, families, and even their own children. 

Read April’s blog here: https://soundphysicians.com/blog/getting-comfortable-with-the-uncomfortable/

Confronting the uncomfortable

This month, we’re scrubbing in with a two-parter on the latest health headlines—literally. From the buzz about “skin cancer soap” to the ongoing debate around BMI, April and Alicia break down the breakthroughs, bust some myths, and ask the big (and sometimes weird) questions facing the future of healthcare. Tune in for your dose of news and nuance.

Healthcare headlines - Part 1

In this episode, Dr. Sergio Zanotti discusses ECPR–Extracorporeal Cardiopulmonary Resuscitation. ECPR is still be considered a niche therapy, but its relevance and availability are increasing. He is joined by Dr. Adam Green, a practicing intensivist at Cooper University Health Care and an Associate Professor of Medicine at Cooper Medical School of Rowan University (CMSRU). Dr. Green is the director of research for the division of Critical Care and has authored over 50 peer-reviewed publications. He has been part of the ECMO team at Cooper since its inception. 

Additional resources:
Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest. The Lancet Respiratory Medicine 2025: https://www.sciencedirect.com/science/article/pii/S2213260025001225  

Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest. JAMA 2022: https://jamanetwork.com/journals/jama/fullarticle/2789313  

Association between increasing institutional experience with ECPR and outcomes in patients with out-of-hospital cardiac arrest: A nationwide multicenter observational study in Japan (the JAAM–OHCA registry) RESUSCITATION 2025: https://www.resuscitationjournal.com/article/S0300-9572(24)00862-1/fulltext  

Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. N Eng J of Med 2023: https://www.nejm.org/doi/full/10.1056/NEJMoa2204511  


Books mentioned in this episode: 

The Perfect Predator: A Scientist’s Race to Save Her Husband from a Deadly Superbug. By S. Strathdee and T Patterson: https://amzn.to/3Hxjmez 

ECPR

Ready for part two? April and Alicia are back with more health news headlines and hot takes! In this episode, they dive into the battle against C-section site infections and the innovations saving the lives of countless women. Also, April unpacks what a compact license means for physician assistants on the move. It's breaking news, and you won't want to miss it!

Healthcare headlines - Part 2

Days are shortening, temperatures are cooling, and pumpkin spice is back - it can only mean one thing: It's Fall, y'all! Our hosts April and Alicia are thrilled to kick off the season with a fact or fiction that will test their knowledge on all things autumnal and cozy. Are there any nutritional benefits in your favorite pumpkin treats? Will colder weather actually make you sick? And is there any truth around "seasonal depression?" Tune in and play along!

It's Fall, y'all!

It's our favorite time of the year here at On Call: National APP Week! Sept. 22-27 is dedicated to recognizing advanced practice providers for the expertise, compassion, and care they bring to patients every day. To celebrate, April and Alicia—APPs themselves—are adding a little friendly competition into the mix with a fact or fiction all about their beloved profession. If you're an APP out there listening, we hope you play along with us and feel celebrated this week!

Happy APP Week!

Originally posted in April of 2023, we are sharing this episode of Critical Matters again as Dr. Sergio Zanotti's discussion about the long journey to healing and recovery for those who've survived critical illness in the ICU remains pertinent and important. This conversation features Dr. Margaret Herridge, Professor of Medicine, Senior Scientist in Critical Care and Respiratory Medicine at the University of Toronto. Dr. Herridge is also Director of Critical Care Research. Director of the RECOVER Program, and Clinical Director of the Grace RECOVER Program for Chronic Critical Illness, in the University Health Network, Toronto, Canada.

Additional Resources:
Outcomes after Critical Illness. M. Herridge and E. Azoulay: https://pubmed.ncbi.nlm.nih.gov/36884324/

Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. Hopkins RO, et al: https://pubmed.ncbi.nlm.nih.gov/10390379/
One-year outcomes in survivors of the acute respiratory distress syndrome. Herridge m, et al: https://pubmed.ncbi.nlm.nih.gov/12594312/

Long-term cognitive impairment after critical illness. Pandharipande PP, et al: https://pubmed.ncbi.nlm.nih.gov/24088092/

The RECOVER Program: disability risk groups and 1-year outcome after 7 or more days of mechanical ventilation. Herridge M, et al: https://pubmed.ncbi.nlm.nih.gov/26974173/

Determinants of long-term outcome in ICU survivors: results from the FROG-ICU study. Gayat E, et al: https://pubmed.ncbi.nlm.nih.gov/29347987/

Symptoms of anxiety and depression in family members of intensive care unit patients. Pochard F, et al: https://pubmed.ncbi.nlm.nih.gov/11588447/

Books Mentioned in this Episode:
Bel Canto. By Ann Patchett: bit.ly/3nWs7Vp
Commonwealth. By Ann Patchett: bit.ly/43pWSCt

Outcomes after critical illness

April and Alicia diving back into the headlines with a chilling twist! This episode, hear some of the latest healthcare news (and personal encounters) about all things creepy, crawly, and cutting-edge. From new-age cadaver labs to advancements in freeze-dried blood, these innovations are as fascinating as they are frightening. Spoiler alert: maybe skip this one if you're scared of bugs!

Healthcare headlines - Spooky edition

Fluid overload is a common problem in critically ill patients. In this episode, Dr. Sergio Zanotti discuss recognizing and managing fluid overload in the ICU with guest Dr. Michael J. Connor, Jr., a practicing intensivist and nephrologist. Dr. Connor is a Professor and Senior Physician of Critical Care Medicine & Nephrology at the Divisions of Pulmonary, Allergy, Critical Care, and Sleep Medicine and Renal Medicine at Emory University School of Medicine. Additionally, he serves as the director of critical care nephrology at the Emory Critical Care Center at Grady Memorial Hospital.

Additional resources
European Society of Intensive Care Medicine Clinical Practice Guideline on fluid therapy in adult critically ill patients: Part 3- fluid removal at de-escalation phase. Intensive Care Med 2025: https://pubmed.ncbi.nlm.nih.gov/40828463/ 

Optimizing Fluid Therapy in the Critically Ill. International Fluid Academy website – 2025: https://www.fluidacademy.org/2025/01/17/optimising-fluid-therapy-in-the-critically-ill-introduction-to-7d/ 

Fluid overload in the ICU: evaluation and management. R. Claure-Del Granado and R. L. Mehta. BMC Nephrology 2016: https://pubmed.ncbi.nlm.nih.gov/27484681/

Books and music mentioned in this episode:
Think Again: The Power of Knowing What You Don’t Know. By Adam Grant: https://bit.ly/4gZvz9c

RUSHMERE. By Mumford & Sons: https://bit.ly/473FzKc

Fluid Overload in the ICU

In this episode, Dr. Sergio Zanotti discusses the administration of vasopressor agents through peripheral intravenous lines (or what we refer to as “peripheral vasopressors”). 
He is joined by Dr. Elizabeth Munroe, a practicing pulmonary/critical care physician and an Assistant Professor of Pulmonary and Critical Care at Intermountain Health in Salt Lake City, Utah. Her research interests include evidence-based resuscitation practices in early sepsis and septic shock, vasopressor administration practices, peripheral vasopressor use, and clinical trials, particularly novel, pragmatic clinical trial designs. 

Additional resources:
Peripheral Vasopressor Use in Early Sepsis-Induced Hypotension. ES Munroe, et al. JAMA Network 2025: https://pubmed.ncbi.nlm.nih.gov/40864467/  

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. Shapiro NI, et al. CLOVERS Trial. New Engl J of Med 2025: https://pubmed.ncbi.nlm.nih.gov/36688507/ 

Overview of Peripheral Vasopressor Use in an Academic Health System. D Shyu, et al. Ann Am Thorac Soc 2025: https://pubmed.ncbi.nlm.nih.gov/40126143/ 

Safety of peripheral intravenous administration of vasoactive medication. J Cardenas-Garcia, et al. J Hosp Med 2015: https://pubmed.ncbi.nlm.nih.gov/26014852/ 

Books mentioned in this episode:
Ending Medical Reversal- Improving Outcomes, Saving Lives. By Vinayak K. Parsad, et al: https://bit.ly/4nhCNam


Peripheral vasopressors

Patients may hear their clinician, but do they really understand them? In this episode, April and Alicia tackle the myths and misunderstandings surrounding health literacy. From mixed messages to medical jargon, they test each other's knowledge on the facts, fictions, and ways clearer communication can transform care.

Health literacy: Making sense of medicine

Welcome to On Call, the insightful and engaging podcast hosted by April Burke and Alicia Scheffer two seasoned Sound advanced practice providers with over 15 years of combined experience in healthcare. Join them as they delve into the ever-evolving landscape of healthcare, exploring trending topics that shape the future of medicine, patient care, and the healthcare workforce.
On Call serves as an indispensable resource for healthcare practitioners, administrators, and anyone passionate about transforming the healthcare system for the better. Whether you're a medical professional looking to stay on top of industry trends or a patient seeking to understand the dynamics shaping your care, this podcast promises thought-provoking conversations and valuable takeaways.

Confronting the uncomfortable

On Call with April and Alicia