One of the best ways we learn is by answering questions. In this episode of The Nurse Anesthesia Podcast Jeremy and Sass cover several Hypermetabolic Syndromes in Round 8 of our Q&A format. We like to periodically host these episodes as a way to sharpen our thinking, reinforce the fundamentals, and keep our clinical decision-making strong. Answering questions about content we’ve learned in the past helps our brains develop the neural connections that makes information stick. This is activ...

Sass and Jeremy talk about the preparation and perioperative management of a patient who requires the removal of a pheochromocytoma. They discuss the important preoperative optimization that’s required to appropriately care for these patients, and what you can do if you ever experience an unexpected pheochromocytoma during the anesthetic care of your patients. References 1. Elisha S. “Anesthesia Case Management for Excision of a Pheochromocytoma.” Case Studies in Nurse Anesthesia...

In this episode of the Nurse Anesthesia Podcast, Jeremy sits down with two SUPERSTAR ultrasound and acute pain management educators…Nicolette Hooge, DNP, CRNA, FAANA and Christian Falyar, DNAP, CRNA, FAANA from the Middle Tennessee School of Anesthesia. They talk about the core ultrasound-guided anesthesia nerve blocks that every CRNA should learn and have available as part of their skill set for anesthesia practice. If you’re interested in peripheral nerve blocks and ultrasound-guided ...

Our guests in this episode are Christian Falyar, DNAP, CRNA, FAANA and Nicolette Hooge, DNP, CRNA, FAANA from the Middle Tennessee School of Anesthesia. They are some of the top educators of regional anesthesia in the country, and direct the only Acute Surgical Pain Management Fellowship for CRNAs. They literally are the rock stars of regional anesthesia! Jeremy had the opportunity to sit down with them and talk about the state of the state regarding ultrasound-guided regional anesthesia educ...

In this episode Jeremy talks about a powerful dual-technique for intubation that blends two modern airway tools — the video laryngoscope and the single-use flexible intubating scope — into a single, coordinated approach. He calls this method Videolaryngoscopy Including Flexible Intubation, or VIFI. This airway technique combines the visibility of the videolaryngoscope with the precision of the flexible intubating scope. During this episode Jeremy talks about some patient conditions and ...

In this episode of The Nurse Anesthesia Podcast, Jeremy, Sass, Mark, and Chloe Gomez discuss the evolution of Topical Thunder for Awake Intubation. They examine how this topical technique for anesthetizing the airway was developed, and talk about each of their unique experiences with Topical Thunder for awake intubation. Topical Thunder is a technique that uses only topical lidocaine to anesthetize the airway in preparation for awake intubation. It consists of three steps: ...

In this episode of The Nurse Anesthesia Podcast, Sass and Jeremy talk about the most commonly used benzodiazepine in anesthesia practice…Midazolam. Without a doubt, this is one of the medications we use frequently to help relieve patient anxiety prior to an operation…it’s just like the Ramones sing…”(They) Wanna Be Sedated!” You won’t want to miss the discussion between Jeremy and Sass as they review the mechanism of action, indications, pharmacokinetics, and reasons we use this drug in anest...

This is the 7th round of Q&A with TNA, and in this round Jeremy and Sass ask some questions and give some answers on Inotropic medications including Epinephrine, Norepinephrine, Milrinone, Dobutamine, Dopamine, and Isoproterenol. This is a perfect episode to brush up on your question and answer skills while learning or relearning these medications at the same time! About The Nurse Anesthesia We are building a commUNITY of learning in anesthesia and critical care! We are educat...

The Nurse Anesthesia Team gets together on this episode to talk all things cricothyrotomy in preparation for the AANA Annual Congress in Nashville! Jeremy, Sass, and Mark will be hosting and running the Advanced Airway Skills Workshop at the Annual Congress. Part of that workshop includes practicing several cricothyrotomy techniques. In this episode, they discuss the three cricothyrotomy techniques that include: (1) percutaneous needle cricothyrotomy; (2) percutaneous wire-guided cricot...

This was a super fu episode where Jeremy invites Rhea Temmermand on the show! Dr. Rhea Temmermand PhD, MSN, CRNA, FAANA is a distinguished research scientist specializing in neuropharmacology within the Department of Pharmacology and Physiology at Drexel University. In addition to her full-time research endeavors, she serves as an Adjunct Professor in Drexel University’s Nurse Anesthesia program. She is also the co-founder of Atomic Anesthesia and co-host of the Atomic Anesthesia Podcast. In ...

Episode Summary In this episode of The Nurse Anesthesia Podcast, Jeremy reviews basic kidney function and focuses on the different types of Diuretic Medications. These include Osmotic agents, Loop Diuretics, Carbonic Anhydrase Inhibitors, Thiazide Diuretics, Aldosterone Antagonists, Potassium Sparing Diuretics, and Vasopressin Antagonists. Some diuretics we use during anesthesia management and some medications patients take to manage medical conditions. If you want to brush up on your d...

In this episode of The Nurse Anesthesia Podcast, Jeremy discusses questions and answers from previous TNA podcast episodes 22 – BIS Monitoring During Anesthesia, 24–Perioperative Hypovolemia: The Tank is Empty, & 25–Albuterol & Epinephrine for the Treatment of Intraoperative Bronchospasm. Here are several examples of questions he discusses in the episode. For a complete review of all the questions, check out the episode wherever you listen to podcasts! 1. Which EEG ...

Episode Summary In this episode of the nurse anesthesia podcast, Jeremy dives into some Airway Management Adventures! He discusses three airway cases from the Emergency Department to the Operating Room. Each case illustrates critical decision-making under challenging circumstances where key actions by the CRNA are essential. The cases include information on preoxygenation with nasal cannula and a non-rebreather mask, RSI, successful first-pass intubation using video-laryngoscopy, cricothyroto...

In Episode 26 we welcome a special guest…Rhea Temmermand from the Atomic Anesthesia Podcast! Jeremy talks with Rhea about cognitive aids—like crisis checklists—which are essential tools in anesthesia for guiding rapid decision-making during high-stakes medical emergencies. Originally inspired by aviation’s Crew Resource Management, these aids were adapted for anesthesia…giving rise to Anesthesia Crisis Resource Management (ACRM). Using crisis checklists can help enhance performance, boosts pa...

Asthma is a chronic inflammatory disorder of the airways characterized by hyperresponsiveness, variable airflow obstruction, and airway remodeling. In the OR, we’re less concerned about chronic control and more focused on acute airway events…namely, bronchospasm. Bronchospasm during general anesthesia can be insidious. You may see rising peak airway pressures, decreased tidal volumes, wheezing if you’re lucky…and if you’re unlucky…desaturation and hypotension. Time is tissue. That’s when it’s...

Episode 23 begins with Jeremy and Sass discussing the historical background of cannabis or “marijuana” use, and then dive into how this psychoactive drug affects each body system. They focus on what you need to know when providing anesthesia for an individual who is a chronic user or acutely intoxicated. Get ready…it’s go time! References Horvath C, et al. “Marijuana Use in the Anesthetized Patient: History, Pharmacology, and Anesthetic Considerations.” AANA journal vol. 87,6 (2019): ...

Episode Summary Monitoring the depth of anesthesia, as a CRNA, is important for any surgical or medical procedure. In this episode of The Nurse Anesthesia Podcast, Jeremy and Sass review the bispectral index (BIS) monitor. They discuss the various electroencephalographic (EEG) waveforms the BIS monitor uses to determine depth of anesthesia, and identify the factors and medications that influence the BIS monitor. They finish the episode with an interesting set of studies that investigated at h...

In this episode of The Nurse Anesthesia Podcast, Jeremy discusses questions and answers from the previous TNA podcast episodes 14 - POCUS of the Cricothyroid Membrane, 15 - How Anesthesia uses Ketamine, 19 - Push-dose Vasopressors, and 20 - Vasoplegic Syndrome. Here are several examples of questions he discusses in the episode. For a complete review of all the questions, check out the episode wherever you listen to podcasts! 1. Which artery extends the length of the cricothyroid membrane? a. ...

In this episode of The Nurse Anesthesia Podcast, Jeremy & Sass discuss what happens when the routine treatments for intraoperative hypotension don’t work, and focus on the interventions you can consider when refractory hypotension occurs. They talk about different causes of refractory hypotension with a focus on vasoplegic syndrome. They discuss the differences between refractory hypotension and vasoplegic syndrome, and then identify the potential causes and specific treatments for this r...