In this episode of The Nurse Anesthesia Podcast, Jeremy, Sass, Mark, and Chloe Gomez discuss the evolution of Topical Thunder for Awake Intubation. They examine how this topical technique for anesthetizing the airway was developed, and talk about each of their unique experiences with Topical Thunder for awake intubation. 

Topical Thunder is a technique that uses only topical lidocaine to anesthetize the airway in preparation for awake intubation. It consists of three steps: 

Step 1 is spraying the oral and hypo-pharyngeal structures with atomized 4% lidocaine solution.

Step 2 utilizes 5% lidocaine paste to anesthetize the posterior tongue and vallecular structures.

Step 3 involves spraying the hypopharyngeal and periglottic structures with atomized 4% lidocaine solution. 

This is an episode you absolutely do not want to miss, because when it comes to awake intubation…it really is…GO TIME!

Resources/information discussed in podcast

Check out the My Favorite Learners Podcast on your favorite podcatcher and on YouTube! https://www.youtube.com/@myfavoritelearners/search

About The Nurse Anesthesia

We are building a commUNITY of learning in anesthesia and critical care! We are seasoned educators and clinicians who know anesthesia. We literally write the textbook! We have the clinical expertise, educational experience, practical know how to give you the most current and relevant anesthesia content available. We’re here for you!

For anyone who wants to learn or if you just want to review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you want to be. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available! 

RN’s get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com  

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia Podcastis for educational and informational purposes only. It does not constitute medical or professional advice. While we strive for accuracy, medicine is constantly evolving, and clinical decisions should always be made based on current guidelines, institutional policies, and individual patient considerations. The views expressed are those of the hosts and guests, and Do NOT necessarily reflect the opinions of any affiliated institutions. Listeners should consult their own healthcare providers before making any medical decisions. 

Music by Alex Grohl 

In this episode of The Nurse Anesthesia Podcast, Sass and Jeremy talk about the most commonly used benzodiazepine in anesthesia practice…Midazolam. Without a doubt, this is one of the medications we use frequently to help relieve patient anxiety prior to an operation…it’s just like the Ramones sing…”(They) Wanna Be Sedated!”

You won’t want to miss the discussion between Jeremy and Sass as they review the mechanism of action, indications, pharmacokinetics, and reasons we use this drug in anesthesia practice.

 Resources/information discussed in podcast

Come check us out at the Western Summit for Nurse Anesthesiology on October 3-5.

We’ll be running the Advanced Airway Workshop on Friday October 3 and presenting on Crisis Management and Awake Intubation using the TOPICAL THUNDER technique on Saturday October 4.

https://westerncrnasummit.com/ 

 About The Nurse Anesthesia

We are building a commUNITY of learning in anesthesia and critical care! We are educators and clinicians who want to provide valuable information to anyone interested in anesthesia and critical care. We’re here for you!

For anyone who wants to learn or review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you have always dreamed of. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available! 

RN’s get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com  

Come get your FREE Anesthesia and Critical Care Crisis Checklists at www.thenurseanesthesia.com

 Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia INC. expressly disclaims any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Music by Alex Grohl

Mixed & Edited by Next Day Podcast

[email protected]

This is the 7th round of Q&A with TNA, and in this round Jeremy and Sass ask some questions and give some answers on Inotropic medications including Epinephrine, Norepinephrine, Milrinone, Dobutamine, Dopamine, and Isoproterenol. 

This is a perfect episode to brush up on your question and answer skills while learning or relearning these medications at the same time!

About The Nurse Anesthesia

We are building a commUNITY of learning in anesthesia and critical care! 

We are educators and practicing anesthesia clinicians who want to provide valuable information to anyone interested in anesthesia and critical care. We’re here for you! 

For anyone who wants to learn or review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you have always dreamed of. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available! 

RN’s get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com  

Get our FREE Crisis Management Checklists at www.thenurseanesthesia.com  

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia INC. expressly disclaims any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Music by Alex Grohl 

The Nurse Anesthesia Team gets together on this episode to talk all things cricothyrotomy in preparation for the AANA Annual Congress in Nashville! Jeremy, Sass, and Mark will be hosting and running the Advanced Airway Skills Workshop at the Annual Congress. Part of that workshop includes practicing several cricothyrotomy techniques. 

In this episode, they discuss the three cricothyrotomy techniques that include: (1) percutaneous needle cricothyrotomy; (2) percutaneous wire-guided cricothyrotomy; & (3) the surgical bougie-assisted cricothyrotomy. Even though this is a rare procedure, it is absolutely essential to have an understanding of these techniques and to regularly practice them so that you’ll be ready if you’re ever in an emergency airway situation where you cannot intubate and cannot ventilate/cannot oxygenate. 

References

1.Apfelbaum JL, et al. 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. Anesthesiology. 2022;136(1):31-81. 

2.Cook TM, et al. Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011 May;106(5):617-31. 

3.Joffe AM, et al. “Management of Difficult Tracheal Intubation: A Closed Claims Analysis.” Anesthesiology vol. 131,4 (2019): 818-829. 

4.Law JA, et al. “Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient.” Canadian journal of anaesthesia vol. 68,9 (2021): 1373-1404.

5.Infographic on the bougie-assisted cricothyrotomy - Price TM, et al. “Emergency front of neck access in airway management.” BJA education vol. 19,8 (2019): 246-253.

Sign up for The Nurse Anesthesia Courses!

Our CRISIS MANAGEMENT VIDEO SERIES is currently available! 

RN’s get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com  

We also have a book of FREE Crisis Checklists 

Come get them at www.thenurseanesthesia.com  

Follow us on Instagram @thenurseanesthesia

This was a super fu episode where Jeremy invites Rhea Temmermand on the show! Dr. Rhea Temmermand PhD, MSN, CRNA, FAANA is a distinguished research scientist specializing in neuropharmacology within the Department of Pharmacology and Physiology at Drexel University. In addition to her full-time research endeavors, she serves as an Adjunct Professor in Drexel University’s Nurse Anesthesia program. She is also the co-founder of Atomic Anesthesia and co-host of the Atomic Anesthesia Podcast.

In this episode, Jeremy and Rhea go through 10 crises with a focus on how to target the correct diagnosis and then appropriately manage each one…and they do this in a format that is rapid fire!

Resources/information discussed in podcast

Go get our FREE Crisis Management Checklists! www.thenurseanesthesia.com

Check out the Atomic Anesthesia Podcast: https://open.spotify.com/show/4Kdd7jV7x0AE5LmejLYc0E  

About The Nurse Anesthesia

We are building a commUNITY of learning in anesthesia and critical care! We are educators and clinicians who want to provide valuable information to anyone interested in anesthesia and critical care. We’re here for you!

For anyone who wants to learn or review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you have always dreamed of. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available! 

RN’s get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com  

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia INC. expressly disclaims any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Music by Alex Grohl 

Mixed & Edited by Next Day Podcast

[email protected]

Episode Summary 

In this episode of The Nurse Anesthesia Podcast, Jeremy reviews basic kidney function and focuses on the different types of Diuretic Medications. These include Osmotic agents, Loop Diuretics, Carbonic Anhydrase Inhibitors, Thiazide Diuretics, Aldosterone Antagonists, Potassium Sparing Diuretics, and Vasopressin Antagonists. Some diuretics we use during anesthesia management and some medications patients take to manage medical conditions. If you want to brush up on your diuretic medications, then turn on this episode and “Let it flow”! 

About The Nurse Anesthesia 

We are building a commUNITY of learning in anesthesia and critical care! We are CRNA educators and clinicians who want to provide valuable information to anyone interested in anesthesia and critical care. We’re here for you! 

For anyone who wants to learn or review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you have always dreamed of. Let's do this together. It's Go Time! 

Sign up for The Nurse Anesthesia Courses 

Our CRISIS MANAGEMENT SERIES is currently available!  

RN’s get CE credits when they purchase this series. 

Learn more about it at www.thenurseanesthesia.com   

ALSO…The Nurse Anesthesia Crisis Checklists are FREE to download from our website! 

Follow us on Instagram @thenurseanesthesia 

Legal Disclaimer 

The Nurse Anesthesia INC. expressly disclaims any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party. 

Music by Alex Grohl  

In this episode of The Nurse Anesthesia Podcast, Jeremy discusses questions and answers from previous TNA podcast episodes 22 – BIS Monitoring During Anesthesia, 24–Perioperative Hypovolemia: The Tank is Empty, & 25–Albuterol & Epinephrine for the Treatment of Intraoperative Bronchospasm.

Here are several examples of questions he discusses in the episode. For a complete review of all the questions, check out the episode wherever you listen to podcasts!

1.     Which EEG waveforms is most commonly associated with deep anesthesia and may indicate a patient who is excessively sedated or in a deeply
hypnotic state?

a. Alpha waves (8-13 Hz)

b. Beta waves (13-30Hz)

c. Theta waves (4-8 Hz)

d. Delta waves (0.5-4Hz)

2.     Which hemodynamic finding is most consistent with severe intraoperative hypovolemia?

a. Widened pulse pressure and bradycardia

b. Elevated central venous pressure (CVP) and warm extremities

c. Narrow pulse pressure and tachycardia

d. Hypertension and bounding pulses

3.     Which is the primary mechanism of action of albuterol causing bronchodilation?

a. Inhibition of muscarinic receptors

b. Inhibition of acetylcholine release at the neuromuscular junction

c. Activation of G-proteins causes increased cAMP & smooth muscle relaxation

d. Direct inhibition of calcium channels in bronchial smooth muscle

About the Nurse Anesthesia

Our goal is to build acommUNITY of learning in anesthesia and critical care! Please consider sharing our podcast with your colleagues and friends. Follow us on Instagram@thenurseanesthesia

Sign up for The Nurse Anesthesia Courses

our CRISIS MANAGEMENT SERIES is available! RNs can get CEs when they take this course.

Learn more about it at www.thenurseanesthesia.com

Legal Disclaimer

The Nurse Anesthesia INC. expressly disclaims any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Music by Alex Grohl
 

Episode Summary

In this episode of the nurse anesthesia podcast, Jeremy dives into some Airway Management Adventures! He discusses three airway cases from the Emergency Department to the Operating Room. Each case illustrates critical decision-making under challenging circumstances where key actions by the CRNA are essential. The cases include information on preoxygenation with nasal cannula and a non-rebreather mask, RSI, successful first-pass intubation using video-laryngoscopy, cricothyrotomy, and awake intubation. Major themes discussed in this episode involve preparation with airway plans, checklist use, stress preparation, adaptability, team coordination, and continuous learning from both success and difficulty in airway management.

Resources/information discussed in podcast

·         Get your free The Nurse Anesthesia Crisis Checklists at www.thenurseanesthesia.com

·         Sign up for our Crisis Management Video Series. You’ll get 10 different crisis management videos packed full of the most up-to-date information. 

·         Nurses…you can get CE credits when you sign up for the Crisis Management Video Series.

About The Nurse Anesthesia

We are building a commUNITY of learning in anesthesia and critical care! We are educators and clinicians who want to provide valuable information to anyone interested in anesthesia and critical care. We’re here for you!

For anyone who wants to learn or review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you have always dreamed of. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available! 

RN’s get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com  

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia INC. expressly disclaims any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Music by Alex Grohl 

In Episode 26 we welcome a special guest…Rhea Temmermand from the Atomic Anesthesia Podcast! Jeremy talks with Rhea about cognitive aids—like crisis checklists—which are essential tools in anesthesia for guiding rapid decision-making during high-stakes medical emergencies. Originally inspired by aviation’s Crew Resource Management, these aids were adapted for anesthesia…giving rise to Anesthesia Crisis Resource Management (ACRM). Using crisis checklists can help enhance performance, boosts patient safety, and supports better outcomes in perioperative care. This was a great conversation with Rhea!

Oh yeah…and don’t forget to grab your FREE Anesthesia Crisis Checklists from www.thenurseanesthesia.com

About The Nurse Anesthesia

We are building a commUNITY of learning in anesthesia and critical care! We are educators and clinicians who want to provide valuable information to anyone interested in anesthesia and critical care. We’re here for you!

For anyone who wants to learn or review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you have always dreamed of. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available! 

RN’s get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com  

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia INC. expressly disclaims any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Music by Alex Grohl 

Mixed & Edited by Next Day Podcast

[email protected]

Asthma is a chronic inflammatory disorder of the airways characterized by hyperresponsiveness, variable airflow obstruction, and airway remodeling. In the OR, we’re less concerned about chronic control and more focused on acute airway events…namely, bronchospasm.

Bronchospasm during general anesthesia can be insidious. You may see rising peak airway pressures, decreased tidal volumes, wheezing if you’re lucky…and if you’re unlucky…desaturation and hypotension. Time is tissue. That’s when it’s time to get medications like albuterol and epinephrine out of the anesthesia cart.

In today’s episode, Sass and Jeremy discuss the pharmacology of albuterol and epinephrine as they relate to the management of intraoperative bronchospasm. 

References

1. Maddah SA, et al. The Effect of Albuterol Spray on Hypoxia and Bronchospasm in Patients with Chronic Obstructive Pulmonary Disease (COPD) under General Anesthesia: A bouble-Blind Randomized Clinical Trial. Ethiop J Health Sci. 2023;33(3):491-498. 
2. von Ungern-Sternberg BS, et al. Effect of Albuterol Premedication vs Placebo on the Occurrence of Respiratory Adverse Events in Children Undergoing Tonsillectomies: The REACT Randomized Clinical Trial. JAMA Pediatr. 2019;173(6):527-533.

Resources/information discussed in podcast

Get your free copy of The Nurse Anesthesia Crisis Management Checklists at www.thenurseanesthesia.com 

About The Nurse Anesthesia

We are building a commUNITY of learning in anesthesia and critical care! We’re educators and clinicians who want to provide valuable information to anyone interested in anesthesia and critical care. We’re here for you!

For anyone who wants to learn or review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you’ve always dreamed of. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available! Registered nurses get continuing education credits (CEUs)

Learn more about it at www.thenurseanesthesia.com  

Follow us on Instagram @thenurseanesthesia

If you have an idea for a show, please let us know. 

Legal Disclaimer

The Nurse Anesthesia INC. expressly disclaims any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Music by Alex Grohl