Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 297: Keywords part 29: PE and Parathyroid
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In this 297th episode I welcome Dr. Tym Kajstura back to the show for another ABA Keyword episode. We cover high yield topics of PE and Hyper and Hypoparathyroidism.
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 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.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 277: Keywords part 26: Adrenal Diseases with Gillian Isaac
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In this 277th episode I welcome Dr. Gillian Isaac back for another ABA keyword episode. We discuss Adrenal Diseases and the questions you’re likely to see about them on your exams.
Correction:
When talking about Addison’s disease, we say ACTH activates melatonin release. It is actually CRH that stimulates both the release of ACTH and MSH (melanocyte stimulating hormone) which both cause the stimulation of melanocytes. These cells create melanin, not melatonin, which is responsible for the darkening of the skin.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 265: Keywords Part 24: Nitroprusside and Nitroglycerin, hemoglobinopathies part 2
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In this 265th episode I welcome Dr. Gillian Isaac back to the show to do another ABA Keyword episode. We follow up on the last one by discussing Nitroprusside, Nitroyglycerin and their effect on hemoglobin.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 259: Keywords part 23: Pulse-Ox and hemoglobinopathies part 1
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In this 259th episode I welcome Dr. Gillian Isaac back to the show to discuss another set of ABA key words. We discuss the pulse oximeter and some hemoglobinopathies that can affect its readings.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 249: Keywords Part 21: Retrobulbar Blocks and the Oculocardiac Reflex
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In this 249th episode I welcome Dr. Gillian Isaac back to the show for another ABA Keyword episode. We discuss retrobulbar blocks and the oculocardiac reflex.