Episode 124: POCUS with Lee Goeddel

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 Am Soc Echocardiogr. 2013 Jun;26(6):567-81. doi: 10.1016/j.echo.2013.04.001.Focused cardiac ultrasound: recommendations from the American Society of Echocardiography.Spencer KT1, Kimura BJKorcarz CEPellikka PARahko PSSiegel RJ.PMID 23711341

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 

Episode 123: Surgical Airway with Andrew Merelman

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 – https://itunes.apple.com/ca/app/the-airway-app/id1112657910?mt=8

Android- https://play.google.com/store/apps/details?id=com.parse.airway&hl=en 

3D printed models – https://link.springer.com/article/10.1007%2Fs12630-017-0926-9 Videos:

https://vimeo.com/132394603

https://vimeo.com/132394747

https://emcrit.org/emcrit/real-surgical-airway/

https://www.airmedicaljournal.com/article/S1067-991X(09)00037-6/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727957/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749220/

https://www.ncbi.nlm.nih.gov/pubmed/20491685

https://www.ncbi.nlm.nih.gov/pubmed/30173584
https://journals.lww.com/jtrauma/Citation/2012/09000/Is_bougie_aided_cricothyrotomy_really__extremely.42.aspx

https://www.researchgate.net/publication/253332531_Comparison_of_a_percutaneous_device_and_the_bougie-assisted_surgical_technique_for_emergency_cricothyrotomy_an_experimental_study_on_a_porcine_model_performed_by_air_ambulance_anaesthesiologists

https://www.ncbi.nlm.nih.gov/pubmed/30686312

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078881/

Episode 122: Key Words Part 1 with Gillian Isaac: Crichothyroid Membrane and Propofol

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.

Episode 121: Difficult Airway Response Team With Lynette Mark

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 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

Episode 120: Lightning Round 1

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.

Episode 117: Global Surgery with Matt Danley

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

Episode 116: Overview of Pediatric Anesthesia with Bommy Mershon

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.

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

References:

  1. Cote and Lerman’s A Practice of Anesthesia for Infants and Children. Fifth Edition.
  2. 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/
  3. 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.
  4. 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
  5. 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
  6. 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

Episode 115: The Contaminated Airway with Steve Freiberg

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 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

Episode 114: The Business of Anesthesia with Jerry Stonemetz

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:

Episode 113: Anesthesia for Aneurysm Clipping With Dave Mintz

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