Category Archives: Anesthesia

Airway, Anesthesia, Critical Care, Procedures

Episode 121: Difficult Airway Response Team With Lynette Mark

May 30, 2019 ACCRAC 3 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 121: Difficult Airway Response Team With Lynette Mark

00:00 / 45:42

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.

CME: https://earnc.me/z1E2G1

References:

https://www.criticalcare.theclinics.com/article/S0749-0704(17)30102-1/abstract

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:

https://www.ncbi.nlm.nih.gov/pubmed/26086513

https://www.ncbi.nlm.nih.gov/pubmed/26086503

Anesthesia, Lightning Rounds

Episode 120: Lightning Round 1

May 20, 2019 ACCRAC 7 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 120: Lightning Round 1

00:00 / 19:37

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.

CME: https://earnc.me/sCnKm4

Outline by Brian Park:Download

Anesthesia, Global Health

Episode 117: Global Surgery with Matt Danley

May 3, 2019 ACCRAC 2 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 117: Global Surgery with Matt Danley

00:00 / 36:54

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.

CME: https://earnc.me/b0LAoy

Matt’s email: Matt.Danley@gmail.com

Links:

LancetGlobalSurgery.org

SafeSurgery2020.org

Lifebox.org

Anesthesia, Peds

Episode 116: Overview of Pediatric Anesthesia with Bommy Mershon

April 23, 2019 ACCRAC 5 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 116: Overview of Pediatric Anesthesia with Bommy Mershon

00:00 / 1:07:01

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 anesthesia and pressers. Please note the original release referred to intranasal dexmedetomidine dosing as mg/kg instead of mcg/kg. The correct units are mcg/kg and the audio has now been updated to reflect that.

CME: https://earnc.me/UpmjW3

We also launch our ACCRAC theme music composed by Dr. Dennis Kuo! Check out his website at studymusicproject.com

References:

Cote and Lerman’s A Practice of Anesthesia for Infants and Children. Fifth Edition.
Kain, Zeev. 2013 ASA Anesthesiology 2013 Refresher Course: Preoperative Evaluation, Premedication, and Induction of Anesthesia in Infants and Children https://www.apsf.org/article/in-my-opinion-a-debate-is-succinylcholine-safe-for-children/
McAuliffe G1, Bissonnette B, Boutin C. Should the routine use of atropine before succinylcholine in children be reconsidered? Can J Anaesth. 1995 Aug;42(8):724-9.
Patel, Davantral. Epidural anesthesia for children. Continuing Education in Anaesthesia Critical Care & Pain. 2006 April;6(2):63-66. https://academic.oup.com/bjaed/article/6/2/63/305090
McCann ME, et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, muticentre, randomised, controlled equivalence trial. Lancet. 2019 Feb;393(10172):664-677 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32485-1/fulltext
Andrew J. Davidson, M.B.B.S., M.D., F.A.N.Z.C.A.; Lena S. Sun, M.D., F.A.A.P., D.A.B.A.. Clinical Evidence for Any Effect of Anesthesia on the Developing Brain Anesthesiology 2018 April; 128(4):840-853. http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2664912&resultClick=1

Airway, Anesthesia, Critical Care, Procedures

Episode 115: The Contaminated Airway with Steve Freiberg

April 15, 2019 ACCRAC 4 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 115: The Contaminated Airway with Steve Freiberg

00:00 / 23:44

In this 115th episode I welcome Dr. Steven Freiberg back to the show to discuss management of the contaminated airway.

CME: https://earnc.me/lDqJUu

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 Laryngoscopy in the Intensive Care Unit. Ann Am Thorac Soc. 2017 Mar;14(3):368-375

Stockton, E.; Lockey, D; et. al. Contamination of the airway in pre-hospital trauma patients. European Journal of Anaesthesiology. 2008. May; 25:188

Uday, J; McCunn, M; et al. Management of the Traumatized Airway. Anesthesiology. 2016, Vol.124, 199-206

PulmCrit: Large-bore suction for intubation: strategies & devices

Anesthesia, Life Lessons, Well-Being

Episode 114: The Business of Anesthesia with Jerry Stonemetz

April 5, 2019 ACCRAC 5 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 114: The Business of Anesthesia with Jerry Stonemetz

00:00 / 1:01:40

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.

CME: https://earnc.me/v7hmpb

Slides are here:

Part 1: Billing and Reimbursement Download

Part 2: Manpower Download

Anesthesia, Neuro

Episode 113: Anesthesia for Aneurysm Clipping With Dave Mintz

March 25, 2019 ACCRAC 3 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 113: Anesthesia for Aneurysm Clipping With Dave Mintz

00:00 / 49:50

In this 113th episode I welcome Dr. David Mintz back to the show to discuss anesthesia for intracranial aneurysm clipping.

CME: https://earnc.me/XKz3WI

References:

Chapter 13 Anesthetic management of cerebral aneurysm surgery in Cottrell and Young, Neuroanesthesia

https://www.ncbi.nlm.nih.gov/pubmed/25014255

Anesthesia, Neuro

Episode 112: Anesthesia for ECT with Christina Miller

March 13, 2019 ACCRAC Leave a comment

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 112: Anesthesia for ECT with Christina Miller

00:00 / 46:56

In this 112th episode I welcome Dr. Christina Miller to the show to discuss Anesthesia for Electroconvulsive Therapy (ECT).

CME: https://earnc.me/4uJ3bR

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. (1990) “An Historical Review of Electroconvulsive Therapy,” Jefferson Journal of Psychiatry: Vol. 8 : Iss. 2 , Article 10.

Nishihara F, Saito S. Pre-ictal bispectral index has a positive correlation with seizure duration during electroconvulsive therapy. Anesth Analg. 2002 May;94(5):1249-52, table of contents.

Gombar S, Aggarwal D, Khanna AK, Gombar KK, Chavan BS. The bispectral electroencephalogram during modified electroconvulsive therapy under propofol anesthesia: relation with seizure duration and awakening. J ECT. 2011 Jun;27(2):114-8.

Sartorius A, Muñoz-Canales EM, Krumm B, Krier A, Andres FJ, Bender HJ, Henn FA. ECT anesthesia: the lighter the better? Pharmacopsychiatry. 2006 Nov;39(6):201-4.

Sebel PS, Bowdle TA, Ghoneim MM, Rampil IJ, Padilla RE, Gan TJ, Domino KB. The incidence of awareness during anesthesia: a multicenter United States study. Anesth Analg. 2004 Sep;99(3):833-9

Airway, Anesthesia, Critical Care, Procedures

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

March 4, 2019 ACCRAC 3 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

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

00:00 / 53:03

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.

CME: https://earnc.me/beqG3N

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

Anesthesia, Anesthetic agents, ERAS, Pain, Pharmacology

Episode 109: Non-Opioid Adjuncts with Drs. Grant and Bicket part 2

February 21, 2019 ACCRAC 5 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 109: Non-Opioid Adjuncts with Drs. Grant and Bicket part 2

00:00 / 36:11

In this 109th episode we pick up where we left off in episode 108 and discuss the intraoperative use of non-opioid adjuncts.

CME: https://earnc.me/k6e6gK

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 Role in Routine Anesthesia Care. Regional Anesthesia and Pain Medicine. 2018:43(8):815-818.

Grant MC, Ouanes JP, Joshi BL. Perioperative Esmolol and Opioids: Is More Really Less? Regional Anesthesia and Pain Medicine. 2018:43(8):813-814.

IV Lidocaine: https://academic.oup.com/bjaed/article/16/9/292/1743710

Ketamine: https://www.ncbi.nlm.nih.gov/pubmed/29870457

Dextramethorphan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755866