Episode 15: IV Fluids

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

Episode 14: Opioids part 2

This is the second of two episodes about opioid medications.  In this episode I cover the pharmacokinetics and pharmacodynamics of opioids, some of the common uses for these medications, mixed agonist-antagonist compounds, opioid antagonists, and opioid interaction with other medications.

Slides to go along with this episode are here: Opioids part 2

Episode 13: Opioids part 1

This is the first of a 2 part series on opioid medications.  In this first episode I will talk about how opioids are categorized and their effects on the different body systems.  In the next episode I will discuss their pharmacokinetics and pharmacodynamics as well as their various uses and some details on mixed agonist/antagonists.

Slides to go along with this episode are here: Opioids part 1

PLEASE NOTE: Around minute 12 I say that auditory evoked potentials are the most sensitive to anesthetics.  This is incorrect.  I should have said visual evoked potentials.  Thanks to Howard Zee for catching that!

Episode 12: Air Embolism with Dr. David Mintz

In this episode I welcome Dr. David Mintz, one of our neuroanesthesiologists here at Johns Hopkins, fellow Brown University Alum, and generally all around great guy, to the show to talk about air embolism, what it is, how it happens and how to manage it.  A big thanks to Dave for taking the time to prepare this information and for being the first ever guest on ACCRAC.

Outline by Brian Park: Outline

Episode 10: IV Induction Agents

In this episode I review the common IV agents used in anesthesia excluding opioids.  I cover Propofol, Barbiturates, Benzodiazepines, Ketamine, Etomidate and Dexmedetomidine.

NOTE: There is an error in the audio recording regarding the dosing units for dexmedetomidine.  I say on the podcast that the dosing units are mcg/kg/min which is INCORRECT.  The correct dosing units are mcg/kg/HOUR.  I have corrected this in the accompanying slides. Thanks to Melanie Browder for picking this up!

Good luck to the recent graduates taking their written board exam on July 29th!

 

Slides to go along with the podcast are here: IV induction agents slides

Episode 9: Basic Med Setup

In this episode I review the basic medication setup for the operating room including premedication, induction, neuromuscular blockade, antibiotics, reversal and antiemetics.  I discuss weight based dosing and comment on a few alternatives to consider once you have the basic setup down.  This episode should be useful for new CA-1s getting started in the OR but I would also like to ask senior residents to comment on what their basic setup is and how it may differ from what I’ve mentioned here.

 

Here is a list of the medications I discuss: Basic med setup w dosing

Episode 8: Management of Respiratory Diseases Part 2

This is the second and final episode dealing with the management of respiratory diseases.  In the first episode I covered the initial evaluation and preop preparation.  In this episode I cover intraoperative management, post-operative management, special issues related to one lung ventilation and special issues related to total pneumonectomy.

Slides to go along with the episode can be downloaded here: Management of Respiratory Diseases part 2 slides

 

 

Episode 7: Management of the patient with respiratory disease part 1

This is the first of a two part series of episodes on the management of patients with respiratory disease.  In this, part 1, I cover the preoperative evaluation, history and physical exam, and the preoperative planning and optimization of the patient.  This includes the key board topics of smoking cessation and cardiac risk assessment.

Here are the slides that go along with this episode: Management of Respiratory Diseases slides part 1

 

Episode 6: The Paraglossal Approach to Intubation

In this episode I first announce the new ACCRAC website here at ACCRAC.com.  Big thanks to Bryan Mariscalchi for his help setting it up.  I also mention the problem the last two episodes had with only playing out of one ear on earphones.  I hope I’ve cleared that problem up.  I mention a fantastic book called “Missing Microbes” by Martin Blaser, here is a link to the NY Times review: Missing Microbes

The bulk of the episode is a description of the paraglossal approach to endotracheal incubation.  Here is a youtube link to a video of the technique: Paraglossal video

Have you ever used this technique?  Do you like it?