Rapid Response RN

Are you ready for some diagnosing fun?! In this episode, host Sarah Lorenzini will challenge your diagnostic skills with the mystery case of Joey, a 14-year-old patient who went from playing football at summer camp to being intubated in the ER.

Joey presented with an altered mental status, and was tachycardic, tachypneic and febrile. Once in the ER, he went into ventricular tachycardia, his blood pressure dropped significantly, and he required intubation. As Sarah shares more details on his presentation, labs results and medical history, you’ll get all the critical clues needed to solve this intriguing case.

So, think you can uncover what’s wrong with the patient? Check back next week when Sarah concludes Joey’s story and reveals his mystery diagnosis!

As host Sarah Lorenzini insightfully explains, “think of autonomic dysreflexia symptoms as the body's way of telling you something is wrong.” Autonomic dysreflexia is a medical emergency that occurs in patients with a spinal cord injury, but it can be hard to recognize because of the body’s confusing responses to stimulation. That’s why it’s crucial for nurses to understand this syndrome and prevent patients from developing any life-threatening complications.

In this episode, host Sarah Lorenzini gives listeners an inside look at a case of autonomic dysreflexia in a quadriplegic patient. She breaks down the patient’s symptoms, medical history and presentation, then shares what helped her recognize the signs of autonomic dysreflexia. As she dives into the pathophysiology of autonomic dysreflexia, you’ll gain a better understanding of this syndrome, including how to manage the symptoms and treat patients.

At first perplexed by this case, it was Sarah’s knowledge and critical thinking that led her to suspect autonomic dysreflexia. Tune in now and take notes so you can diagnose autonomic dysreflexia and deliver timely intervention the next time you encounter it!

Topics discussed in this episode:

• The patient’s symptoms and initial assessment
• Identifying the problem and starting treatment
• Understanding autonomic dysreflexia
• Causes and management of autonomic dysreflexia

Mentioned in this episode:

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Goals of care discussions are among the most difficult to navigate as a nurse, BUT there are ways to provide both comfort and clarity to patients and their families in these emotionally charged situations.

In this episode, host Sarah Lorenzini and Hospice Nurse AJ share tips and insights on how to approach these challenging discussions with sensitivity and respect, all while keeping patient’s wishes at the forefront of treatment. From how to start the conversation to addressing concerns, they cover strategies for approaching family members in person or on the phone.

This episode explores not just the words and phrases nurses should employ, but also the compassion that patients and their families need as they step into the grieving process. AJ and Sarah also discuss how to handle various scenarios, including ones where the family is in disagreement or is struggling to make a decision on care.

After listening, you’ll have skills necessary to navigate the nuances of communicating effectively about goals of care and balancing clinical objectives with empathy. Tune in to learn how to have clear, compassionate goals of care discussions!

Topics discussed in this episode:

• How to start the conversation on goals of care
• Things to say to the family and things to avoid
• What DNR means for end of life care
• Dealing with conflicting family opinions
• Communicating with family by telephone
• Preparing the family to see critically ill loved ones
• A nurse’s role in facilitating the family’s grieving process

Mentioned in this episode:

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Orienting as a new Nurse in the ICU is much like climbing your first big mountain — both require basic knowledge, passion, and the ability to learn quickly and adapt in a demanding environment. But without these attributes, you have an arduous, possibly insurmountable journey ahead of you.

In this episode, host Sarah Lorenzini and Sarah Vance RN delve into the controversial topic of new grads going straight into the ICU after graduation, exploring the challenges and opportunities it presents for new nurses. They discuss the essential skills and mindset needed to thrive in such an intense setting, emphasizing the crucial role of self-care and support for success in the ICU.

This episode answers common questions from Rapid Response RN listeners, including “what types of people do well in the ICU, and what types of people struggle? What can I do to prepare for a job in the ICU? What are the most common struggles of nurses in the ICU, and how can they mitigate those challenges?”

As a critical care nurse and educator, Sarah’s insights will help you assess your readiness for joining the exciting but challenging world of the ICU. Tune in now!

Topics discussed in this episode:

• The debate around new grads joining the ICU
• What type of people who do well in the ICU
• Challenges new grads face in the ICU
• How to prepare for a job in the ICU
• Navigating the common struggles of ICU nurses
• The importance of learning from your mistakes

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/

What’s your craziest, most shocking nursing story? In this episode, you’ll hear one of host Sarah Lorenzini’s most memorable stories as a rapid response nurse!

Sarah recounts her experience treating a severe case of a prolapsed rectum, describing the unconventional yet effective approach that not only resolved the medical dilemma but caught the attention of Rapid Response RN listeners, becoming the most shared episode of the podcast!

As Sarah delves into this case of rectal prolapse, she explains the science behind using sugar as treatment and important lessons learned from her experience with these rectal prolapse emergencies. Tune in now!

Topics discussed in this episode:

• How Sarah responded to a patient’s severe case of prolapsed rectum
• Pathophysiology of rectal prolapse
• Using sugar to reduce prolapse
• Key takeaways from Sarah’s experience

Mentioned in this episode:

RRA mid december ad 2023

If you want to learn more about the Rapid Response Academy: The Heart and Science of Caring for the Sick... you can click here https://www.rapidresponseandrescue.com/community to find out more and sign up.

Foreign objects in the bladder, urinary retention, priapism. These are just a few of the urological emergencies host Sarah Lorenzini is discussing with Dr. Shailen Sehgal!

Nurses are the first line of defense in treating emergencies and play an important role in managing their care. In this episode, Dr. Shailen Sehgal explores these emergencies and shares great tips and tricks to treat conditions like testicular torsion, assess for hematuria, and troubleshoot catheter insertions, bladder spasms, and more.

Sarah’s conversation with Dr. Shailen Sehgal highlights the pivotal role of nurses in treating urological emergencies that require quick intervention. After listening, you’ll have a deeper understanding of common urological challenges and better be able to decide when it’s time to stop troubleshooting and call the urologist.

Tune in now to learn from Dr. Shailen Sehgal’s expertise and insights!

Topics discussed in this episode:

• Dr. Shailen Sehgal’s interesting urological cases
• The role of nurses in urological emergencies
• How to diagnose and manage testicular torsion
• Troubleshooting Foley catheters and Coude catheters
• Tips for female catheter insertion
• Dealing with catheter leakage
• Continuous bladder irrigation (CBI)
• Advice on caring for urology patients

Dr. Shailen Sehgal attended medical school at Cornell University and did his urology residency at the University of Pennsylvania. His fellowship in robotic/minimally invasive surgery was also completed at the University of Pennsylvania.  His clinical research fellowship was done at the National Institutes of Health.  He is board certified by the American Board of Urology. He practices urology and urologic surgery in Western Pennsylvania and West Virginia.

Dr. Shailen Sehgal, MD is one of the founders of UroCoach, a comprehensive library of urology education videos, free to the public. In these videos, urology topics are explained by practicing urologists in easy-to-understand language for patients, nurses, trainees, and anyone interested in urology!

https://youtube.com/@UroCoach

https://www.instagram.com/urocoaches/

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

https://www.facebook.com/profile.php?id=100090540351025

Mentioned in this episode:

RRA mid december ad 2023

If you want to learn more about the Rapid Response Academy: The Heart and Science of Caring for the Sick... you can click here https://www.rapidresponseandrescue.com/community to find out more and sign up.

Snake bite care: where the cost and long-term complications can sting harder than the bite.

Managing snake bites requires quick intervention, making it crucial for nurses to understand how to navigate this type of emergency. So in this episode, host Sarah Lorenzini welcomes Sealy RN to share her firsthand experience of being bitten. As a nurse who has also treated snake bites, she has great insights on the challenges of snake bite care.

Sarah and Sealy discuss the use of antivenom, specifically the short and long-term risks of CroFab, what can happen if a snake bite is left untreated, and the role of nurses in snake bite management.

Sealy's story highlights the importance of prompt and informed treatment, taking charge of your own care and advocating for patients. Plus, you’ll find out what steps you should (and shouldn’t) take if you get bitten by a snake.

Tune in to learn everything you need to know from a nursing and patient perspective!

Topics discussed in this episode:

• Sealy’s snakebite story
• Snake bite treatment and the recovery process
• Snake bite symptoms and possible complications
• What to do when you’ve been bitten
• Takeaways from Sealy’s experience

Download the SnakeBite 911 app:

https://crofab.com/crofab-resources/snakebite911

How does AFib RVR escalate into a life-threatening situation in just 30 minutes?

Join host Sarah Lorenzini as she reflects on a perplexing case of sympathetic crashing acute pulmonary edema, also known as flash pulmonary edema. This patient’s rapid deterioration led to an emergency intubation that perplexed the rapid response team, but the patient's true condition became clear in hindsight.

In this episode, Sarah walks us through the case, sharing the patient's presentation and medical history, how the team treated his symptoms, and why their initial interventions failed. She delves into the pathophysiology of SCAPE, the patient’s progression into sympathetic surge, and his ultimate treatment.

Tune in to learn from Sarah’s look back at this patient story!

Topics discussed in this episode:

• Sarah’s complex A-Fib RVR patient story
• Reflecting on the patient’s treatment and hindsight lessons
• The progression of sympathetic crashing acute pulmonary edema (SCAPE)
• Causes of SCAPE and stopping the spiral towards death
• Managing SCAPE (what to and not to use)
• Case summary and key takeaways

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:

Host Sarah Lorenzini and Christian Guzman APRN are back to conclude this three-part heart failure series by examining the use of mechanical circulatory support for cardiogenic shock. This episode expands on the topics covered in previous parts, focusing on the application of mechanical circulatory support methods like the intra-aortic balloon pump, Impella, CentriMag, LVADs, and ECMO.

Christian and Sarah review the risks and benefits of each device, when to use them, and the key factors that impact these decisions. They also address the ethical challenges of ECMO, including the clinical judgment involved when determining who’s a good candidate and when to escalate care.

By the end of this episode, you’ll understand how these devices function, their critical role in managing cardiogenic shock in heart failure patients, and the value nurses bring to a multidisciplinary team.

Tune in for a knowledge-packed finale of this comprehensive heart failure series!

Topics discussed in this episode:

• The role of mechanical circulatory support devices
• Benefits and risks of the intra-aortic balloon pump and Impella device
• How to properly use Impella devices
• CentriMag and Left Ventricular Assist Devices (LVADs)
• The evolution of permanent LVADs
• Extracorporeal Membrane Oxygenation (ECMO) for cardiac support
• Challenges and ethical considerations of ECMO
• The importance of nursing knowledge and confidence

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:

Building on last week’s introduction to heart failure, this episode explores the nuances in the medical management of cardiogenic shock. Host Sarah Lorenzini and Christian Guzman APRN continue this three-part heart failure series by completing the case study of a patient in cardiogenic shock, and breaking down key treatment concepts and strategies.

They discuss goal-directed therapy to optimize heart function, with a specific focus on the vital aspects of contractility, afterload, and preload, and their pivotal roles in patient care. As their conversation progresses, they delve into the use of medical interventions, covering the pros and cons of medications used to treat heart failure at each stage from beginning to extremis.

Christian and Sarah go beyond what you’ll read from textbooks, shedding light on the challenges and clinical decision-making process of heart failure care by sharing real life examples and insights.

Tune in now to learn how to assess patients for cardiogenic shock and manage their care at every stage of heart failure!

Topics discussed in this episode:

• The treatment of last week’s patient
• Goal-directed therapy for heart failure
• Methods to increase contractility
• Preload optimization
• The use of inotropes in heart failure management
• Assessing patients for cardiogenic shock
• When to use beta blockers for heart failure
• When to pull the trigger for mechanical circulatory support

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: