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    Health

    Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

    A Podcast for Anesthesia and Critical Care Reviews, Debates and Commentary

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    Copyright: © 2016 ACCRAC Podcast

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    Latest Episodes:
    Episode 293: Master Clinician Part 2: Keith Baker Oct 19, 2024

    In this 293rd episode I interview Dr. Keith Baker in another master clinician episode. Dr. Baker is a professor at Harvard Medical School, the Vice Chair for Education at MGH and was formerly the residency program director there for 15 years.


    Our Sponsors:
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    Episode 292: Leadership Panel Live from The NEAR Conference in Boston Oct 05, 2024

    In this 292nd episode I play the audio from the live episode we did at the Northeast Anesthesia Resident Conference in Boston on 9/14/24. I interviewed Aalok Agarwala, Associate CMO at MGH, Joanne Conroy, President and CEO of Dartmouth Health, and Sunil "Sunny" Eappen, CEO of UVM Health. We discuss their careers, and their tips for aspiring leaders in healthcare.


    Our Sponsors:
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    Episode 291: Psychedelics for Chronic Pain and Depression with Patrick Finan and Rebecca Ehrenkranz Sep 22, 2024

    In this 290th episode I welcome Drs. Finan and Ehrenkranz to the show to discuss the data on using psilocybin and other psychedelics for treating chronic pain and depression as well as their ongoing study on the topic.


    Our Sponsors:
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    Episode 290: Post-op Cardiac Surgery Care with Mike Grant Sep 08, 2024

    In this 290th episode I welcome Dr. Mike Grant back to the show to discuss post-op care for patients having cardiac surgery.


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    Episode 289: Master Clinicians Part 1: Dr. Dave Berman Aug 25, 2024

    In this new series on master clinicians I will be interviewing people who have been identified by their colleagues and trainees as "master clinicians", people who others go to for advice and clinical guidance, people who are masters of their craft. In this episode I welcome Dr. Dave Berman back to the show to discuss how he has, in a relatively short time, become one of these master clinicians and what advice he has for all of you.


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    Episode 288: Keywords Part 28: ECT and Transfusion Reactions with Tym Kajstura Aug 12, 2024

    In this 288th episode I welcome Dr. Tym Kajstura to the show to do an ABA keyword episode. We discuss considerations for electroconvulsive therapy (ECT) and transfusion reactions.


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    Episode 287: Perioperative Care of Transgender and Gender-Diverse Patients with Kyle Sanchez and Dan Ellis Jul 28, 2024

    In this 287th episode I welcome Drs. Kyle Sanchez and Dan Ellis to the show to discuss the perioperative care of transgender and gender-diverse Patients. We discuss terminology, different medications and surgeries that you may see, preop, intraop and postop considerations.


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    Episode 286: Central Lines with Elisa Walsh Jul 14, 2024

    In this 286th episode I welcome Dr. Elisa Walsh to the show to discuss Central Venous Catheters. We discuss where they can be placed, what can go wrong, how to teach people how to place them safely and how to confirm placement.


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    Episode 285: Signals Update with Andrea Dutoit Jun 30, 2024

    In this 285th episode I welcome Dr. Andrea Dutoit back to the show to discuss the most recent data on program signaling and what we know about how it affected applicants' chances of getting and interview and matching.


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    Episode 284: Perioperative Hand-offs with Jamie Sparling and Aalok Agarwala Jun 05, 2024

    In this 284th episode I welcome Drs. Sparling and Agarwala to the show to discuss the importance of, and evidence for, perioperative hand-offs. We discuss what hand-offs are, what kinds of handoffs occur during the perioperative period, why they matter, how they can cause harm when poorly done, and how implementing good hand-offs can reduce harm.


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    Episode 283: Introducing The Style Points Podcast Episode on Primate Anesthesia Jun 02, 2024

    In this 283rd episode I introduce a new podcast from University of Cincinnati Department of Anesthesiology hosted by Dr. John Crowe. This episode is about Primate Anesthesia and John interviews one of his colleagues who does some anesthesia for primates at the local zoo. I think they're doing great work on this podcast and look forward to more episodes to come!


    Our Sponsors:
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    Episode 282: Navigating Applying in Anesthesiology with Tricia Pendergrast May 19, 2024

    In this 282nd episode I welcome Dr. Tricia Pendergrast to the show to discuss how to navigate the process of applying for residency in anesthesiology. We discuss how to set yourself up for success, how to figure out how competitive you are, when to consider an away rotation, when to consider dual applying, and how to figure out how to best use your signals.


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    Episode 281: Glycemic Control in the ICU with Traci Grucz May 06, 2024

    In this 281st episode I welcome our SICU pharmacist, Traci Grucz, to the show to discuss glycemic management of critical ill patients.


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    Episode 280: Keywords Part 27: Shock States and A Tribute to Dr. Gillian Isaac Apr 21, 2024

    In this 280th episode I share the shocking and tragic news that Dr. Gillian Isaac died suddenly and unexpectedly a few weeks ago. She was an incredible human being, teacher, doctor, wife and mother. She will be missed more than I can say by more people than we can possibly count. I know that she would want us to continue with these keyword episodes that she loved doing and so I am going to try. I know they will never be the same, but they will be dedicated to her memory. Today I address the keyword of shock states and discuss the 4 types of shock and how they may be covered on your exams. I miss you, Gillian.


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    Episode 279: What does an Anesthesiologist Do with Phil Carullo Apr 07, 2024

    In this 279th episode I welcome Dr. Phil Carullo back to the show to discuss what, exactly, an anesthesiologist does and how we fit into the perioperative experience for patients.


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    Episode 278: Liver Physiology Mar 23, 2024

    In this 278th episode I discuss what you need to know about liver physiology for your exams.


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    Episode 277: Keywords part 26: Adrenal Diseases with Gillian Isaac Mar 10, 2024

    In this 277th episode I welcome Dr. Gillian Isaac back for another ABA keyword episode. We discuss Adrenal Diseases and the questions you're likely to see about them on your exams.


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    Episode 276: Perioperative URIs in Kids with Rita Saynhalath Feb 25, 2024

    In this 276th episode I welcome pediatric anesthesiologist Dr. rita Saynhalath to the show to discuss how to manage kids presenting for surgery with a recent URI. We discuss the evidence for proceeding versus postponing, whether the type of virus matters, and how to handle COVID infections.


    Our Sponsors:
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    Episode 275: Healthy Cooking with Myles Snider Feb 11, 2024

    In this 275th episode I welcome Chef Myles Snider to the show to discuss how busy professionals can cook tasty, healthy meals for themselves and their families.


    Our Sponsors:
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    Episode 274: Anaphylaxis and Other Perioperative Hypersensitivity Reactions with Jonathan Kay Jan 28, 2024

    In this 274th episode I welcome Dr. Jonathan Kay (JK) to the show to discuss perioperative hypersensitivity reactions. We focus on the diagnosis and treatment of anaphylaxis and also discuss antibiotic allergies and how to deal with the ever present allergy to PCN.


    Our Sponsors:
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    Episode 273: Anesthesia for Fetal Surgery with Caitlin Sutton Jan 14, 2024

    In this 273rd episode I welcome Dr. Caitlin Sutton to the show to discuss Anesthesia for fetal surgical procedures. We discuss some common procedures, how the anesthesia is done and why, what can go wrong and how to prepare, and what the future holds.


    Our Sponsors:
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    Episode 272: Supporting Mothers in Anesthesiology with Kinza Berical Jan 01, 2024

    In this 272nd episode I welcome Dr. Kinza Berical to the show to discuss her work developing support systems for mothers who practice anesthesiology. We discuss navigating pregnancy and prenatal care, breastfeeding, mentorship around pregnancy loss, IVF and childcare.


    Our Sponsors:
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    Episode 271: Keywords Part 25: Lower Extremity Nerve Blocks Dec 18, 2023

    In this 271st episode I welcome Dr. Gillian Isaac back to the show for another ABA keyword episode. We discuss lower extremity nerve blocks.


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    Episode 270: Dexmedetomidine as an Adjuvant with Drs. Douglas and Soloniuk Dec 05, 2023

    In this 270th episode I welcome Drs. Michael Douglas and Leonard Soloniuk to the show to discuss the use of dexmedetomidine in spinals, epidurals and nerve blocks.


    Our Sponsors:
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    Episode 269: New Frontiers in Preop Assessment and Optimization with Dr. Jeanna Blitz Nov 19, 2023

    In this 269th episode I welcome Dr. Jeanna Blitz to the show to discuss the newest, most evidence based approach to preoperative assessment and optimization of patients. We discuss the use of biomarkers, alternatives to RCRI and using METS alone and assessment and optimization of frailty, nutritional status, anemia, psychological status and functional status.


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    Episode 268: The State of Fellowships In Anesthesiology Nov 05, 2023

    In this 268th episode I welcome Drs. Carullo, Kostibas, Isaac, Banks and Segna to the show. They are our peds, cardiac, OB, critical care and regional fellowship directors and we discuss the state of fellowships in anesthesiology.


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    Episode 267: The Anesthesia Patient Safety Foundation (APSF) with Alli Bechtel Oct 23, 2023

    In this 267th episode I welcome Dr. Alli Bechtel to the show to discuss the Anesthesia Patient Safety Foundation where she works as their podcast host. We discuss the APSF top 10 priorities, what they include and what guidance clinicians can get from them.


    Our Sponsors:
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    Episode 266: Live from ASA 2023! Post-op Delirium and Patient Monitoring with Drs. Culley and Eichorn Oct 19, 2023

    This special 266th episode was recorded before a live audience at the Anesthesiology 2023 Annual Meeting in San Francisco. I interviewed Dr. Deb Culley about post-op delirium and Dr. John Eichorn about the history and future of patient monitoring.


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    Episode 265: Keywords Part 24: Nitroprusside and Nitroglycerin, hemoglobinopathies part 2 Oct 08, 2023

    In this 265th episode I welcome Dr. Gillian Isaac back to the show to do another ABA Keyword episode. We follow up on the last one by discussing Nitroprusside, Nitroyglycerin and their effect on hemoglobin


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    Episode 264: TAAA Repair with Dr. Mimi Wynn Sep 24, 2023

    In this 264th episode I welcome Dr. Mimi Wynn to the show to discuss anesthesia for TAAA repair. We discuss preoperative concerns, intraoperative management, postoperative concerns especially spinal cord ischemia, and how to reduce the risk of that dreaded complication.


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    Episode 263: Radiation Safety with Dr. Mahesh Sep 11, 2023

    In this 263rd episode I welcome Dr. Mahesh to the show to discuss radiation safety for anesthesia providers in the OR and procedure suites.


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    Episode 262: Perioperative Methadone with Evan Kharash Aug 28, 2023

    In this 262nd episode I welcome Dr. Evan Kharash to the show to discuss the use of methadone perioperatively instead of more commonly used opioids such as fentanyl and dilaudid. We discuss the safety of methadone, how it works, and the evidence for superiority in terms of pain control, total opioid use, and patient satisfaction.


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    Episode 261: Aviation Safety Applied to Medicine with Matt Renz Aug 14, 2023

    In this 261st episode I welcome professional commercial pilot and safety expert Matt Renz to the show to discuss aviation safety and how it can apply to medicine.


    Our Sponsors:
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    Episode 260: Malignant Hyperthermia with Dr. Berman Jul 30, 2023

    In this 260th episode I welcome Dr. Dave Berman back to the show to discuss malignant hyperthermia. Dr. Berman is a volunteer with the MH hotline and he discussed the history, epidemiology, genetics, testing, prevention and management of MH and then we discuss some cases.


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    Episode 259: Keywords part 23: Pulse-Ox and hemoglobinopathies part 1 Jul 16, 2023

    In this 259th episode I welcome Dr. Gillian Isaac back to the show to discuss another set of ABA key words. We discuss the pulse oximeter and some hemoglobinopathies that can affect its readings.


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    Episode 258: Pro-con debate: Whether to use an existing labor epidural for C-section with Drs. Hofkamp and Sharpe Jul 03, 2023

    In this 258th episode I welcome Dr Emily Sharpe and Dr. Mike Hofkamp back to the show to have a pro-con debate about what to do when a woman in labor with an epidural in place has to go unexpectedly for c-section. Dr. Hofkamp argues for removing the epidural and doing a second neuraxial technique while Dr. Sharpe argues for using the existing epidural.


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    Episode 257: Transsphenoidal Pituitary Surgery with Dr. Cara Esser Jun 19, 2023

    In this 257th episode I welcome Dr. Cara Esser back to the show to discuss the ins and outs of transsphenoidal pituitary surgery and what to keep in mind preoperatively, intraoperatively and postoperatively.


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    Episode 256: Neuromuscular Diseases with Dr. Cara Esser Jun 04, 2023

    In this 256th episode I welcome Dr. Cara Esser to the show to discuss neuromuscular diseases that are important to know for Anesthesia and Critical Care.


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    Episode 255: Program Signals, Geographic Preferences and Applying in Anesthesiology with Drs. Dutoit and Teeter May 21, 2023

    In this 255th episode I welcome Drs. Dutoit and Teeter to the show to discuss the changes to the ERAS application system including program signals, geographic preferences, experiences, and general advice. We answer questions submitted by the ASA Medical Student Component.


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    Episode 254: Keywords Part 22: Dystrophies and Trisomy 21 May 08, 2023

    In this 254th episode I welcome Dr. Gillian Isaac back to the show for another ABA Keyword episode. We discuss muscular dystrophies and trisomy 21.


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    Episode 253: The Acute Pain Service with Drs. Segna, Rayaz, Jaremko and Barnhart Apr 24, 2023

    In this 253rd episode I welcome Drs. Segna, Rayaz, Jaremko and Barnhart to the show to discuss the acute pain service, how to formulate a multimodal acute pain regimen for a patient, and how to think about the various medications involved.


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    Episode 252: Palliative Care in the ICU with Dr. Tim Poore Apr 10, 2023

    In this 252nd episode I welcome Dr. Tim Poore, a palliative care physician, to the show to discuss palliative care in general and in the ICU in particular. He gives us some concrete tools to use when having difficult, end of life conversations with patients and families.


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    Episode 251: Organ Donation with Drs. Vail and Goyal Mar 27, 2023

    In this 251st episode I welcome Dr. Emily Vail and Dr. Varun Goyal to the show to discuss the Anesthesiologist's role in organ donation.


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    Episode 250: Careers in Anesthesiology with Drs. Essandoh, Cody and Kjome Mar 13, 2023

    In this 250th episode I welcome back Drs. Essandoh and Cody and, for the first time, Dr. Kjome, to discuss different career settings in anesthesiology. We discuss academics, the military and private practice.


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    Episode 249: Keywords Part 21: Retrobulbar Blocks and the Oculocardiac Reflex Feb 27, 2023

    In this 249th episode I welcome Dr. Gillian Isaac back to the show for another ABA Keyword episode. We discuss retrobulbar blocks and the oculocardiac reflex.


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    Episode 248: AKI in the ICU with Samir Gautam Feb 13, 2023

    In this 248th episode I welcome Dr. Samir Gautam to the show. Dr. Gautam is a nephrologist specializing in AKI in the ICU and we talk about the diagnosis, causes, treatment and prognosis of AKI.


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    Episode 247: The Awake and Walking ICU and the ABCDEF Bundle with Kali Dayton Jan 30, 2023

    In this 247th episode I welcome Kali Dayton back to the show to discuss her work helping ICUs around the country learn how to get their intubated patients awake and up and walking and implement the ABCDEF bundle.


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    Episode 246: Tape with Dr. Phil Carullo Jan 17, 2023

    In this 246th episode I welcome Dr. Phil Carullo to the show to discuss Tape. That's right, tape. We discuss tape as a medical device, the tape-skin interface, how to prevent injury and infections from tape, and the evidence for different taping techniques.


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    Episode 245: Simulation in Anesthesia Education with Drs. Miller and Schiavi Jan 02, 2023

    In this 245th episode I welcome Drs. Christina Miller and Adam Schiavi to the show to discuss the importance of simulation, the evidence for using it in education, and important lessons learned in how to develop an effective program for trainees.


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    Episode 244: Pulmonary Artery Pulsatility Index to Assess Right Heart Function with Drs. Essandoh and Kumar Dec 20, 2022

    In this 244th episode I welcome back Dr. Mike Essandoh and welcome for the first time Dr. Nick Kumar to discuss their recent article about using a novel hemodynamic measurement, the Pulmonary Artery Pulsatility Index (PAPI) to assess right heart function in general and in LVAD recipients specifically.


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    Episode 243: Dental Anesthesia with Jae Grymes Dec 05, 2022

    In this 243rd episode I welcome Dr. Jae Grymes to the show. Jae is a board certified pediatric dentist and a board certified dental anesthesiologist. We talk about the field of dental anesthesiology, its history, training, and the role that it plays in dentistry. We also discuss the controversial practice of dentists doing their own anesthesia.


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    Episode 242: The Rescue with Harry Harris Nov 21, 2022

    In this 242nd episode I welcome Dr. Richard "Harry" Harris to the show to discuss his incredible experience saving the lives of the Thai boys soccer team that was trapped in a flooded cave in Thailand in 2018.


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    Episode 241: Jesse Ehrenfeld Live in New Orleans Nov 07, 2022

    In this 241st episode we play the audio from our live podcast in New Orleans at the Anesthesiology 2022 conference. We discuss Jesse's impressive career including his recent election as president-elect of the AMA, his advocacy work, and his work with AI in healthcare.


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    Episode 240: Inadequate Analgesia During C-section with Mike Hofkamp and Emily Sharpe Oct 24, 2022

    In this 240th episode I welcome Drs. Hofkamp and Sharpe to the show to discuss their work investigating whether there may be inadequate analgesia for patients undergoing cesarean delivery.


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    Announcement: Live ACCRAC Episode at ASA in New Orleans! Oct 15, 2022

    Hey there ACCRAC listeners! If you'll be at the ASA annual meeting in New Orleans on October 22nd come check out our live podcast at 2pm from Center Stage. We'll be interviewing Dr. Jesse Ehrenfeld, president-elect of the AMA!


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    Episode 239: Determined: How Burned Out Doctors Can Thrive in a Broken Medical System with Dr. Jimmy Turner Oct 10, 2022

    In this 239th episode I welcome Dr. Jimmy Turner back to the show. Jimmy is an academic anesthesiologist at Wake Forest in North Carolina and a certified coach for physicians. He is also the founder of The Physician Philosopher blog and podcast. In addition to this, he is the author of a book that came out in July of 2022 entitled Determined: How Burned Out Doctors Can Thrive in a Broken Medical System. We discuss his book and it's messages about burnout and resilience.


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    Episode 238: Financial Planning Update with Justin Harvey Sep 26, 2022

    In this 238th episode I welcome back Financial Planner Justin Harvey to discuss the recent changes in student loans, public service loan forgiveness, the No Surprises Act, the pros and cons of doing a fellowship versus going straight into practice, and mistakes to avoid when starting a new job.


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    Episode 237: Health Care Provider Burnout with Bryan Sexton Sep 11, 2022

    In this 237th episode I welcome Dr. Bryan Sexton to the show to discuss his work with characterizing, researching and trying to address healthcare provider burnout. We discuss what burnout is and how it differs from moral injury, how to prevent it, treat it, and what a better system might look like.


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    Episode 236: Gun Violence Prevention with Dr. Katherine Hoops Aug 29, 2022

    In this 236th episode I welcome Dr. Katherine Hoops to the show to discuss her work with gun violence prevention. We discuss the horrific statistics around gun violence during the COVID pandemic, what can be done to try to prevent it, and what providers can do to help.


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    Episode 235: What Happens When Doctors Get Sick, the Physician-as-patient, with Drs. Castro-Frenzel and Saadat Aug 15, 2022

    In this 235th episode I welcome Drs. Karla Castro-Frenzel and Haleh Saadat to the show. They share their stories of being diagnosed with serious diseases, becoming physician-as-patients, and how they coped with the diagnosis and figured out how to move forward.


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    Episode 234: Keywords Part 20: PONV Aug 01, 2022

    In this 234th episode I welcome Dr. Gillian Isaac back to the show to discuss another ABA keyword. We cover PONV for the Basic and Advanced exam.


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    Episode 233: Presenting Anesthesia Plans with Drs. Madan and Buhl Jul 18, 2022

    In this 233rd episode we post a recording from Drs. Elena Madan and Lauren Buhl about how to optimally present anesthesia plans.


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    Episode 232: WikiAnesthesia with Drs. Wang, Larson and Rishel Jul 04, 2022

    In this 232nd episode I welcome Drs. Wang, Larson and Rishel to the show to discuss WikiAnesthesia. We discuss what it is, how it came to be, what it offers for anesthesia practitioners, and how people can get involved.


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    Episode 231: Total Artificial Heart with Mike Essandoh Jun 20, 2022

    In this 231st episode I welcome Dr. Mike Essandoh back to the show to discuss the Total Artificial Heart. We discuss what it is, how it works, how it is put in, who is a good candidate, and how to manage people with TAHs from an anesthetic perspective when they come in for non-cardiac surgery.


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    Episode 230: AI in Healthcare with Greg Booth Jun 06, 2022

    In this 230th episode I welcome Dr. Greg Booth to the show to discuss how artificial intelligence can be used in healthcare, how it works, what the benefits are, and what the potential downsides are that we need to be aware of.


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    Episode 229: Keywords Part 19: Epidurals May 23, 2022

    In this 229th episode I welcome Dr. Gillian Isaac back to the show to discuss another ABA keyword. We discuss Epidurals for both the Basic and Advanced Exam.


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    Episode 228: Liver Transplant Revisited with Nicole Rizkalla May 09, 2022

    In this 228th episode I welcome Dr. Nicole Rizkalla to the show to discuss the details of liver transplant anesthesiology. We discuss patient selection and preparation, intraop and postop management, the training pathway to be a transplant anesthesiologist and what the future may hold.


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    Episode 227: Hyperoxia and The VIXIE Trial with Christian Meyhoff Apr 25, 2022

    In this 227th episode I welcome Dr. Christian Meyhoff to the show from Denmark where he is one of the world leaders on hyperoxia research. We discuss his recent VIXIE Trial as well as his A&A article looking at the VISION study data retrospectively. We also discuss why the data on hyperoxia is so mixed and what future studies should examine.


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    Episode 226: Keywords Part 18: Newborn Emergencies Apr 11, 2022

    In this 226th episode I welcome back Dr. Gillian Isaac to do another ABA keyword episode. We cover all 9 of the newborn emergencies that are laid out in the ABA keywords.


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    Episode 225: Artificial Intelligence in Anesthesiology with Maxime Cannesson Mar 28, 2022

    In this 225th episode I welcome Dr. Maxime Cannesson to the show to discuss his work developing AI systems for use in anesthesiology. We discuss what these systems can do, the evidence for their use, and whether they will replace human providers.


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    Episode 224: The MitraClip Procedure with Mike Essandoh and Joe Cody Mar 15, 2022

    In this 224th episode I welcome back Drs. Essandoh and Cody to talk about the MitraClip procedure. We review the pathophysiology of mitral regurgitation and then talk about the indications for this endovascular procedure, how it's done and what complications can arise.


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    Episode 223: The Glycocalyx with Marius Fassbinder Feb 28, 2022

    In this 223rd episode I welcome Dr. Marius Fassbinder back to the show to discuss the glycocalyx. We discuss what it is, what roll it plays in fluid dynamics, and what we need to know about how it influences our fluid management.


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    Episode 222: Aversive Racism with Drs. Chen and Lucero Feb 14, 2022

    In this 222nd episode I welcome Drs. Catherine Chen and Jennifer Lucero to the show to discuss their NEJM article about aversive racism in academic medicine. We talk about what aversive racism is, what role it plays, and how we can try to work to counter its effects.


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    Episode 221: Oral Board Prep with Anna Gitterman Jan 31, 2022

    In this 221st episode I welcome Dr. Anna Gitterman to the show to put me through the oral board ringer. She takes me through a stem and we break down strategy for you.


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    Episode 220: Every Deep Drawn Breath with Wes Ely Jan 17, 2022

    In this 220th episode I welcome Dr. Wes Ely to the show to discuss his new book, Every Deep Drawn Breath and the personal journey as an intensivist that he took to writing it. We discuss PICS and PICS-F, early mobility, and bringing humanity to the ICU.


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    Episode 219: Medical Ethics with Steven Bradley Jan 03, 2022

    In this 219th episode I welcome Dr. Steven Bradley to the show to discuss medical ethics in general and some specific issues that arise in anesthesiology.


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    Episode 218: The REGAIN trial with Mark Neuman Dec 20, 2021

    In this 218th episode I welcome Dr. Mark Neuman to the show. Dr. Neuman is the PI of the REGAIN trial, published in the NEJM which compared spinal and sedation vs. GA for hip surgery. We discuss the trial and the results.


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    Episode 217: Social Media in Anesthesiology Education with David Convissar Dec 07, 2021

    In this 217th episode I welcome Dr. David Convissar to the show to talk about the landscape of social media resources in anesthesiology education and the pros and cons of using those resources.


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    Episode 216: Intralipid for AFE Nov 22, 2021

    In this 216th episode I discuss case reports of using Lipid Emulsion Therapy for Amniotic Fluid Embolus. Big thanks to Dr. Adam Olson for bringing this to my attention!


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    Episode 215: Transition From Training to Practice with Drs. Sedghi and Freiberg Nov 08, 2021

    In this 215th episode I welcome Dr. Kia Sedghi and Dr. Stephen Freiberg to the show to discuss tips and tricks for making the transition from training to practice.


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    Episode 214: Keywords Part 17: Non-depolarizing blockers and Myesthenic Syndromes Oct 25, 2021

    In this 214th episode I welcome back Dr. Gillian Isaac to do another ABA Keyword episode. We review non-depolarizing neuromuscular blockers and myesthenic syndromes.


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    Episode 213: Live from Anesthesiology 2021 with Drs. Ambardekar and Bacon in Front of a Live Audience Oct 11, 2021

    In this 213th episode we take the show on the road in front of a live audience at Anesthesiology 2021 in San Diego! I interview Dr. Aditee Ambardekar about her programatic leadership roles at UT Southwestern and the ACGME and we also discuss her practice with pediatric burn anesthesia. I also interview Dr. Doug Bacon about his interest in the history of anesthesiology, anesthesiology during WWII, and his leadership role as a department chair.


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    Episode 212: Healthcare's Impact on Health with Matt Meyer Sep 27, 2021

    In this 212th episode I welcome Dr. Matt Meyer to the show to discuss the environmental impact of modern healthcare including the downsides of Desflurane and how we can make personal and system changes to help the environment.


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    Episode 211: Ventilatory Challenges in Obesity with Lorenzo Berra and Roberta Santiago Sep 14, 2021

    In this 211th episode I welcome Drs. Lorenzo Berra and Roberta Santiago to the show to discuss why traditional one size fits all ventilation approaches are not ideal in an increasingly obese population and how we can optimize our ventilation settings for our patients.


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    Episode 210: An overview of Pain with Steve Cohen Aug 30, 2021

    In this 210th episode I welcome international pain expert Dr. Steve Cohen to the show to discuss pain in general, how we categorize it, how we try to treat it, and what the future holds.


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    Episode 209: Behavioral Economics in Anesthesiology with John Fiadjoe Aug 16, 2021

    In this 209th episode I welcome Dr. John Fiadjoe from Boston Children's Hospital and Harvard Medical School to the show to discuss what we can learn in anesthesiology from behavioral economics theory.


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    Episode 208: RV Failure in COVID and Critical Care Ultrasound's Increasing Utility Aug 02, 2021

    In this 208th episode I welcome Drs. Kopanczyk, Al-Qudsi and Bhatt to the show to discuss RV Failure in COVID-19. We talk about how they are using POCUS to assess R heart function, what the new NBE CCEexam is all about, and the growth of POCUS in Anesthesiology.


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    Episode 207: Structural Heart with Drs. Essandoh, Graul and Cody Jul 19, 2021

    In this 207th episode I welcome back Drs. Essandoh, Graul and Cody to discuss anesthesia for structural heart procedures. We cover the Mitraclip, TAVR and Watchman.


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    Episode 206: CRRT in the ICU with Derek Fine Jul 05, 2021

    In this 206th episode I welcome Dr. Derek Fine to the show to discuss the use of CRRT (Continuous Renal Replacement Therapy) in the ICU.


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    Episode 205: ECMO update with Drs. Essandoh, Cody and Graul Jun 21, 2021

    In this 205th episode I welcome Drs. Essandoh, Cody and Graul back to the show to discuss ECMO including significant new technology and devices that have come into play since I last covered ECMO.


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    Episode 204: Management of Patients with LVADs for Non-cardiac Surgery with Kia Sedghi Jun 05, 2021

    In this 204th episode I welcome Dr. Kia Sedghi to the show to discuss the perioperative management of patients with LVADs coming in for non-cardiac surgery.


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    Episode 203: Writing a Novel and Anesthesiologists in Popular Fiction with Tammy Euliano May 25, 2021

    In this 203rd episode I welcome Dr. Tammy Euliano to the show to discuss how she got involved in writing fiction, how she took her idea all the way to a published novel called Fatal Intent, and how anesthesiologists are portrayed in popular fiction.


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    Episode 202: RADAR and Anti-racism in Anesthesiology with Matt Wixson May 17, 2021

    In this 202nd episode I welcome Dr. Matt Wixson, co-founder of RADAR (Raising Anesthesiology Diversity and Anti-Racism) to the show to discuss anti-racism in Anesthesiology.


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    Episode 201: The Simplified Adductor Canal Block with Jeff Swenson May 10, 2021

    In this 201st episode I welcome Dr. Jeff Swenson to the show to discuss his invention of the original adductor canal block and why he is now doing a simplified version.


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    Episode 200: Highlights From 5 Years and 200 Episodes of ACCRAC May 03, 2021

    In this 200th episode I look back over the past 5 years and 200 episodes of ACCRAC to highlight some of the most memorable episodes and most significant lessons.


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    Episode 199: Pharmacology for the Neuro ICU with Salia Farrokh Apr 27, 2021

    In this 199th episode I welcome Salia Farrokh to the show to discuss pharmacology in the neuro ICU. We discuss treatment for status epilepticus, ICP crisis, reversal of anticoagulants in ICH, neurostimulants in TBI and BP management in stroke.


    Salia is on LinkedIn at https://www.linkedin.com/in/salia-farrokh-pharm-d-bcps-bcccp-845b1b38/


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    Episode 198: Non-Transvenous Cardiovascular Implantable Electronic Device Technology Apr 13, 2021

    In this 198th episode I welcome Drs. Essandoh, Cody and Graul to the show to discuss new technology for non-transvenous cardiac devices such as subcutaneous ICDs, leadless pacemakers and wireless-CRT.


    Dr. Cody's email is: Joseph.Cody@osumc.edu


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    Episode 197: Environmental Sustainability in Anesthesia with Shreya Aggarwal Mar 30, 2021

    In this 197th episode I welcome Dr. Shreya Aggarwal to the show to discuss the environmental impact of healthcare in general and anesthesiology specifically. We discuss what the impact is and what we can do to mitigate it.


    Dr. Aggarwal is available at: shreya.aggarwal@northwestern.edu


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    Episode 196: Keywords part 16: Urologic surgery and Renal Failure Mar 16, 2021

    In this 196th episode I welcome Dr. Gillian Isaac back to the show to discuss another ABA keyword. We discuss urologic surgery and renal failure.


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    Episode 195: Invention and Device Development in Anesthesiology with Trevor Gibbs Mar 02, 2021

    In this 195th Episode I welcome Dr. Trevor Gibbs to the show to discuss the process of taking an idea all the way to market as a new device. He talks through how he came up with his novel idea for a unique anesthesia stand, the long process of developing a company, getting a patent …

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    Episode 194: COVID in kids with Anna Sick-Samuels Feb 15, 2021

    In this 194th episode I welcome Dr. Anna Sick-Samuels, a pediatric infectious disease specialist, to the show to discuss COVID in kids. Dr. Sick-Samuels is on Twitter @asicksamuels References: Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, et al. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. …

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    Episode 193: Keywords Part 15: Pharmacology of Inhaled Anesthetics Feb 01, 2021

    In this 193rd episode I welcome Dr. Gillian Isaac back to the show to discuss another ABA Key Word topic. This time we discuss the pharmacology of inhaled anesthetic agents. References: Barash Clinical Anesthesia 8th edition and Anesthesiahub.com Random Recs: Chess.com A Woman of No Importance
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    Episode 192: Keywords part 14: Maternal Physiology with Gillian Isaac Jan 18, 2021

    In this 192nd episode I welcome Dr. Gillian Isaac back to the show to discuss another ABA keyword, maternal physiology. References: Barash Clinical Anesthesia 8th edition and Anesthesiahub.com
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    Episode 191: Preop assessment for ambulatory surgery with Bobbie Sweitzer Jan 05, 2021

    In this episode I welcome Dr. Bobbie Sweitzer to the show to discuss how to identify high risk patients for ambulatory surgery in order to reduce the risk of postop complications. We review important perioperative guidelines and how the patient population for ambulatory surgery is changing. Random Recs: Oreo Cheesecake: https://preppykitchen.com/oreo-cheesecake/ Malcolm X Biography: Link …

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    Episode 190: NORA (Non-OR Anesthesia) with Yasmeen Beg Dec 21, 2020

    In this 190th episode I welcome Dr. Yasmeen Beg to the show to discuss how Non-OR Anesthesia (NORA) differs from traditional OR anesthesia and what practitioners should keep in mind for these cases. Dr. Beg is on twitter @yasmeenb2
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    Episode 189: Timing of Surgery After Recovery From COVID-19 with Jason Chi Dec 07, 2020

    In this 189th episode I welcome Dr. Jason Chi to the show to discuss what we know about how to plan for surgery in patients who have recovered from COVID-19. Jason’s email: jasonchi1000@gmail.com Random Recs: Minari: https://youtu.be/KQ0gFidlro8 Doctors Without Borders: www.doctorswithoutborders.org Daniel Tiger: https://pbskids.org/daniel/
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    Episode 188: Anesthesia for Thoracic Surgery Nov 24, 2020

    In this 188th episode I discuss the approach to Anesthesia for patients having thoracic surgery including highly tested concepts for board exams. Reference: Clinical Anesthesia. 2017. 8th Ed. Barash, Paul G.; Cullen, Bruce F.; Stoelting, Robert K.; Cahalan, Michael K.; Stock, M. Christine; Ortega, Rafael; Sharar, Sam R.; Holt, Natalie F.Publisher: Lippincott Williams & Wilkins …

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    Episode 187: PEEP for Robotic Surgery with Gabe Tharp Nov 10, 2020

    In this 187th episode I welcome Dr. Gabe Tharp to the show to discuss his recent article in Anesthesiology: “Body Habitus and Dynamic Surgical Conditions Independently Impair Pulmonary Mechanics during Robotic-assisted Laparoscopic Surgery.” We discuss his findings and whether we should be using much higher levels of PEEP than we currently do. Gabe’s group is …

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    Episode 186: What anesthesiologists need to know about cannabis with Jen Meeker Oct 27, 2020

    In this 186th episode I welcome Dr. Jennifer Meeker to the show to discuss the increased use of cannabis in the general population and what that means for anesthesiologists taking care of patients who may have acute or chronic use. Random Recs: Tuesday Nights Cookbook: Link Vertellis: https://vertellis.com
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    Episode 185: Fluid Responsiveness in the OR with Lee Goeddel Oct 13, 2020

    In this 185th episode I welcome back Dr. Lee Goeddel to discuss assessment of fluid responsiveness in the operating room. References: Michard F. Changes in Arterial Pressure during Mechanical Ventilation. Anesthesiology. 2005;103(2):419-428. doi:10.1097/00000542-200508000-00026 Using Dynamic Variables to Guide Perioperative Fluid ManagementAzriel Perel, M.D.Anesthesiology October 2020, Vol. 133, 929–935. https://doi.org/10.1097/ALN.0000000000003408
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    Episode 184: Truncal Blocks with Drs. Segna and Rayaz Sep 29, 2020

    In this 184th episode I welcome back Drs. Kara Segna and Hassan Rayaz to discuss truncal blocks. We discuss rectus sheath, transversus abdominis plane, quadratus lumborum and erector spinae plane blocks. Random Recs: The Wirecutter: https://www.nytimes.com/wirecutter/ How to be an anti-racist: Link Instant Hotel: https://www.netflix.com/title/81023011 Love Island Australia: https://en.wikipedia.org/wiki/Love_Island_Australia
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    Episode 183: Keywords Part 13 with Gillian Isaac: Thyroid for the Basic and Advanced Exams Sep 14, 2020

    In this 183rd episode I welcome back Dr. Gillian Isaac to do another keyword episode where we review the ABA keyword topics of Thyroid for the Basic Exam and Thyroid for the Advanced Exam. Show notes by Brian Park, MD References: Barash Clinical Anesthesia 8th edition American Board of Anesthesiology Website Anesthesiahub.com Random Recs: Serious …

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    Episode 182: Med Student Concerns and PD Responses for the COVID Interview Season Sep 02, 2020

    In this 182nd episode I welcome the president of the ASA medical student component, Stacia Griebahn, and the president-elect, Abigail Schirmer to the show to discuss what medical students applying in anesthesiology are concerned about this year and the responses that PDs have to those concerns. ASA medical student component webpage: https://www.asahq.org/education-and-career/asa-medical-student-component Abigail is on …

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    Episode 181: Evidence-based perioperative teaching with Dave Berman. Aug 18, 2020

    In this 181st episode I welcome Dr. Dave Berman back to the show to discuss what the evidence tells us about how to effectively teach in the perioperative arena. References: Chickering AW, Gamson ZF. Seven principles for good practice in undergraduate education. Biochem Educ 1989;17(3):140–1. Knowles MS. The modern practice of adult education. New York: …

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    Episode 180: Keywords part 12 with Gillian Isaac: Local Anesthetics Aug 04, 2020

    In this 180th episode I welcome back Dr. Gillian Isaac for another ABA keyword episode. We review local anesthetics. Also check out Episode 41 for an in-depth episode on local anesthetics CORRECTION: At 28:58 I state that hyperventilation increases the seizure threshold. This is incorrect, it DECREASES the seizure threshold. Reference: Barash Clinical Anesthesia 8th …

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    Episode 179: Ambulating While Intubated with Kali Dayton Jul 20, 2020

    In this 179th episode I welcome Kali Dayton, an ICU NP, to the show to discuss a major area of interest for her, getting intubated patients up and walking. Kali has a podcast dedicated to the topic called Walking Home from the ICU where she interviews patients about their experiences. Links: Anchor: https://anchor.fm/restoringlife iTunes: https://podcasts.apple.com/us/podcast/walking-home-from-the-icu/id1497431005 Spotify: https://open.spotify.com/show/61pYjGvlyitt3sgALgHYBg Google: https://podcasts.google.com/?feed=aHR0cHM6Ly9hbmNob3IuZm0vcy8xMmU1NWRhMC9wb2RjYXN0L3Jzcw&ved=2ahUKEwjFudzsof_pAhWNaM0KHRLrBLIQ4aUDegQIARAC&hl=en …

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    Episode 178: The Post-Bypass Period with Steve Freiberg Jul 06, 2020

    In this 178th episode I welcome back Dr. Stephen Freiberg to discuss how to manage the patient in the post cardiopulmonary bypass period. Dr. Freiberg’s social media: thedadesthesiologist.comInstagram: @thedadesthesiologistTwitter: @dadesthesiaTik Tok: @thedadesthesiologist
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    Episode 177: How To Be a Star Resident Jun 22, 2020

    In this 177th episode I discuss a survey of Anesthesiology program directors where I asked them both what makes a great resident great and what red flags make them worry about a resident. I go through the responses and lay out key points about how to earn the reputation of being a star resident. A …

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    Episode 176: Keywords Part 11: Barbiturates and Bier Blocks Jun 09, 2020

    In this 176th episode I welcome Dr. Gillian Isaac back to the show to discuss another 2 ABA key words. This time we discuss Barbiturates and Bier Blocks. I also take a moment up front to share some thoughts on the horrible tragedy of George Floyd’s death at the hands of the police and the …

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    Episode 175: Financial Planning in the Time of COVID with Justin Harvey Jun 01, 2020

    In this 175th episode I welcome Justin Harvey back to the show to discuss the financial implications of COVID-19 for medical students, residents, fellows and attending physicians. Justin is a fee-only financial advisor and CFP (Certified Financial Planner). References: Recommended student loan consulting company: www.studentloanplanner.com Anesthesiologist-founded physician-specific lending: https://www.doc2doclending.com/ A great flow chart for how to think …

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    Episode 174: Keywords Part 10: OR Fires and Electrical Safety May 18, 2020

    In this 174th episode I welcome back Dr. Gillian Isaac to discuss another 2 highly tested ABA keywords, OR fires and electrical safety in the OR. OR Fires Risk for airway fire during laser resection of tracheal tumor DECREASED inA. CO2 rather than GAD laserB. Helium > 60%C. N2O > 60%D. PVC ETTE. Halothane in …

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    Episode 173: Innovation In The Time of Covid: The MasksOn.org story with Drs. Sanjay Vakil, Jackie Boehme and Alex Stone May 03, 2020

    In this episode I welcome Sanjay Vakil, Jackie Boehme and Alex Stone to the show. Jackie and Alex are two of the co-founders of MasksOn.org and Sanjay is the Executive Director. We discuss the story of their company that provides free masks to healthcare workers and how people can go about innovating to help others …

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    Episode 172: A Pregnant Patient with Congenital Heart Disease May 01, 2020

    In this 172nd episode I welcome a panel of experts to discuss the management of a pregnant patient with congenital heart disease. Drs. Hofkamp, Vaught and Meng join me to discuss the preoperative evaluation, obstetric management, and postoperative care.
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    Episode 171: Anesthetic Management of Ruptured Cerebral Aneurysm with Dave Mintz Apr 20, 2020

    In this 171st episode, a follow up to episode 113, I welcome Dr. Mintz back to the show to discuss anesthetic management for cerebral aneurysm surgery. References: Chapter 13 Anesthetic management of cerebral aneurysm surgery in Cottrell and Young, Neuroanesthesia http://www.joacp.org/article.asp?issn=0970-9185;year=2014;volume=30;issue=3;spage=328;epage=337;aulast=Kundra The Guns of August: https://www.amazon.com/Guns-August-Pulitzer-Prize-Winning-Outbreak/dp/0345476093 Cognitive Aid website: www.rnsascar.com
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    Episode 170: Lessons from 40 COVID Patients in the ICU with Brian Garibaldi Apr 07, 2020

    In this 170th episode I welcome Dr. Brian Garibaldi to the show to discuss his experience taking care of 40 critically ill COVID patients and what we’ve learned. We got through by system, head to toe, and discuss strategies and approaches. References: Lessons from China: https://jamanetwork.com/journals/jama/fullarticle/2762130 Convalescent Plasma: https://jamanetwork.com/journals/jama/fullarticle/2763983?widget=personalizedcontent&previousarticle=2762130 Management of patients with COVID: https://jamanetwork.com/journals/jama/fullarticle/2763879
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    Episode 169: PPE and Modified Difficult Airway Algorithm for COVID Apr 05, 2020

    In this episode I introduce Dr. Christina Miller’s video, linked below, that goes through PPE considerations including how to safely don and doff, and suggestions for how to handle a difficult airway in COVID patients. Video: https://drive.google.com/file/d/1AFYIouqGVLRlstU3xXSOJTHbtorWvQ7L/view
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    Episode 168: COVID in Pregnancy with Dr. Nixon Mar 30, 2020

    In this 168th episode I welcome Dr. Heather Nixon to the show to discuss what is being done for pregnant women and women in labor who have or are suspected to have COVID-19. The COVID book for kids by Taylor Purvis: https://playatrickonthecoronas.weebly.com/ Link for Anesthesia Toolbox daily online learning session: https://www.anesthesiatoolbox.com/docs/DOC-5178 References: https://s3.amazonaws.com/cdn.smfm.org/media/2277/SMFM-SOAP_COVID_LD_Considerations_3-27-20_(final)_PDF.pdf SOAP website: …

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    Episode 167: COVID Clinical Care Update Mar 26, 2020

    In this 167th episode I review the most recent changes that we’ve made to our protocols for caring for COVID patients and share a fantastic one page summary sheet that 3 of our ICU fellows put together. Huge thanks to Drs. Navarette, Herekar and Baronos for their work on this. It is available for download …

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    Episode 166: COVID Airway Management with Aliaksei Pustavoitau Mar 21, 2020

    In this 166th episode I welcome Dr. Aliaksei Pustavoitau to the show to discuss management of the hypoxemia COVID-19 patient including initial triage, escalating support, endotracheal intubation, and ventilator management. References:
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    Episode 165: COVID with Drs. Scott, Cereda and Nacoti Mar 15, 2020

    In this 165th episode I welcome Drs. Scott and Cereda from University of Pennsylvania and Dr. Nacoti from Italy to talk about COVID-19, what it is, what we know about it, what it’s like on the ground in Italy right now, and what we can learn from their experience to try to prevent it from …

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    Episode 164: Keywords part 9: Fentanyl and Breathing Circuits Mar 10, 2020

    In this 164th episode I welcome back Dr. Gillian Isaac to do another ABA keywords episode. We discuss fentanyl and breathing systems (Mapleson and Circle systems). Great info from Aaron Sandock: The toxicity was reported in rats and research was published in the early-mid 90’s. Gonsowski, C., Laster, M., Eger, E., Ferrell, L. and Kerschmann, …

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    Episode 163: Thoracic Wall Blocks with Barbara Versyck Mar 03, 2020

    In this 163rd episode I welcome Dr. Barbara Versyck to the show to discuss thoracic wall blocks. We discuss the types of blocks, what they are used for, and what the evidence is for their efficacy. References: Videos: Pecs II: https://www.youtube.com/watch?v=YFWneF4pwOA Serratus Anterior block: https://www.youtube.com/watch?v=K2w46jjMgfMErector Spinae plane block: https://www.youtube.com/watch?v=EVowRjEFUfk Literature: Chin, Ki Jinn. “Thoracic wall blocks: from paravertebral …

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    Episode 162: Hypertensive Disorders of Pregnancy with Juanita Henao Feb 25, 2020

    In this 162nd episode I welcome Dr. Henao back to the show to discuss hypertensive disorders of pregnancy and how to manage them. CLARIFICATIONS: During our discussion of treatment of eclamptic seizures Dr. Henao said benzos were first line treatment. This is assuming the patient is already getting magnesium. For test questions, the answer for …

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    Episode 161: Dual Training in Anesthesiology and Emergency Medicine Feb 18, 2020

    In this 161st episode I welcome Drs. Regan and Lester to the show to discuss the country’s first combined Anesthesiology and Emergency Medicine dual training program. Website for the program: https://www.hopkinsmedicine.org/emergencymedicine/combined-residency/
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    Episode 160: Non-OB Surgery in Pregnancy With Dave Berman Feb 11, 2020

    In this 160th episode I welcome Dr. Dave Berman back to the show to discuss anesthesia for non-OB surgery during pregnancy. References: 1. Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology 2016;124(2):270–300. 2. Nonobstetric Surgery …

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    Episode 159: Postpartum hemorrhage with Juanita Henao Feb 04, 2020

    In this 159th episode I welcome Dr. Juanita Henao to the show to discuss prevention and management of postpartum hemorrhage. One CORRECTION: At about minute 4:30 Dr. Henao states that in women with PPH the mortality rate is 10% but what she meant to say is that PPH accounts for 10% of maternal deaths in …

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    Episode 158: Keywords part 8-hepatic disease for the advanced exam and PACU for the basic exam with Gillian Isaac Jan 28, 2020

    In this 158th episode we return with another keywords episode with Dr. Gillian Isaac. We discuss hepatic disease for the advanced exam and PACU care for the basic exam. Random recs: Cloud Atlas: https://www.amazon.com/Cloud-Atlas-Novel-Liam-Callanan/dp/0385336950 Wolf Hall: https://www.amazon.com/s?k=wolf+hall+by+hilary+mantel&i=stripbooks&crid=2F978D2O2UCW&sprefix=wolf+hall%2Cstripbooks%2C135&ref=nb_sb_ss_i_1_9 Bottle of Lies: https://www.amazon.com/Bottle-Lies-Inside-Story-Generic-ebook/dp/B07JG49BQW/ref=sr_1_1?keywords=bottle+of+lies&qid=1581089047&s=books&sr=1-1 Thanks to Brian Robinson for pointing out: reversal of rocuronium with Sugammadex can occasionally …

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    Episode 157: Intermittent Fasting with Mark Mattson Jan 21, 2020

    In this 157th episode I welcome Dr. Mark Mattson to the show to discuss the science behind intermittent fasting including in the perioperative period. Dr. Mattson’s review from NEJM: https://www.nejm.org/doi/full/10.1056/NEJMra1905136 Dr. Mattson’s Tedx Talk: https://www.youtube.com/watch?v=4UkZAwKoCP8
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    Episode 156: Personal Finance and Burnout with Jimmy Turner Jan 16, 2020

    In this 156th episode I welcome Dr. Jimmy Turner to the show to discuss the intersection of personal finance and physician burnout. References: Dr. Turner’s about page: http://thephysicianphilosopher.com/about/ Dr. Turner’s website: https://thephysicianphilosopher.com/ Dr. Turner’s new podcast: http://moneymeetsmedicine.com/ Blogpost about burnout and finance: https://thephysicianphilosopher.com/what-causes-physician-burnout/ How to think about Money book: https://www.amazon.com/Think-About-Money-Jonathan-Clements/dp/1523770813 If You Can free PDF …

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    Episode 155: Opioid-Free Anesthesia with Michael Manning Jan 07, 2020

    In this 155th episode I welcome Dr. Michael Manning to the show to discuss opioid-reduced and opioid-free anesthesia. We discuss the downsides of opioid usage and what we can do to reduce our use in our patients or even eliminate it completely. References: 1. Koepke EJ, Manning EL, Miller TE et al. The rising tide of opioid …

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    Episode 154: EEG monitoring with Dr. Emery Brown Dec 25, 2019

    In this 154th episode I welcome Dr. Emery Brown to the show to discuss how we monitor the depth of anesthesia. We discuss the drawbacks to BIS and why Dr. Brown thinks the EEG itself is the best way to go. References: EEG reading tutorials: https://eegforanesthesia.iars.org/ Purdon et al: The Ageing Brain: Age-dependent changes in …

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    Episode 153: Women in Anesthesiology with Dr. Sasha Shillcutt Dec 17, 2019

    In this 153rd episode I welcome Dr. Sasha Shillcutt to the show to discuss the movement to support and promote the success of women in Anesthesiology. Dr. Shillcutt is on twitter at @sashashillcutt and @RUBraveEnough. Her website is https://www.becomebraveenough.com References:
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    Episode 152: Keywords Part 7: MH and Hepatic Disease for the Basic Exam Dec 10, 2019

    In this 152nd episode I welcome Dr. Gillian Isaac back for another 2 ABA keywords. We discuss malignant hyperthermia and the portion of hepatic disease that is covered by the Basic Exam. We’ll do the portion covered by the Advanced Exam on the next keywords episode. Malignant Hyperthermia Website: www.mhaus.org Great review website where Dr. …

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    Episode 151: Advanced Practice Providers in the ICU Dec 03, 2019

    In this 151st episode I welcome Brandon Oto to the show. Brandon is an ICU PA and we discuss the roles and relationships of APPs in the ICU environment. Brandon’s blog is http://critcon.org/ Brandon is on Twitter @critconcepts
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    Episode 150: Keywords Part 6: Supraclavicular, Axillary and Benzos Nov 26, 2019

    In this 150th episode I welcome back Dr. Gillian Isaac to do another round of ABA keywords. We discuss 2 additional upper extremity blocks (supraclavicular and axillary) and then benzodiazepines.
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    Episode 149: Transitioning: From Intern to CA-1 year and Beyond Nov 19, 2019

    In this 149th episode I discuss common challenges to the transition from intern year to CA1 year including some of why it’s difficult, the mistakes commonly made, the causes of those mistakes and some suggested solutions. Although I focus on the intern to CA1 transition, much of this applies to any major transition in life.
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    Episode 148: Marijuana Use In Healthcare Providers with Mike Fitzsimons Nov 12, 2019

    In this 148th episode I welcome Dr. Fitzsimons back to the show to discuss the use of marijuana in healthcare providers. We discuss what we know about prevalence, what the potential consequences are, what the status of testing is, and what we may see happen in the future. NEJM article on adverse effects of marijuana: …

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    Episode 147: Lower Extremity Nerve Blocks Part 2: Front of Leg Nov 05, 2019

    In this 147th episode I welcome back Drs. Segna and Rayaz to finish up our discussion of lower extremity nerve blocks. This time we cover the front of leg blocks (femoral, adductor canal, fascia iliaca and obturator).
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    Episode 146: Critical Care Ultrasound with Lee Goeddel Oct 29, 2019

    In this 146th episode I welcome back Dr. Lee Goeddel to the show to discuss critical care ultrasound including how it differs from POCUS and how people can prepare for the new certification exam. References: Pears and Pitfalls in Critical Care Ultrasonography: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693549/
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    Episode 145: Personalized PEEP with Dr. Wiener-Kronish Live from ASA 2019 Oct 21, 2019

    In this 145th episode recorded live from Anesthesiology 2019, the annual ASA meeting, I welcome Dr. Jeanine Wiener-Kronish to the show to discuss the progress we’ve made with mechanical ventilation and how we can personalize the way we deliver it to our patients to improve their outcomes. References: Pereira, SM, Tucci, MR, Morais, CCA, Simões, …

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    Episode 144: The Anesthesiologist-Surgeon Relationship with Jeffrey Cooper Live From ASA 2019 Oct 20, 2019

    In this 144th episode we record live from Anesthesiology 2019 in Orlando Florida. I welcome Dr. Jeffrey Cooper to the show to discuss the relationship between anesthesiologists and surgeons and what can be done to improve it in a way that will foster patient safety. Correction: The Center for Medical Simulation is not part of …

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    Episode 143: Fluid management and cardiac output monitors in ERAS with Michael Scott Oct 15, 2019

    In this 143rd episode I welcome Dr. Michael Scott to the show to discuss fluid management in ERAS cases and how cardiac output monitoring may help us do that well. Topmedtalk: https://www.topmedtalk.com
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    Episode 142: Driving Pressure and Transpulmonary Pressure with Marcos Vidal Melo Oct 08, 2019

    In this 142nd episode I welcome Dr. Marcos Vidal Melo to the show to discuss Driving Pressure and Transpulmonary pressure. We discuss what they are, how they differ from plateau pressure, and how they may help guide safe mechanical ventilation. References: Driving Pressure and Transpulmonary Pressure: How Do We Guide Safe Mechanical Ventilation? Williams EC, Motta-Ribeiro …

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    Episode 141: Nutrition in the ICU with Paul Wischmeyer Oct 01, 2019

    In this 141st episode I welcome Dr. Paul Wischmeyer to the show to discuss nutrition for critically ill patients with a focus on the question of whether to give enteral feeds to patients on pressors. You can follow Dr. Wischmeyer on twitter @Paul_Wischmeyer. References: Dr. Wischmeyer’s article on enteral nutrition for patients on vasopressors: https://journals.lww.com/ccmjournal/Citation/onlinefirst/Enteral_Nutrition_Can_Be_Given_to_Patients_on.95859.aspx
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    Episode 140: Transfusion Triggers and The TRICS 3 Trial with David Mazer Sep 24, 2019

    In this 140th episode I welcome Dr. David Mazer to the show. Dr. Mazer was the PI and first author on the TRICS 3 trial looking at liberal versus restrictive transfusion strategies in moderate to high risk cardiac surgery patients published in the NEJM in 2017. Dr. Mazer would like to add the following random …

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    Episode 139: Keywords Part 5: Succinylcholine and Interscalene Block Sep 17, 2019

    In this 139th episode I welcome Dr. Gillian Isaac back to the show to discuss another 2 ABA keywords, succinylcholine and interscalene brachial plexus block.
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    Episode 138: Lower Extremity Blocks Part 1: Ankle and Sciatic Sep 10, 2019

    In this 138th episode I welcome Drs. Segna and Rayaz back to the show to discuss lower extremity nerve blocks. We cover the ankle block and sciatic nerve block approaches today and will cover the anterior leg in a later episode. The Medium Article: https://medium.com/@admiralcloudberg/the-near-crash-of-air-canada-flight-759-c61094867d45
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    Episode 137: Contracts and Negotiation with Steve Kaufman Sep 04, 2019

    In this 137th episode I welcome Steve Kaufman to the show to discuss contracts and negotiation for doctors. Steve is a lawyer with decades of experience helping doctors negotiate contracts. If you have questions for Steve you can contact him directly at 410-659-1385, or email at SKaufman@wcslaw.com and he’s on twitter at @SKaufmanWCS
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    Episode 136: Keywords part 4: Celiac Plexus Block and Dexmedetomidine Aug 28, 2019

    In this 136th episode I welcome Dr. Gillian Isaac back to the show to discuss another 2 ABA keywords, Celiac Plexus Block and Dexmedetomidine.
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    Episode 135: A Case For Low Dose Norepinephrine Aug 21, 2019

    In this 135th episode I discuss my argument for using low dose norepinephrine to treat or even prevent hypotension in the OR and ICU. I discuss the CENSER trial looking at early norepinephrine in sepsis as well as a paper looking at preemptive norepinephrine in open cystectomies and a review article of trials looking at …

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    Episode 134: How to podcast Aug 12, 2019

    In this 134th episode I turn over the host chair to Dr. Dave Berman and he interviews me about how I got started in podcasting and things to think about for anyone interested in starting a podcast. Reference: https://www.ncbi.nlm.nih.gov/pubmed/31222949
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    Episode 133: Introducing the Depth of Anesthesia Podcast Aug 06, 2019

    In this 133rd episode we bring you the first episode from a new, fantastic anesthesia podcast called “Depth of Anesthesia” hosted by David Hao at MGH. in this episode they explore the evidence behind verifying mask ventilation before administering paralytic.
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    Episode 132: Key Words Part 3: Spinals and Etomidate Aug 05, 2019

    In this 132nd episode I welcome back Dr. Gillian Isaac to do more ABA keyword review. We review Spinals for the Basic Exam and Etomidate.
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    Episode 131: Disabilities in Medicine with Drs. Meeks, Brookman and Fitzsimons Jul 29, 2019

    In this 131st episode I welcome Drs. Meeks, Brookman and Fitzsimons to the show to discuss what it means to be a resident with a disability, what needs to be done to assure adequate and legal accommodations for these trainees, and why it’s important to do so. References: Meeks LM, Herzer KR. Prevalence of self-disclosed …

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    Episode 130: Adults with Congenital Heart Disease with Jochen Steppan Jul 22, 2019

    In this 130th episode I welcome back Dr. Jochen Steppan to discuss the perioperative care of adults with congenital heart disease. We discuss the incidence, evaluation and management including the different types of physiology that a provider might see and how to manage each one. References: http://www.pted.org/ For pictures of the lesions Stoelting’s Anesthesia and Co-Existing …

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    Episode 129: Vascular Access with Dave Berman Jul 14, 2019

    In this 129th episode I welcome Dr. Dave Berman back to the show to discuss vascular access devices. We talk about what kinds of lines exist, how to choose, what the pros and cons are, and how to know what kind of flow you will get with a given catheter. References are here:
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    Episode 128: Opioid Induced Respiratory Depression (The PRODIGY Trial) with Dr. Ashish Khanna Jul 09, 2019

    In this 128th episode I welcome Dr. Ashish Khanna to the show to discuss his trial, the PRODIGY trial, looking at opioid induced respiratory depression. We discuss the background of the trial, what it took to run a 16 site, 3 continent trial, what the risk factors were that went into the risk prediction model …

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    Episode 127: Upper Extremity Blocks with Drs. Segna and Rayaz Jul 04, 2019

    In this 127th episode I welcome Drs. Segna and Rayaz to the show to discuss upper extremity nerve blocks. We discuss how they’re done, what they’re done for, and some high yield board style questions that may come up based on them. References: Hadzic, Admir. Hadzic’s textbook of regional anesthesia and acute pain management. McGraw Hill …

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    Episode 126: Key Words with Gillian Isaac Part 2: Ketamine and Laryngospasm Jun 28, 2019

    In this 126th episode I welcome back Dr. Gillian Isaac to discuss 2 more ABA key words: Ketamine and Laryngospasm.
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    Episode 125: Abusive Head Trauma with Erik Smith Jun 24, 2019

    In this 125th episode I welcome Dr. Erik Smith to the show to discuss Abusive Head Trauma (formerly known as shaken baby syndrome). We discuss how victims present, what to look out for, how to manage their anesthesia, how to report, and how it can impact providers. References: Christian, C. W., Block, R., Committee on …

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    Episode 124: POCUS with Lee Goeddel Jun 18, 2019

    In this 124th episode I welcome Dr. Lee Goeddel to the show to discuss Point Of Care Ultrasound (POCUS). We discuss what it is, what it covers in the cardiac, pulmonary, abdominal and vascular system, and what next steps are for those interested in taking their skills further. References: Anesth Analg. 2017 Mar;124(3):753-760. doi: 10.1213/ANE.0000000000001861.The Nuts and Bolts of Performing Focused Cardiovascular Ultrasound (FoCUS).PMID:28207445 J …

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    Episode 123: Surgical Airway with Andrew Merelman Jun 12, 2019

    In this 123rd episode I welcome Andrew Merelman to the show. Andrew is a paramedic and medical student with an interest in emergent surgical airway management. We discuss the human factors involved in the procedure, when it is indicated, how to do it and how to practice. References and Links: Airway Ap information: http://www.airwaycollaboration.org/ iOS …

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    Episode 122: Key Words Part 1 with Gillian Isaac: Crichothyroid Membrane and Propofol Jun 06, 2019

    In this 122nd episode Dr. Gillian Isaac and I launch the first in a series of episodes to give high yield information on ABA key words. The first two we address are the crichothyroid membrane and propofol.
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    Episode 121: Difficult Airway Response Team With Lynette Mark May 30, 2019

    In this 121st episode I welcome Dr. Lynette Mark to the show. Dr. Mark is the founder of our Difficulty Airway Response Team (DART) here at Hopkins and a founding director for the Society of Airway Management. We discuss the origins of the DART program and how to approach a difficult airway. References: https://www.criticalcare.theclinics.com/article/S0749-0704(17)30102-1/abstract Difficult …

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    Episode 120: Lightning Round 1 May 20, 2019

    In this first ever ACCRAC lightning round I take the contribution and advice of Andrew Salai, a med student in Brazil, and do some rapid fire review of high yield topics. If you have some factoids you’d like to contribute to a future lightning round send them to accrac@accrac.com.
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    Episode 119: STOP-IT Trial with Rob Sawyer May 13, 2019

    In this 119th episode I welcome Dr. Robert Sawyer to the show. Dr. Sawyer was the PI on the STOP-IT trial comparing a short course of antibiotics versus a longer course for complicated intraabdominal infections. We discuss the trial, the outcomes, and what the future of antimicrobial management in the surgical ICU may look like. …

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    Episode 118: Mother’s Day May 08, 2019

    In this 118th episode which we are publishing a few days before Mother’s Day, 2019, I welcome Dr. Gillian Isaac to the show to discuss the challenges of being a mother and a trainee and some important advice for how to make it through and feel supported. Happy Mother’s Day and Thank you to all …

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    Episode 117: Global Surgery with Matt Danley May 03, 2019

    In this 117th episode I welcome Dr. Matt Danley to the show to discuss his recent trip to Kenya, the different approaches to global health in surgery and anesthesia, and some of the ways to get involved. Matt’s email: Matt.Danley@gmail.com Links: LancetGlobalSurgery.org SafeSurgery2020.org Lifebox.org
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    Episode 116: Overview of Pediatric Anesthesia with Bommy Mershon Apr 23, 2019

    In this 116th episode I welcome Dr. Bommy Mershon to the show. We discuss pediatric anesthesiology including how kids differ from adults, pre-op meds, IV vs. inhaled inductions, parental presence, choosing a tube, when to put on monitors, how to do an inhaled induction, controversies around succinylcholine, weight-based dosing, deep extubation, laryngospasm, emergency delirium, regional …

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    Episode 115: The Contaminated Airway with Steve Freiberg Apr 15, 2019

    In this 115th episode I welcome Dr. Steven Freiberg back to the show to discuss management of the contaminated airway. References: Han, S; Fisher, J. Airway Management During Persistent Flooding Of the Oropharyngeal Airway. Anesthesiology News. 2016. March. Joshi, R; Hypes, C; et al. Difficult Airway Characteristics Associated with First-Attempt Failure at Intubation Using Video …

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    Episode 114: The Business of Anesthesia with Jerry Stonemetz Apr 05, 2019

    In this 114th episode I welcome Dr. Jerry Stonemetz to the show to discuss the business side of Anesthesiology. Specifically we discuss billing, compliance, contract negotiation and Jerry’s thoughts on where the industry is heading. Slides are here:
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    Episode 113: Anesthesia for Aneurysm Clipping With Dave Mintz Mar 25, 2019

    In this 113th episode I welcome Dr. David Mintz back to the show to discuss anesthesia for intracranial aneurysm clipping. References: Chapter 13 Anesthetic management of cerebral aneurysm surgery in Cottrell and Young, Neuroanesthesia https://www.ncbi.nlm.nih.gov/pubmed/25014255
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    Episode 112: Anesthesia for ECT with Christina Miller Mar 13, 2019

    In this 112th episode I welcome Dr. Christina Miller to the show to discuss Anesthesia for Electroconvulsive Therapy (ECT). References: Ding Z, White PF. Anesthesia for electroconvulsive therapy. Anesth Analg. 2002 May;94(5):1351-64. Sadowksy, Jonathan. Electroconvulsvie Therapy: A History of Controversy, but Also of Help. The Conversation. Scientific American. January 13, 2017. Wright, M.D., Bruce A. …

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    Episode 111: Tracheostomies, Cricothyrotomies and ENT surgery with Dr. Zandy Hillel Mar 04, 2019

    In this 111th episode I welcome Dr. Zandy Hillel to the show. Dr. Hillel is an otolaryngologist here at Johns Hopkins and we discuss tracheostomies, Cricothyrotomies, laryngeal surgery and difficult airways. References: Crichothyrotomies: https://www.ncbi.nlm.nih.gov/pubmed/30054081 https://www.ncbi.nlm.nih.gov/pubmed/30726035 Difficult Airway Response Teams: https://www.ncbi.nlm.nih.gov/pubmed/26086513
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    Episode 110: Financial Planning For Healthcare Providers With Justin Harvey Feb 27, 2019

    In this 110th episode I welcome Justin Harvey to the show. Justin is a financial planner with an interest in helping anesthesiologists and pain specialists make the best possible financial choices. We discuss financial planning, managing loan repayment, and investing. Justin’s email: Justin@quantifiplanning.com Justin’s podcast: AnesthesiaSuccess.com Justin’s financial planning company: www.quantifiplanning.com XY Planning network: https://www.xyplanningnetwork.com …

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    Episode 109: Non-Opioid Adjuncts with Drs. Grant and Bicket part 2 Feb 21, 2019

    In this 109th episode we pick up where we left off in episode 108 and discuss the intraoperative use of non-opioid adjuncts. References: Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697. Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing …

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    Episode 108: Non-opioid adjuncts with Drs. Grant and Bicket Part 1 Feb 19, 2019

    In this 108th episode I welcome Dr. Mike Grant and Dr. Mark Bicket to the show to discuss various non-opioid adjuncts such as esmolol, ketamine, dexmedetomidine, lidocaine, and magnesium, and the role they may play in multimodal anesthesia. In this episode, part 1, we discuss pre and post-op use. Intraop use will be discussed in …

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    Episode 107: Suicide in Anesthesia with Mike Fitzsimons Feb 04, 2019

    In this 107th episode I welcome Dr. Mike Fitzsimons back to the show to discuss the topic of suicide in physicians in general and in Anesthesia providers specifically. References: Bucknill JC, Duke DH. A Manual of Psychological Medicine. London, England: John Churchill;1958 Yaghmour NA, Brigham TP, Richter T, Miller RS, Philibert I, Baldwin DC, Nasca …

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    Episode 106: Hydroxyethyl Starches with Marius Fassbinder Jan 27, 2019

    In this 106th episode I welcome Dr. Marius Fassbinder to the show to discuss the use of hydroxyethyl starches. References: 1. Woodcock, T. E. & Woodcock, T. M. Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy. British Journal of Anaesthesia 108, 384–394 (2012). 2. …

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    Episode 105: Blood Management Part 1 With Drs. Frank & Cha Jan 18, 2019

    In this 105th episode, which will be the first part in a series on blood management, I turn over the mic to Dr. Stephanie Cha who interviews Dr. Steve Frank about blood management in cardiac surgery and how to do “bloodless” surgery for patients who refuse blood transfusions. References: 1. Myles PS, Smith JA, Forbes …

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    Episode 104: Sepsis with Pam Lipsett Jan 12, 2019

    In this 104th episode I welcome Dr. Pam Lipsett to the show to discuss the diagnosis and treatment of sepsis. References: Sepsis-3 guidelines from JAMA: https://jamanetwork.com/journals/jama/fullarticle/2492881 Marik Sepsis cocktail: Marik PE et al. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock. 2017: 151(6);1229–1238. ADRENAL trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1705835 APROCCHSS Trial: https://www.nejm.org/doi/10.1056/NEJMoa1705716 SEPSISPAM Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1312173
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    Episode 103: Neuromonitoring with Drs. Ritzl and Russo Jan 07, 2019

    In this 103rd episode I welcome Dr. Eva Ritzl and Dr. Alyson Russo to the show to discuss intraoperative neuromonitoring. Reference: Solt K and Froman S. Correlating the clinical actions and molecular mechanisms of general anesthetics. Curr Op in Anaes. 2007:20(4);300-306.
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    Episode 102: Life Lessons with Dan Lowenstein Dec 20, 2018

    In this 102nd episode I welcome Dr. Dan Lowenstein to the show. Dr. Lowenstein is a professor of Neurology and the Executive Vice Chancellor and Provost at University of California San Francisco (UCSF). We discuss his lessons and advice for how to be successful professionally and personally. The Three Marriages book: http://www.davidwhyte.com/the-three-marriages/
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    Episode 101: Coming off Bypass with Stephen Freiberg Dec 17, 2018

    In this 101st episode I welcome back Dr. Stephen Freiberg to the show to discuss how to successfully come off bypass when doing cardiac surgery with cardiopulmonary bypass. References: -Barash Anesthesia for Cardiac Surgery -Barry AE, Chaney MA, London MJ. Anesthetic management during cardiopulmonary bypass: a systematic review. Anesth Analg 2015; 120:749. -Denault AY, Tardif …

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    Episode 100: Response to Listener Questions Dec 11, 2018

    In this 100th episode I respond to questions, both clinical and personal, from ACCRAC listeners.
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    Episode 99: Substance Abuse in Anesthesia Providers with Mike Fitzsimons Dec 06, 2018

    In this episode, episode 99, I welcome Dr. Mike Fitzsimons from MGH to the show to talk about substance abuse in anesthesia providers and his recent article in Anesthesiology detailing their program to decrease rates of abuse. References: https://www.ncbi.nlm.nih.gov/pubmed/30020101
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    Episode 98: Update on Bicarb: BICAR-ICU Nov 14, 2018

    In this episode, episode 98, I discuss the BICAR-ICU trial and what it tells us about using sodium bicarbonate to treat metabolic acidosis. References: BICAR-ICU Trial: https://www.ncbi.nlm.nih.gov/pubmed/29910040 BICAR-ICU Editorial: https://www.ncbi.nlm.nih.gov/pubmed/29910039 Forsythe: https://www.ncbi.nlm.nih.gov/pubmed/10631227 Sabatini: https://www.ncbi.nlm.nih.gov/pubmed/18322160 Pulmcrit post: https://emcrit.org/pulmcrit/bicar-icu/
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    Episode 97: Waking up Nov 08, 2018

    In this episode, episode 97, I discuss how to optimize your wakeup at the end of an anesthetic.
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    Episode 96: Peds difficult airway with Nick Dalesio Oct 30, 2018

    In this episode, episode 96, I welcome Dr. Nick Dalesio to the show. Dr. Dalesio is the director of the pediatric difficult airway program here at Johns Hopkins. We discuss the pediatric difficult airway response team, consult service, and how to anticipate and manage difficult airways in kids, both anticipated and unanticipated. Reference: Planning Prevents …

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    Episode 95: Anesthesiology News with James Prudden Oct 19, 2018

    In this episode, episode 95, I interview James Prudden, editorial director at Anesthesiology News, on the floor of the ASA conference in San Francisco. We discuss the coverage of the field of anesthesiology, how providers can contribute, and how to get your work considered for coverage. James can be reached at Jprudden@mcmahonmed.com
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    Episode 94: Organ Donation with Clint Burns Oct 05, 2018

    In this episode, episode 94, I welcome Clint Burns to the show. Clint received a liver transplant in 1994, then went on to go to nursing school, have 4 children, be an ICU nurse, and he now runs the organ and tissue donation program here at Johns Hopkins. We discuss his story, the process of …

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    Episode 93: CABG with Tom Metkus Sep 28, 2018

    In the episode, episode 93, I welcome Dr. Tom Metkus back to the show to discuss perioperative considerations for CABG surgery. References: Syntax Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa0804626 STICH Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1100356 ROOBY Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa0902905 CORONARY Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1200388 PREVENT IV Trial: https://www.ncbi.nlm.nih.gov/pubmed/16287955 ART Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1610021
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    Episode 92: Early Mobility in the PICU with Sapna Kudchadkar Sep 21, 2018

    In this episode, episode 92, I welcome Dr. Sapna Kudchadkar to the show to discuss her PICU Up program for early mobility in the PICU. We discuss the benefits of early mobility in general and specifically with pediatric patients, how she started her program, and what has led it to be so successful. Dr. Kudchadkar …

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    Episode 91: Perioperative evaluation for non-cardiac surgery with Tom Metkus Sep 11, 2018

    In this episode, episode 91, I welcome Dr. Tom Metkus back to the show to discuss how we risk-stratify patients for non-cardiac surgery. Outline by Dr. Kimia Kashkooli References: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000104 http://www.onlinejacc.org/content/64/22/e77 https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ESC-ESA-Guidelines-on-non-cardiac-surgery-cardiovascular-assessment-and-managem http://www.onlinejacc.org/content/accj/69/14/1861.full.pdf
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    Episode 90: OSA Aug 11, 2018

    In this episode, episode 90, I discuss best practices for preoperative management of adults with Obstructive Sleep Apnea (OSA). Outline by April Liu: Episode 90 References: Gross JB et al. Practice Guidelines for the Perioperative Managementof Patients with OSA. Aneshtesiology 2014: 120(2): 1-19 Chung F, et al. STOP-Bang Questionnaire: A practical Approach to Screen for …

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    Episode 89: Veterinary Anesthesia with Bonnie Gatson Aug 07, 2018

    In this episode, episode 89, I welcome Dr. Bonnie Gatson to the show. She is a veterinary anesthesiologist and we discuss her training, the differences and similarities between human and animal anesthesia, and the benefits of working together.
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    Episode 88: ERAS for Cardiac Surgery with Mike Grant Jul 24, 2018

    In this episode, episode 88, I welcome Dr. Mike Grant to the show to discuss Enhanced Recovery After Surgery (ERAS) protocols for cardiac surgery. References: https://www.ncbi.nlm.nih.gov/pubmed/?term=Enhanced+recovery+after+surgery+pathway+for+patients+undergoing+cardiac+surgery%3A+a+randomized+clinical+trial https://www.ncbi.nlm.nih.gov/pubmed/?term=Enhanced+Recovery+for+Cardiac+Surgery+Noss https://www.ncbi.nlm.nih.gov/pubmed/27321791 https://www.ncbi.nlm.nih.gov/pubmed/?term=27832832
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    Episode 87: Aortic Dissection with Tom Metkus Jul 11, 2018

    In this episode, episode 87, I welcome Dr. Tom Metkus to the show. Dr. Metkus is a cardiologist and intensivist and we discuss the etiology, presentation, management and outcomes of acute aortic dissections. Outline by Brian Park: Aortic Dissection Outline
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    Episode 86: Thromboelastography with Bob Sikorski Jun 21, 2018

    In this episode, episode 86, I welcome Dr. Bob Sikorski back to the show to discuss thromboelastography (TEG) and thromboelastometry (ROTEM). We discuss how they work, what they tell us and how we can use them. Example TEG:
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    Episode 85: Teaching and Learning with Tina Tran Jun 14, 2018

    In this episode, episode 85, I welcome back Dr. Tina Tran and we discuss how to be successful as a medical student on an anesthesia clerkship, how to be a successful teacher if you are a resident teaching medical students, and how to create a great medical student rotation if you are a clerkship director.
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    Episode 84: Anesthesia for spine surgery with Alyson Russo Jun 13, 2018

    In this episode, episode 84, I welcome back Dr. Alyson Russo to discuss anesthesia for spine surgery.
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    Episode 83: AICDs and Pacemakers with Jared Miller May 18, 2018

    In this episode, episode 83, I welcome Dr. Jared Miller to the show. Dr. Miller is finishing his electrophysiology fellowship and we discuss the preoperative management of pacemakers and AICDs. Outline by Brian Park: AICD Outline Reference: https://www.ncbi.nlm.nih.gov/pubmed/24182719
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    Episode 82: Pediatric OSA with Deb Schwengel May 10, 2018

    In this episode, episode 82, I welcome Dr. Deb Schwengel back to the show to discuss pediatric obstructive sleep apnea (OSA). We discuss the prevalence, diagnosis and preoperative management. Outline by Brian Park: Peds OSA Outline
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    Episode 81: Anesthesia for Craniotomies with Alyson Russo May 09, 2018

    In this episode, episode 81, I welcome Dr. Alyson Russo to the show to discuss how to prepare for and conduct anesthesia for craniotomy surgery.
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    Episode 80: Lessons from the Military with Jonathan Curley May 06, 2018

    In this episode, episode 80, I welcome Dr. Jonathan Curley to the show. Jonathan is an anesthesia resident and a veteran of an elite pararescue unit in the United States Air Force. We talk about some of the lessons that Jonathan learned from his time in the military and from some of the brave soldiers …

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    Episode 79: Pediatric Cardiothoracic Anesthesia with Dheeraj Goswami Apr 23, 2018

    In this episode, episode 79, I welcome Dr. Dheeraj Goswami to the show to discuss pediatric cardiothoracic anesthesiology. We discuss the training required to do these cases, the most common cases and concerns, and how it differs from other forms of anesthesia.
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    Episode 78: The Obesity Code Book Review Apr 05, 2018

    In this episode, episode 78, I do something a little different as I review the fantastically interesting book, “The Obesity Code: Unlocking the secrets of weight loss”, by Dr. Jason Fung. Full disclosure, there’s no real relationship to anesthesia and critical care, just some really interesting insights into the obesity epidemic and what can be …

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    Episode 77: Reversal of Neuromuscular Blockade Mar 28, 2018

    In this episode, episode 77, I discuss reversal of neuromuscular blockade. This is a follow up to episode 66 in which I covered neuromuscular blockade. Outline by Brian Park: NMB Reversal Outline References: Miller’s Anesthesia 8th Edition. Reversal (Antagonism) of Neuromuscular Blockade. Murphy GS, de Boer HD, Eriksson LI and Miller RD. Chapter 35, 995-1027.e5. Appiah-Ankam …

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    Episode 76: Pain Pathways with Mark Bicket Mar 14, 2018

    In this episode, episode 76, I welcome Dr. Mark Bicket to the show to discuss pain pathways. We shape this one around some great board style questions that Mark put together. Episode outline by Brian Park: Pain Pathways Outline
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    Episode 75: OB Oral Board Stem with Drs. Galvan and Hofkamp Mar 01, 2018

    In this episode, episode 75, I welcome back Drs. Galvan and Hofkamp to do an OB oral board stem. We juxtapose examples of “right” and “wrong” answers to highlight important approaches to the exam. The stem is here: Stem
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    Episode 74: Opioid Crisis Engagement with Chad Brummett Feb 23, 2018

    In this episode, episode 74, I welcome Dr. Chad Brummett to the show. Chad is the co-director of the Opioid Prescribing Engagement Network (OPEN) in Michigan and leads some fantastic and extremely effective initiatives to combat the opioid crisis. His website has more details and materials for anyone interested in starting similar initiatives elsewhere. Check …

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    Episode 73: Medical Liability with Darrell Ranum Feb 22, 2018

    In this episode, episode 73, I welcome Darrell Ranum, an attorney and malpractice insurance executive, to the show to discuss his article on Anesthesia related liability claims. We discuss why people sue anesthesia providers and how to reduce the risk of being sued. The article is: Ranum D, Beverly A, Shapiro FE and Urman RD. …

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    Episode 72: Oral board prep 2: part 2 Feb 15, 2018

    In this episode, episode 72, I finish the oral board prep episode that was started in episode 71 with Drs. Tran and Beaudry. In a twist, they flip the tables on me and make me be the examinee. The stem and questions are here: Oral board stem
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    Episode 71: Oral Board Prep 2: part 1 Feb 15, 2018

    In this episode, episode 71, combined with the next episode, episode 72, I welcome back Drs. Tran and Beaudry to do an oral board prep example. We got through how not to do it and then how to do it well. This is part 1, episode 72 will be part 2. The stem and questions …

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    Episode 70: Anesthesia Assistants Feb 06, 2018

    In this mini episode I thank Shirley Li, an Anesthesia Assistant student in Texas, for teaching me a bit about the career path of an Anesthesia Assistant and I share some of what she shared with me for any who are interested.
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    Episode 69: Intro to Trauma with Bob Sikorski Feb 02, 2018

    In this episode, Episode 69, I welcome Dr. Bob Sikorski, director of trauma anesthesiology at Johns Hopkins, to the show to discuss a general overview of trauma anesthesia. We discuss prehospital, ER and OR management and key things to keep in mind when caring for trauma patients. References: Trauma references list TEG diagram:
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    Episode 68: CRNAs with Andy Benson Jan 30, 2018

    In this episode, episode 68, I welcome our chief CRNA, Andy Benson, to the show to discuss his career path and how we can all work together to provide the best patient care possible.
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    Episode 67: High Value Care with Pam Johnson Jan 26, 2018

    In this episode, episode 67, I welcome Dr. Pam Johnson to the show. Dr. Johnson is a radiologist here at Hopkins who has taken an interest in high value care initiatives. She and I discuss what this means and how people can get involved in reducing unnecessary testing and improving the quality of the care …

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    Episode 66: Neuromuscular Blockers Jan 05, 2018

    In this episode, episode 66, I go through an overview of neuromuscular blockers including how they work, how to use them, and what their adverse effects are. Happy New Year! The dose of glycopyrrolate should be 0.01 to 0.015mg/kg, not 0.1 to 0.15. Outline by Brian Park: Outline References: Miller’s Anesthesia 7th edition: Chapter 29: …

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    Episode 65: Time Management Dec 20, 2017

    In this episode, episode 65 and the last of 2017, I give my tips and tricks for being as efficient as possible with your time management so that you can maximize your success with your work and your life in general. Have a wonderful holiday and start to the new year! Outline by Brian Park: Outline
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    Episode 64: Problems during pregnancy with Jacqueline Galvan part 2 Dec 08, 2017

    In this episode, episode 64, I welcome back Dr. Jacqueline Galvan to finish our discussion of programs during pregnancy and delivery. We discuss hematologic, neurologic, respiratory, renal and infectious disease issues and how they affect pregnancy, delivery, and anesthetic management. Slides with references and notes: Problems during pregnancy part 2
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    Episode 63: Chemo Prophylaxis with Andrew Jarrell Dec 01, 2017

    In this episode, episode 63, I welcome back Andrew Jarrell to learn to pronounce his name properly, and to discuss VTE and stress ulcer prophylaxis. References are here: References
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    Episode 62: Problems during pregnancy with Jacqueline Galvan part 1 Nov 17, 2017

    In this episode, episode 62, I discuss problems that can occur during pregnancy with Dr. Jacqueline Galvan. We discuss a wide range of high yield topics from gestational diabetes to molar pregnancies to maternal heart disease. References are here: References Outline by April Liu
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    Episode 61: The Opioid Crisis with Shravani Durbhakula Nov 08, 2017

    In this episode, episode 61, I welcome Dr. Shravani Durbhakula, one of our chronic pain doctors, to the show. We discuss the opioid crisis in American from the perspective of a chronic pain physician including what it is, how it came about, how it impacts our patients, and what we can do about it. References …

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    Episode 60: Surgical Antibiotic Prophylaxis with Andrew Jarrell Oct 27, 2017

    In this episode, episode 60, I welcome Andrew Jarrell, one of our amazing surgical ICU pharmacists to the show. We discuss antibiotic prophylaxis for surgery including what to use, how to time it, how long to continue it, and what the evidence says about things like indwelling drains. A fantastically helpful outline of the episode …

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    Episode 59: Pulmonary HTN with Jochen Steppan Oct 17, 2017

    In this episode, episode 59, I welcome international pulmonary hypertension expert Dr. Jochen Steppan to the show to discuss pulmonary hypertension and how to manage the preoperative care of patients with this disease. Outline by Brian Park: Outline
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    Episode 58: Medications For Neuraxial Anesthesia with Dave Berman and Anh Nguyen Oct 11, 2017

    In this episode, episode 58, I welcome our two OB Anesthesia fellows to the show, Dr. Dave Berman and Dr. Anh Nguyen. We discuss the medications used for neuraxial anesthesia including local anesthetics, opioids, and adjuncts such as epinephrine, clonidine and more. Outline by Brian Park: Outline Dave’s email is dberma20@jhmi.edu and Anh’s is tnguy193@jhmi.edu. References …

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    Episode 57: Bugs and Drugs Part 2 With Rachel Kruer Oct 05, 2017

    In this episode, episode 57, I welcome back Rachel Kruer, our amazing SICU pharmacist and we complete our two part series on bugs and drugs in the ICU. We discuss different infections that are commonly seen in ICUs and how to treat them. Outline by April LiuSee other interactive posts
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    Episode 56: Bugs and Drugs Part 1 with Rachel Kruer Sep 28, 2017

    In this episode, episode 56, I welcome Rachel Kruer to the show. Rachel is one of our amazing ICU pharmacists and we discuss common bacteria and the drugs we use to treat them. This is part 1 of a 2 part series that I’ll be doing with Rachel on this topic. Skip to specific topics: …

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    Episode 55: Term Pregnancy Part 2 with Mike Hofkamp Sep 20, 2017

    In this episode, episode 55, I welcome back frequent guest of the show Dr. Mike Hofkamp to pick up where I left off last time with Dr. Jacqueline Galvan as we discuss problems that can occur with pregnancy at term (part 2) including complications of labor and delivery. Outline by Brian Park: Outline
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    Episode 54: Term Pregnancy Part 1 with Jacqueline Galvan Aug 30, 2017

    In this episode, episode 54, I welcome back Dr. Jacqueline Galvan and we discuss complications and physiology of term pregnancy. This is part 1 of a 2 part series. Outline by Brian Park: Outline
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    Episode 53: Analgesia for C-section with Mike Hofkamp Aug 11, 2017

    In this episode, episode 53, I welcome back Dr. Mike Hofkamp to discuss analgesia for cesarean delivery. We discuss indications for C-section, urgent and emergent sections, anesthetic techniques and associated complications, how to approach the difficult airway in a pregnant patient, and aspiration prophylaxis. Additional information: Outline by Brian Park Discussion references Urgent cesarean section …

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    Episode 52: Diastolic Heart Failure with Todd Dorman Aug 07, 2017

    In this episode, episode 52, I welcome Dr. Todd Dorman to the show. Dr. Dorman is a professor of anesthesiology here at Johns Hopkins, is the Vice Chair for Critical Care, and is the immediate past president of the Society of Critical Care Medicine (SCCM). Dr. Dorman and I discuss diastolic heart failure or heart …

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    Episode 51: Labor Analgesia with Jacqueline Galvan Jul 24, 2017

    In this episode, episode 51, I welcome back Dr. Jacqueline Galvan to discuss labor analgesia. We cover opioids including remifentanil, nitrous oxide, neuraxial anesthesia and other nerve blocks. References: Hess PE, et al. An association between severe labor pain and cesarean delivery. Anesth Analg. 2000 Apr;90(4):881-6 Van den Bussche E. Why women prefer epidural analgesia …

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    Episode 50: CSE vs Epidural Debate with Mike Hofkamp and Jacqueline Galvan Jul 13, 2017

    In this episode, episode 50, I welcome back Dr. Mike Hofkamp, and, for the first time, I welcome Dr. Jacqueline Galvan to the show. Drs. Hofkamp and Galvan go head to head in a debate over which is a better, more evidence-based technique, the traditional epidural or the CSE (combined spinal epidural). All of the …

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    Episode 49: High Reliability with Peter Pronovost Jun 30, 2017

    In this episode, episode 49, I welcome Dr. Peter Pronovost to the show to discuss the high reliability movement and how it relates to healthcare. Dr. Pronovost is one of the world’s foremost experts on patient safety and we discuss how a hospital can be as reliably safe as an aircraft carrier and how best …

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    Episode 48: TAVRs with Clint Tippett Jun 28, 2017

    In this episode, episode 48, I welcome Dr. Clint Tippett to the show. Dr. Tippett is a cardiac anesthesiologist with an interest in anesthesia for Transcutaneous Aortic Valve Replacement (TAVR) and we discuss the approach to anesthesia for these cases including preoperative planning, intraoperative management, and post-operative concerns. Regarding stroke risk here is an editorial …

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    Episode 47: Arterial Lines with Stephen Freiberg Jun 13, 2017

    In this episode, episode 47, I welcome back Dr. Stephen Freiberg, one of our chief residents, to discuss all you ever wanted to know about arterial lines. We discuss the indications, contraindications, complications, placement technique, and how to interpret the waveform. Slides with figures mentioned in the podcast can be found here: Arterial Line Podcast Images …

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    Episode 46: Obstetric Pharmacology and Fetal Assessment with Mike Hofkamp Jun 08, 2017

    In this episode, episode 46, I welcome back Dr. Mike Hofkamp to discuss obstetric pharmacology and fetal assessment. Outline by Brian Park: Outline
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    Episode 45: Postop Delirium with Charlie Brown May 24, 2017

    In this episode, episode 45, I welcome Dr. Charlie Brown to the show. Dr. Brown is one of our cardiac anesthesiologists with a research interest in postop delirium. We discuss risk factors, consequences, prevention and treatment of postop delirium.
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    Episode 44: Intro to cardiac anesthesia with Megan Kostibas May 23, 2017

    In this episode, episode 44, I welcome Dr. Megan Kostibas to the show. Dr. Kostibas is trained in cardiac anesthesia and critical care medicine and is an assistant professor here at Hopkins. She is also the associate program director for the cardiac anesthesia fellowship. We discuss the basics of how to prepare, induce and manage …

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    Episode 43: Maternal Physiology with Mike Hofkamp May 23, 2017

    In this episode, episode 43, I welcome Dr. Mike Hofkamp to the show. Dr. Hofkamp is Director of OB Anesthesia at Baylor Scott & White Memorial Hospital and Clinical Associate Professor of Anesthesiology at Texas A&M Health Science Center College of Medicine. We discuss the changes to women’s physiology when they become pregnant and the …

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    Episode 42: Post-op Nausea and Vomiting (PONV) May 02, 2017

    In this episode, episode 42, I discuss Post-op Nausea and Vomiting (PONV). I discuss risk factors, complications, treatment and prevention and side effects. Outline by April Liu: Outline UPDATE April, 2018: In this episode I mention that the evidence is not good for Midazolam in preventing PONV. However, a good friend and colleague, Dr. Michael …

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    Episode 41: Local Anesthetics Apr 21, 2017

    In this episode, episode 41, I review local anesthetics including the mechanism of action, commonly used agents, pharmacodynamics and kinetics, toxicity and treatment, and common blocks. Outline by April Liu: Outline
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    Episode 40: OR Vent modes Apr 07, 2017

    In this episode, episode 40, I go over the basics of Vent modes and settings in the operating room and how they differ from the ICU. I also discuss a few common special cases and how to adjust the vent to deal with them. Outline by April Liu: Episode 40
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    Episode 39: Liver Transplant with Dr. Steve Frank Mar 27, 2017

    In this episode, episode 39, I interview Dr. Steve Frank, Professor of Anesthesia and Critical Care Medicine at Johns Hopkins, Medical Director of Blood Management for Johns Hopkins Health System and Chief of Adult Anesthesiology about anesthesia for liver transplants.
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    Episode 37: OR Crises Mar 13, 2017

    In this episode, episode 37, I go over crises that can happen in the OR, when to suspect them, and what to do about them. I draw from two excellent sets of OR crisis checklists that are available for free. The Stanford Anesthesia Cognitive Aid Group’s lists and the Ariadne Labs/Brigham/Harvard School of Public Health …

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    Episode 36: Pediatric respiratory anatomy and physiology with Dr. Schwengel Feb 28, 2017

    In this episode, episode 36, I welcome Dr. Deb Schwengel, one of our pediatric anesthesiologists and our residency program director, to the show to discuss the differences in anatomy and physiology in pediatric versus adult patients. Outline by April Liu: Outline
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    Episode 35: Pleural effusions with Dr. David Feller-Kopman Feb 17, 2017

    In this episode, number 35, I welcome Dr. David Feller-Kopman to the show. Dr. Feller-Kopman is an associate professor of medicine and Otolaryngology and the director of Bronchoscopy and Interventional Pulmonology here at Johns Hopkins. I interview him about pleural effusions including what they are, where they come from, how to categorize them, how to …

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    Episode 34: Oral Board Prep with Drs. Tran and Beaudry Feb 16, 2017

    In this episode, episode 34, I welcome Dr. Tina Tran and Dr. Steve Beaudry to the show to give you two run throughs of an oral board stem. First Dr. Tran demonstrates some common errors and then Dr. Beaudry demonstrates an example of the “right way” to do it. We then mention some learning points …

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    Episode 33: ECMO with Dr. Rosanne Sheinberg Feb 06, 2017

    In this episode, episode 33, I welcome cardiac anesthesiologist Dr. Rosanne (Rosie) Sheinberg to the show to discuss ECMO. We go through a comprehensive overview of what ECMO is, how it is used, how it is managed, the complications that can be seen and how to manage them and how to wean it off.
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    Episode 31: Massive Transfusion with Dr. Stephen Freiberg Feb 02, 2017

    In this episode, episode 31, I welcome one of our amazing chief residents to the show, Dr. Stephen Freiberg. Stephen has taken an interest in massive transfusion and he goes over the highlights of when to do it, how to do it, what complications you see from it and how to manage those complications.
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    Episode 30: Management of anticoagulation for non-valvular a-fib Jan 17, 2017

    In this episode, episode 30, I discuss the new American College of Cardiology Guidelines for the periprocedural management of anticoagulation for patients with non-valvular atrial fibrillation. This includes whether to stop, when to stop, whether to bridge, how to bridge, and how and when to restart. Outline by Brian Park: AC for Afib Outline
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    Episode 29: PA catheters with Dr. Glenn Whitman Jan 09, 2017

    In this episode, episode 29, I welcome to the show Dr. Glenn Whitman. Dr. Whitman is a cardiac surgeon and intensivist and runs the cardiac surgical ICU here at Johns Hopkins. I interview Dr. Whitman about PA catheters. We discuss when to place them, when not to place them, how to use them and when …

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    Episode 28: Airway topicalization with Dr. Laeben Lester Jan 05, 2017

    In this episode I welcome Dr. Laeben Lester to the show. Dr. Lester is trained in Emergency Medicine and Anesthesiology and has completed fellowship training in Cardiac Anesthesiology. He shares with us his “Nearly Needleless 5-Step Approach” to airway topicalization for awake intubation.
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    Episode 27: Airway Management Dec 30, 2016

    In this episode I review the ABA topic of airway management. This is obviously a huge topic but in this episode I highlight key points about the components of airway management recommended by the ABA including identification of a difficult airway, management of a difficult airway, the difficult airway algorithm, different tools and adjuncts, and …

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    Episode 26: Sugammadex with Dr. Amit Prabhakar Dec 21, 2016

    In this episode I welcome Dr. Amit Prabhakar, one of our critical care fellows, to the show to discuss Sugammadex, a relatively recently approved (in the USA) reversal agent for Rocuronium and Vecuronium. Outline by Brian Park: Sugammadex outline
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    Episode 25: Advanced Ventilator Modes With Dr. Scott Stephens Dec 19, 2016

    In this episode I am joined once again by Dr. Scott Stephens as we review advanced ventilator modes, prone positioning, and ventilation of patients on VV ECMO. Outline by April Liu: Outline The fantastic review article I mentioned is: Mireles-Cabodevila E. Et al. Alternative Modes of mechanical ventilation: A review for the hospitalist. Cleveland Clinic …

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    Episode 24: The Evils of Sodium Bicarbonate Dec 11, 2016

    In this episode I first suggest you take a look at the recently published (ahead of print) VANCS study on the use of vasopressin as a sole agent in the treatment of vasoplegic shock. Then I review the reasons never to use sodium bicarbonate in lactic acidosis. The Vancs study: https://www.ncbi.nlm.nih.gov/pubmed/27841822 The two articles I recommend …

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    Episode 23: Basic Ventilator Review with Dr. Scott Stephens Dec 05, 2016

    In this episode I welcome Dr. Scott Stephens, Pulmonary Critical Care Physician at Johns Hopkins to the show. Dr. Stephens and I discuss basic ventilator settings, how to appropriately ventilate patients with hypoxemic vs. hypercarbic respiratory failure and how to think about weaning patients off of the ventilator. Outline by Brian Park: Outline
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    Episode 22: Postop Visual Loss with Dr. Joe Hughes Dec 01, 2016

    In this episode I interview Dr. Joseph Hughes, one of our neuro anesthesiologists, about the history, etiology, pathophysiology and prevention of postoperative visual loss. We refer to a thromboelastogram which looks like this. It is the fibrinolysis portion that can be prevented with tranexamic acid (TXA): High Yield Outline by Brian Park can be found …

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    Episode 21: ERAS with Dr. Chris Wu Nov 23, 2016

    In this episode I interview Dr. Chris Wu, professor of anesthesiology and pain medicine and internationally renowned expert in Enhanced Recovery After Surgery (ERAS) pathways. We discuss the different aspects of ERAS pathways and the evidence for improved outcomes. The ERAS society website can be found here: http://erassociety.org Check out this fantastic outline of the episode …

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    Episode 20: pH Stat and Alpha Stat Nov 20, 2016

    In this episode I review two methods for managing arterial blood gasses in hypothermic patients, usually during cardiac surgery–pH Stat and Alpha Stat. Check out this fantastic episode recap put together by Brian Park from Drexel Medical School: Show recap
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    Episode 19: Vasoactive medications Nov 11, 2016

    In this episode I review the receptors that vasoactive drugs act on. I then review the main vasoactive medications used in the OR and the ICU to treat acute hypotension and the ones used to treat acute hypertension. Outline by April Liu: Outline
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    Episode 18: Tips and Tricks for Line Placement Oct 18, 2016

    In this episode I go over some tips and tricks for maximizing your success with peripheral IVs, arterial lines, central venous catheters and pulmonary artery catheters (Swan Ganz catheters). The New England Journal videos that I recommend you take a look at for detailed reviews of each of these are here: Peripheral IV: http://www.nejm.org/doi/full/10.1056/NEJMvcm0706789 Arterial: …

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    Episode 17: Awake intubation Oct 09, 2016

    In this episode I discuss awake intubation. I discuss the indications, techniques, nerve blocks, sedation and different methods of performing awake intubation. Slides to go along with the podcast are here: awake intubation slides The youtube video of the MGH anesthesiologist intubating himself is here: self-intubation
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    Episode 16: Increased ICP Therapy with Dave Mintz Sep 21, 2016

    In this episode I welcome back Dr. David Mintz, neuroanesthesiologist, to discuss the treatment of increased intracranial pressure in the perioperative period and brain relaxation during neurosurgery. Dr. Mintz will be back in the future to talk about the physiology of increased ICP.
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    Episode 15: IV Fluids Sep 05, 2016

    In this episode I discuss the use of IV fluids for perioperative use including how to decide when to give fluid, the downsides of over resuscitation, whether to use crystalloid or colloid, and whether to use saline or a balanced salt solution such as LR. Slides to go along with this episode are here: IV …

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    Episode 14: Opioids part 2 Aug 17, 2016

    This is the second of two episodes about opioid medications. In this episode I cover the pharmacokinetics and pharmacodynamics of opioids, some of the common uses for these medications, mixed agonist-antagonist compounds, opioid antagonists, and opioid interaction with other medications. Slides to go along with this episode are here: Opioids part 2
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    Episode 13: Opioids part 1 Aug 13, 2016

    This is the first of a 2 part series on opioid medications. In this first episode I will talk about how opioids are categorized and their effects on the different body systems. In the next episode I will discuss their pharmacokinetics and pharmacodynamics as well as their various uses and some details on mixed agonist/antagonists. …

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    Episode 12: Air Embolism with Dr. David Mintz Aug 05, 2016

    In this episode I welcome Dr. David Mintz, one of our neuroanesthesiologists here at Johns Hopkins, fellow Brown University Alum, and generally all around great guy, to the show to talk about air embolism, what it is, how it happens and how to manage it. A big thanks to Dave for taking the time to …

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    Episode 11: Hyperoxia Jul 27, 2016

    In this episode I discuss hyperoxia and review the evidence in regards to the damage it can cause in patients with a wide variety of illnesses. Slides to accompany the episode can be found here: hyperoxia slides
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    Episode 10: IV Induction Agents Jul 19, 2016

    In this episode I review the common IV agents used in anesthesia excluding opioids. I cover Propofol, Barbiturates, Benzodiazepines, Ketamine, Etomidate and Dexmedetomidine. NOTE: There is an error in the audio recording regarding the dosing units for dexmedetomidine. I say on the podcast that the dosing units are mcg/kg/min which is INCORRECT. The correct dosing …

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    Episode 9: Basic Med Setup Jul 10, 2016

    In this episode I review the basic medication setup for the operating room including premedication, induction, neuromuscular blockade, antibiotics, reversal and antiemetics. I discuss weight based dosing and comment on a few alternatives to consider once you have the basic setup down. This episode should be useful for new CA-1s getting started in the OR …

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    Episode 8: Management of Respiratory Diseases Part 2 Jun 30, 2016

    This is the second and final episode dealing with the management of respiratory diseases. In the first episode I covered the initial evaluation and preop preparation. In this episode I cover intraoperative management, post-operative management, special issues related to one lung ventilation and special issues related to total pneumonectomy. Slides to go along with the …

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    Episode 7: Management of the patient with respiratory disease part 1 Jun 24, 2016

    This is the first of a two part series of episodes on the management of patients with respiratory disease. In this, part 1, I cover the preoperative evaluation, history and physical exam, and the preoperative planning and optimization of the patient. This includes the key board topics of smoking cessation and cardiac risk assessment. Here …

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    Episode 6: The Paraglossal Approach to Intubation Jun 22, 2016

    In this episode I first announce the new ACCRAC website here at ACCRAC.com. Big thanks to Bryan Mariscalchi for his help setting it up. I also mention the problem the last two episodes had with only playing out of one ear on earphones. I hope I’ve cleared that problem up. I mention a fantastic book …

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    Episode 5: Restrictive Lung Disease Jun 15, 2016

    In this episode I review restrictive lung disease. This is meant to be a companion episode to Episode 4 which covered obstructive lung disease. I cover the following topics: -Definition and diagnosis of restrictive lung disease -Spirometry -Extra-pulmonary causes (neurologic, musculoskeletal, pleural/mediastinal) -Parenchymal causes -Infant RDS -ARDS -Pulmonary Fibrosis The accompanying slides can be downloaded …

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    Episode 4: Obstructive Lung Disease Jun 15, 2016

    In this episode I mention the new ACCRAC mailing list which you can sign up for with the link right below the show description on the website accrac.libsyn.com. You can also post comments on the website and email questions to accrac@accrac.com or accracpodcast@gmail.com. I also highlight Rob MacSweeney’s fantastic critical care site called criticalcarereviews.com and his newsletter which …

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    Episode 3: Announcements and FIO2 in one lung ventilation Jun 15, 2016

    There are a few announcements I wanted to make including: Check out pedsanesthesia.net. Dr. Robert Greenberg, a pediatric anesthesiologist here at Johns Hopkins runs it and it has lots of great information and topics in pediatric anesthesiology. If you have suggestions for a better website than this one please let me know! If you know …

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    Episode 2: Temperature Regulation Jun 15, 2016

    In this episode I review the topics of intraoperative hypothermia and temperature regulation. Lots of good board review topics and some sample board review questions. The slides are available here: Temperature Regulation Slides You can leave comments here or email accracpodcast@gmail.com. Topics covered: Hypothermia: Etiology, Prevention, Treatment, Complications Effect of Drugs/Anesthesia on Temperature regulation Heat Loss …

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    Episode 1: Properties and laws of volatile anesthetics Jun 15, 2016

    This is a very high yield episode to help you review for the anesthesia board exam. I cover the board key word section entitled gas laws which includes a focus on volatile anesthetics, their properties, and how they act on, and in, the human body. Topics covered will include: Full post for episode links Vapor …

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