In this 114th episode I welcome Dr. Jerry Stonemetz to the show to discuss the business side of Anesthesiology. Specifically we discuss billing, compliance, contract negotiation and Jerry’s thoughts on where the industry is heading.
CME: https://earnc.me/v7hmpb
Slides are here:
In this 113th episode I welcome Dr. David Mintz back to the show to discuss anesthesia for intracranial aneurysm clipping.
CME: https://earnc.me/XKz3WI
References:
Chapter 13 Anesthetic management of cerebral aneurysm surgery in Cottrell and Young, Neuroanesthesia
In this 112th episode I welcome Dr. Christina Miller to the show to discuss Anesthesia for Electroconvulsive Therapy (ECT).
CME: https://earnc.me/4uJ3bR
References:
Ding Z, White PF. Anesthesia for electroconvulsive therapy. Anesth Analg. 2002 May;94(5):1351-64.
Sadowksy, Jonathan. Electroconvulsvie Therapy: A History of Controversy, but Also of Help. The Conversation. Scientific American. January 13, 2017.
Wright, M.D., Bruce A. (1990) “An Historical Review of Electroconvulsive Therapy,” Jefferson Journal of Psychiatry: Vol. 8 : Iss. 2 , Article 10.
Nishihara F, Saito S. Pre-ictal bispectral index has a positive correlation with seizure duration during electroconvulsive therapy. Anesth Analg. 2002 May;94(5):1249-52, table of contents.
Gombar S, Aggarwal D, Khanna AK, Gombar KK, Chavan BS. The bispectral electroencephalogram during modified electroconvulsive therapy under propofol anesthesia: relation with seizure duration and awakening. J ECT. 2011 Jun;27(2):114-8.
Sartorius A, Muñoz-Canales EM, Krumm B, Krier A, Andres FJ, Bender HJ, Henn FA. ECT anesthesia: the lighter the better? Pharmacopsychiatry. 2006 Nov;39(6):201-4.
Sebel PS, Bowdle TA, Ghoneim MM, Rampil IJ, Padilla RE, Gan TJ, Domino KB. The incidence of awareness during anesthesia: a multicenter United States study. Anesth Analg. 2004 Sep;99(3):833-9
In this 111th episode I welcome Dr. Zandy Hillel to the show. Dr. Hillel is an otolaryngologist here at Johns Hopkins and we discuss tracheostomies, Cricothyrotomies, laryngeal surgery and difficult airways.
CME: https://earnc.me/beqG3N
References:
Crichothyrotomies:
https://www.ncbi.nlm.nih.gov/pubmed/30054081
https://www.ncbi.nlm.nih.gov/pubmed/30726035
Difficult Airway Response Teams:
In this 110th episode I welcome Justin Harvey to the show. Justin is a financial planner with an interest in helping anesthesiologists and pain specialists make the best possible financial choices. We discuss financial planning, managing loan repayment, and investing.
CME: https://earnc.me/RZmxJT
Justin’s email: Ju****@**************ng.com
Justin’s podcast: AnesthesiaSuccess.com
Justin’s financial planning company: www.quantifiplanning.com
XY Planning network: https://www.xyplanningnetwork.com
Student Loan Planner: https://www.studentloanplanner.com
Resources for getting started with investing:
https://investor.vanguard.com/investing/how-to-invest/asset-allocationhttps://www.marketwatch.com/lazyportfoliohttps://www.amazon.com/Investment-Answer-Daniel-C-Goldie/dp/1455503304/
Places to find a fee-only financial advisor:www.xyplanningnetwork.comwww.napfa.org
Other physician finance blogs Justin Recommends:
physicianonfire.comthephysicianphilosopher.com
A fun calculator to see how soon you can retire based on your monthly free cash flow:
In this 109th episode we pick up where we left off in episode 108 and discuss the intraoperative use of non-opioid adjuncts.
CME: https://earnc.me/k6e6gK
References:
Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697.
Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing Role in Routine Anesthesia Care. Regional Anesthesia and Pain Medicine. 2018:43(8):815-818.
Grant MC, Ouanes JP, Joshi BL. Perioperative Esmolol and Opioids: Is More Really Less? Regional Anesthesia and Pain Medicine. 2018:43(8):813-814.
IV Lidocaine: https://academic.oup.com/bjaed/article/16/9/292/1743710
Ketamine: https://www.ncbi.nlm.nih.gov/pubmed/29870457
Dextramethorphan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755866
In this 108th episode I welcome Dr. Mike Grant and Dr. Mark Bicket to the show to discuss various non-opioid adjuncts such as esmolol, ketamine, dexmedetomidine, lidocaine, and magnesium, and the role they may play in multimodal anesthesia. In this episode, part 1, we discuss pre and post-op use. Intraop use will be discussed in episode 109.
CME: https://earnc.me/oDhyER
References:
Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697.
Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing Role in Routine Anesthesia Care. Regional Anesthesia and Pain Medicine. 2018:43(8):815-818.
Grant MC, Ouanes JP, Joshi BL. Perioperative Esmolol and Opioids: Is More Really Less? Regional Anesthesia and Pain Medicine. 2018:43(8):813-814.
IV Lidocaine: https://academic.oup.com/bjaed/article/16/9/292/1743710
Ketamine: https://www.ncbi.nlm.nih.gov/pubmed/29870457
Dextramethorphan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755866/ R
In this 107th episode I welcome Dr. Mike Fitzsimons back to the show to discuss the topic of suicide in physicians in general and in Anesthesia providers specifically.
CME: https://earnc.me/XK77Ak
References:
In this 106th episode I welcome Dr. Marius Fassbinder to the show to discuss the use of hydroxyethyl starches.
CME: https://earnc.me/sFF08C
References:
1. Woodcock, T. E. & Woodcock, T. M. Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an
improved paradigm for prescribing intravenous fluid therapy. British Journal of Anaesthesia 108, 384–394 (2012).
2. Westphal, M. et al. Hydroxyethyl starches: different products–different effects. Anesthesiology 111, 187–202 (2009).
3. Brunkhorst, F. M. et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N. Engl. J. Med. 358, 125–139
(2008).
4. Perner, A. et al. Hydroxyethyl Starch 130/0.42 versus Ringer’s Acetate in Severe Sepsis. N. Engl. J. Med. 367, 124–134 (2012).
6. Myburgh, J. A. et al. Hydroxyethyl Starch or Saline for Fluid Resuscitation in Intensive Care. N. Engl. J. Med. 367, 1901–1911
(2012).
7. Annane, D. et al. Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with
hypovolemic shock: the CRISTAL randomized trial. JAMA 310, 1809–1817 (2013).
8. Joosten, A. et al. Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System: A
Randomized, Double-blinded, Controlled Trial in Major Abdominal Surgery. Anesthesiology 128, 55–66 (2018).
9. Gillies, M. A. et al. Incidence of postoperative death and acute kidney injury associated with 6% hydroxyethyl starch use: systematic review and meta-analysis. British Journal of Anaesthesia 112, 25–34 (2014).
In this 105th episode, which will be the first part in a series on blood management, I turn over the mic to Dr. Stephanie Cha who interviews Dr. Steve Frank about blood management in cardiac surgery and how to do “bloodless” surgery for patients who refuse blood transfusions.
CME: https://earnc.me/LixhZj
References:
