Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

In this 114th episode I welcome Dr. Jerry Stonemetz to the show to discuss the business side of Anesthesiology. Specifically we discuss billing, compliance, contract negotiation and Jerry’s thoughts on where the industry is heading. Slides are here: Our Sponsors: * Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.betterhelp.com * Check out FIGS and use my code FIGS...

In this 113th episode I welcome Dr. David Mintz back to the show to discuss anesthesia for intracranial aneurysm clipping. References: Chapter 13 Anesthetic management of cerebral aneurysm surgery in Cottrell and Young, Neuroanesthesia https://www.ncbi.nlm.nih.gov/pubmed/25014255 Our Sponsors: * Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.betterhelp.com * Chec...

In this 112th episode I welcome Dr. Christina Miller to the show to discuss Anesthesia for Electroconvulsive Therapy (ECT). References: Ding Z, White PF. Anesthesia for electroconvulsive therapy. Anesth Analg. 2002 May;94(5):1351-64. Sadowksy, Jonathan. Electroconvulsvie Therapy: A History of Controversy, but Also of Help.  The Conversation. Scientific American.  January 13, 2017. Wright, M.D., Br...

In this 111th episode I welcome Dr. Zandy Hillel to the show. Dr. Hillel is an otolaryngologist here at Johns Hopkins and we discuss tracheostomies, Cricothyrotomies, laryngeal surgery and difficult airways. References: Crichothyrotomies: https://www.ncbi.nlm.nih.gov/pubmed/30054081 https://www.ncbi.nlm.nih.gov/pubmed/30726035 Difficult Airway Response Teams: https://www.ncbi.nlm.nih.gov/pubmed/26...

In this 110th episode I welcome Justin Harvey to the show. Justin is a financial planner with an interest in helping anesthesiologists and pain specialists make the best possible financial choices. We discuss financial planning, managing loan repayment, and investing. Justin’s email: Justin@quantifiplanning.com Justin’s podcast: AnesthesiaSuccess.com Justin’s financial planning company: www.quanti...

In this 109th episode we pick up where we left off in episode 108 and discuss the intraoperative use of non-opioid adjuncts. References: Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697. Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing … Continue reading...

In this 108th episode I welcome Dr. Mike Grant and Dr. Mark Bicket to the show to discuss various non-opioid adjuncts such as esmolol, ketamine, dexmedetomidine, lidocaine, and magnesium, and the role they may play in multimodal anesthesia. In this episode, part 1, we discuss pre and post-op use. Intraop use will be discussed in … Continue reading "Episode 108: Non-opioid adjuncts with Drs. Gr...

In this 107th episode I welcome Dr. Mike Fitzsimons back to the show to discuss the topic of suicide in physicians in general and in Anesthesia providers specifically. References: Bucknill JC, Duke DH. A Manual of Psychological Medicine. London, England: John Churchill;1958 Yaghmour NA, Brigham TP, Richter T, Miller RS, Philibert I, Baldwin DC, Nasca … Continue reading "Episode 107: Suicide in...

In this 106th episode I welcome Dr. Marius Fassbinder to the show to discuss the use of hydroxyethyl starches. References: 1. Woodcock, T. E. & Woodcock, T. M. Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy. British Journal of Anaesthesia 108, 384–394 (2012). 2. … Continue reading "Episode 1...

In this 105th episode, which will be the first part in a series on blood management, I turn over the mic to Dr. Stephanie Cha who interviews Dr. Steve Frank about blood management in cardiac surgery and how to do “bloodless” surgery for patients who refuse blood transfusions. References: 1.         Myles PS, Smith JA, Forbes … Continue reading "Episode 105: Blood Management Part 1 With Drs. Fr...

In this 104th episode I welcome Dr. Pam Lipsett to the show to discuss the diagnosis and treatment of sepsis. References: Sepsis-3 guidelines from JAMA: https://jamanetwork.com/journals/jama/fullarticle/2492881 Marik Sepsis cocktail: Marik PE et al. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock. 2017: 151(6);1229–1238. ADRENAL trial: https://www.nejm.o...

In this 103rd episode I welcome Dr. Eva Ritzl and Dr. Alyson Russo to the show to discuss intraoperative neuromonitoring. Reference: Solt K and Froman S. Correlating the clinical actions and molecular mechanisms of general anesthetics. Curr Op in Anaes. 2007:20(4);300-306. Our Sponsors: * Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.betterhelp.com * Check out F...

In this 102nd episode I welcome Dr. Dan Lowenstein to the show.  Dr. Lowenstein is a professor of Neurology and the Executive Vice Chancellor and Provost at University of California San Francisco (UCSF).  We discuss his lessons and advice for how to be successful professionally and personally. The Three Marriages book: http://www.davidwhyte.com/the-three-marriages/ Our Sponsors: * Check out Better...

In this 101st episode I welcome back Dr. Stephen Freiberg to the show to discuss how to successfully come off bypass when doing cardiac surgery with cardiopulmonary bypass. References: -Barash Anesthesia for Cardiac Surgery -Barry AE, Chaney MA, London MJ. Anesthetic management during cardiopulmonary bypass: a systematic review. Anesth Analg 2015; 120:749. -Denault AY, Tardif … Continue reading &#...

In this 100th episode I respond to questions, both clinical and personal, from ACCRAC listeners. Our Sponsors: * Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.betterhelp.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor and use my code factormeals.com/accrac50off for a great deal: https://www.factor75.com * Che...

In this episode, episode 99, I welcome Dr. Mike Fitzsimons from MGH to the show to talk about substance abuse in anesthesia providers and his recent article in Anesthesiology detailing their program to decrease rates of abuse. References: https://www.ncbi.nlm.nih.gov/pubmed/30020101   Our Sponsors: * Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.betterhelp.com *...

In this episode, episode 98, I discuss the BICAR-ICU trial and what it tells us about using sodium bicarbonate to treat metabolic acidosis. References: BICAR-ICU Trial: https://www.ncbi.nlm.nih.gov/pubmed/29910040 BICAR-ICU Editorial: https://www.ncbi.nlm.nih.gov/pubmed/29910039 Forsythe: https://www.ncbi.nlm.nih.gov/pubmed/10631227 Sabatini: https://www.ncbi.nlm.nih.gov/pubmed/18322160 Pulmcrit p...

In this episode, episode 97, I discuss how to optimize your wakeup at the end of an anesthetic. Our Sponsors: * Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.betterhelp.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor and use my code factormeals.com/accrac50off for a great deal: https://www.factor75.com * Chec...

In this episode, episode 96, I welcome Dr. Nick Dalesio to the show.  Dr. Dalesio is the director of the pediatric difficult airway program here at Johns Hopkins.  We discuss the pediatric difficult airway response team, consult service, and how to anticipate and manage difficult airways in kids, both anticipated and unanticipated. Reference: Planning Prevents … Continue reading "Episode 96: P...

In this episode, episode 95, I interview James Prudden, editorial director at Anesthesiology News, on the floor of the ASA conference in San Francisco.  We discuss the coverage of the field of anesthesiology, how providers can contribute, and how to get your work considered for coverage. James can be reached at Jprudden@mcmahonmed.com Our Sponsors: * Check out BetterHelp and use my code betterhelp...

In this episode, episode 94, I welcome Clint Burns to the show.  Clint received a liver transplant in 1994, then went on to go to nursing school, have 4 children, be an ICU nurse, and he now runs the organ and tissue donation program here at Johns Hopkins.  We discuss his story, the process of … Continue reading "Episode 94: Organ Donation with Clint Burns" Our Sponsors: * Check out Better...

In the episode, episode 93, I welcome Dr. Tom Metkus back to the show to discuss perioperative considerations for CABG surgery. References: Syntax Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa0804626 STICH Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1100356 ROOBY Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa0902905 CORONARY Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1200...

In this episode, episode 92, I welcome Dr. Sapna Kudchadkar to the show to discuss her PICU Up program for early mobility in the PICU.  We discuss the benefits of early mobility in general and specifically with pediatric patients, how she started her program, and what has led it to be so successful. Dr. Kudchadkar … Continue reading "Episode 92: Early Mobility in the PICU with Sapna Kudchadkar...

In this episode, episode 91, I welcome Dr. Tom Metkus back to the show to discuss how we risk-stratify patients for non-cardiac surgery. Outline by Dr. Kimia Kashkooli References: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000104 http://www.onlinejacc.org/content/64/22/e77 https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ESC-ESA-Guidelines-on-non-cardiac-surgery-cardiova...

In this episode, episode 90, I discuss best practices for preoperative management of adults with Obstructive Sleep Apnea (OSA). Outline by April Liu: Episode 90 References: Gross JB et al. Practice Guidelines for the Perioperative Managementof Patients with OSA. Aneshtesiology 2014: 120(2): 1-19 Chung F, et al. STOP-Bang Questionnaire: A practical Approach to Screen for … Continue reading "Epi...