Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 289: Master Clinicians Part 1: Dr. Dave Berman
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In this new series on master clinicians I will be interviewing people who have been identified by their colleagues and trainees as “master clinicians”, people who others go to for advice and clinical guidance, people who are masters of their craft. In this episode I welcome Dr. Dave Berman back to the show to discuss how he has, in a relatively short time, become one of these master clinicians and what advice he has for all of you.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 288: Keywords Part 28: ECT and Transfusion Reactions with Tym Kajstura
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In this 288th episode I welcome Dr. Tym Kajstura to the show to do an ABA keyword episode. We discuss considerations for electroconvulsive therapy (ECT) and transfusion reactions.
Big thanks to Dr. Pranav Shah, a cardiac anesthesiologist/intensivist at VCU and one of their physician informaticists. He provided some great detail on how blood preparation works:
Cross-matching isn’t a physical process majority of time, and hasn’t been for about 20 years per our Blood Bank. “Electronic Crossmatch” is the norm.
Details:
*A patient needs “two” samples within a certain time-period. -time-period is institutional, but commonly (for inpatients) about 3 days. -one sample is “historical” for ABO/Rh status -one sample is “current” for ABO/Rh Status “confirmation” (to reduce the likelihood of a single clerical error for leading to harm)
Current specimens are “Type and Screen” where one part is above (ABO/Rh)..
Second part is screening … for a large library of common antibodies. (Kell, Duffy etc.)
*Scenario A (common): Conditions: patient has two samples, antibody screen is negative (current and PAST) patient isn’t “special” (e.g. sickle cell where special blood rules exist)
In this very common scenario (majority of patients), the cross-match is VIRTUAL.
When you request a unit of pRBC, Blood Bank “says” the patient “has two samples” + “samples give same ABO / Rh” + “no antibodies ever” + “not quirky Blood Bank subpopulation”… .. then they run an “Electronic” crossmatch. Fundamentally just hands you a blood off the shelf that meets the criteria. There is no vial mixing.
Therefore, in this scenario, Blood is available VERY quickly!
*Scenario B: 1) patient has two samples 2) patient has antibody screen that is positive.
Now, blood bank doesn’t just do an electronic screen. They do use that to identify a high-probability match unit (in my words). But they need to do a physical cross-match (my understanding). Depending on the frequency of the antigen that the antibody is to (e.g. say Anti-Starwars antibody. But StarWars antigen is present in 96% of folks in US), the cross-match may take DAYS.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 287: Perioperative Care of Transgender and Gender-Diverse Patients with Kyle Sanchez and Dan Ellis
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In this 287th episode I welcome Drs. Kyle Sanchez and Dan Ellis to the show to discuss the perioperative care of transgender and gender-diverse Patients. We discuss terminology, different medications and surgeries that you may see, preop, intraop and postop considerations.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 286: Central Lines with Elisa Walsh
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In this 286th episode I welcome Dr. Elisa Walsh to the show to discuss Central Venous Catheters. We discuss where they can be placed, what can go wrong, how to teach people how to place them safely and how to confirm placement.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 285: Signals Update with Andrea Dutoit
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In this 285th episode I welcome Dr. Andrea Dutoit back to the show to discuss the most recent data on program signaling and what we know about how it affected applicants’ chances of getting and interview and matching.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 284: Perioperative Hand-offs with Jamie Sparling and Aalok Agarwala
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In this 284th episode I welcome Drs. Sparling and Agarwala to the show to discuss the importance of, and evidence for, perioperative hand-offs. We discuss what hand-offs are, what kinds of handoffs occur during the perioperative period, why they matter, how they can cause harm when poorly done, and how implementing good hand-offs can reduce harm.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 283: Introducing The Style Points Podcast Episode on Primate Anesthesia
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In this 283rd episode I introduce a new podcast from University of Cincinnati Department of Anesthesiology hosted by Dr. John Crowe. This episode is about Primate Anesthesia and John interviews one of his colleagues who does some anesthesia for primates at the local zoo. I think they’re doing great work on this podcast and look forward to more episodes to come!
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 282: Navigating Applying in Anesthesiology with Tricia Pendergrast
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In this 282nd episode I welcome Dr. Tricia Pendergrast to the show to discuss how to navigate the process of applying for residency in anesthesiology. We discuss how to set yourself up for success, how to figure out how competitive you are, when to consider an away rotation, when to consider dual applying, and how to figure out how to best use your signals.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 280: Keywords Part 27: Shock States and A Tribute to Dr. Gillian Isaac
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In this 280th episode I share the shocking and tragic news that Dr. Gillian Isaac died suddenly and unexpectedly a few weeks ago. She was an incredible human being, teacher, doctor, wife and mother. She will be missed more than I can say by more people than we can possibly count. I know that she would want us to continue with these keyword episodes that she loved doing and so I am going to try. I know they will never be the same, but they will be dedicated to her memory. Today I address the keyword of shock states and discuss the 4 types of shock and how they may be covered on your exams. I miss you, Gillian.
