Episode 24: The Evils of Sodium Bicarbonate

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 24: The Evils of Sodium Bicarbonate
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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.

CME: https://earnc.me/3CX3ha

The Vancs study: https://www.ncbi.nlm.nih.gov/pubmed/27841822

The two articles I recommend on bicarb:

Forsythe: https://www.ncbi.nlm.nih.gov/pubmed/10631227

Sabatini: https://www.ncbi.nlm.nih.gov/pubmed/18322160

Outline by Brian Park: Outline

Episode 23: Basic Ventilator Review with Dr. Scott Stephens

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 23: Basic Ventilator Review with Dr. Scott Stephens
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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.

CME: https://cmefy.com/moment?id=K8lsklY

Outline by Brian Park: Outline

Episode 22: Postop Visual Loss with Dr. Joe Hughes

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 22: Postop Visual Loss with Dr. Joe Hughes
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In this episode I interview Dr. Joseph Hughes, one of our neuro anesthesiologists, about the history, etiology, pathophysiology and prevention of postoperative visual loss.

CME: https://cmefy.com/moment?id=kBhJW6F

We refer to a thromboelastogram which looks like this.  It is the fibrinolysis portion that can be prevented with tranexamic acid (TXA):

screen-shot-2016-12-01-at-12-08-46-pm

High Yield Outline by Brian Park can be found here: Outline

Episode 21: ERAS with Dr. Chris Wu

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 21: ERAS with Dr. Chris Wu
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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.

CME: https://cmefy.com/moment?id=6N5q_p2

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

Episode 20: pH Stat and Alpha Stat

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 20: pH Stat and Alpha Stat
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In this episode I review two methods for managing arterial blood gasses in hypothermic patients, usually during cardiac surgery–pH Stat and Alpha Stat.

CME: https://cmefy.com/moment?id=Ckj_tW4

Check out this fantastic episode recap put together by Brian Park from Drexel Medical School: Show recap

Episode 19: Vasoactive medications

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 19: Vasoactive medications
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In this episode I review the receptors that vasoactive drugs act on.  I then review the main vasoactive medications used in the OR and the ICU to treat acute hypotension and the ones used to treat acute hypertension.

CME: https://cmefy.com/moment?id=3VcC8Y8

Outline by April Liu: Outline

Episode 18: Tips and Tricks for Line Placement

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 18: Tips and Tricks for Line Placement
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In this episode I go over some tips and tricks for maximizing your success with peripheral IVs, arterial lines, central venous catheters and pulmonary artery catheters (Swan Ganz catheters).

CME: https://cmefy.com/moment?id=Ms0mgDd

The New England Journal videos that I recommend you take a look at for detailed reviews of each of these are here:

And this is a great article from Ausmed on assessing and caring for peripheral IVs: Click Here

Episode 17: Awake intubation

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 17: Awake intubation
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In this episode I discuss awake intubation.  I discuss the indications, techniques, nerve blocks, sedation and different methods of performing awake intubation.

CME: https://cmefy.com/moment?id=HN3fg8z

Slides to go along with the podcast are here: awake intubation slides

The youtube video of the MGH anesthesiologist intubating himself is here: self-intubation

Episode 16: Increased ICP Therapy with Dave Mintz

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 16: Increased ICP Therapy with Dave Mintz
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In this episode I welcome back Dr. David Mintz, neuroanesthesiologist, to discuss the treatment of increased intracranial pressure in the perioperative period and brain relaxation during neurosurgery.  Dr. Mintz will be back in the future to talk about the physiology of increased ICP.

CME: https://cmefy.com/moment?id=tYk0MWQ

Episode 15: IV Fluids

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 15: IV Fluids
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In this episode I discuss the use of IV fluids for perioperative use including how to decide when to give fluid, the downsides of over resuscitation, whether to use crystalloid or colloid, and whether to use saline or a balanced salt solution such as LR.

CME: https://cmefy.com/moment?id=mg5zX5c

Slides to go along with this episode are here: IV Fluids slides

Anesthesia and Critical Care Reviews and Commentary