Rapid Response RN

During a normal day gardening, an active woman in her 60s was suddenly struck with chest tightness. Thinking it was just an asthma attack, she tried to let the pain pass. What she didn’t realize was that she was having a full blown myocardial infarction, and this was only the beginning of her journey.

In this episode, host Sarah Lorenzini is joined by her friend, Christian Guzman APRN, to discuss this patient story and the pathophysiology of heart failure. As they go through this case study, Christian provides a comprehensive breakdown of the types of heart failure, the classifications of heart failure, and how chronic heart failure can lead into cardiogenic shock.

Most importantly, you’ll learn the signs and symptoms of heart failure, including the subtle ones that are key for early detection, and find out what’s important to look at on an echocardiogram.

This is just the first installment of a three-part series on heart failure, so be sure to not miss this opening episode. Tune in now!

Topics discussed in this episode:

• Pathophysiology of heart failure
• Case study of Christian’s heart failure patient
• Myocardial infarction symptoms in women
• Types of heart failure
• Symptoms of right vs left heart failure
• The difference between systolic vs diastolic heart failure
• How chronic heart failure develops into cardiogenic shock
• Early signs of heart failure
• SCAI classifications of cardiogenic shock

Connect with Christian Guzman APRN on Instagram:

https://www.instagram.com/thenerdynursepractitioner/

Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videos

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building:

Have you ever started a new and promising job, only to discover that it wasn’t the nurturing and supportive space you thought it was? In this episode, host Sarah Lorenzini, armed with nearly two decades of nursing experience in various departments and leadership roles, provides a guideline to spotting the red and green flags that can signal a healthy or hostile workplace.

Sarah explores what makes a healthy work environment, beyond reputation and first impressions, as she does a deep dive into the American Association of Critical Care Nurses' (AACN) six pillars of a healthy work environment. From communication to authentic leadership, she equips both new and seasoned nurses with strategies to assess key characteristics of prospective employers and identify signs of a healthy culture.

For those dedicated to their current organization but seeking a better work culture that allows them to grow in their role, Sarah also reveals how nurses can promote positive change in their current work environment.

Tune in to hear the essential interview questions you should be asking to evaluate potential work environments and make an informed career decision!

Topics discussed in this episode:

• The AACN's standards for a healthy work environment
• Examples of an unhealthy work environment
• How leaders affect work culture
• Identifying red flags in potential work environments
• Ideas to improve your current work environment

Check out the AACN’s Healthy Work Environments website: https://www.aacn.org/nursing-excellence/healthy-work-environments

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building:

You may already be familiar with the trauma triad… but in this episode, host Sarah Lorenzini is once again joined by her friend and critical care nurse and educator, Sarah Vance to break down a 4th component to trauma resuscitation. Last week, they discussed the treatment of a trauma patient with neuro and respiratory injuries, but today they’re getting into the “blood and guts” of trauma cases as Sarah Vance RN walks us through a multiple gunshot wound case study. Similar to last week’s patient, this case study highlights how the body’s systems all work together, and sometimes against each other, in trauma cases.

Sarah’s GSW patient’s injuries resulted in massive blood loss, leading to rounds of MTP (massive transfusion protocol), but treating blood loss is more complex than just replacing blood so we’re diving into the pathophysiology of hypothermia, coagulopathy, hypocalcemia, and acidosis — all components of the trauma diamond of death.

As a nursing educator, Sarah Vance RN is the best person to break down these challenging concepts and make them easy to understand. You’ll learn why they happen in trauma cases, how they impact each other, and what you can do to fix these issues and prevent death.

By the end of this episode, you’ll have the knowledge you need to manage the treatment of a trauma patient with major blood loss. Tune in now!

Topics discussed in this episode:

• Components of the trauma diamond of death
• Sarah’s trauma patient and his treatment 
• MTP, or Massive Transfusion Protocol
• What causes hypothermia in trauma patients
• How to support coagulopathy and why it’s important
• Hypocalcemia and the role of calcium in the body
• Managing calcium levels in trauma cases 
• Acidosis and its place in the diamond of death
• Key lessons from this patient’s case

Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videos

Connect with Sarah Vance!

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

TikTok: https://www.tiktok.com/@iseeu_nurse

Website: https://iseeunurse.com/

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building:

If you hear “trauma” and immediately think of blood and guts, this episode with host Sarah Lorenzini’s friend, critical care nurse and educator Sarah Vance, will show you that there’s so much more to trauma cases. Because even localized injuries can affect the whole body, and issues can pile up and require conflicting treatments. That’s why trauma cases require an advanced level of assessment and critical thinking skills.

During this episode, Sarah Vance RN tells the story of a patient who was admitted with a brain bleed, orthopedic, and cervical injuries after a motorcycle accident. Like many trauma cases, the patient’s condition got a lot more complicated as his injuries progressed and he sustained secondary injuries within the respiratory system. The patient had a long list of issues, including traumatic head injury, ARDS, fistulas, necrotizing pneumonia, and MORE.

Sarah Vance also goes into more detail on his pathophysiological injuries, as well as how the ICU team assessed and treated his competing issues to lead the patient to a miracle recovery. 

Tune in to learn about the management of complex multisystem trauma cases!

Topics discussed in this episode:

• Sarah’s career journey and why she took a break from nursing
• The trauma patient’s injuries and the initial interventions
• The ICU team’s concerns and how his care evolved as more damage set in
• What prompted them to place an external ventricular drain
• How the patient developed ARDS
• How the ICU team treated the patient’s opposing issues
• The patient’s long journey to recovery

Connect with Sarah Vance!

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

TikTok: https://www.tiktok.com/@iseeu_nurse

Website: https://iseeunurse.com/

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building:

Every nurse knows the havoc chemotherapy wreaks on the body, but most nurses aren’t as knowledgeable on how to treat chemo reactions as, say, chemo or oncology nurses. Even host Sarah Lorenzini is slightly intimidated by unpredictable reactions from chemotherapy! That’s why this episode is centered around those super scary chemotherapy reactions and how to treat them.

To help us dive further into this topic, Sarah is speaking with another rapid response nurse, Montana RN. He has a dramatic patient story to share about rigors, a chemotherapy reaction that occurs as the body is trying to mount a febrile response to the medication. Not only was his patient visibly struggling, but he was hypoxic and there was no doctor available to prescribe medication to treat the reaction.

As Montana and Sarah study this patient’s case, you’ll find out what type of reaction the patient was having and walk away with the knowledge of how to treat chemotherapy reactions and their symptoms, the use of desensitization procedures for reactions to chemo agents, and why it’s important to know your hospital’s chemo reaction protocol.

There’s so much to learn about chemotherapy reactions and the nurse’s role in caring for this patient population during a really scary experience.

Topics discussed in this episode:

• What led Montana to become a rapid response nurse
• How the patient presented and his initial assessment
• What rigors looks like and the pathophysiology behind this scary looking symptom
• Treatment options for rigors
• Why Montana had to bring the patient to the ER
• How to treat a reaction and its symptoms
• The patient’s treatment and outcome
• Montana’s takeaways from this experience

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building:

In this episode of Rapid Response RN, host Sarah Lorenzini is joined by Casey BSN, RN, CCRN-CMC, CFRN, CTRN, CEN, TCRN, CPEN, CNRN, NRP. And yes, you read her title right — Casey has a whopping eight certifications and is one of the few nurses with ALL five BCEN certifications. And she’s using her knowledge and skills to advocate for her patients and teach others.

Today, Casey tells the story of a patient who came into the ER after a fall and was later diagnosed with a basilar skull fracture. Complicating the case even more is that the patient was a child under the age of 2, so it was more difficult to assess the signs of his injury. Casey’s hospital provider dismissed the fall as normal childhood injury, but she did what any good nurse would do and followed her hunch that something more was going on.

Casey shares how the patient presented, how they arrived at the diagnosis and treated him. You’ll also learn the telltale signs and symptoms of basilar skull fracture, and how to check for signs of abuse if you see a pediatric head injury.

Tune in for a lesson in pediatric basilar skull fractures, and advocating for your intuition as a new nurse!

Topics discussed in this episode:

• Casey’s nursing journey to earn so many certifications
• Why Casey’s patient came into the ER and how he presented
• What made her think something more was going on
• Results of the patient’s CT and their diagnosis
• Classic signs and symptoms of basilar skull fractures
• How to assess mental status in children
• Determining if injury is a sign of child abuse
• How they treated the patient for a basilar skull fracture
• What nurses need to prioritize when treating a basilar skull fracture

Connect with Casey:

https://www.instagram.com/criticalcarecasey/

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building:

Rapid Response and Rescue Intro Course

CONNECT

In this episode of Rapid Response RN, host Sarah Lorenzini is joined by Casey BSN, RN, CCRN-CMC, CFRN, CTRN, CEN, TCRN, CPEN, CNRN, NRP. And yes, you read her title right — Casey has a whopping eight certifications and is one of the few nurses with ALL five BCEN certifications. And she’s using her knowledge and skills to advocate for her patients and teach others.

Today, Casey tells the story of a patient who came into the ER after a fall and was later diagnosed with a basilar skull fracture. Complicating the case even more is that the patient was a child under the age of 2, so it was more difficult to assess the signs of his injury. Casey’s hospital provider dismissed the fall as normal childhood injury, but she did what any good nurse would do and followed her hunch that something more was going on.

Casey shares how the patient presented, how they arrived at the diagnosis and treated him. You’ll also learn the telltale signs and symptoms of basilar skull fracture, and how to check for signs of abuse if you see a pediatric head injury.

Tune in for a lesson in pediatric basilar skull fractures, and advocating for your intuition as a new nurse!

Topics discussed in this episode:

• Casey’s nursing journey to earn so many certifications
• Why Casey’s patient came into the ER and how he presented
• What made her think something more was going on
• Results of the patient’s CT and their diagnosis
• Classic signs and symptoms of basilar skull fractures
• How to assess mental status in children
• Determining if injury is a sign of child abuse
• How they treated the patient for a basilar skull fracture
• What nurses need to prioritize when treating a basilar skull fracture

Connect with Casey:

https://www.instagram.com/criticalcarecasey/

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building:

Intubation is a life-saving intervention, but it can also kill your patient! That’s why this follow-up episode to last week’s patient story is covering the process of intubation, what can go wrong and how nurses can mitigate risk factors to avoid bad outcomes like cardiac arrest.

In part two of this intubation series, host Sarah Lorenzini details proper intubation preparation and the role of nurses during intubation. She walks through the entire process from assembling a team to what supplies and medications you need, and how to use them so that you reduce harm to the patient. You’ll hear about key factors to consider when giving patients sedative or paralytic agents, as well as how to prepare for a blood pressure drop after intubation.

This episode is full of useful information that will help you during your next intubation, such as pre-oxygenation strategies, RSI (rapid sequence intubation) vs when to opt for DSI (delayed sequence intubation), and how to mitigate some of the negative side effects that go along with these drugs.

Plus, find out how Sarah’s patient story from last week’s episode ends. Tune in for all this and more!

Topics discussed in this episode:

• The dangers of intubation, such as peri-intubation cardiac arrest
• What it means to intubate and how to prepare for intubation
• Why and how to preoxygenate your patient
• Supplies and equipment needed for intubation
• The medications we use for intubation and what to expect once you push them
• The pathophysiology of why BP drops after intubation
• How to prepare for a drop in blood pressure post-intubation
• When to opt for delayed sequence intubation
• The intubation story of last week’s patient

Mentioned in this episode:

Rapid Response and Rescue Intro Course

CONNECT

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building:

Intubation is a life-saving intervention, but it can also kill your patient! That’s why this follow-up episode to last week’s patient story is covering the process of intubation, what can go wrong and how nurses can mitigate risk factors to avoid bad outcomes like cardiac arrest.

In part two of this intubation series, host Sarah Lorenzini details proper intubation preparation and the role of nurses during intubation. She walks through the entire process from assembling a team to what supplies and medications you need, and how to use them so that you reduce harm to the patient. You’ll hear about key factors to consider when giving patients sedative or paralytic agents, as well as how to prepare for a blood pressure drop after intubation.

This episode is full of useful information that will help you during your next intubation, such as pre-oxygenation strategies, RSI (rapid sequence intubation) vs when to opt for DSI (delayed sequence intubation), and how to mitigate some of the negative side effects that go along with these drugs.

Plus, find out how Sarah’s patient story from last week’s episode ends. Tune in for all this and more!

Topics discussed in this episode:

• The dangers of intubation, such as peri-intubation cardiac arrest
• What it means to intubate and how to prepare for intubation
• Why and how to preoxygenate your patient
• Supplies and equipment needed for intubation
• The medications we use for intubation and what to expect once you push them
• The pathophysiology of why BP drops after intubation
• How to prepare for a drop in blood pressure post-intubation
• When to opt for delayed sequence intubation
• The intubation story of last week’s patient

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: