In this episode, episode 54, I welcome back Dr. Jacqueline Galvan and we discuss complications and physiology of term pregnancy. This is part 1 of a 2 part series.
In this episode, episode 53, I welcome back Dr. Mike Hofkamp to discuss analgesia for cesarean delivery. We discuss indications for C-section, urgent and emergent sections, anesthetic techniques and associated complications, how to approach the difficult airway in a pregnant patient, and aspiration prophylaxis.
References to the articles discussed are here: References
In this episode, episode 52, I welcome Dr. Todd Dorman to the show. Dr. Dorman is a professor of anesthesiology here at Johns Hopkins, is the Vice Chair for Critical Care, and is the immediate past president of the Society of Critical Care Medicine (SCCM). Dr. Dorman and I discuss diastolic heart failure or heart failure with preserved ejection fraction (HFPEF), how it differs from systolic heart failure or heart failure with reduced ejection fraction (HFREF), how it presents, and how to manage it perioperatively.
References for peripheral vasopressors:
- Medlej K et al. Complications from Administration of Vasopressors Through Peripheral Venous Catheters: An Observational Study. JEM 2018. PMID: 29110979
In this episode, episode 51, I welcome back Dr. Jacqueline Galvan to discuss labor analgesia. We cover opioids including remifentanil, nitrous oxide, neuraxial anesthesia and other nerve blocks.
- Hess PE, et al. An association between severe labor pain and cesarean delivery. Anesth Analg. 2000 Apr;90(4):881-6
- Van den Bussche E. Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing. Eur J Pain. 2007 Apr;11(3):275-82.
- Varposhti MR et al. Comparison of remifentanil: Entonox with Entonox alone in labor analgesia. Adv Biomed Res. 2013 Nov 30;2:87
In this episode, episode 50, I welcome back Dr. Mike Hofkamp, and, for the first time, I welcome Dr. Jacqueline Galvan to the show. Drs. Hofkamp and Galvan go head to head in a debate over which is a better, more evidence-based technique, the traditional epidural or the CSE (combined spinal epidural).
All of the articles that were referenced can be found here: References
In this episode, episode 49, I welcome Dr. Peter Pronovost to the show to discuss the high reliability movement and how it relates to healthcare. Dr. Pronovost is one of the world’s foremost experts on patient safety and we discuss how a hospital can be as reliably safe as an aircraft carrier and how best to approach an angry patient in the ICU.
In this episode, episode 48, I welcome Dr. Clint Tippett to the show. Dr. Tippett is a cardiac anesthesiologist with an interest in anesthesia for Transcutaneous Aortic Valve Replacement (TAVR) and we discuss the approach to anesthesia for these cases including preoperative planning, intraoperative management, and post-operative concerns.
Regarding stroke risk here is an editorial (Thanks to Stephen Freiberg for providing this link): http://circinterventions.ahajournals.org/content/8/6/e002801
And Dr. Tippett wanted to add that early studies of the 1st and second generation valves had higher stroke rates than SAVR, however the most current genreration valves(Edwards Sapien 3 and Medtronic Evolut R) both have been shown to have not significantly different stroke rates from TAVR.(Surtavi trial and this observational study http://thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)30073-3.pdf).
Finally, when discussing benefits of TAVR, we should have mentioned a significantly lower risk of post-op AFib in addition to lower bleeding risk and lower rates of AKI.
In this episode, episode 47, I welcome back Dr. Stephen Freiberg, one of our chief residents, to discuss all you ever wanted to know about arterial lines. We discuss the indications, contraindications, complications, placement technique, and how to interpret the waveform.
Slides with figures mentioned in the podcast can be found here: Arterial Line Podcast Images
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In this episode, episode 46, I welcome back Dr. Mike Hofkamp to discuss obstetric pharmacology and fetal assessment.
In this episode, episode 45, I welcome Dr. Charlie Brown to the show. Dr. Brown is one of our cardiac anesthesiologists with a research interest in postop delirium. We discuss risk factors, consequences, prevention and treatment of postop delirium.