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 different types of tubes. This will be the final post of 2016. Thanks so much to all of you for listening and being a part of ACCRAC’s inaugural year in 2016. Here’s wishing you a wonderful start to your 2017!
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
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.
The fantastic review article I mentioned is: Mireles-Cabodevila E. Et al. Alternative Modes of mechanical ventilation: A review for the hospitalist. Cleveland Clinic Journal of Medicine. 2009(75);7:417-430.
Pubmed link here
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 on bicarb:
Outline by Brian Park: Outline
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.
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.
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: http://www.nejm.org/doi/full/10.1056/NEJMvcm044149
- Central: http://www.nejm.org/doi/full/10.1056/NEJMvcm055053
- PA catheter: http://www.nejm.org/doi/full/10.1056/NEJMvcm1212416
And this is a great article from Ausmed on assessing and caring for peripheral IVs: Click Here
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
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.
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 Fluids slides