In today’s podcast Jeremy and Mark review several anesthesia concepts that were covered in previous episodes…specifically Malignant Hyperthermia, Pulse Oximetry, and Adrenal Crisis. 

As educators we know it’s important to revisit and review anesthesia concepts in order to help with long term memory retention. There’s actually a learning technique called 

spaced learning (or spaced repetition) where information is reviewed at increasing intervals over time, instead of being crammed in a single session. 

This method leverages the psychological spacing effect, where learning and retention are more effective when study sessions are spread out. And in the context of learning anesthesia concepts, spaced learning helps learners more efficiently memorize and deeply understand complex topics by reinforcing the material at various intervals, allowing for better long-term retention.

Also, since all CRNAs will need to recertify their credential in the future with the NBCRNAs new MAC questions…these episodes will help with that too! 

References

1. Bruder EA, Ball IM, Pickett W. 2015. Single induction dose of etomidate versus other induction agents for endotracheal intubation in critically ill patients. Cochrane Database Syst Rev. doi 10.1002/14651858. 
2. Chabre O, et al. 2017. Epidemiology of primary and secondary adrenal insufficiency. Ann Endocrinol. 78(6):490-494.
3. Chan ED, et al. Pulse oximetry: understanding its basic principles 
    facilitates appreciation of its limitations. Respir Med. 2013 Jun;107(6):789-99. 
4. Elisha, S., Heiner, J. S., & Nagelhout J. J. (2023). Nurse Anesthesia (7th ed.) Elsevier Saunders.
5. Elshal MM, et al. Perfusion Index: Could It Be a New Vital Sign? Front Med (Lausanne). 2021 Oct 1;8:651909. 
6. Liu M., 2017. Perioperative steroid management. Anesthesiology, 127(1), 166-172.
7. www.mhaus.org 
8. Yamamoto LG, et al. Nail polish does not significantly affect pulse oximetry measurements in mildly hypoxic subjects. Respir Care. 2008 Nov;53(11):1470-4. 

Resources/information discussed in podcast

About The Nurse Anesthesia

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

Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com  

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Click here to share your comments and suggestions. 

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]

In today’s episode Jeremy and Sass start by diving into normal physiologic function of the Hypothalamic-Pituitary-Adrenal (HPA) Axis. They then review how it’s regulated and the pathology/medications that can alter the HPA Axis. After that, it’s all about the adrenal glands, and Jeremy and Sass differentiate between Acute Adrenal Crisis and Adrenal Insufficiency. They talk about why chronic steroid use puts patients at risk for Adrenal Crisis and why cortisol is necessary for proper cardiovascular function and a whole lot more. This is definitely the nuts and bolts of “What you need to know”!

References

1. Bruder EA, Ball IM, Pickett W. 2015. Single induction dose of etomidate versus other induction agents for endotracheal intubation in critically ill patients. Cochrane Database Syst Rev. doi 10.1002/14651858. 

2. Chabre O, et al. 2017. Epidemiology of primary and secondary adrenal insufficiency. Ann Endocrinol. 78(6):490-494.

3. Liu M., 2017. Perioperative steroid management. Anesthesiology, 127(1), 166-172.

About The Nurse Anesthesia

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

Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Click here to share your comments and suggestions. 

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

Nitrous oxide is one the OG of anesthesia gases and is one of three gases pipped into our anesthesia gas machine. It’s known on the anesthesia workstation by the color blue. In this episode Jeremy and Mark discuss the current use of nitrous oxide and both it’sdesirable and undesirable effects. Gear up to review or learn about the “Original Blue Gas”!

Resources/information discussed in podcast

You can pick up a copy of Emergency Management in Anesthesia and Critical Care (EMACC) on Amazon, or from Elsevier:https://evolve.elsevier.com/cs/product/9780443106934?role=student   

About The Nurse Anesthesia

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

We are currently developing anesthesia content! Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com

Follow us on Instagram

We post about all things anesthesia. Follow us on Instagram @thenurseanesthesia

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Please contact us on Instagram with suggestions.

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

This is a special episode where Jeremy & Sass talk with the one and only Dr. John Nagelhout, PhD, CRNA, FAAN. They talk with him about what it was like when he first went to anesthesia school, his transition into academics, how he gathered a group of CRNAs together to write the very first Nurse Anesthesia textbook, and the thousands of lives he’s influenced with his pharmacology lectures. 

There’s a reason we call him the “Grand Master of Nurse Anesthesia Education” and this is a piece of history you won’t want to miss!

About The Nurse Anesthesia

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

Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com  

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Click here to share your comments and suggestions. 

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 & Edit by Next Day podcast

Episode Summary

The pulse oximeter is a primary anesthesia and critical care monitor. Not only does it help identify hypoxemia, but it provides several other pieces of essential information when monitoring a patient during anesthesia and surgery. 

In this episode, we go over how the pulse oximeter functions, the current advantages and disadvantages, and other practical considerations that make pulse oximetry monitoring simple awesome!

References

1. Wilkins MC. Residual bacterial contamination on reusable pulse oximetry
    sensors. Respir Care. 1993 Nov;38(11):1155-60. PubMed PMID: 10145923.
2. Yamamoto LG, et al. Nail polish does not significantly affect pulse oximetry measurements in mildly hypoxic subjects. Respir Care. 2008 Nov;53(11):1470-4. PubMed PMID: 18957149.
3. van Genderen ME, et al. Peripheral perfusion index as an early predictor for central hypovolemia in awake healthy volunteers. Anesth Analg. 2013 Feb;116(2):351-6. PMID: 23302972.
4. Elshal MM, et al. Perfusion Index: Could It Be a New Vital Sign? Front Med (Lausanne). 2021 Oct 1;8:651909. doi: 10.3389/fmed.2021.651909. PMID: 34660615 
5. Chan ED, et al. Pulse oximetry: understanding its basic principles
    facilitates appreciation of its limitations. Respir Med. 2013 Jun;107(6):789-99.
    PMID: 23490227
6. Abdelnasser A, et al. Predicting successful supraclavicular brachial plexus block using pulse oximeter perfusion index. Br J Anaesth. 2017 Aug 1;119(2):276-280. doi: 10.1093/bja/aex166. PMID: 28854539.

About The Nurse Anesthesia

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

Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com  

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Click here to share your comments and suggestions. 

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 

This is our second Q&A episode and in this one, we review the anesthesia gas machine! We go over all the different pressure systems, variations in some of the anesthesia machines, we talk about some monitoring issues, and review content that falls within the anesthesia technology category…basically we talk about the stuff you will be tested on. There are sure to be some pearls you won’t want to miss!

About The Nurse Anesthesia

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

Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com  

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Click here to share your comments and suggestions. 

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 today’s episode Jeremy and Sass talk about the anaphylactic shock state. They discuss the most common triggers for anaphylaxis, how it occurs at the cellular level, the signs and symptoms associated with anaphylaxis, and most important…how to manage this critical event. 

References

1. Macy E. Penicillin and B-lactam allergy: Epidemiology and diagnosis. Curr Allergy Asthma Rep. 2014;14(11):476.
2. Sadleir PHM, et al. Anaphylaxis. To neuromuscular blocking drugs: Incidence and cross reactivity in Western Australia from 2002-2011. British Journal of Anaesthesia. 2013;110(6):981-87.
3. Dewachter P, et al. Anaphylaxis and anesthesia: controversies and new insights. Anesthesiology. 2009;111:1141-50. APSF Newsletter, June 2018.
4. Tazazawa T, et al. Sugammadex and rocuronium induced anaphylaxis. J Anesth. 2016;30:290-97.
5. Reber LL, et al. The pathophysiology of anaphylaxis. J Allergy Clin Immunol. 2017;140:335-48.

About The Nurse Anesthesia

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

Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com  

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Click here to share your comments and suggestions. 

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]

Anesthesia induction agents are essential anesthesia medications that anesthesia providers need to learn about and understand so they can select the correct medication for the right patient/situation. The primary induction agents used in today’s anesthesia practice include: Propofol, Etomidate, and Ketamine…we refer to these as “The Knock Out Buch!” 

Without a doubt, propofol is used more often than any other anesthesia induction agent. 

In today’s episode, we talk about the pharmacokinetics, pharmacodynamics, mechanism of action, and clinical indications of each one of the anesthesia induction medications. Get ready, because this is an episode filled with key concepts and important information used for exams that is hard to find!

References

1. Nagelhout J, Intravenous Induction Agents. Elisha S, Heiner J, Nagelhout J, eds. Nurse Anesthesia. 7th ed. Elsevier; 2023:101-117.
2. Hailu S, et al. Effectiveness of ketofol versus propofol induction on hemodynamic profiles in adult elective surgical patients: A Randomized Controlled Trial. International Journal of Surgery Open. Vol 37, 2021.
3. Carlson P. Spreading depolarization in acute brain injury inhibited by ketamine: a prospective, randomized, multiple crossover trial. J Neurosurg. 2018 May 25;1-7.
4. Albanese J., et al., Ketamine Decreases Intracranial Pressure and Electroencephalographic Activity in Traumatic Brain Injury Patients during Propofol Sedation . Anesthesiology 1997; 87:1328–1334 doi: https://doi.org/10.1097/00000542-199712000-00011
5. Gregers M., et. al., Ketamine as an Anesthetic for Patients with Acute Brain Injury: A Systematic Review. Neurocrit Care. 2020 Aug;33(1):273-282. doi: 10.1007/s12028-020-00975-7. 

About The Nurse Anesthesia

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

Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com  

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Click here to share your comments and suggestions. 

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]

In this episode we highlight the various difficult airway algorithms and failed airway checklists developed by professional airway organizations. These tools used by anesthesia providers to develop their personal airway management plans and to help guide decision making in the event of a difficult or failed airway. 

References

1. Apfelbaum JL, et.al. 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. Anesthesiology. 2022 Jan 1;136(1):31-81. doi: 10.1097/ALN.0000000000004002. PMID: 34762729. 
2. Frerk C, et al. Difficult Airway Society intubation guidelines working group. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015 Dec;115(6):827-48. doi: 10.1093/bja/aev371. 
3. Jung H. A comprehensive review of difficult airway management strategies for patient safety. Anesth Pain Med (Seoul). 2023 Oct;18(4):331-339. doi: 10.17085/apm.23123. 
4. Law JA, et. al. Canadian Airway Focus Group. Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway. Can J Anaesth. 2021 Sep;68(9):1405-1436. doi: 10.1007/s12630-021-02008-z. 
5. Law JA, et. Al. Canadian Airway Focus Group. Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient. Can J Anaesth. 2021 Sep;68(9):1373-1404. doi: 10.1007/s12630-021-02007-0. 

Resources/information discussed in podcast

 | Ariadne Labs OR Crisis Checklists: https://www.ariadnelabs.org/safe-surgery-safe-systems/surgical-safety/or-crisis-checklists/or-crisis-checklist-download/
Stanford Emergency Manual: https://emergencymanual.stanford.edu/ 
The Nurse Anesthesia Failed Airway Checklist: 
 
 
About The Nurse Anesthesia

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

Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com  

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Click here to share your comments and suggestions. 

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]

We’ve heard from a lot of anesthesia students, RNs, and CRNAs about how they want some question-and-answer episodes…so we’re here to deliver! This is the first Anesthesia Q&A, and we’re calling it Round 1 (ding! ding! ding!). What better way to start Anesthesia Q & A than with some respiratory anatomy and physiology. 

We’ve had extensive experience writing questions for anesthesia students, CRNAs, and for national certifying exams. So put the gloves on, it’s time to jump into the ring and dive into some of the favored respiratory topics that are tested in anesthesia school and on national certification exams.

About The Nurse Anesthesia

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

Learn more about The Nurse Anesthesia at www.thenurseanesthesia.com  

Comments or Suggestions?

We’re here to help you improve your anesthesia learning and practice, and we want to make sure our content is relevant for you. Click here to share your comments and suggestions. 

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]