Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

In this episode, episode 64, I welcome back Dr. Jacqueline Galvan to finish our discussion of programs during pregnancy and delivery.  We discuss hematologic, neurologic, respiratory, renal and infectious disease issues and how they affect pregnancy, delivery, and anesthetic management. Slides with references and notes: Problems during pregnancy part 2 Our Sponsors: * Check out BetterHelp and use...

In this episode, episode 63, I welcome back Andrew Jarrell to learn to pronounce his name properly, and to discuss VTE and stress ulcer prophylaxis. References are here: References 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...

In this episode, episode 62, I discuss problems that can occur during pregnancy with Dr. Jacqueline Galvan.  We discuss a wide range of high yield topics from gestational diabetes to molar pregnancies to maternal heart disease. References are here: References Outline by April Liu Our Sponsors: * Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.betterhelp.com * Chec...

In this episode, episode 61, I welcome Dr. Shravani Durbhakula, one of our chronic pain doctors, to the show.  We discuss the opioid crisis in American from the perspective of a chronic pain physician including what it is, how it came about, how it impacts our patients, and what we can do about it. References … Continue reading "Episode 61: The Opioid Crisis with Shravani Durbhakula" Our S...

In this episode, episode 60, I welcome Andrew Jarrell, one of our amazing surgical ICU pharmacists to the show.  We discuss antibiotic prophylaxis for surgery including what to use, how to time it, how long to continue it, and what the evidence says about things like indwelling drains. A fantastically helpful outline of the episode … Continue reading "Episode 60: Surgical Antibiotic Prophylaxi...

In this episode, episode 59, I welcome international pulmonary hypertension expert Dr. Jochen Steppan to the show to discuss pulmonary hypertension and how to manage the preoperative care of patients with this disease. Outline by Brian Park: Outline 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 episode, episode 58, I welcome our two OB Anesthesia fellows to the show, Dr. Dave Berman and Dr. Anh Nguyen.  We discuss the medications used for neuraxial anesthesia including local anesthetics, opioids, and adjuncts such as epinephrine, clonidine and more. Outline by Brian Park: Outline Dave’s email is dberma20@jhmi.edu and Anh’s is tnguy193@jhmi.edu. References … Continue reading "...

In this episode, episode 57, I welcome back Rachel Kruer, our amazing SICU pharmacist and we complete our two part series on bugs and drugs in the ICU.  We discuss different infections that are commonly seen in ICUs and how to treat them. Outline by April LiuSee other interactive posts Our Sponsors: * Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.betterhelp.com...

In this episode, episode 56, I welcome Rachel Kruer to the show.  Rachel is one of our amazing ICU pharmacists and we discuss common bacteria and the drugs we use to treat them.  This is part 1 of a 2 part series that I’ll be doing with Rachel on this topic. Skip to specific topics: … Continue reading "Episode 56: Bugs and Drugs Part 1 with Rachel Kruer" Our Sponsors: * Check out BetterHel...

In this episode, episode 55, I welcome back frequent guest of the show Dr. Mike Hofkamp to pick up where I left off last time with Dr. Jacqueline Galvan as we discuss problems that can occur with pregnancy at term (part 2) including complications of labor and delivery. Outline by Brian Park: Outline Our Sponsors: * Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.b...

In this episode, episode 54, I welcome back Dr. Jacqueline Galvan and we discuss complications and physiology of term pregnancy.  This is part 1 of a 2 part series. Outline by Brian Park: Outline 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...

In this episode, episode 53, I welcome back Dr. Mike Hofkamp to discuss analgesia for cesarean delivery.  We discuss indications for C-section, urgent and emergent sections, anesthetic techniques and associated complications, how to approach the difficult airway in a pregnant patient, and aspiration prophylaxis. Additional information: Outline by Brian Park Discussion references Urgent cesarean se...

In this episode, episode 52, I welcome Dr. Todd Dorman to the show.  Dr. Dorman is a professor of anesthesiology here at Johns Hopkins, is the Vice Chair for Critical Care, and is the immediate past president of the Society of Critical Care Medicine (SCCM).  Dr. Dorman and I discuss diastolic heart failure or heart … Continue reading "Episode 52: Diastolic Heart Failure with Todd Dorman" O...

In this episode, episode 51, I welcome back Dr. Jacqueline Galvan to discuss labor analgesia.  We cover opioids including remifentanil, nitrous oxide, neuraxial anesthesia and other nerve blocks. References: Hess PE, et al. An association between severe labor pain and cesarean delivery. Anesth Analg. 2000 Apr;90(4):881-6 Van den Bussche E. Why women prefer epidural analgesia … Continue reading &#3...

In this episode, episode 50, I welcome back Dr. Mike Hofkamp, and, for the first time, I welcome Dr. Jacqueline Galvan to the show.  Drs. Hofkamp and Galvan go head to head in a debate over which is a better, more evidence-based technique, the traditional epidural or the CSE (combined spinal epidural). All of the … Continue reading "Episode 50: CSE vs Epidural Debate with Mike Hofkamp and Jacq...

In this episode, episode 49, I welcome Dr. Peter Pronovost to the show to discuss the high reliability movement and how it relates to healthcare.  Dr. Pronovost is one of the world’s foremost experts on patient safety and we discuss how a hospital can be as reliably safe as an aircraft carrier and how best … Continue reading "Episode 49: High Reliability with Peter Pronovost" Our Sponsors:...

In this episode, episode 48, I welcome Dr. Clint Tippett to the show.  Dr. Tippett is a cardiac anesthesiologist with an interest in anesthesia for Transcutaneous Aortic Valve Replacement (TAVR) and we discuss the approach to anesthesia for these cases including preoperative planning, intraoperative management, and post-operative concerns. Regarding stroke risk here is an editorial … Continue read...

In this episode, episode 47, I welcome back Dr. Stephen Freiberg, one of our chief residents, to discuss all you ever wanted to know about arterial lines.  We discuss the indications, contraindications, complications, placement technique, and how to interpret the waveform. Slides with figures mentioned in the podcast can be found here: Arterial Line Podcast Images … Continue reading "Episode 4...

In this episode, episode 46, I welcome back Dr. Mike Hofkamp to discuss obstetric pharmacology and fetal assessment. Outline by Brian Park: Outline 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/accrac50o...

In this episode, episode 45, I welcome Dr. Charlie Brown to the show.  Dr. Brown is one of our cardiac anesthesiologists with a research interest in postop delirium.  We discuss risk factors, consequences, prevention and treatment of postop delirium. 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 FIG...

In this episode, episode 44, I welcome Dr. Megan Kostibas to the show.  Dr. Kostibas is trained in cardiac anesthesia and critical care medicine and is an assistant professor here at Hopkins.  She is also the associate program director for the cardiac anesthesia fellowship.  We discuss the basics of how to prepare, induce and manage … Continue reading "Episode 44: Intro to cardiac anesthesia w...

In this episode, episode 43, I welcome Dr. Mike Hofkamp to the show.  Dr. Hofkamp is Director of OB Anesthesia at Baylor Scott & White Memorial Hospital and Clinical Associate Professor of Anesthesiology at Texas A&M Health Science Center College of Medicine.  We discuss the changes to women’s physiology when they become pregnant and the … Continue reading "Episode 43: Maternal Physiol...

In this episode, episode 42, I discuss Post-op Nausea and Vomiting (PONV).  I discuss risk factors, complications, treatment and prevention and side effects. Outline by April Liu: Outline UPDATE April, 2018: In this episode I mention that the evidence is not good for Midazolam in preventing PONV.  However, a good friend and colleague, Dr. Michael … Continue reading "Episode 42: Post-op Nausea...

In this episode, episode 41, I review local anesthetics including the mechanism of action, commonly used agents, pharmacodynamics and kinetics, toxicity and treatment, and common blocks. Outline by April Liu: Outline 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://wear...

In this episode, episode 40, I go over the basics of Vent modes and settings in the operating room and how they differ from the ICU.  I also discuss a few common special cases and how to adjust the vent to deal with them. Outline by April Liu: Episode 40 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...