Rapid Response RN

Latest Episodes:

79: Heart Failure 101 with Guest Christian Guzman APRN Nov 17, 2023

Show notes

During a normal day gardening, an active woman in her 60s was suddenly struck with chest tightness. Thinking it was just an asthma attack, she tried to let the pain pass. What she didn’t realize was that she was having a full blown myocardial infarction, and this was only the beginning of her journey.

In this episode, host Sarah Lorenzini is joined by her friend, Christian Guzman APRN, to discuss this patient story and the pathophysiology of heart failure. As they go through this case study, Christian provides a comprehensive breakdown of the types of heart failure, the classifications of heart failure, and how chronic heart failure can lead into cardiogenic shock.

Most importantly, you’ll learn the signs and symptoms of heart failure, including the subtle ones that are key for early detection, and find out what’s important to look at on an echocardiogram.

This is just the first installment of a three-part series on heart failure, so be sure to not miss this opening episode. Tune in now!

Topics discussed in this episode:

Pathophysiology of heart failure
Case study of Christian’s heart failure patient
Myocardial infarction symptoms in women
Types of heart failure
Symptoms of right vs left heart failure
The difference between systolic vs diastolic heart failure
How chronic heart failure develops into cardiogenic shock
Early signs of heart failure
SCAI classifications of cardiogenic shock

Connect with Christian Guzman APRN on Instagram:

https://www.instagram.com/thenerdynursepractitioner/

Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videos

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

78: Healthy vs Hostile: Recognizing the Nursing Red Flags and Green Flags of a Work Environment Nov 10, 2023

Show notes

Have you ever started a new and promising job, only to discover that it wasn’t the nurturing and supportive space you thought it was? In this episode, host Sarah Lorenzini, armed with nearly two decades of nursing experience in various departments and leadership roles, provides a guideline to spotting the red and green flags that can signal a healthy or hostile workplace.

Sarah explores what makes a healthy work environment, beyond reputation and first impressions, as she does a deep dive into the American Association of Critical Care Nurses' (AACN) six pillars of a healthy work environment. From communication to authentic leadership, she equips both new and seasoned nurses with strategies to assess key characteristics of prospective employers and identify signs of a healthy culture.

For those dedicated to their current organization but seeking a better work culture that allows them to grow in their role, Sarah also reveals how nurses can promote positive change in their current work environment.

Tune in to hear the essential interview questions you should be asking to evaluate potential work environments and make an informed career decision!

Topics discussed in this episode:

The AACN's standards for a healthy work environment
Examples of an unhealthy work environment
How leaders affect work culture
Identifying red flags in potential work environments
Ideas to improve your current work environment

Check out the AACN’s Healthy Work Environments website: https://www.aacn.org/nursing-excellence/healthy-work-environments

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

77: THE TRAUMA DIAMOND OF DEATH: 4 Treatment Priorities in Trauma Care With Guest Sarah Vance Nov 03, 2023

Show notes

You may already be familiar with the trauma triad… but in this episode, host Sarah Lorenzini is once again joined by her friend and critical care nurse and educator, Sarah Vance to break down a 4th component to trauma resuscitation. Last week, they discussed the treatment of a trauma patient with neuro and respiratory injuries, but today they’re getting into the “blood and guts” of trauma cases as Sarah Vance RN walks us through a multiple gunshot wound case study. Similar to last week’s patient, this case study highlights how the body’s systems all work together, and sometimes against each other, in trauma cases.

Sarah’s GSW patient’s injuries resulted in massive blood loss, leading to rounds of MTP (massive transfusion protocol), but treating blood loss is more complex than just replacing blood so we’re diving into the pathophysiology of hypothermia, coagulopathy, hypocalcemia, and acidosis — all components of the trauma diamond of death.

As a nursing educator, Sarah Vance RN is the best person to break down these challenging concepts and make them easy to understand. You’ll learn why they happen in trauma cases, how they impact each other, and what you can do to fix these issues and prevent death.

By the end of this episode, you’ll have the knowledge you need to manage the treatment of a trauma patient with major blood loss. Tune in now!

Topics discussed in this episode:

Components of the trauma diamond of death
Sarah’s trauma patient and his treatment
MTP, or Massive Transfusion Protocol
What causes hypothermia in trauma patients
How to support coagulopathy and why it’s important
Hypocalcemia and the role of calcium in the body
Managing calcium levels in trauma cases
Acidosis and its place in the diamond of death
Key lessons from this patient’s case

Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videos

Connect with Sarah Vance!

Instagram: https://www.instagram.com/iseeu_nurse/

TikTok: https://www.tiktok.com/@iseeu_nurse

Website: https://iseeunurse.com/

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

76: Trauma Breakdown: Beyond the Blood and Guts... A Complicated Case Study with Guest Sarah Vance RN Oct 27, 2023

Show notes

If you hear “trauma” and immediately think of blood and guts, this episode with host Sarah Lorenzini’s friend, critical care nurse and educator Sarah Vance, will show you that there’s so much more to trauma cases. Because even localized injuries can affect the whole body, and issues can pile up and require conflicting treatments. That’s why trauma cases require an advanced level of assessment and critical thinking skills.

During this episode, Sarah Vance RN tells the story of a patient who was admitted with a brain bleed, orthopedic, and cervical injuries after a motorcycle accident. Like many trauma cases, the patient’s condition got a lot more complicated as his injuries progressed and he sustained secondary injuries within the respiratory system. The patient had a long list of issues, including traumatic head injury, ARDS, fistulas, necrotizing pneumonia, and MORE.

Sarah Vance also goes into more detail on his pathophysiological injuries, as well as how the ICU team assessed and treated his competing issues to lead the patient to a miracle recovery.

Tune in to learn about the management of complex multisystem trauma cases!

Topics discussed in this episode:

Sarah’s career journey and why she took a break from nursing
The trauma patient’s injuries and the initial interventions
The ICU team’s concerns and how his care evolved as more damage set in
What prompted them to place an external ventricular drain
How the patient developed ARDS
How the ICU team treated the patient’s opposing issues
The patient’s long journey to recovery

Connect with Sarah Vance!

Instagram: https://www.instagram.com/iseeu_nurse/

TikTok: https://www.tiktok.com/@iseeu_nurse

Website: https://iseeunurse.com/

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

75: Rigors and Other Super Scary Chemotherapy Reactions With Guest Montana, Rapid Response RN Oct 20, 2023

Show notes

Every nurse knows the havoc chemotherapy wreaks on the body, but most nurses aren’t as knowledgeable on how to treat chemo reactions as, say, chemo or oncology nurses. Even host Sarah Lorenzini is slightly intimidated by unpredictable reactions from chemotherapy! That’s why this episode is centered around those super scary chemotherapy reactions and how to treat them.

To help us dive further into this topic, Sarah is speaking with another rapid response nurse, Montana RN. He has a dramatic patient story to share about rigors, a chemotherapy reaction that occurs as the body is trying to mount a febrile response to the medication. Not only was his patient visibly struggling, but he was hypoxic and there was no doctor available to prescribe medication to treat the reaction.

As Montana and Sarah study this patient’s case, you’ll find out what type of reaction the patient was having and walk away with the knowledge of how to treat chemotherapy reactions and their symptoms, the use of desensitization procedures for reactions to chemo agents, and why it’s important to know your hospital’s chemo reaction protocol.

There’s so much to learn about chemotherapy reactions and the nurse’s role in caring for this patient population during a really scary experience.

Topics discussed in this episode:

What led Montana to become a rapid response nurse
How the patient presented and his initial assessment
What rigors looks like and the pathophysiology behind this scary looking symptom
Treatment options for rigors
Why Montana had to bring the patient to the ER
How to treat a reaction and its symptoms
The patient’s treatment and outcome
Montana’s takeaways from this experience

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

74: Pediatric Basilar Skull Fracture With Guest Casey BSN, RN, CCRN-CMC, CFRN, CTRN, CEN, TCRN, CPEN, CNRN, NRP Oct 13, 2023

Show notes

In this episode of Rapid Response RN, host Sarah Lorenzini is joined by Casey BSN, RN, CCRN-CMC, CFRN, CTRN, CEN, TCRN, CPEN, CNRN, NRP. And yes, you read her title right — Casey has a whopping eight certifications and is one of the few nurses with ALL five BCEN certifications. And she’s using her knowledge and skills to advocate for her patients and teach others.

Today, Casey tells the story of a patient who came into the ER after a fall and was later diagnosed with a basilar skull fracture. Complicating the case even more is that the patient was a child under the age of 2, so it was more difficult to assess the signs of his injury. Casey’s hospital provider dismissed the fall as normal childhood injury, but she did what any good nurse would do and followed her hunch that something more was going on.

Casey shares how the patient presented, how they arrived at the diagnosis and treated him. You’ll also learn the telltale signs and symptoms of basilar skull fracture, and how to check for signs of abuse if you see a pediatric head injury.

Tune in for a lesson in pediatric basilar skull fractures, and advocating for your intuition as a new nurse!

Topics discussed in this episode:

Casey’s nursing journey to earn so many certifications
Why Casey’s patient came into the ER and how he presented
What made her think something more was going on
Results of the patient’s CT and their diagnosis
Classic signs and symptoms of basilar skull fractures
How to assess mental status in children
Determining if injury is a sign of child abuse
How they treated the patient for a basilar skull fracture
What nurses need to prioritize when treating a basilar skull fracture

Connect with Casey:

https://www.instagram.com/criticalcarecasey/

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

73: Resuscitate Before You Intubate: How to NOT KILL YOUR PATIENT When You Intubate Oct 06, 2023

Show notes

Intubation is a life-saving intervention, but it can also kill your patient! That’s why this follow-up episode to last week’s patient story is covering the process of intubation, what can go wrong and how nurses can mitigate risk factors to avoid bad outcomes like cardiac arrest.

In part two of this intubation series, host Sarah Lorenzini details proper intubation preparation and the role of nurses during intubation. She walks through the entire process from assembling a team to what supplies and medications you need, and how to use them so that you reduce harm to the patient. You’ll hear about key factors to consider when giving patients sedative or paralytic agents, as well as how to prepare for a blood pressure drop after intubation.

This episode is full of useful information that will help you during your next intubation, such as pre-oxygenation strategies, RSI (rapid sequence intubation) vs when to opt for DSI (delayed sequence intubation), and how to mitigate some of the negative side effects that go along with these drugs.

Plus, find out how Sarah’s patient story from last week’s episode ends. Tune in for all this and more!

Topics discussed in this episode:

The dangers of intubation, such as peri-intubation cardiac arrest
What it means to intubate and how to prepare for intubation
Why and how to preoxygenate your patient
Supplies and equipment needed for intubation
The medications we use for intubation and what to expect once you push them
The pathophysiology of why BP drops after intubation
How to prepare for a drop in blood pressure post-intubation
When to opt for delayed sequence intubation
The intubation story of last week’s patient

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

72: How Do You Know When it's Time to Intubate? Sep 29, 2023

Show notes

Patients get intubated in every department of the hospital… not just the ICU. So it’s important that every nurse know the signs and symptoms of when it’s time to intubate.

Our host Sarah Lorenzini, has been asked the same type of questions about intubation multiple times this week, so we felt it was necessary to address them. Sarah’s extensive knowledge and experience in critical care and rapid response situations has prepared her to be able to provide expertise and insights on this topic, which she wants to share with all of you today!

In this episode, Sarah addresses some common questions related to intubation: how to know when it's time to intubate a patient and what it means when a patient is not protecting their airway.

She shares a story from her own experience to illustrate the importance of recognizing the signs that indicate the need for intubation and walks through some of the obvious, and not so obvious signs that it’s time to intubate.

This episode is packed with experiential knowledge that you don’t want to miss. So tune in for this and more!

Topics discussed in this episode:

Signs to look for to determine when to intubate
How to recognize when a patient is not protecting their airway
What to do when patients are working too hard or not hard enough to improve their oxygen saturation
Recognizing patients who cannot oxygenate or ventilate on their own
Looking beyond the vital signs and focusing on the clinical presentation to determine if a definitive airway is needed

This episode was produced by Podcast Boutique https://www.podcastboutique.com

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

71: Recognition and Treatment of Septic Shock With Guest Yesha APRN Sep 22, 2023

Show notes

September is Sepsis Awareness Month, so host Sarah Lorenzini is throwing it back to one of the earliest Rapid Response RN podcast episodes with guest Yesha APRN. This episode tells the story of a patient with sepsis, and it’s one of Sarah’s favorite episodes because it exemplifies all of the classic signs and symptoms of sepsis as well as the important role the nurse plays in caring for septic patients.

Last week, you learned about fluid resuscitation and the potential harm of fluid overload in the treatment of sepsis. In this episode, you’ll hear how Sarah and Yesha’s patient responded to fluid boluses and what made them advocate for a different treatment approach.

Sarah then goes deeper into the pathophysiology of sepsis, indicators of sepsis using SIRS criteria and the qSOFA score, and more indicators any nurse can test without a tool. You’ll also find out how to treat a patient with sepsis, which diagnostics to run, and what you can do to promote a return to homeostasis in your patient.

Tune in to learn the signs and symptoms of sepsis and septic shock, and how to facilitate early detection. Plus, hear Yesha’s takeaways from this patient story that will benefit all nurses in their treatment of sepsis!

Topics discussed in this episode:

Yesha’s nursing journey and updates on her career
How Yesha’s patient presented and his response to fluid administration
What made her decide to call a rapid response nurse, Sarah
Sarah’s assessment of the patient and how they treated him
The pathophysiology of sepsis
SIRS criteria and qSOFA score for prediction of sepsis
What happens in the “septic inflammatory cascade of awfulness”
How to detect sepsis early
Treatment and management of a sepsis patient

Read the article, “Fluid selection & pH-guided fluid resuscitation” by Dr. Josh Farkas, here:

https://emcrit.org/ibcc/fluid/

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

70: Stop Guessing When Fluid Resuscitating With Guest Corinne RN From FloPatch Sep 15, 2023

Show notes

Often when a patient’s blood pressure has dropped, we administer fluids without truly knowing the exact reason for the change. Does the patient have low volume, were they vasodilating, or is their heart not squeezing effectively? Fluid resuscitation is not always the answer, but there’s no clear guideline to assess patients without advanced tools that take time and specialists. Enter the FloPatch from Flosonics, an innovative device that quickly measures blood flow in real time.

Fluids can cause damage when given in excess, so it’s crucial for nurses to understand why blood pressure isn’t an adequate indicator of fluid responsiveness, and how a patient can show signs of fluid responsiveness but cardiac output is not increasing. That’s why host Sarah Lorenzini is speaking with Corinne RN to find out more about how Flosonics is helping nurses guide their fluid resuscitation using the portable FloPatch device.

In this episode, Corinne shares patient stories to exhibit how FloPatch can improve patient outcomes, especially in those with sepsis. Corinne and Sarah also discuss the concept of Frank-Starling’s law, the components of stroke volume, and MORE.

FloPatch can help you assess patients and provide precise care. Tune in to find out how it works, the benefits of the product, and why you want to use it at your hospital!

Topics discussed in this episode:

How Corrine RN became so passionate about fluid resuscitation
Why blood pressure isn’t the best tool for determining cardiac output
Factors that influence blood pressure
The relationship between preload, afterload, and contractility
The consequences of fluid overload
Examples of how FloPatch can improve patient care

FloPatch is a game-changing advancement in precision fluid management for critical care, particularly in the management of sepsis. As the world's first wireless, wearable Doppler ultrasound technology, it provides real-time, non-invasive assessments of arterial and venous blood flow. FloPatch empowers clinicians at the bedside to make rapid, data-driven decisions on fluid resuscitation, mitigating risks of complications such as pulmonary edema and acute kidney injury. FloPatch holds the potential to transform the way clinicians approach and manage hemodynamic assessments, paving the way for increased clinical confidence for more efficient, effective, and patient-centered care.

Visit their website to learn more and request a demo: https://flosonicsmedical.com/

Share this podcast episode with your colleagues to spread the word about FloPatch.

Follow FloPatch on Instagram, Twitter and LinkedIn for the latest updates and clinical insight:

Instagram: https://www.instagram.com/flopatch_/

Twitter: https://twitter.com/Flosonics/

LinkedIn: https://www.linkedin.com/company/flosonics-medical

Have questions for Corinn? Email her at czehner@flosonicsmedical.com

Join the Sepsis Alliance Summit 2023 during Sepsis Awareness Month! This virtual event is hosted on September 27th to 28th. Learn more here: https://learn.sepsis.org/virtual-conference

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

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