Rapid Response RN

No power, no water, no communication. How do healthcare teams provide care during disasters? In this episode, host Sarah Lorenzini and Brooke MSN, RN, CCRN, NE-BC share their experiences working as disaster response nurses after the hurricanes in Asheville, NC and Tampa, FL.

Get a glimpse into the challenges, collaboration, and determination that define hurricane relief nursing, as well as the unity and resilience shown by patients and communities in recovery. Listen to learn about the realities of crisis care, from deployment to being an effective nurse leader in a chaotic environment!

Topics discussed in this episode:

• Deploying to Asheville with limited resources
• What it’s like working on a disaster relief nursing team
• The coordination of patient care and operations in disaster relief
• Stories of humanity, kindness, and uplifting moments in crisis
• Common medical issues and challenges during hurricane disasters
• How to maintaining team morale as a nurse leader
• The biggest lessons from working as a hurricane relief nurse

Check out Accuryn for yourself:

https://accuryn.com/why-accuryn/

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You never forget your most embarrassing nursing moment — especially when it happens in the middle of a critical situation. In this episode, Sarah recounts an unforgettable, cringe-worthy blunder during a rapid response call for a COPD patient in respiratory distress. Discover how she managed the patient’s COPD exacerbation and advocated for the patient’s care despite a lack of urgency from some on the medical team.

Sarah also dives into the pathophysiology of COPD and intervention strategies, evaluating the pros and cons of the various oxygen delivery modalities like non-rebreather masks and BiPAP. Curious how an awkward moment turned into a valuable lesson for COPD care? Tune in now!

Topics discussed in this episode:

• The embarrassing BBQ incident
• Lessons from a COPD patient story
• Pathophysiology of COPD
• The truth about hypoxic drive
• Oxygen therapy and choosing the right delivery method for your patient
• When intubation is the best intervention

Mentioned in this episode:

Rapid Response and Rescue Intro Course

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Caring for patients withdrawing from alcohol can be challenging to say the least. In this episode, host Sarah Lorenzini shares a case of a patient recovering from emergency surgery, and highlights the subtle but critical signs of alcohol withdrawal—like anxiety, tremors, confusion, tachycardia, and hypertension—that often go unrecognized until symptoms escalate.

Key topics covered in this episode include:

• The pathophysiology of alcohol withdrawal, focusing on how chronic alcohol use disrupts the balance between the brain’s inhibitory GABA and excitatory glutamate neurotransmitter systems.
• A detailed timeline of alcohol withdrawal symptoms, from early signs (6-12 hours) to severe complications like delirium tremens (48-72 hours).
• The importance of compassionate, non-judgmental care for patients with alcohol use disorder (AUD) during withdrawal, and why judgment rarely leads to positive change.
• The role of CIWA-Ar scoring to assess withdrawal severity and guide treatment, including common medications like benzodiazepines and the emerging use of phenobarbital for symptom management.
• Critical reminders to carefully evaluate all symptoms and avoid misattributing every instance of confusion or agitation to alcohol withdrawal, ensuring comprehensive care.

Tune in to learn how to recognize and manage alcohol withdrawal, keep patients safe, and provide the compassionate care they need during this vulnerable time.

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick?

Rapid Response and Rescue Intro Course

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Bringing calm to chaos is an underrated skill in medicine. During her talk at the ResusX Conference, Sarah explored this concept and the importance of guiding teams through high-stress situations. In today’s episode, you’ll hear what happened when Sarah responded to a bloody code blue that ended in tears and defeat. This patient story is a prime example of why being a great resuscitationist requires more than clinical skills, and how leadership and communication can make or break a team’s performance under pressure.

So, what makes for a great resuscitationist? Tune in as Sarah breaks down three areas you should focus on to become a better resuscitationist leader!

Topics discussed in this episode:

• Lessons from a chaotic code blue
• What makes a great resuscitationist?
• How to effectively lead a resuscitation team
• The crucial role of debriefs

Mentioned in this episode:

Rapid Response and Rescue Intro Course

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Behind every POTS diagnosis is a patient who had to fight for answers. Postural orthostatic tachycardia syndrome (POTS) is often misdiagnosed because its symptoms mimic so many other conditions. In fact, it is often dismissed as “just anxiety”, but anxiety is a secondary side effect of the fact that the patient keeps having syncopal episodes without explanation.

To dig deeper into its diagnosis and treatment challenges, Sarah turned to Dr. Alexis Cutchins, cardiologist and co-author of a key article on the management of POTS. In this episode, Dr. Cutchins breaks down the symptoms, possible causes and contributing factors of this complex and misunderstood disorder. She also explores treatment strategies and new research that could improve patient outcomes.

Tune in to hear Dr. Cutchins’ insights into how healthcare professionals can better recognize POTS and advocate for patients!

Topics discussed in this episode:

• What is postural orthostatic tachycardia syndrome (POTS)?
• Causes and contributing factors of POTS
• Common symptoms of POTS
• Diagnostic tests and diagnostic challenges
• The treatment process and effective strategies
• New developments in POTS research
• Treating POTS in an emergency situation
• How to better manage and advocate for patients

Read Dr. Cutchins' article, Narrative Review of Postural Orthostatic Tachycardia Syndrome: Associated Conditions and Management Strategies: https://www.uscjournal.com/articles/narrative-review-postural-orthostatic-tachycardia-syndrome-associated-conditions-and

POTS patients can find more information and resources here:

https://www.dysautonomiainternational.org/

Print this guide to plan for POTS emergencies with your physician!

https://supertmastcell.org/wp-content/uploads/2024/04/SuperT-PatientReferenceGuide-2024.pdf

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick?

Rapid Response and Rescue Intro Course

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Pee might be the key to saving your patient’s life. In this episode of Rapid Response RN, we dive into the critical yet often overlooked early sign of clinical deterioration — urine output. Join us as Tom Colabro, MNS-HCSM, RN, NEA-BC, shares his expert insights on why accurate urine output can be a cost-effective biomarker in patient care.

Tom introduces the Accuryn Monitoring System, which not only identifies AKI up to 33.4 hours faster than traditional methods but also features Active Drain Line Clearance, significantly reducing the risk of CAUTI. You’ll learn how this innovative technology both eases the nursing workload and improves patient outcomes.

From a patient case study to practical tips, this episode covers everything you need to know about the development and prevention of AKI. Tune in for an engaging discussion on the importance of early detection through urine output monitoring!

Topics discussed in this episode:

• Overlooked dangers of acute kidney injury
• What happens in the body to cause AKIs
• Good pee versus bad pee
• The correlation between urine output and patient outcomes
• Case study on the AKI cascade
• The three stages of AKI: prerenal, intrarenal, and postrenal
• Challenges in accurate urine output monitoring
• How CMS mandatory reporting regulations could impact hospitals
• Accuryn’s innovative work in the early detection of AKIs
• Tips for advocating for new technology at your workplace
• The most important takeaways from this episode

Starting in October 2024, CMS is including AKI as a reportable measure under the IPPS eCQMS Patient Safety reporting. Mandatory reporting of AKI Stage 2 and greater will begin by 2026. Click here to learn more: 

https://accuryn.com/why-accuryn/

Mentioned in this episode:

Rapid Response and Rescue Intro Course

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Burned out by hospital life? For Becca RN, serving a two-year mission with Mercy Ships reignited her passion for nursing and introduced her to a global community of volunteers. Her experience as a nurse on a hospital ship in West Africa went beyond traditional patient care, allowing her to play a role in both the physical and emotional healing of her patients.

In this episode, she shares what daily life is like on Mercy Ships, talks about the diverse education and team-focused work environment, and reflects on the personal growth that came from living and working in a multicultural setting aboard Mercy Ships.

Tune in to learn how Mercy Ships provided life-changing opportunities for both patients and volunteers!

Topics discussed in this episode:

• Becca’s journey to join Mercy Ships
• Mercy Ships’ mission and volunteer opportunities
• The training process to live and work on a ship
• A day in the life as a Mercy Ships nurse
• Community and social life on Mercy Ships
• Educational perks and collaborative work environment 
• Mercy Ships’ profound impact on patients and volunteers
• Want to volunteer with Mercy Ships?

Mercy Ships is a global charity that operates the world’s largest hospital ships. Since its founding in 1978, Mercy Ships has brought hope and healing to Africa through surgical care, education, training, community development, and health programs. The life-changing work of our hospital ships is made possible all because of our vibrant community of volunteers from around the world. Whether you are a Perioperative, Critical Care, Ophthalmology, or a Pediatric Nurse, there is a place on board for you! Find your place and join Mercy Ship as a volunteer to help change the lives of people in great need.   

Follow Mercy Ships:  

Facebook: https://www.facebook.com/MercyShips

Instagram: https://www.instagram.com/mercyships/

LinkedIn: https://www.linkedin.com/company/mercy-ships/

Learn more:

https://opportunities.mercyships.org/volunteer-now/

Mentioned in this episode:

Rapid Response and Rescue Intro Course

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Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick?

When Michelle discovered her patient was paralyzed, it surprised the whole medical team. This patient who was previously mobile and recovering from septic shock was now paralyzed and ultimately diagnosed with spinal cord ischemia, but could early intervention have changed the outcome?

In this episode, we discuss the causes, signs, diagnosis and treatment of spinal cord ischemia. Michelle shares powerful insights from her work in neurocritical care, including a technique for detecting easy-to-miss neurological changes.

Tune in to find out how you can improve patient outcomes when managing spinal cord ischemia!

Topics discussed in this episode:

• Michelle’s passion for patient care and nurse advocacy
• Critical case study: discovering a spinal cord abscess
• How the patient developed spinal cord ischemia
• Pathophysiology and signs of spinal cord ischemia
• Neurological assessment tips
• Peripheral versus central nervous system assessments
• Diagnostic criteria and the diagnostic process
• Prognosis and patient recovery
• Treatment options and challenges
• The role of the ABCDEF bundle in critical care

Connect with Michelle:

https://www.michellededeo.com/

https://www.instagram.com/michellededeo/

Listen to Michelle’s podcasts, the SCRN Prep Podcast and Narrative Nurse Project Podcast!

Get 20% off Michelle’s Stroke Review Bootcamp with code RAPIDRN20!

https://www.nicolekupchikconsulting.com/booksAndCourses/online-courses/61/stroke-review-bootcamp-case-studies-in-optimizing-care

Mentioned in this episode:

Rapid Response and Rescue Intro Course

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This week, we are talking about every cardiac nurse’s worst nightmare: cardiac tamponade. Host Sarah Lorenzini is joined by Brian McCain RN to share a crazy case of cardiac tamponade where quick intervention made all the difference. In this episode, they discuss the critical signs, symptoms and pathophysiology of cardiac tamponade.

Brian and Sarah cover clinical findings like Beck’s triad and dampened arterial line waveforms, assessment techniques for patients who rapidly decline versus those with a gradual buildup of symptoms, and the nurse’s role in preparing patients for an open arrest.

Tune in to learn how to recognize and manage this cardiac emergency! 

Topics discussed in this episode:

• What Brian loves about the nursing profession
• A classic case of cardiac tamponade
• Pathophysiology of cardiac tamponade
• The clinical findings of cardiac tamponade
• Assessment and diagnosis of cardiac tamponade
• Differentiating between cardiac tamponade and pericardial effusion
• Preparing the patient for an open arrest

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Rapid Response and Rescue Intro Course

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A patient arrives at the ER, complaining of chest pain that dramatically worsens when she lies down. What could this clue reveal about her condition? In this episode, host Sarah Lorenzini recounts her experience caring for her first pericarditis patient and the subtle yet critical signs that distinguish it from more common cardiac emergencies.

Sarah dives into the tricky nature of chest pain, sharing how the PQRST pain assessment and an EKG played a critical role in uncovering the patient’s condition. She also outlines the diagnostic criteria that help differentiate pericarditis from more serious conditions like myocardial infarction, emphasizing the symptoms that can make diagnosis challenging.

Listen to the episode for insights on recognizing the easily mistaken signs of pericarditis, diagnosing the condition, and providing effective treatment!

Topics discussed in this episode:

• Patient case study of a young woman with chest pain
• Assessment and diagnosis of pericarditis
• Pathophysiology of pericarditis
• Infectious vs. noninfectious causes of pericarditis
• The diagnostic criteria for pericarditis
• EKG characteristics in pericarditis vs. myocardial infarction
• Key takeaways on the diagnosis and treatment of pericarditis

Learn more by reading this Brady et al article about ECG morphology in pericarditis:

https://pubmed.ncbi.nlm.nih.gov/11581081/

Mentioned in this episode:

Rapid Response and Rescue Intro Course

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Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick?