Anesthesia Guidebook

Today I’m joined by Will Cohen to talk about clinical precepting.  We discuss ways to create effective learning environments, how to expect excellence while being supportive and other tips for mastering the art of precepting. Will created the Facebook page CRNA Preceptors and has become well known in the CRNA world for creating masterfully crafted […]

Leadership in emergencies is about leadership outside of emergencies. The art and science of resuscitation involves understanding and mastering both the systems design and human factors at play in emergencies. In this episode, I unpack research by Weinger, et. al. (2017) to help us see the potential for improvement in our response to emergencies as […]

Today I talk with Marcus House, BSN, SRNA about his decision to live in an ambulance during remote clinical rotations in anesthesia school. Marcus is currently working towards completing his Doctor of Nurse Anesthesia Practice at Missouri State University. He holds Bachelor of Science degrees in Education and Nursing, both from Southeast Missouri State University. […]

Kiki Mattress, MSNA, CRNA runs the blog The CRNA Chase which seeks to “empower, inspire, and educate” people who are interested in becoming CRNAs. In this episode, I talk with Kiki about her journey to become a CRNA and her passion for helping others understand and be successful on that same path. “Don’t just talk […]

MJ Hiblen is an illustrator from Norwich, United Kingdom who’s first book of art titled, Front Line Heroes is available now from Eyewear Publishing.  This book is incredibly powerful.  I’ve followed MJ’s work on Instagram since the early days of the COVID19 pandemic when he began drawing images depicting the coronavirus as a classic comic-book […]

MJ Hiblen is an illustrator from Norwich, United Kingdom who’s first book of art titled, Front Line Heroes is available now from Eyewear Publishing. 

This book is incredibly powerful.  I’ve followed MJ’s work on Instagram since the early days of the COVID19 pandemic when he began drawing images depicting the coronavirus as a classic comic-book style menacing villain with healthcare workers squaring off as the front line heroes the world has come to know them as.  When I saw that this collection of art was coming together in a limited edition hardcover, I immediately put my order in.  The book went to print in August 2020 and over the last few weeks I’ve shared it with colleagues in my anesthesia department.  Their first glance at the artwork – during busy shifts at our level 1 trauma center – was often much like mine:  at first intrigued and then within pages, fighting back tears as we realize the beauty and power of what M.J. Hiblen has captured in his images.  His work is evocative & heart wrenching, at once it powerfully represents the human toll and suffering this virus has brought around the world while also casting healthcare workers as the defiant, battle-worn and ultimately triumphant care providers they are.

You owe it to yourself, after the year we’ve all experienced, to look M.J. Hiblen up on Instagram and get a copy of this book for yourself.  You can find it on Amazon or directly from the publisher at Eyewear Publishing.  Links to the book are in the show notes and if you hurry, you might still be able to get one only 1000 first edition hardcovers, signed by M.J. Hiblen.

Click here: M.J. Hiblen on Instagram

Order your copy of Front Line Heroes, art by M.J. Hiblen here.

This episode on succinylcholine will unravel the mysteries and controversies around the medication – from it’s molecular shape and how that influences which receptors subtypes and locations it exerts its effects on to practical information on dosing and how to optimize airway management while mitigating the side effects of succinylcholine.  At the time of this […]

This episode on succinylcholine will unravel the mysteries and controversies around the medication – from it’s molecular shape and how that influences which receptors subtypes and locations it exerts its effects on to practical information on dosing and how to optimize airway management while mitigating the side effects of succinylcholine. 

At the time of this recording in March of 2018, Michael was a second-year Student Registered Nurse Anesthetist at the University of Scranton and a student representative for the AANA Foundation.  He has since passed his boards as a CRNA and began his anesthesia practice in the greater Boston area. His background includes experience as a cardiac critical care Registered Nurse in Austin, Texas.   As part of his graduate studies, Michael completed an in-depth project regarding the history, latest research and controversies surrounding succinylcholine. Michael has presented on succinylcholine at state association conferences and went on to give a podium presentation at the 2018 AANA Annual Congress in Boston titled “Succinylcholine:  From Discovery to Current Evidence for Everyday Practice.” 

Resources:

Alvarellos, M. L., McDonagh, E. M., Patel, S., McLeod, H. L., Altman, R. B., & Klein, T. E. (2015). PharmGKB summary: succinylcholine pathway, pharmacokinetics/pharmacodynamics. Pharmacogenetics and genomics, 25(12), 622.

Barash, P. G. (Ed.). (2009). Clinical anesthesia. Lippincott Williams & Wilkins.

Fukano, N., Suzuki, T., Ishikawa, K., Mizutani, H., Saeki, S., & Ogawa, S. (2011). A randomized trial to identify optimal precurarizing dose of rocuronium to avoid precurarization-induced neuromuscular block. Journal of anesthesia, 25(2), 200-204.

Lee, C. (2003). Conformation, action, and mechanism of action of neuromuscular blocking muscle relaxants. Pharmacology & therapeutics, 98(2), 143-169.

Nagelhout, J. J., & Plaus, K. L. (2014). Nurse anesthesia. Elsevier Health Sciences.

Miller, R. D. (2015). Miller’s anesthesia (8th ed.). Philadelphia, PA: Churchill Livingstone/Elsevier.

Schreiber, J. U., Lysakowski, C., Fuchs-Buder, T., & Tramer, M. R. (2005). Prevention of Succinylcholine-induced Fasciculation and MyalgiaA Meta-analysis of Randomized Trials. Anesthesiology: The Journal of the American Society of Anesthesiologists, 103(4), 877-884.

Tran, D. T., Newton, E. K., Mount, V. A., Lee, J. S., Wells, G. A., & Perry, J. J. (2015). Rocuronium versus succinylcholine for rapid sequence induction intubation. The Cochrane Library.

This is a quick run down on the use dexmedetomidine in the perioperative environment.

Matt Poirier, MSNA, CRNA joins Anesthesia Guidebook to give a run down on dexmedetomidine. We cover the pharmacology & dosing right off the bat in this episode and then we take some time to discuss the art of using dexmedetomidine peri-operatively.

Matt Poirier is a Certified Registered Nurse Anesthetist at Maine Medical Center, a level 1 trauma center in Portland, Maine.  He obtained his Bachelor of Science in nursing from the University of Southern Maine and his Master of Science in nurse anesthesia from the University of New England.  Prior to Matt’s nursing career, he attended Assumption College in Worcester Massachusetts and obtained a Bachelor of Arts in biology and chemistry and subsequently worked as both an analytic and synthetic chemist.

References

Kaur, M., & Singh, P. M. (2011). Current role of dexmedetomidine in clinical anesthesia and intensive care. Anesthesia, essays and researches, 5(2), 128. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173414/.

Liu, Y., Liang, F., Liu, X., Shao, X., Jiang, N., & Gan, X. (2018). Dexmedetomidine reduces perioperative opioid consumption and postoperative pain intensity in neurosurgery: a meta-analysis. Journal of neurosurgical anesthesiology, 30(2), 146-155.

McEvoy, M. D., Scott, M. J., Gordon, D. B., Grant, S. A., Thacker, J. M., Wu, C. L., & … Miller, T. E. (2017). American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery: part 1–from the preoperative period to PACU. Perioperative Medicine, 61. doi:10.1186/s13741-017-0064-5