Atomic Anesthesia

🚀 Try the Atomic Anesthesia platform free for 3 days: Start your free trial

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Pulmonary hypertension can feel like a pile of numbers, groups and drug names, but board questions keep coming back to one idea: protect the right ventricle. In week 5 of our 12-week SEE/NCE series, we start with a patient on daily sildenafil whose blood pressure falls after propofol, and we show you how to recognize the RV failure spiral and what to do first.

In this episode:

• The current definition of pulmonary hypertension and how wedge pressure and PVR separate precapillary from postcapillary disease
• The five WHO groups, plus a memory trick to place any patient
• The RV failure spiral and why systemic hypotension is so dangerous
• What raises PVR (hypoxemia, hypercarbia, acidosis, hypothermia, pain) and what lowers it, including why nitrous oxide is the gas to avoid
• Managing acute right ventricular failure on induction with vasopressors, inotropes and inhaled nitric oxide
• Why nitroglycerin is dangerous in a patient taking sildenafil

Want more content like this? Become a member of our learning platform

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

🚀 Try the Atomic Anesthesia platform free for 3 days: Start your free trial

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Every capnogram reports on three things at once: metabolism, circulation and ventilation. Change any one of them and the waveform changes. In this members-only Week 4 episode of our 12-week SEE/NCE series, we learn to read the normal waveform, then name the abnormal ones, with a worksheet to practice on.

In this episode:

• Capnometry vs capnography, and sidestream vs mainstream monitors
• The normal capnogram: phases I to III and the alpha and beta angles
• ETCO2 vs PaCO2, and hypoventilation vs hyperventilation
• Bronchospasm and obstruction
• When the baseline won't return to zero: rebreathing, an exhausted absorber, incompetent valves
• When CO2 disappears: esophageal intubation, disconnection and sudden cardiovascular collapse
• The curare cleft, and a method for reading any capnogram

Want more content like this? Become a member of our learning platform.

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

🚀 Try the Atomic Anesthesia platform free for 3 days: Start your free trial

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Your patient's SpO2 reads 100 percent, but they were just pulled out of a house fire. Can you trust it? In Week 4 of our 12-week SEE/NCE series, we break down the assumptions behind that number so you can predict every misleading reading the boards throw at you.

In this episode:

• What SpO2 measures, and why a perfect number doesn't rule out anemia or low cardiac output
• The Beer-Lambert law, red vs infrared light at 660 and 940 nm, and how the AC/DC ratio finds the pulse
• Functional vs fractional saturation and the oxyhemoglobin curve landmarks
• Why SpO2 can hide a big drop in PaO2 and can't monitor ventilation
• Carboxyhemoglobin, methemoglobin and the dyes that fool the probe
• Low perfusion, venous pulsation, probe site and response time

Want more content like this? Become a member of our learning platform.

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

🚀 Try the Atomic Anesthesia platform free for 3 days: Start your free trial

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

How many minutes of oxygen are left in that tank? Why does the nitrous gauge read full when the tank is almost empty? In Week 4 of our 12-week SEE/NCE series, we take every gas law straight to a patient and then give you a memory trick so it actually sticks.

In this episode:

• Boyle's, Charles's and Gay-Lussac's laws, from a pneumothorax at altitude to a cylinder near a fire
• Why the ideal gas law lets an oxygen gauge tell you what's left, plus quick E-cylinder math
• Critical temperature, and why the nitrous gauge reads full until the tank is nearly empty
• Dalton's and Henry's laws: partial pressure, desflurane at altitude and dissolved oxygen
• Diffusion with Graham's and Fick's laws, and why nitrous expands a pneumothorax or an obstructed bowel
• Laminar vs turbulent flow, Poiseuille's law, heliox and the Venturi mask

Want more content like this? Become a member of our learning platform.

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

Want more content like this? Become a member of our learning platform.

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Your patient can't come off bypass, the pressors are climbing, and the surgeon wants a balloon. In this members-only episode of our SEE/NCE series, we break down the intra-aortic balloon pump, ventricular assist devices and ECMO with three questions you can use for every device: what does it support, how much, and for how long?

In this episode:

• Why mechanical support is used, and where it fits when a patient can't come off bypass
• IABP placement, counterpulsation, and the four timing errors (and which two are dangerous)
• IABP contraindications and complications
• LVAD physiology: preload dependence, afterload sensitivity, suction events and the right ventricle
• Why your LVAD patient may have no palpable pulse, and how to assess perfusion
• VA vs VV ECMO, LV distention, differential hypoxia, the Impella and the anesthesia plan for LVAD patients

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan: a structured, week-by-week plan to pass your boards

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform.

Letter codes, electrocautery, and a magnet that does something different depending on the device. Pacemakers and ICDs show up in almost every OR, and on boards. In Week 3 of our 12-week SEE/NCE series, we boil it down to two questions: what is this device doing for the patient, and what will electrical noise do to it?

In this episode:

• Pacemaker vs ICD, plus resynchronization, leadless and subcutaneous devices
• The pacemaker code letter by letter, and the modes you'll actually see (AAI, VVI, DDD, DOO)
• Why pacemaker dependence is the most important question you can ask
• What electrocautery does to pacemakers and ICDs, and monopolar vs bipolar cautery
• What a magnet does to a pacemaker vs an ICD, with board-style scenarios
• Preoperative device evaluation and the intraoperative and postoperative plan

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
• Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
• GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform.

The pump, the cannulas, the cardioplegia, the drips. CABG can feel like too many moving parts to keep straight for boards. In Week 3 of our 12-week SEE/NCE series, we tie every step of the case back to one idea, myocardial oxygen supply versus demand, so the decisions finally make sense.

In this episode:

• Coronary perfusion pressure, the coronary territories and why tachycardia is the enemy
• Preoperative medications, monitoring and the hemodynamic goals for induction
• Cardiopulmonary bypass basics, heparin dosing, ACT targets and protamine, plus why you never draw up protamine ahead of time
• Cardioplegia: how it stops the heart, and antegrade vs retrograde delivery
• Separating from bypass, vasoplegia and post-bypass ventricular dysfunction
• The major complications, from bleeding and tamponade to stroke and AKI

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
• Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
• GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform.

A lot of EKG questions are really measurement questions in disguise, and a scary strip on the monitor is sometimes just a loose lead. In this members-only Week 2 episode of our 12-week SEE/NCE series, we walk through 18 rhythm strips on the study sheet with one system you can use every time, so you can name the rhythm and know when it actually needs treatment in the OR.

In this episode:

• Reading the grid, two quick heart rate methods, and a seven-step system for every strip
• Sinus rhythms and their most common intraoperative causes
• Atrial fibrillation, atrial flutter, SVT and the Wolff-Parkinson-White trap
• PVCs, ventricular tachycardia, torsades de pointes and VF, plus synchronized cardioversion vs defibrillation
• All four AV blocks, with a memory trick for each
• Electrolyte and ischemia changes, and three questions to ask before you treat any new rhythm

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
• Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
• GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform.

Strange suffixes, different labs, different hold times and a different antidote for every drug. Anticoagulants are where a lot of board points get lost. In Week 2 of our 12-week SEE/NCE series, we organize every anticoagulant around one question: where in the coagulation cascade does it hit? Answer that, and you can predict the lab, the risks and the reversal.

In this episode:

• A simple map of the coagulation cascade and which lab tests which pathway (PT/INR, aPTT, ACT)
• Unfractionated heparin, heparin resistance, ACT targets for bypass, and protamine dosing and reactions
• Heparin-induced thrombocytopenia: why it's a clotting problem, not a bleeding problem
• Low-molecular-weight heparin, fondaparinux and the neuraxial hold times you need to know
• Warfarin, the "1972" factors, and when to reach for vitamin K, four-factor PCC or FFP
• The DOACs and their antidotes (idarucizumab and andexanet alfa), antiplatelet agents, and balancing bleeding against thrombosis

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
• Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
• GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform.

Valvular heart disease feels like a memorization topic, but the table of arrows in every review book isn't random. In Week 2 of our 12-week SEE/NCE series, we show you how two questions (pressure or volume problem, systole or diastole) let you rebuild the hemodynamic goals for every valve lesion in the middle of your exam.

In this episode:

• The shortcut: stenosis is full, slow and tight; regurgitation is full, fast and forward
• Aortic stenosis: severe AS numbers, the atrial kick, why phenylephrine is the go-to and why CPR rarely works
• Aortic regurgitation: acute vs chronic, why neuraxial is well tolerated, and the balloon pump contraindication
• Mitral stenosis: protecting the right heart, avoiding PVR triggers, and why wedge pressure overestimates LVEDP
• Mitral regurgitation: the large v wave and why phenylephrine can worsen the leak
• A rapid-fire board review of every lesion, plus how to handle mixed valve disease

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
• Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
• GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/