Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

In this 164th episode I welcome back Dr. Gillian Isaac to do another ABA keywords episode. We discuss fentanyl and breathing systems (Mapleson and Circle systems). CME: https://earnc.me/delVJ8 Great info from Aaron Sandock: The toxicity was reported in rats and research was published in the early-mid 90’s.  Gonsowski, C., Laster, M., Eger, E., Ferrell, L. … Continue reading Episode 164:...

In this 163rd episode I welcome Dr. Barbara Versyck to the show to discuss thoracic wall blocks. We discuss the types of blocks, what they are used for, and what the evidence is for their efficacy. CME: https://earnc.me/4hNt3X References: Videos:  Pecs II: https://www.youtube.com/watch?v=YFWneF4pwOA Serratus Anterior block: https://www.youtube.com/watch?v=K2w46jjMgfMErector Spinae p...

In this 162nd episode I welcome Dr. Henao back to the show to discuss hypertensive disorders of pregnancy and how to manage them. CME: https://earnc.me/tyN3SI CLARIFICATIONS: During our discussion of treatment of eclamptic seizures Dr. Henao said benzos were first line treatment. This is assuming the patient is already getting magnesium. For test questions, the … Continue reading Episode 162...

In this 161st episode I welcome Drs. Regan and Lester to the show to discuss the country’s first combined Anesthesiology and Emergency Medicine dual training program. CME: https://earnc.me/5Wuljl Website for the program: https://www.hopkinsmedicine.org/emergencymedicine/combined-residency/

In this 160th episode I welcome Dr. Dave Berman back to the show to discuss anesthesia for non-OB surgery during pregnancy. CME: https://earnc.me/zVSggO References: 1. Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology 2016;124(2):27...

In this 159th episode I welcome Dr. Juanita Henao to the show to discuss prevention and management of postpartum hemorrhage. One CORRECTION: At about minute 4:30 Dr. Henao states that in women with PPH the mortality rate is 10% but what she meant to say is that PPH accounts for 10% of maternal deaths in … Continue reading Episode 159: Postpartum hemorrhage with Juanita Henao →

In this 158th episode we return with another keywords episode with Dr. Gillian Isaac. We discuss hepatic disease for the advanced exam and PACU care for the basic exam. CME: https://earnc.me/rEmBIA Show Notes by Dr. Brian Park Random recs: Cloud Atlas: https://www.amazon.com/Cloud-Atlas-Novel-Liam-Callanan/dp/0385336950 Wolf Hall: https://www.amazon.com/s?k=wolf+hall+by+hilary+mantel&i=stripbo...

In this 157th episode I welcome Dr. Mark Mattson to the show to discuss the science behind intermittent fasting including in the perioperative period. CME: https://earnc.me/1dnYNl Dr. Mattson’s review from NEJM: https://www.nejm.org/doi/full/10.1056/NEJMra1905136 Dr. Mattson’s Tedx Talk: https://www.youtube.com/watch?v=4UkZAwKoCP8

In this 156th episode I welcome Dr. Jimmy Turner to the show to discuss the intersection of personal finance and physician burnout. CME: https://earnc.me/0d07wD References: Dr. Turner’s about page: http://thephysicianphilosopher.com/about/ Dr. Turner’s website: https://thephysicianphilosopher.com/ Dr. Turner’s new podcast: http://moneymeetsmedicine.com/ Blogpost about burnout and...

In this 155th episode I welcome Dr. Michael Manning to the show to discuss opioid-reduced and opioid-free anesthesia. We discuss the downsides of opioid usage and what we can do to reduce our use in our patients or even eliminate it completely. CME: https://earnc.me/ntZLxe References: 1. Koepke EJ, Manning EL, Miller TE et al. The rising tide … Continue reading Episode 155: Opioid-...

In this 154th episode I welcome Dr. Emery Brown to the show to discuss how we monitor the depth of anesthesia. We discuss the drawbacks to BIS and why Dr. Brown thinks the EEG itself is the best way to go. CME: https://earnc.me/fbGYsk References: EEG reading tutorials: https://eegforanesthesia.iars.org/ Purdon et al: The Ageing Brain: Age-dependent … Continue reading Episode 154: EEG monitor...

In this 153rd episode I welcome Dr. Sasha Shillcutt to the show to discuss the movement to support and promote the success of women in Anesthesiology. Dr. Shillcutt is on twitter at @sashashillcutt and @RUBraveEnough. Her website is https://www.becomebraveenough.com CME: https://earnc.me/JlM00P References:

In this 152nd episode I welcome Dr. Gillian Isaac back for another 2 ABA keywords. We discuss malignant hyperthermia and the portion of hepatic disease that is covered by the Basic Exam. We’ll do the portion covered by the Advanced Exam on the next keywords episode. CME: https://earnc.me/NU3JPS Malignant Hyperthermia Website: www.mhaus.org Great review website … Continue reading Episod...

In this 151st episode I welcome Brandon Oto to the show. Brandon is an ICU PA and we discuss the roles and relationships of APPs in the ICU environment. CME: https://earnc.me/qcZ7cm Brandon’s blog is http://critcon.org/ Brandon is on Twitter @critconcepts

In this 150th episode I welcome back Dr. Gillian Isaac to do another round of ABA keywords. We discuss 2 additional upper extremity blocks (supraclavicular and axillary) and then benzodiazepines. CME: https://earnc.me/4aBzu8

In this 149th episode I discuss common challenges to the transition from intern year to CA1 year including some of why it’s difficult, the mistakes commonly made, the causes of those mistakes and some suggested solutions. Although I focus on the intern to CA1 transition, much of this applies to any major transition in life. … Continue reading Episode 149: Transitioning: From Intern to...

In this 148th episode I welcome Dr. Fitzsimons back to the show to discuss the use of marijuana in healthcare providers. We discuss what we know about prevalence, what the potential consequences are, what the status of testing is, and what we may see happen in the future. CME: https://earnc.me/8jVcyb NEJM article on adverse effects … Continue reading Episode 148: Marijuana Use In Healthcare...

In this 147th episode I welcome back Drs. Segna and Rayaz to finish up our discussion of lower extremity nerve blocks. This time we cover the front of leg blocks (femoral, adductor canal, fascia iliaca and obturator). CME: https://earnc.me/AyfE0B

In this 146th episode I welcome back Dr. Lee Goeddel to the show to discuss critical care ultrasound including how it differs from POCUS and how people can prepare for the new certification exam. CME: https://earnc.me/AnFeQx References: Pears and Pitfalls in Critical Care Ultrasonography: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693549/

In this 145th episode recorded live from Anesthesiology 2019, the annual ASA meeting, I welcome Dr. Jeanine Wiener-Kronish to the show to discuss the progress we’ve made with mechanical ventilation and how we can personalize the way we deliver it to our patients to improve their outcomes. CME: https://earnc.me/9RE5Ww References: Pereira, SM, Tucci, MR, Morais, … Continue reading Episod...

In this 144th episode we record live from Anesthesiology 2019 in Orlando Florida. I welcome Dr. Jeffrey Cooper to the show to discuss the relationship between anesthesiologists and surgeons and what can be done to improve it in a way that will foster patient safety. CME: https://earnc.me/6o7gPk Correction: The Center for Medical Simulation is not … Continue reading Episode 144: The Anesthesi...

In this 143rd episode I welcome Dr. Michael Scott to the show to discuss fluid management in ERAS cases and how cardiac output monitoring may help us do that well. CME: https://earnc.me/wcjdkb Topmedtalk: https://www.topmedtalk.com

In this 142nd episode I welcome Dr. Marcos Vidal Melo to the show to discuss Driving Pressure and Transpulmonary pressure. We discuss what they are, how they differ from plateau pressure, and how they may help guide safe mechanical ventilation. CME: https://earnc.me/IVPnjN References: Driving Pressure and Transpulmonary Pressure: How Do We Guide Safe Mechanical Ventilation? Williams … C...

In this 141st episode I welcome Dr. Paul Wischmeyer to the show to discuss nutrition for critically ill patients with a focus on the question of whether to give enteral feeds to patients on pressors. You can follow Dr. Wischmeyer on twitter @Paul_Wischmeyer. CME: https://earnc.me/xPgtPv References: Dr. Wischmeyer’s article on enteral nutrition for patients on … Continue reading Episode...

In this 140th episode I welcome Dr. David Mazer to the show. Dr. Mazer was the PI and first author on the TRICS 3 trial looking at liberal versus restrictive transfusion strategies in moderate to high risk cardiac surgery patients published in the NEJM in 2017. CME: https://earnc.me/6SR7cb Dr. Mazer would like to add the … Continue reading Episode 140: Transfusion Triggers and The TRICS 3 Tr...