In this episode, episode 30, I discuss the new American College of Cardiology Guidelines for the periprocedural management of anticoagulation for patients with non-valvular atrial fibrillation. This includes whether to stop, when to stop, whether to bridge, how to bridge, and how and when to restart.
In this episode, episode 29, I welcome to the show Dr. Glenn Whitman. Dr. Whitman is a cardiac surgeon and intensivist and runs the cardiac surgical ICU here at Johns Hopkins. I interview Dr. Whitman about PA catheters. We discuss when to place them, when not to place them, how to use them and when to take them out.
In this episode I welcome Dr. Laeben Lester to the show. Dr. Lester is trained in Emergency Medicine and Anesthesiology and has completed fellowship training in Cardiac Anesthesiology. He shares with us his “Nearly Needleless 5-Step Approach” to airway topicalization for awake intubation.
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 interview Dr. Joseph Hughes, one of our neuro anesthesiologists, about the history, etiology, pathophysiology and prevention of postoperative visual loss.
We refer to a thromboelastogram which looks like this. It is the fibrinolysis portion that can be prevented with tranexamic acid (TXA):
High Yield Outline by Brian Park can be found here: Outline
In this episode I interview Dr. Chris Wu, professor of anesthesiology and pain medicine and internationally renowned expert in Enhanced Recovery After Surgery (ERAS) pathways. We discuss the different aspects of ERAS pathways and the evidence for improved outcomes.
The ERAS society website can be found here: http://erassociety.org
Check out this fantastic outline of the episode put together by Brian Park: ERAS outline