Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 130: Adults with Congenital Heart Disease with Jochen Steppan
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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.
Stoelting’s Anesthesia and Co-Existing Disease, 7th EditionChapter 7 “Congenital Heart Disease” by Jochen Steppan and Bryan Maxwell
Int Anesthesiol Clin. 2018 Fall;56(4):3-20. “When Your 35-Year-Old Patient has a Sternotomy Scar: Anesthesia for Adult Patients with Congenital Heart Disease Presenting for Noncardiac Surgery” By Cheema A, Ibekwe S, Nyhan D, Steppan J.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 129: Vascular Access with Dave Berman
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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.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 128: Opioid Induced Respiratory Depression (The PRODIGY Trial) with Dr. Ashish Khanna
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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 they developed, and where we go from here.
CME: https://earnc.me/jQCZV8
References:
Sun Z, Sessler DI, Dalton JE, et al. Postoperative Hypoxemia Is Common and Persistent: A Prospective Blinded Observational Study. Anesth Analg. 2015;121(3):709–715. doi:10.1213/ANE.0000000000000836
Lee LA, Caplan RA, Stephens LS, Posner KL, Terman GW, Voepel-Lewis T, Domino KB. Postoperative opioid-induced respiratory depression: a closed claims analysis. Anesthesiology. 2015 Mar;122(3):659-65. doi: 10.1097/ALN.0000000000000564.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 127: Upper Extremity Blocks with Drs. Segna and Rayaz
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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.
Hadzic, Admir. Hadzic’s textbook of regional anesthesia and acute pain management. McGraw Hill Professional, 2017.
Hall, Brian A., and Robert C. Chantigian. Anesthesia: A Comprehensive Review E-Book. Elsevier Health Sciences, 2014.
Horlocker, Terese T., Erik Vandermeuelen, Sandra L. Kopp, Wiebke Gogarten, Lisa R. Leffert, and Honorio T. Benzon. “Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines.” Regional anesthesia and pain medicine43, no. 3 (2018): 263-309.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 125: Abusive Head Trauma with Erik Smith
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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.
CME: https://earnc.me/iFmtNQ
References:
Christian, C. W., Block, R., Committee on Child Abuse and Neglect, & American Academy of Pediatrics. (2009). Abusive Head Trauma in Infants and Children. PEDIATRICS, 123(5), 1409–1411. https://doi.org/10.1542/peds.2009-0408
Gazoni, F. M., Amato, P. E., Malik, Z. M., & Durieux, M. E. (2012). The Impact of Perioperative Catastrophes on Anesthesiologists. Anesthesia & Analgesia, 114(3), 596–603. https://doi.org/10.1213/ANE.0b013e318227524e
Kochanek, P. M., Tasker, R. C., Carney, N., Totten, A. M., Adelson, P. D., Selden, N. R., … Wainwright, M. S. (2019). Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition. Pediatric Critical Care Medicine, 20, S1–S82. https://doi.org/10.1097/PCC.0000000000001735
Lee, J. K., Brady, K. M., & Deutsch, N. (2016). The Anesthesiologist’s Role in Treating Abusive Head Trauma. Anesthesia & Analgesia, 122(6), 1971–1982. https://doi.org/10.1213/ANE.0000000000001298
Smith, E. B., Lee, J. K., Vavilala, M. S., & Lee, S. A. (2019). Pediatric Traumatic Brain Injury and Associated Topics: An Overview of Abusive Head Trauma, Nonaccidental Trauma, and Sports Concussions. Anesthesiology Clinics, 37(1), 119–134. https://doi.org/10.1016/J.ANCLIN.2018.10.002
Vavilala, M. S., Lee, L. A., & Lam, A. M. (2003). The lower limit of cerebral autoregulation in children during sevoflurane anesthesia. Journal of Neurosurgical Anesthesiology, 15(4), 307–312. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14508171
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 124: POCUS with Lee Goeddel
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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.
CME: https://earnc.me/aEbwZG
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
Chest. 2015 Jun;147(6):1659-1670. doi: 10.1378/chest.14-1313.BLUE-protocol and FALLS-protocol: two applications of lung ultrasound in the critically ill.Lichtenstein DA1.PMID: 26033127
Surg Clin North Am. 2011 Feb;91(1):195-207. doi: 10.1016/j.suc.2010.10.008.Focused assessment with sonography for trauma: methods, accuracy, and indications.Patel NY1, Riherd JM. PMID: 21184909
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 123: Surgical Airway with Andrew Merelman
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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.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 122: Key Words Part 1 with Gillian Isaac: Crichothyroid Membrane and Propofol
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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.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 121: Difficult Airway Response Team With Lynette Mark
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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.
Difficult Airway Algorithm and Rescue Cricothyrotomy (DAARC): http://sgschallenge.com/2018daarc/
https://wamm2019.com World Airway Management Meeting, Amsterdam, Netherlands, November, 2019. Drs. Mark and Feinleib will be presenting about the DART program.
Dr. Cooper’s article on surgical airway: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2724164
Dr. Mark’s article from A&A and the accompanying editorial: