Can you guess what was Mr. James' diagnosis?

Why was he having periods of apnea?

Why was he tachycardic?

Why was he hypertensive?

Why was he so rigid?

Why wouldn't he wake up?

Tune in Friday for Episode 114 to hear the reveal of the diagnosis and breakdown of the pathophysiology and how to treat Mr. James' condition

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Awesome nurses don’t always make great preceptors. So what does it take to nurture new talent into capable and confident professionals? This episode delves into fundamental qualities, mindset and teaching strategies necessary to excel in the role of a preceptor.

Host Sarah Lorenzini reflects on her experiences with both good and bad preceptors, sharing insights on how to create a supportive and empowering learning environment that encourages independence. From setting expectations and goals to dealing with difficult trainees, she outlines proven methods to help nurses become an effective mentor. You’ll learn techniques for providing constructive criticism, building up critical thinking skills, promoting self-efficacy in trainees, and more!

Tune in to learn how to become an exceptional preceptor and make a positive impact on the next generation of nurses!

Topics discussed in this episode:

• Qualities of a good preceptor
• How to promote self-efficacy in trainees
• The importance of establishing expectations
• Effective teaching strategies
• Goal setting and building confidence
• How to handle difficult trainees
• Why preceptors are crucial to the profession

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The summer heat brings fun in the sun, relaxing days, and even the threat of heat stroke. In this episode, host Sarah Lorenzini explores the spectrum of heat-related illnesses, highlighting the crucial differences between heat stroke and heat exhaustion. She recounts an emergency case of a young man with all the classic symptoms of heat stroke — and the highest temperature of any patient she’s ever seen.

Sarah delves into the complications that can arise from heat stroke and effective treatment protocols for cooling down patients. You’ll learn about the factors that increase the risk of heat stroke, the danger zone of hyperthermia, and how to prevent hypothermia during the treatment of heat stroke.

Listen to this episode to learn more about recognizing and managing heat stroke!

Topics discussed in this episode:

• Heat stroke case study
• Differentiating heat stroke from heat exhaustion
• Signs and symptoms of heat stroke
• Emergency steps for treating heat stroke
• Risk factors of heat stroke

Check out the EM Cases episode about heat stroke:

https://emergencymedicinecases.com/em-quick-hits-september-2021/

Read Dr. Swaminathan's article on environmental hyperthermia:

https://coreem.net/core/environmental-hyperthermia/

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Rapid Response Academy Link

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

When the diseased liver is unable to filter out neurotoxins like ammonia, we can see a spectrum of the neuropsychiatric symptoms of hepatic encephalopathy.  For the final installment in our liver failure series, host Sarah Lorenzini highlights a complicated case of hepatic encephalopathy where critical thinking and interdisciplinary teamwork were key to preventing further complications.

She examines the common signs and symptoms of hepatic encephalopathy, factors that trigger or exacerbate the condition, and challenges nurses face in the diagnostic process. This episode also dives into treatment strategies and how to differentiate between hepatic encephalopathy and alcohol withdrawal.

Tune in to learn how cirrhosis can lead to hepatic encephalopathy, the effect of neurotoxins in the brain, and how you, as a nurse, can manage patient care!

Topics discussed in this episode:

• Assessment of Sarah’s rapid response consult patient
• The team’s interventions and patient outcome
• Pathophysiology of hepatic encephalopathy
• Signs and symptoms of hepatic encephalopathy
• Diagnostic challenges and aggravating factors
• Strategies to manage hepatic encephalopathy
• Hepatic encephalopathy versus alcohol withdrawal

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Managing liver failure often means walking a tightrope with kidney function. This episode explores what happens when the kidneys begin to fail due to liver disease, a condition known as hepatorenal syndrome. Host Sarah Lorenzini sheds light on this common but severe complication of cirrhosis, sharing a critical case that exemplifies the challenges of diagnosing and treating hepatorenal syndrome.

Tune in to gain a better understanding of the pathophysiology of hepatorenal syndrome, the importance of early intervention, and effective treatment strategies. Listen to part three of this liver failure series now!

Topics discussed in this episode:

• Case study of a patient with suspected hepatorenal syndrome
• Pathophysiology of hepatorenal syndrome
• Diagnostic and treatment strategies for hepatorenal syndrome
• Key takeaways for nurses

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A cirrhosis patient has stable vitals, but then starts vomiting blood. What do you do next? This episode delves into a case study that highlights the urgent management of esophageal varices in liver failure patients. Host Sarah Lorenzini reveals how a rapid response call quickly spiraled into a life-threatening emergency, and the critical steps taken to stabilize the patient.

Sarah explains the pathophysiology of cirrhosis and the development of esophageal varices, detailing the pharmacological and procedural interventions that can make the difference between life and death. You’ll get a comprehensive overview of evidence-based treatment strategies, how to manage complications, and the crucial role of nurses in patient care.

Tune in to arm yourself with the knowledge to handle this critical liver emergency!

Topics discussed in this episode:

• Management of a cirrhosis patient with a GI bleed 
• How liver failure can lead to a bleeding esophagus
• Challenges of giving blood transfusions to liver failure patients
• Pharmacological interventions: octreotide, antibiotics, and beta-blockers
• Procedural interventions: endoscopic variceal ligation, TIPS procedure, and balloon tamponade

Listen to Episode 77, “The Trauma, Diamond of Death:” https://podcasts.apple.com/us/podcast/77-the-trauma-diamond-of-death-4-treatment-priorities/id1535997752?i=1000633582257

To learn more about balloon tamponade, check out this breakdown of the procedure: https://first10em.com/balloon-tamponade-of-massive-gi-bleeding/

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Rapid Response Academy Link

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

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No matter your specialty, every nurse cares for patients with liver failure. Host Sarah Lorenzini starts off this four-part series on liver failure by sharing the story of a rapid response call that featured classic complications of cirrhosis: ascites, jaundice, and hypotension. Exacerbating the patient’s terminal condition was a suspected diagnosis of spontaneous bacterial peritonitis.

In this episode, Sarah details how her team managed this case and breaks down the pathophysiology of cirrhosis, including why liver failure leads to so many complications. She covers how to assess and care for patients with cirrhosis, emphasizing the important role of nurses in educating families on liver failure.

Tune in for critical insights into the management of liver failure and its complications!

Topics discussed in this episode:

• Initial assessment of a rapid response call for hypotension
• Pathophysiology of cirrhosis and its complications
• Management of spontaneous bacterial peritonitis
• Role of nurses in liver failure patient care

Mentioned in this episode:

Rapid Response Academy Link

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

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NTI 2024 brought together critical care nurses from across the country, and this episode highlights over 10 of their most heartwarming and unforgettable stories. Host Sarah Lorenzini speaks to ICU nurses and nurse educators who share tales of human connection, critical thinking, and compassionate care. From navigating crazy shifts to creating new patient programs, their stories showcase the incredible impact nurses have on patients’ lives and the healthcare system.

Tune in to celebrate the dedication, empathy, and resiliency of today's nurses!

Connect with Maddi Flanagan:

https://www.instagram.com/nurse.maddi/

Connect with Michael DeFrancisco:

https://www.instagram.com/camp_competency

Connect with Nicole Kupchik:

https://www.instagram.com/nicolekupchik/

Connect with Nick McGowan:

https://www.instagram.com/critical_care_academy/

Connect with Kali Dayton:

https://www.instagram.com/daytonicuconsulting/

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Nursing care plans are the bane of many a nursing student’s academic experience. They are seen as an unnecessary burden to their already heavy workload. But they play an important role in the nursing process, and nurses put these plans into clinical practice every day — whether they realize it or not.

In this episode, Nurse Gwenny, an ER and flight nurse turned EMS educator, speaks with host Sarah Lorenzini about the relevancy and value of nursing care plans. She shares real-life examples of the impact these plans have on critical care thinking and decision-making, especially in high-pressure environments. Nurse Gwenny also discusses her passion for teaching, and how she leverages her experience and insights in her role as an educator.

Sarah and Nurse Gwenny also explore the “green flags” of nursing practice, diving into notable traits like a positive attitude, desire to learn from mistakes, and more.

Tune in to learn how to embrace care plans, improve patient care and your nursing skills!

Topics discussed in this episode:

• The value of nursing care plans
• Bridging theory and practice in critical care education
• Utilizing care plans in during critical care scenarios
• Practicing critical care thinking and decision making
• Identifying key traits of exemplary nurses
• The importance of continuous learn and growth in nursing

Connect with Nurse Gwenny:

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

https://www.tiktok.com/@nurse.gwenny/

Check out Gwenny's book, BUT WHY?: Going Beyond the What So You Can Understand the Why of Critical Care Transport: https://a.co/d/28tLpjP

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Nursing educators may not hold the most glamorous position, but they are undoubtedly the backbone of the profession. Nurse Educator Patrick McMurray exemplifies this by bringing creativity and inclusivity into nursing education, supporting nurses at every stage of their career.

In this episode, host Sarah Lorenzini talks to Patrick about his approach to teaching complex concepts and preparing students to succeed beyond the classroom. Using interactive learning strategies and holistic methods, Patrick helps nurses deepen their understanding of nursing practices and effectively apply their knowledge in clinical settings.

Patrick also offers a glimpse into a day in the life of a nursing educator, and discusses the profound impact nursing educators have on the future of nursing. His insights will help you determine if a transition to nursing education is the right next step in your career.

Join us for part two of the “So You Want to Go Back to School” series with Patrick McMurray!

Topics discussed in this episode:

• The appeal of nursing education as a career
• What it means to be a good educator
• Rewards and challenges of being a nursing educator
• Redefining nursing education
• A day in the life of a nursing educator
• Nursing education as an act of justice
• The future of nursing education

Learn more about Patrick and find free educational resources on his website!

https://www.patmacrn.com/

Connect with Patrick McMurray:

https://www.instagram.com/patmacrn/

https://twitter.com/nursepatmacrn

https://www.tiktok.com/@patmacrn

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