What happens when a trauma patient isn’t just a trauma patient? In today’s episode, we’re diving into “Trauma Plus” — those high-stakes situations where comorbidities, medications, environmental exposures, or underlying medical emergencies complicate recognition of decompensation and change everything about how we care for our patients.

I’m joined by Flight Nurse Gwenny, who brings her expertise from the field to walk us through three complex trauma cases where things aren’t what they first appear to be. You’ll hear her real-time thought process as she navigates evolving scenarios and shares her assessment priorities, differential diagnoses, and critical interventions.

If you’ve ever cared for a trauma patient and thought, “Something doesn’t add up,” this episode will help sharpen your assessment skills and give you a framework for approaching the next challenging trauma case.

• Recognizing subtle signs of trauma decompensation
• Assessing geriatric trauma patients with limited compensatory reserves
• Managing trauma patients on anticoagulation
• Understanding how hypothermia worsens bleeding and coagulopathy
• Identifying and interrupting the trauma “triad of death”
• Balancing trauma care with underlying medical emergencies
• Avoiding anchoring bias when a patient’s story doesn’t add up
• Prioritizing assessments and interventions during flight transport
• Building a mental checklist for “Trauma Plus” patients

Connect with Nurse Gwenny:

Youtube:

https://www.youtube.com/channel/UCLhEo_HaDEkPFA_cpQPAz2w

Instagram:

https://www.instagram.com/nursegwennyrn/

TikTok:

https://www.tiktok.com/@nurse.gwenny?_t=8qUUMwXhv5P&_r=1

Purchase her books:

https://www.nursegwenny.com/shop

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

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Why would a healthy newborn suddenly stop eating and start vomiting? When a fussy baby comes into the ER, it's easy to assume it's nothing urgent — like colic or gas. But in today's case, there were small signs that pointed to something more.

This episode unpacks the high-risk condition and treatment of neonatal cardiogenic shock with Natalie Pleiman, pediatric nurse and clinical coach. From the early (often misleading) signs to critical assessments, you'll learn what makes cardiogenic shock different in neonates (specifically ductal dependent lesions), what to look for in patient labs, and how to manage the risks of treatment.

Tune in for insights that will help you on your next pediatric cardiac emergency!

Topics discussed in this episode:

• Neonatal triage: initial assessment and red flags
• Physical exam and early diagnostics
• Differences in neonatal anatomy and physiology
• Preductal vs. postductal vitals
• Signs of coarctation of the aorta
• Assessing for sepsis vs. cardiogenic shock
• The dangers of fluid boluses
• How to effectively administer prostaglandins
• The risk and process of neonatal intubation
• Pathophysiology of coarctation of the aorta
• ICU stabilization to optimize cardiac function
• Key signs of congenital heart conditions
• Natalie’s framework for understanding congenital heart defects

Connect with Natalie:

https://www.instagram.com/chatwithnat_rn/

Listen to Chat with Nurse Nat on Spotify:

https://open.spotify.com/show/7Jh2qe44KipudVKkdXFwWH

Listen to Chat with Nurse Nat on Apple Podcasts:

https://podcasts.apple.com/us/podcast/chat-with-nurse-nat/id1815541418

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

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One unstable patient, three departments, and every nurse on alert... Let's break down what really happens during a high-risk STEMI. This episode follows the case of a 62-year old patient from ER to the Cath Lab to the ICU. Nurses Sarah Vance and Caitlyn Nichols help us explore the role of nurses in each stage of care, from stabilizing the patient to placing an Impella device.

We cover everything from IV placement and medications to monitoring patients through each phase of care. Learn how to prepare patients for the Cath Lab, manage complications like V-fib and bleeding post-PCI, and support the next team during handoffs. This is a must-listen for nurses involved in cardiac care!

Topics discussed in this episode:

• Case presentation of a 62-year old patient
• ER nurse priorities for STEMI patients
• Initial treatment and stabilization
• Why “M.O.N.A.” is an outdated practice
• Preparing the patient for the Cath Lab team
• Cath Lab nurse responsibilities and role during PCI
• High-risk PCI vs. standard PCI
• Managing common complications
• Transitioning from Cath Lab to ICU
• ICU nurse priorities for post-PCI patients
• Impella placement and monitoring
• Managing reperfusion arrhythmias
• Long-term care and getting patients off the Impella
• Patient and family education

Connect with Sarah Vance:

https://www.instagram.com/iseeu_nurse/

Connect with Caitlyn Nichols:

https://www.instagram.com/icunursingnotesbycaitlyn/

Mentioned in this episode:

CONNECT

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Often, the first symptom of hypertrophic cardiomyopathy is sudden death. But sometimes, we get a warning— and that’s where clinical judgment at the bedside saves lives.

Today, Sarah goes over the case of her patient Ben, a 20-year-old experiencing syncope and chest pain. As his condition quickly deteriorated, the team had to carefully manage the patient before reaching a diagnosis of hypertrophic cardiomyopathy. Hear what pointed them to this diagnosis, why some standard interventions can be dangerous in HCM cases, and the critical decisions made during his treatment.

Listen now for a deep dive into the pathophysiology and treatment of hypertrophic cardiomyopathy!

Topics discussed in this episode:

• Case presentation of a young patient with chest pain
• How we got to the patient’s diagnosis
•  Pathophysiology of hypertrophic cardiomyopathy
• Why the patient deteriorated and our treatment approach
• Emergency management of HCM
• Other types of cardiomyopathy
• Key takeaways for bedside nurses

Listen to episode 98, “Broken Heart Syndrome” aka Takotsubo Cardiomyopathy, here: https://healthpodcastnetwork.com/episodes/rapid-response-rn/98-broken-heart-syndrome-aka-takotsubo-cardiomyopathy/

Mentioned in this episode:

CONNECT

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Remember when we used to use stacked shocks for ventricular arrhythmias or load patients up with high doses of epinephrine and bicarb? Over the last 25 years, resuscitation guidelines have evolved and it’s our job to stay updated on the current protocols.

Here to help us break down what’s changed and what still works is Dr. Ashish Panchal, Chair of Emergency Cardiovascular Care for the AHA and host of the In the Heart of Care podcast. We discuss how a common cardiac arrest scenario would be treated from 2000 to today, highlighting key guideline changes like the shift to neuroprotective strategies, high-quality CPR, and post-arrest care.

Tune in to stay current and hear how science continues to shape the way we save lives!

Topics discussed in this episode:

• How AHA guidelines are developed
• Dr. Panchal’s research and impact
• Early 2000s resuscitation guidelines
• “Save the brain” approach in the 2010s
• How medication use has evolved, like epinephrine
• The current focus on high-performance CPR and neuroprotective strategies
• Post-arrest care and survivorship
• Balancing clinical trends with scientific validation
• How nurses can stay current on AHA guidelines

Check out the In the Heart of Care Podcast here:

https://rqipartners.com/podcast/

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

CONNECT

Think of a case where you ignored your intuition, leaned on your training, and followed protocol… but something still felt off. Today, we're talking about how to balance evidence-based practice with those gut instincts that can change patient outcomes.

Dr. Vicki Good, DNP and Andrea Schmitt, hosts of the Voices in Nursing Podcast, share stories that highlight why intuition is just as important as clinical data and why nurses need to confidently speak up. You’ll learn how to develop your own intuition, teach others to trust their instincts, and the value of hindsight wisdom in building a database of red flags for patient decline.

Listen now and start tapping into your nursing wisdom!

Topics discussed in this episode:

• What it really means to be a leader in nursing
• Why intuition matters in nursing
• How to develop nursing intuition
• Practical application of intuition
• Ideas for educating nurses and building intuition
• The importance of psychological safety for growth
• How to get involved with AACN
• The best and worst nursing advice

Connect with Vicki and Andrea:

[email protected]

[email protected]

Check out the Voices in Nursing Podcast:

https://www.aacn.org/education/podcast-series

Mentioned in this episode:

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Rapid response teams provide so much more than reducing morbidity and mortality!  Think about how quickly things can spiral without the support of RRTs.

As the former director of specialty teams, Jaclyn Bond MSN-LM, MBA-HM has seen how a rapid response program can improve outcomes while also improving nursing job satisfaction and promoting retention. We talk about the MANY benefits of rapid response teams, including fewer code blues, more confident nurses, and their impact on hospital culture.

Learn how to advocate for these teams at your facility, collect data that will help you build your case, and start a program with limited resources!

Topics discussed in this episode:

• The unique role of specialty teams
• Strategies to advocate for additional staff
• Why rapid response nurses are crucial in hospitals
• Data collection basics and tips
• The cultural impact of rapid response teams
• How to start a rapid response team

Jaclyn’s article on the nurse-led sepsis response:

https://pubmed.ncbi.nlm.nih.gov/39526100/

Download Jaclyn’s SBAR template to help you make the case for rapid response teams:

https://drive.google.com/file/d/12ltxvEfblwBh-ezaxyTNhU7m2p_tw9GZ/view?usp=sharing

Jaclyn Bond’s views expressed on this podcast are her own and do not reflect the views of any organizations or entities.

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

CONNECT

You’re 30,000 feet in the air when you hear, “Is there a medical professional onboard?” Answering that call is a little more complicated than you might think.

In this episode, Alexandra Jabr, PhD, EMT-P joins Sarah to discuss what happened during their first in-flight medical emergencies — what surprises came up, what resources they had, and how they responded with limited supplies. They share what they learned about caring for patients mid-flight, from the most common in-flight emergencies to the legal considerations of volunteering. Tune in to find out how you can prepare and respond if you ever hear that call in the air!

Topics discussed in this episode:

• Alex’s international flight medical emergency
• What went wrong during Sarah’s first in-flight emergency
• Protocols and challenges of in-flight care
• Aircraft medical kits and limitations
• Legal protections for volunteers
• Should you accept gifts from airlines?
• Common in-flight medical emergencies
• How to prepare for in-flight emergencies
• Documentation protocols and follow-up

Connect with Alex:

https://www.emergencyresilience.com/

https://www.instagram.com/emergencyresilience

Check out the list of FAA mandated medical supplies on every flight:

https://mobile.fpnotebook.com/ER/Pharm/FMndtdEmrgncyMdclKt.htm

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

CONNECT

The flight team may be on the way, but your work isn’t done yet. Flight medic Sam, host of the Nine One One Nonsense podcast, shares what the ideal patient handoff looks like between hospital staff and flight crews, and why those final moments at the bedside matter more than you think. You’ll hear real-life examples of where in-hospital care teams often go wrong and how you can help create a safer, smoother transfer.

Sam also shares what it’s really like to be part of a flight crew — the challenges, team dynamics, and common misconceptions that affect patient care. No matter your role, this episode will help nurses and flight crews understand their role and how to better work together!

Topics discussed in this episode:

• The role of ground versus flight paramedics
• Gaps between pre-hospital care and in-hospital care
• Common handoff mistakes (and how to avoid them)
• Misconceptions about flight transfers and patient care
• Why sedation matters before takeoff
• Managing medications and supplies in-flight
• How bedside nurses can better support flight teams
• The importance of team dynamics in flight medicine
• Advice for future flight medics and nurses

Check out Sam's podcast, Nine One One Nonsense, here:

https://podcasts.apple.com/us/podcast/nine-one-one-nonsense/id1673565406

Connect with Sam on Instagram: https://www.instagram.com/911nonsense/

Mentioned in this episode:

CONNECT

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

What began as a stroke alert turned into a different kind of emergency: aortic dissection. Today's patient case study follows a series of clinical decisions that saved an elderly man from a fatal misdiagnosis. Christian Guzman APRN walks us through the case — from the patient’s misleading symptoms to the diagnostic tests that showed something more was going on.

We dive into the anatomy, pathophysiology, and clinical signs of aortic dissection, including how the location of tears changes the presentation of symptoms. From emergency treatment strategies to post-op care, you’ll learn how to navigate the nuances of managing this complex condition!

Topics discussed in this episode:

• Patient’s initial presentation
• Symptoms of aortic dissection and diagnostic imaging
• Bilateral blood pressure and perfusion checks
• Aortic dissection vs. aortic aneurysm
• Why symptoms vary so widely
• Bedside assessment and monitoring
• Treatment priorities and pain management
• Post-op care and long-term complications

Mentioned in this episode:

CONNECT

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7