The Nurse Anesthesia Podcast

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 Patie...

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 t...

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 wher...

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 a...

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? References Kee W, e...

  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 episod...

Episode Summary Every 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 ane...

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 th...

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 Sw...

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...

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) wher...

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 steroi...

Episode Summary Nitrous 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...

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.  The...

Episode Summary The 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 pul...

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 t...

Episode Summary In 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.  References Macy E. Penicillin and B-lactam allergy: Epidemiology and diagnosis. Curr Allergy Asthma Rep . 201...

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 th...

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.  References Apfelbaum JL, et.al. 2022 American Society of Anesthesiologists Practic...

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...

Episode Summary Laryngoscopy 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...

Episode Summary Jeremy 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...

Episode Summary In 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!  References Elisha, S., He...