February is the month of hearts! Heart boxes full of chocolate, heart-shaped cards, chalky conversations hearts; but what about the most important heart - the one beating in your chest and keeping you alive? We at On Call have you covered because we're celebrating Heart Month, the time of year dedicated to learning and raising awareness about heart disease's leading cause of death in the U.S. April and Alicia put their heart health knowledge to the test, swapping cardiovascular facts and essential tips to keeping your ticker in top shape. Tune in for a heart-racing competition!

Matters of the Heart

Due to advancements in medical and surgical care, the survival of patients with congenital conditions into adulthood has dramatically increased. However, as these individuals transition to adulthood, their unique physiology, chronic complications, and evolving care needs create significant challenges for their management when they are admitted to adult intensive care units (ICUs). This episode will discuss adult congenital disease in the ICU. Dr. Zanotti is joined by Dr. Cameron Dezfulian, a pediatric and adult critical care physician. He is the director of the Adult Congenital Heart Disease Program Development for the Section of Critical Care at Texas Children's Hospital and a faculty member at Cardiothoracic Critical Care at Baylor St. Luke's Medical Center. He is also a Senior Faculty member at Baylor College of Medicine in Houston, Texas. 

Additional resources:
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease. Circulation 2008: https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.108.190690  

Special Considerations in Critical of the Congenital Heart Disease Patient. E Neethling, et al. Can J Cardiol. 2023: https://pubmed.ncbi.nlm.nih.gov/36682483/ 

Management of the Critically Ill Adult with Congenital Heart Disease. WB Kratzert, et al. J Cardiothorac Vasc Anesth 2018: https://pubmed.ncbi.nlm.nih.gov/29500124/ 

Adults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units. J Edwards, et al. J Crit Care 2015: https://pubmed.ncbi.nlm.nih.gov/25466316/

Down Syndrome. MJ Bull. N Eng J Med 2020. https://www.nejm.org/doi/full/10.1056/NEJMra1706537  


Books and Music mentioned in this episode:
The Bible: https://bit.ly/3EK4LL6

Adult congenital disease in the ICU

When facing the unthinkable, one's mental battle is just as important as their physical battle. It's Women's History Month, and April and Alicia are joined by Adriana Santos, a dear friend, former colleague, and cancer survivor. After a tumor was discovered on her pancreas, Adriana's life was turned upside-down with intense treatments and surgeries. In this episode, she shares her patient journey, detailing how her attitude - and gratitude - carried her through some of the most difficult times in her life.  

Choosing gratitude ft. Adriana Santos

In a previous episode, Dr. Sergio Zanotti explored the importance of challenging dogma, particularly when the supporting evidence is weak or absent. Today, he continues that discussion by examining critical care practices that persist despite a lack of strong scientific validation. He's joined by Dr. Mervyn Singer, an internationally recognized leader in critical care medicine. Dr. Singer is a professor of intensive care medicine at University College London and a distinguished clinician, researcher, and educator. Through his research, publications, and dynamic presentations, he has inspired Dr. Zanotti — and countless intensivists worldwide — to think critically, challenge conventions, and push the boundaries of our field.

Additional resources:
Challenging management dogma where evidence is non-existent, weak, or outdated: part II. DA Hofmaennner and M. Singer. Intensive Care Med2024: https://pubmed.ncbi.nlm.nih.go 

Challenging management dogma where evidence is non-existent, weak, or outdated. DA Hofmaennner and M. Singer. Intensive Care Med 2022: https://pubmed.ncbi.nlm.nih.gov/35303116/ 

Biomarker-Guided Antibiotic Duration for Hospitalized Patients with Suspected Sepsis. The ADAPT-Sepsis Randomized Clinical Trial. JAMA 2025: https://pubmed.ncbi.nlm.nih.gov/39652885/  

Hyperglycemic Crises in Adults with Diabetes: A Consensus Report. Diabetes Care 2024: https://pubmed.ncbi.nlm.nih.gov/38907161/ 

Books and music mentioned in this episode.
Influenza: The Hundred-Year Hunt to Cure the 1918 Spanish Flu Pandemic. By. Jeremy Brown: https://amzn.to/3Ftb0mO

Beethoven: 9 Symphonies / Karajan 1963: https://amzn.to/3R1M9ZO

Challenging dogma in the ICU (Part II)

As we continue celebrating Women's History Month, former guest and friend of the podcast Tiffany Coyle returns to catch up with April and Alicia - with a new job title, no less! As Sound Physician's Chief Operating Officer, Tiffany joins us On Call to get candid about how her leadership journey started and how its new heights have brought interesting challenges. Having navigated imposter syndrome, harsh assumptions, and all the highs and lows of leadership, Tiffany speaks to the power of embracing humanity in leadership, offering wisdom on authenticity, setting boundaries, and giving yourself grace.

Give yourself some grace ft. Tiffany Coyle

In this episode, Dr. Sergio Zanotti explores one of medicine's fastest-evolving frontiers: artificial intelligence (AI). From predictive analytics to decision-support tools, AI is beginning to influence how we deliver critical care — but what does that actually mean for frontline clinicians? Dr. Zanotti is joined by Dr. Sharad Patel, a critical care physician with additional board certification in nephrology and Echocardiography. He is a Critical Care Intensivist at Cooper University Health Care, the assistant program Director for the Internal Medicine Residency Program, and an Assistant Professor of Medicine at Cooper Medical School of Rowan University. Dr. Patel is deeply interested in applying artificial intelligence and technology at the bedside.

Additional resources:
Landing page for New England Journal of Medicine – AI in Medicine section. A multitude of articles and resources on the topic: https://www.nejm.org/ai-in-medicine  

Attention Is All You Need. A Vaswani et al. NIPS 2017: https://proceedings.neurips.cc/paper_files/paper/2017/file/3f5ee243547dee91fbd053c1c4a845aa-Paper.pdf 

Artificial Intelligence Courses Online: https://www.coursera.org/courses?query=artificial%20intelligence 

UDEMY landing page for AI courses. https://www.udemy.com/AI 

Books mentioned in this episode:
Meditations. By Marcus Aurelius (Author), Gregory Hayes (Translator): https://amzn.to/4iLvfLA

Thinking Fast and Slow. By Daniel Kahneman: https://bit.ly/4c6pANu

AI in Critical Care

In this episode, Dr. Sergion Zanotti discusses TEE in cardiac arrest and shock. Critical care clinicians commonly utilize transthoracic echocardiography in the ICU as part of their point-of-care-ultrasonography (POCUS) toolkit. However, there is a growing push to train intensivists in using transesophageal echocardiography (TEE) for cardiac arrest and peri-arrest situations in the ICU. Our guest is Dr. Sara Nikravan, a cardiothoracic anesthesia critical care physician with training in advanced perioperative echocardiography. Dr. Nikravan is an Associate Professor of Cardiothoracic Anesthesiology and Critical Care Medicine at the University of Washington Medical School and practices at the UW Medical Center. She is recognized as an expert and master educator in Critical Care, Perioperative echocardiography, and Point of Care Ultrasound. She has authored numerous peer-reviewed papers and is the guidelines co-chair of the Society of Critical Care Medicine Guidelines on Adult Critical Care Ultrasonography: Focused Update 2024, recently published in Critical Care Medicine.  

Additional links:
Society of Critical Care Medicine Guidelines on Adult Critical Care Ultrasonography: Focused Update 2024, Crit Care Med 2025: https://pubmed.ncbi.nlm.nih.gov/39982182/ 

Focused Transesophageal Echocardiography During Cardiac Arrest Resuscitation: JACC Review Topic of the Week. JACC 2020: https://pubmed.ncbi.nlm.nih.gov/32762909/ 

Landing page for the Resuscitative TEE Project website: https://www.resuscitativetee.com/ 

Books mentioned in this episode:
The Prophet. By Kahlil Gibran: https://www.amazon.com/dp/998247037X?psc=1&smid=ATVPDKIKX0DER&ref_=chk_typ_imgToDp

TEE in Cardiac Arrest

In this episode, Dr. Zanotti discussed the Society of Critical Care Medicine “Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU." This is also known as the PADIS Guidelines. He is joined by Joanna L. Stollings, PharmD, a Board-Certified Pharmacotherapy Specialist and a Board-Certified Critical Care Pharmacotherapy Specialist. Joanna is the Medical Intensive Care Unit (MICU) Clinical Pharmacy Specialist at the Vanderbilt University Medical Center. She also served as vice chair for the PADIS Guideline Focused Update and co-authored the guidelines.

Additional resources:
Society of Critical Care Medicine Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2025 Update: https://pubmed.ncbi.nlm.nih.gov/39982143/ 

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2018 Guidelines: https://pubmed.ncbi.nlm.nih.gov/30113379/ 

Link to a previous episode of Critical Matters discussing the PADIS 2018 Guidelines: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=635606964 

Landing page for the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center: https://www.icudelirium.org/  

Books mentioned in this episode:
The Prophet. By Kahlil Gibran: https://bit.ly/4lA2Jhx

PADIS Guidelines Update

In this episode, Dr. Zanotti discusses the science of hope. He's joined by Dr. Stephen Trzeciak, a physician-scientist, the Edward D. Viner Endowed Chief of Medicine at Cooper University Health Care, and Professor and Chair of Medicine at Cooper Medical School of Rowan University in Camden, New Jersey. Dr. Trzeciak is a practicing intensivist and a clinical researcher with more than 100 publications in the scientific literature. In addition, he is co-author of two excellent books: Wonder Drug: 7 Scientifically Proven Ways That Serving Others Is the Best Medicine for Yourself (2022) and Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference (2019).

Additional resources:
Recovery Expectations and Long-term Prognosis of Patients with Coronary Heart Disease Barefoot JC, et al. JAMA Internal Medicine 2011: https://pubmed.ncbi.nlm.nih.gov/21357800/ 

Optimism and Rehospitalization After Coronary Artery Bypass Graft Surgery. Scheler MF, et al. JAMA Int Med 1999: https://pubmed.ncbi.nlm.nih.gov/10219928/ 

The median is not the message. By Jay Gould: https://journalofethics.ama-assn.org/sites/joedb/files/2018-05/mnar1-1301.pdf

Books mentioned in this episode:
Man’s Search for Meaning. By Viktor E. Frankl: https://bit.ly/3SqsNyt

Wonder Drug: 7 Scientifically Proven Ways That Serving Others Is the Best Medicine for Yourself. By Stephen Trzeciak and Anthony Mazzarelli: https://bit.ly/4kiyA5q

Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference. By Stephen Trzeciak and Anthony Mazzarelli: https://bit.ly/43ul5IE

The science of hope

In this episode, April and Alicia have the pleasure of sitting down with friend, colleague, and adventurer extraordinaire Stephanie Byrne. As VP of Specialized Clinical Solutions at Sound, Stephanie knows a thing or two about problem solving, providing support, and conflict resolution - all things that make a great leader. Tune in to hear Stephanie's story!

The art of showing up feat. Stephanie Byrne

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.

New tracks tagged #bringingbettertothebedside