Podcast

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 AnesthesiaWe are building a commUNITY of learning in anesthesia and critical care! We are educators and […]

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 […]

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 diuretic […]

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 waveforms […]

Episode SummaryIn 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, cricothyrotomy, […]

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, […]

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. […]

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! ReferencesHorvath C, et al. “Marijuana Use in the Anesthetized Patient: History, Pharmacology, and Anesthetic Considerations.” AANA journal vol. 87,6 […]

Episode SummaryMonitoring 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 how […]

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 […]

Anesthesia induced hypotension is commonly treated with push dose vasopressors. Today Jeremy & Sass dive into what the evidence is showing us about the use of phenylephrine, ephedrine, and norepinephrine IV bolus doses. We talk about cerebral oxygen concentrations and cardiac output when administering these vasopressors, and ultimately ask ourselves…should we be less pushy?ReferencesKee W, et al. Randomized double-blinded comparison of norepinephrine and phenylephrine for maintenance of […]

 Episode Summary Point of care ultrasound (POCUS) assessments of the airway is simply awesome! By utilizing POCUS during our preoperative airway examination, we can now determine with a greater certitude the level of difficulty of a patient’s airway as well as locate anatomical structures (such as the cricothyroid membrane) and endotracheal tube positioning within the airway. In today’s episode Jeremy and Mark go over basic ultrasound skills and then discuss the various POCUS airway […]

Episode SummaryEvery fourth episode we will release a podcast where we ask and answer questions about an anesthesiology or pharmacological topic and we’ll call it ANESTHESIA Q&A. We do this to help our community solidify their learning! We also produce these episodes because nurse anesthesia students and practicing CRNAs are all engaged in answering questions whether it be on exams during anesthesia school or for CRNA recertification.In today’s episode we focus on reversal medications […]

We all experience acute stress. Sometimes on a daily basis. In this episode Jeremy breaks down acute stress and talks about the anatomy and physiology of stress. He reviews a theory on how highly stressful situations can both physiologically and psychologically affect our thinking and performance. He also points out how a certain amount of acute stress is actually helpful.Then Jeremy discusses the meaning of BVM and how breathing, body position, visualizing success, speaking positively and […]

In Episode 15 of the Nurse Anesthesia Podcast, Jeremy and Sass dive into the pharmacological world of ketamine. They talk about all the anesthesia situations where it can be useful. They discuss the pharmacology of ketamine, appropriate dosing, what the current evidence really shows about its use with increased intracranial pressure, and how it is frequently used for analgesia. It really is the Swiss army knife of anesthetic meds!ReferencesAleksandrova LR, et al. Antidepressant effects of […]

In this episode Jeremy and Mark focus on the cricothyroid membrane. They discuss the anatomy, sizing, vasculature and orientation of this important airway landmark. They then highlight techniques for palpating the cricothyroid membrane, and finish up with a discussion that explains how to use Point of Care Ultrasound (POCUS) to mark where exact position of this membrane is on the neck. This is an episode you won’t want to miss!ReferencesLin J, Bellinger R, Shedd A, et al. Point-of-Care […]

In today’s podcast Jeremy and Mark review several anesthesia concepts that were covered in previous episodes…specifically Malignant Hyperthermia, Pulse Oximetry, and Adrenal Crisis. As educators we know it’s important to revisit and review anesthesia concepts in order to help with long term memory retention. There’s actually a learning technique called spaced learning (or spaced repetition) where information is reviewed at increasing intervals over time, instead of being crammed in a […]

In today’s episode Jeremy and Sass start by diving into normal physiologic function of the Hypothalamic-Pituitary-Adrenal (HPA) Axis. They then review how it’s regulated and the pathology/medications that can alter the HPA Axis. After that, it’s all about the adrenal glands, and Jeremy and Sass differentiate between Acute Adrenal Crisis and Adrenal Insufficiency. They talk about why chronic steroid use puts patients at risk for Adrenal Crisis and why cortisol is necessary for proper […]

Episode SummaryNitrous oxide is one the OG of anesthesia gases and is one of three gases pipped into our anesthesia gas machine. It’s known on the anesthesia workstation by the color blue. In this episode Jeremy and Mark discuss the current use of nitrous oxide and both it’sdesirable and undesirable effects. Gear up to review or learn about the “Original Blue Gas”!Resources/information discussed in podcastYou can pick up a copy of Emergency Management in Anesthesia and Critical Care […]

This is a special episode where Jeremy & Sass talk with the one and only Dr. John Nagelhout, PhD, CRNA, FAAN. They talk with him about what it was like when he first went to anesthesia school, his transition into academics, how he gathered a group of CRNAs together to write the very first Nurse Anesthesia textbook, and the thousands of lives he’s influenced with his pharmacology lectures. There’s a reason we call him the “Grand Master of Nurse Anesthesia Education” and this is a […]

Episode SummaryThe pulse oximeter is a primary anesthesia and critical care monitor. Not only does it help identify hypoxemia, but it provides several other pieces of essential information when monitoring a patient during anesthesia and surgery. In this episode, we go over how the pulse oximeter functions, the current advantages and disadvantages, and other practical considerations that make pulse oximetry monitoring simple awesome!ReferencesWilkins MC. Residual bacterial contamination on […]

This is our second Q&A episode and in this one, we review the anesthesia gas machine! We go over all the different pressure systems, variations in some of the anesthesia machines, we talk about some monitoring issues, and review content that falls within the anesthesia technology category…basically we talk about the stuff you will be tested on. There are sure to be some pearls you won’t want to miss!About The Nurse AnesthesiaFor anyone who wants to learn or review anesthesia […]

Episode SummaryIn today’s episode Jeremy and Sass talk about the anaphylactic shock state. They discuss the most common triggers for anaphylaxis, how it occurs at the cellular level, the signs and symptoms associated with anaphylaxis, and most important…how to manage this critical event. ReferencesMacy E. Penicillin and B-lactam allergy: Epidemiology and diagnosis. Curr Allergy Asthma Rep. 2014;14(11):476.Sadleir PHM, et al. Anaphylaxis. To neuromuscular blocking drugs: Incidence and cross […]

Anesthesia induction agents are essential anesthesia medications that anesthesia providers need to learn about and understand so they can select the correct medication for the right patient/situation. The primary induction agents used in today’s anesthesia practice include: Propofol, Etomidate, and Ketamine…we refer to these as “The Knock Out Buch!” Without a doubt, propofol is used more often than any other anesthesia induction agent. In today’s episode, we talk about the […]

In this episode we highlight the various difficult airway algorithms and failed airway checklists developed by professional airway organizations. These tools used by anesthesia providers to develop their personal airway management plans and to help guide decision making in the event of a difficult or failed airway. ReferencesApfelbaum JL, et.al. 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. Anesthesiology. 2022 Jan 1;136(1):31-81. doi: […]

We’ve heard from a lot of anesthesia students, RNs, and CRNAs about how they want some question-and-answer episodes…so we’re here to deliver! This is the first Anesthesia Q&A, and we’re calling it Round 1 (ding! ding! ding!). What better way to start Anesthesia Q & A than with some respiratory anatomy and physiology. We’ve had extensive experience writing questions for anesthesia students, CRNAs, and for national certifying exams. So put the gloves on, it’s time to jump […]

Episode SummaryLaryngoscopy and intubation are core skills that anesthesia providers need to perfect. In this episode Jeremy and Sass discuss some of the keys to direct laryngoscopy and intubation. They start by identifying the primary keys when preparing to perform a direct laryngoscopy called “SOAP ME”. They then discuss the keys used when actually performing direct laryngoscopy and intubating the trachea. Spoiler alert…it’s all about “Epiglotoscopy”! About The Nurse […]

Episode SummaryJeremy and Mark begin this episode by discussing the history of anesthesia gases. They discuss how volatile agents work and why we actually call them “volatile agents”. They discuss the pharmacokinetics and pharmacodynamics, get into the mechanism of action and discuss those test heavy topics of Oil:Gas and Blood:Gas Partition Coefficients. Phew! They round it out by talking about both adverse effects and contraindications. This is a great discussion about some core […]

Episode SummaryIn this episode you’ll learn about the pathophysiology of malignant hyperthermia (MH), talk about prevention, and then review the managing techniques for this critical event. We review the use of Dantrolene for treatment of MH and talk about potential complications. If you’re currently learning or practicing anesthesia…this is a crisis you need to review! ReferencesElisha, S., Heiner, J. S., & Nagelhout J. J. (2023). Nurse Anesthesia (7th ed.) Elsevier […]