From the Head of the Bed

This is a throw down for Black Friday… I’ve got 2 challenges for you: 1. Make an extra student loan payment this week. 2. Opt Outside. What’s up with these? Why is an anesthesia podcast dropping a challenge about what you should do on Black Friday? Because what you do on Black Friday matters. It matters for your future and our future. It’s kind of a big deal, actually. The challenges are simple and the podcast is short – take a listen. If you’ve got student loan debt, I challenge you to make an extra payment this week. Any amount. Just once. Take some money you were gonna put towards a consumer purchase and put it towards your loans. It’s a small step towards financial freedom and becoming debt free. If you can take one small step, then you can find ways to take another and another. If you’re a SRNA or resident, don’t worry about making a student loan payment right now… you can start hammering on those once you’re a practicing clinician. But you have a similar challenge: skip Black Friday. Skip a consumer purchase. Save the money. Spend a little less. Your future self will thank you. And if you’re someone who’s already paid their debt off, you have a challenge, too: give to an organization you believe in this week. Take a few dollars of what you were going to spend this weekend on sales & deals and give it to an organization you believe in. The one I gave to is Protect Our Winters, a non-profit focused on advocating for action on climate change. Here’s a few lines from POW’s “About Us” page: “Founded by professional snowboarder Jeremy Jones in 2007, POW turns passionate outdoor people into effective climate advocates. POW leads a community of athletes, thought pioneers and forward-thinking business leaders to affect systemic solutions to climate change.” Protect Our Winters (2019). About Us [website]. Retrieved from https://protectourwinters.org/about-us/. The second challenge is Opt Outside. This challenges goes right to the heart of our annual post-Thanksgiving consumer holiday:  Skip the malls, the internet, the big box stores and your town’s shopping district this weekend and go outside and play.  Just skip the madness.  Avoid it.  Turn it off.  And go outside and play.   Opt Outside started with REI – the giant outdoor sports retailer – in 2015 when they closed their stores on Black Friday, paid their 12,000 employees for a day of work any way, and encouraged everyone to get outside and enjoy the natural world around us.   That year alone, 1.4 million people and 170 outdoor companies, organizations and nonprofits took Black Friday off to play outside.  To date, 700 organizations and 7 million people have chose to opt outside.  (These stats are according to REI’s website.) Opt Outside is a remarkable idea.  Black Friday is the day, as I’m sure you know, when most US retailers try to scoop up as many consumer dollars as possible in order to get their profits “in the black” for the year.  And it’s a day when millions of people – consumers like you and me – commit to spend hundreds and thousands of dollars, stand in long lines, withstand incredible traffic jams and partake in literal stampedes in stores across the country in order to buy stuff.  Opt Outside changes all of that.

Kate currently practices anesthesia as a CRNA in the Department of Anesthesiology and Perioperative Medicine at Maine Medical Center.  Prior to nursing, Kate was an organic chemist with research and management experience in both industrial as well as pharmaceutical research labs.  Kate has earned a Masters of Science in Nurse Anesthesia from the University of New England, a Bachelors of Science in Nursing from the University of Massachusetts, and an American Chemical Society certified Bachelors of Science in Chemistry with a minor in Biology from Northeastern University. In this podcast, we talk about Kate choosing to go back to school for anesthesia as a mother of two small kids and about Kate’s remarkable effort to pay off $140,000 of student loan debt in just over a year. Check out the links below to think more about student loan debt. Death, Sex & Money podcast series on student loan debt. Take the Quiz… see where you line up on WNYC’s Death, Sex & Money student loan project quiz. Beyond the Mask with Jermey Stanley: Episode 23 – The Wealthy CRNA. Get tips on financial management specific to CRNAs in the above podcast and through Jeremy’s company: CRNA Financial Planning. Cycle back to Episode 18 of this show to hear Jeremy talk through freelancing options for CRNAs.

The Top Drawer Run Down covers the most common medications found in the top drawer of an anesthesia cart. Developing a mastery of these medications lays the foundation to a safe and effective anesthesia practice. This podcast is a start – or maybe a refresher – to developing that mastery. Here’s the medications we will cover in this series: Part 1 * Propofol* Etomidate* Ketamine* Lidocaine* Fentanyl * Morphine* Hydromorphone* Remifentanil* Sufentanil* Alfentanil* Succinylcholine* Rocuronium* Vecuronium* Cisatracurium Part 2 * Atropine* Glycopyrrolate * Neostigmine* Sugammadex * Metoprolol* Labetalol* Esmolol* Hydralizine* Phenylephrine* Ephedrine* Epinephrine* Calcium Chloride Part 3 * Heparin* Naloxone* Albuterol* Dexamethasone* Famotidine* Ondansetron* Haloperidol* Furosemide* Metoclopramide* Ketorolac* Oxytocin* Methylergonovine* Carboprost Michael Mielniczek, MSN, CRNA bio: Michael graduated from the University of Scranton with a Master’s in Nursing in December 2018. He currently practices anesthesia as a CRNA in Austin, Texas. He has an interest in pharmacology related to anesthesia and enjoys helping others understand this fascinating topic.  Succinylcholine was the focus of Michael’s graduate research and he’s presented on the medication at both state CRNA conferences and national AANA Annual Congress. You may remember Michael from his previous contribution to From the Head of the Bed when he and I recorded a deep dive on succinylcholine back in March of 2018 (episode 39). Disclaimer Michael and I sourced our information from the leading anesthesia textbooks including Miller, Katzung, Oullette and Naglehout, as well as cross referencing with published journal articles and Up to Date.  That means that we’re bringing you the core, basic information about these medications.  It does NOT mean that everything we say is flawless and completely accurate.   Some of what we say may actually be a matter of opinion, personal preference and technique – you or the people you work with may have other opinions or techniques.   And that’s ok – it’s part of developing the art of providing anesthesia which is something you can do once you have a solid foundation of the science of anesthesia.  Michael and I both edited and reviewed our notes and I edited the content again in post-production.  However, as with any podcast or blog post, you should take what you learn here and cross reference it with published, peer-reviewed literature.  Your clinical practice and your decision making is your responsibility.  It can be super dangerous to just take something you hear in a podcast or read on a blog and immediately implement it in your practice without first doing your own due diligence by making sure you have both accurate information and a good understanding of how to integrate that into best practice.  Additionally, some of the common ways anesthesia providers use medications perioperatively are not FDA approved or are considered off-label.  We try to point those out in this series but again, your practice is your responsibility.  References Assante, J., Collins, S., & Hewer, I. (2015).

The Top Drawer Run Down covers the most common medications found in the top drawer of an anesthesia cart. Developing a mastery of these medications lays the foundation to a safe and effective anesthesia practice. This podcast is a start – or maybe a refresher – to developing that mastery. Here’s the medications we will cover in this series: Part 1 * Propofol* Etomidate* Ketamine* Lidocaine* Fentanyl * Morphine* Hydromorphone* Remifentanil* Sufentanil* Alfentanil* Succinylcholine* Rocuronium* Vecuronium* Cisatracurium Part 2 * Atropine* Glycopyrrolate * Neostigmine* Sugammadex * Metoprolol* Labetalol* Esmolol* Hydralizine* Phenylephrine* Ephedrine* Epinephrine* Calcium Chloride Part 3 * Heparin* Naloxone* Albuterol* Dexamethasone* Famotidine* Ondansetron* Haloperidol* Furosemide* Metoclopramide* Ketorolac* Oxytocin* Methylergonovine* Carboprost Michael Mielniczek, MSN, CRNA bio: Michael graduated from the University of Scranton with a Master’s in Nursing in December 2018. He currently practices anesthesia as a CRNA in Austin, Texas. He has an interest in pharmacology related to anesthesia and enjoys helping others understand this fascinating topic.  Succinylcholine was the focus of Michael’s graduate research and he’s presented on the medication at both state CRNA conferences and national AANA Annual Congress. You may remember Michael from his previous contribution to From the Head of the Bed when he and I recorded a deep dive on succinylcholine back in March of 2018 (episode 39). Disclaimer Michael and I sourced our information from the leading anesthesia textbooks including Miller, Katzung, Oullette and Naglehout, as well as cross referencing with published journal articles and Up to Date.  That means that we’re bringing you the core, basic information about these medications.  It does NOT mean that everything we say is flawless and completely accurate.   Some of what we say may actually be a matter of opinion, personal preference and technique – you or the people you work with may have other opinions or techniques.   And that’s ok – it’s part of developing the art of providing anesthesia which is something you can do once you have a solid foundation of the science of anesthesia.  Michael and I both edited and reviewed our notes and I edited the content again in post-production.  However, as with any podcast or blog post, you should take what you learn here and cross reference it with published, peer-reviewed literature.  Your clinical practice and your decision making is your responsibility.  It can be super dangerous to just take something you hear in a podcast or read on a blog and immediately implement it in your practice without first doing your own due diligence by making sure you have both accurate information and a good understanding of how to integrate that into best practice.  Additionally, some of the common ways anesthesia providers use medications perioperatively are not FDA approved or are considered off-label.  We try to point those out in this series but again, your practice is your responsibility.  References Brull, S. J., & Kopman, A. F. (2017). Current Status of Neuromuscular Reversal and Monitoring Challenges and Opportuniti...

The Top Drawer Run Down covers the most common medications found in the top drawer of an anesthesia cart. Developing a mastery of these medications lays the foundation to a safe and effective anesthesia practice. This podcast is a start – or maybe a refresher – to developing that mastery. Here’s the medications we will cover in this series: Part 1 * Propofol* Etomidate* Ketamine* Lidocaine* Fentanyl * Morphine* Hydromorphone* Remifentanil* Sufentanil* Alfentanil* Succinylcholine* Rocuronium* Vecuronium* Cisatracurium Part 2 * Atropine* Glycopyrrolate * Neostigmine* Sugammadex * Metoprolol* Labetalol* Esmolol* Hydralizine* Phenylephrine* Ephedrine* Epinephrine* Calcium Chloride Part 3 * Heparin* Naloxone* Albuterol* Dexamethasone* Famotidine* Ondansetron* Haloperidol* Furosemide* Metoclopramide* Ketorolac* Oxytocin* Methylergonovine* Carboprost Michael Mielniczek, MSN, CRNA bio: Michael graduated from the University of Scranton with a Master’s in Nursing in December 2018. He currently practices anesthesia as a CRNA in Austin, Texas. He has an interest in pharmacology related to anesthesia and enjoys helping others understand this fascinating topic.  Succinylcholine was the focus of Michael’s graduate research and he’s presented on the medication at both state CRNA conferences and national AANA Annual Congress. You may remember Michael from his previous contribution to From the Head of the Bed when he and I recorded a deep dive on succinylcholine back in March of 2018 (episode 39). Michael Mielniczek, MSN, CRNA Disclaimer Michael and I sourced our information from the leading anesthesia textbooks including Miller, Katzung, Oullette and Naglehout, as well as cross referencing with published journal articles and Up to Date.  That means that we’re bringing you the core, basic information about these medications.  It does NOT mean that everything we say is flawless and completely accurate.   Some of what we say may actually be a matter of opinion, personal preference and technique – you or the people you work with may have other opinions or techniques.   And that’s ok – it’s part of developing the art of providing anesthesia which is something you can do once you have a solid foundation of the science of anesthesia.  Michael and I both edited and reviewed our notes and I edited the content again in post-production.  However, as with any podcast or blog post, you should take what you learn here and cross reference it with published, peer-reviewed literature.  Your clinical practice and your decision making is your responsibility.  It can be super dangerous to just take something you hear in a podcast or read on a blog and immediately implement it in your practice without first doing your own due diligence by making sure you have both accurate information and a good understanding of how to integrate that into best practice.  Additionally, some of the common ways anesthesia providers use medications perioperatively are not FDA approved or are considered off-label.  We try to point those out in this series but again, your practice is your responsibility.  References Çoruh, B., Tonelli, M. R., & Park, D. R. (2013).

This is a distillation of 10 key tips to help folks learning airway management to improve their skills. It’s also a framework for experienced providers to approach airway management from. This show gets straight to the point: 10 tips for airway management in 10 minutes. 10 Tips for Airway Management 1. Develop a growth mindset and practice deliberately 2. Do a good airway assessment 3. Develop and follow a plan 4. Control your environment 5. Position the patient and yourself for success 6. Preoxygenate adequately 7. Communicate effectively 8. Choose meds appropriately and let them work 9. Take your time with laryngoscopy 10. Recognize when you need to change your plan and do so deliberately Chong, J. (2016).  Airway management in obese patients.  EMNote.  Retrieved from http://www.emnote.org/emnotes/airway-management-in-obese-patients This is my personal ramp preference – a stack of blankets wrapped in one blanket (which helps with removing the ramp after intubation) and either a pillow or foam shay on top. Photo by Jon Lowrance. Resources… delve in, read more: Achar, S. K., Pai, A. J., & Shenoy, U. K. (2014). Apneic oxygenation during simulated prolonged difficult laryngoscopy: comparison of nasal prongs versus nasopharyngeal catheter: a prospective randomized controlled study. Anesthesia, essays and researches, 8(1), 63. Booth, A. W. G., Vidhani, K., Lee, P. K., & Thomsett, C. M. (2017). SponTaneous Respiration using IntraVEnous anaesthesia and Hi-flow nasal oxygen (STRIVE Hi) maintains oxygenation and airway patency during management of the obstructed airway: an observational study. BJA: British Journal of Anaesthesia, 118(3), 444-451 Caputo, N., Azan, B., Domingues, R., Donner, L., Fenig, M., Fields, D., … & McCarty, M. (2017). Emergency Department use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). Academic Emergency Medicine, 24(11), 1387-1394. Chong, J. (2016).  Airway management in obese patients.  EMNote.  Retrieved from http://www.emnote.org/emnotes/airway-management-in-obese-patients Dearani, J. A., Gold, M., Leibovich, B. C., Ericsson, K. A., Khabbaz, K. R., Foley, T. A., … & Daly, R. C. (2017). The role of imaging, deliberate practice, structure, and improvisation in approaching surgical perfection. The Journal of thoracic and cardiovascular surgery, 154(4), 1329-1336. Ericsson, K. A. (2015). Acquisition and Maintenance of Medical Expertise: A Perspective From the Expert – Performance Approach With Deliberate Practice. Academic Medicine, 90(11), 1471. doi:10.1097/ACM.0000000000000939 Ericsson, A., & Pool, R. (2016). Peak: Secrets from the new science of expertise. Houghton Mifflin Harcourt. Ericsson, K. A. (2004). Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic medicine, 79(10), S70-S81. e Silva, L. O. J., Cabrera, D., Barrionuevo, P., Johnson, R. L., Erwin, P. J., Murad, M. H., & Bellolio, M. F. (2017). Effectiveness of apneic oxygenation during intubation: a systematic review and meta-analysis. Annals of emergency medicine, 70(4), 483-494.  Heard, A., Toner, A. J., Evans, J. R., Palacios,

In this episode, Skyler provides a thorough overview of local anesthetics including relevant anatomy and physiology (i.e. nerve fibers, sodium channels, pKa, etc), types of local anesthetics and factors that effect onset, potency, duration of action and absorption. We touch on methemoglobinemia, Local Anesthetic Systemic Toxicity (LAST) and common dosing and max dosing for local anesthetics. This is a great run down for anyone wanting to brush up on local anesthetics! At the time of this recording, Skyler Rouhselang was a second-year SRNA at Marian University in Indianapolis, IN. She attended Ball State University for her undergraduate education where she earned her BSN in 2013. Skyler went on to work in the medical ICU at a Level 1 Trauma Center in downtown Indianapolis for 5 years before returning to school to complete her Doctor of Nursing Practice degree. She is expected to graduate in May 2020. References Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2018). Morgan and Mikhail’s clinical anesthesiology. McGraw-Hill Education. Miller, R. D. (2014). Miller’s anesthesia. Philadelphia, PA: Elsevier.  Nagelhout, J. J., Elisha, S., & Plaus, K. (2017). Nurse anesthesia. Elsevier Health Sciences.

In this episode, Ashley walks us through an overview of the most common IV anesthesia induction agents. We cover propofol, ketamine, etomidate, barbiturates (e.g. methohexital), dexmedetomidine and benzodiazepines (e.g. midazolam). A run down of the mechanism of action, dosing, onset, metabolism and physiologic effects are provided. At the time of this recording, Ashley Scheil was a second-year SRNA at Marian University in Indianapolis, IN. She earned her BSN from Purdue University in 2012. Ashley worked as a critical care Registered Nurse in the surgical ICU at the Roudebush VA Medical Center in Indianapolis for 6 years before going back to anesthesia school. She is expected to graduate in May of 2020 with her DNP degree. References Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2018). Morgan and Mikhail’s clinical anesthesiology. McGraw-Hill Education. Miller, R. D. (2014). Miller’s anesthesia. Philadelphia, PA: Elsevier.  Nagelhout, J. J., Elisha, S., & Plaus, K. (2017). Nurse anesthesia. Elsevier Health Sciences.

In this episode, Skyler walks us through the pharmacodynamics of volatile anesthetics. We talk extensively about the concepts related to minimum alveolar concentration (MAC), the mechanism of action of volatile anesthetics and the physiologic response to volatiles. You don’t want to miss this excellent overview of core anesthesia concepts! At the time of this recording, Skyler Rouhselang was a second-year SRNA at Marian University in Indianapolis, IN. She attended Ball State University for her undergraduate education where she earned her BSN in 2013. Skyler went on to work in the medical ICU at a Level 1 Trauma Center in downtown Indianapolis for 5 years before returning to school to complete her Doctor of Nursing Practice degree. She is expected to graduate in May 2020. References Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2018). Morgan and Mikhail’s clinical anesthesiology. McGraw-Hill Education. Miller, R. D. (2014). Miller’s anesthesia. Philadelphia, PA: Elsevier.  Nagelhout, J. J., Elisha, S., & Plaus, K. (2017). Nurse anesthesia. Elsevier Health Sciences.

In this episode, Skyler gives a succinct run down on the pharmacokinetics of volatile anesthetics. We talk about uptake, distribution, elimination and metabolism and unpack concepts such as blood gas solubility, oil gas solubility, Fa/Fi curves and more. You don’t want to miss this excellent overview of core anesthesia concepts! At the time of this recording, Skyler Rouhselang was a second-year SRNA at Marian University in Indianapolis, IN. She attended Ball State University for her undergraduate education where she earned her BSN in 2013. Skyler went on to work in the medical ICU at a Level 1 Trauma Center in downtown Indianapolis for 5 years before returning to school to complete her Doctor of Nursing Practice degree. She is expected to graduate in May 2020. References Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2018). Morgan and Mikhail’s clinical anesthesiology. McGraw-Hill Education. Miller, R. D. (2014). Miller’s anesthesia. Philadelphia, PA: Elsevier.  Nagelhout, J. J., Elisha, S., & Plaus, K. (2017). Nurse anesthesia. Elsevier Health Sciences

In this episode, Ashley provides a detailed overview of the anesthesia machine, its components and key tips for using and troubleshooting it. If you want to know about or review the anesthesia machine… this is your podcast! At the time of this recording, Ashley Scheil was a second-year SRNA at Marian University in Indianapolis, IN. She earned her BSN from Purdue University in 2012. Ashley worked as a critical care Registered Nurse in the surgical ICU at the Roudebush VA Medical Center in Indianapolis for 6 years before going back to anesthesia school. She is expected to graduate in May of 2020 with her DNP degree. E – Cylinder Calculation Amount of oxygen in cylinder in liters divided by liters of flow Ex:       660 liters / 3 lpm = 220 minutes of oxygen              330 liters / 10 lpm = 33 minutes of oxygen References Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2018). Morgan and Mikhail’s clinical anesthesiology. McGraw-Hill Education. Miller, R. D. (2014). Miller’s anesthesia. Philadelphia, PA: Elsevier.  Nagelhout, J. J., Elisha, S., & Plaus, K. (2017). Nurse anesthesia. Elsevier Health Sciences.

In this episode, Ashley and I talk through how to set up an operating room anesthesia workstation, perform preoperative patient assessment and progress through an IV induction and intubation. This is a great podcast to help SRNAs and other anesthesia learners to get their clinical flow down! At the time of this recording, Ashley Scheil was a second-year SRNA at Marian University in Indianapolis, IN. She earned her BSN from Purdue University in 2012. Ashley worked as a critical care Registered Nurse in the surgical ICU at the Roudebush VA Medical Center in Indianapolis for 6 years before going back to anesthesia school. She is expected to graduate in May of 2020 with her DNP degree. References Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2018). Morgan and Mikhail’s clinical anesthesiology. McGraw-Hill Education. Miller, R. D. (2014). Miller’s anesthesia. Philadelphia, PA: Elsevier.  Nagelhout, J. J., Elisha, S., & Plaus, K. (2017). Nurse anesthesia. Elsevier Health Sciences.

I had the distinct pleasure to talk with John Preston, DNSc, CRNA, APN and Lisa Kamen, CAE of the National Board of Certification & Recertification for Nurse Anesthetists (NBCRNA) on the Continued Professional Certification (CPC) Program. If you want to know what’s up with the CPC Program, you’ve landed on the right podcast. We walk through a comprehensive overview of the program from what’s required in each 4-year cycle, a run down on Class A & B credits, Core Modules, the 2-year check-in requirements and, of course, an overview of the CPC Assessment or examination process. Additionally, we talk about the significance of the CPC Program from an continuing education standpoint and how it stacks up to what other professionals are doing and we wrap up the show with a conversation on the challenges and opportunities CRNAs will face in the coming years. John Preston, DNSc, CRNA, APN is the Chief Credentialing Officer for the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).   Dr. Preston has been active in nurse anesthesia accreditation, education and regulation for over 20 years.  His previous career accomplishments include nurse anesthesia program administrator, Chair of the Council on Accreditation and AANA Senior Director for Education and Professional Development. He has been a registered nurse for 31-years and a Certified Registered Nurse Anesthetist since 1994.   Lisa Kamen, CAE is the Senior Director of Communications, Publications and Governance with the NBCRNA and has been with the NBCRNA since 2015. Lisa earned the Certified Association Executive designation in 2018. The CAE credential is the marker of a committed association professional who has demonstrated the wide range of knowledge essential to manage an association in today’s challenging environment. She has more than 20 years of experience in the health care communications field, having worked with numerous health care non-profit organizations and associations. Resources: NBCRNA CPC Program website. This is where you want to for further information on the CPC Program at large. NBCRNA CPC Program Calculator – this will walk you through the key CPC Program dates tailored to where you are in your specific recertification cycle. Upload Class B credits with AANA here. This is the site, if you’re a member of the American Association of Nurse Anesthetists, that you can upload class be credits. Click “Class B Submissions” on the top banner and follow the instructions. NBCRNA’S CPC Program Timeline. (2018). Retrieved from: https://www.nbcrna.com/continued-certification

In this episode, we explore opioid free anesthesia with Tom Baribeault, MSN, CRNA and Jayme Reuter, MS, CRNA. Tom is the founder of the Society for Opioid Free Anesthesia and Jayme is the founder of Cornerstone Anesthesia Conferences. The three of us came together in Scottsdale, Arizona at one of Cornerstone’s continuing education conferences for CRNAs. We discuss the progression to opioid free anesthesia (OFA) in our field, where OFA fits into enhanced recovery programs and the specific techniques of how to provide a comfortable, opioid-free perioperative experience for our patients. Click the following link to find out more about the Society for Opioid Free Anesthesia, including a resource-filled members-only section of their website which includes overviews of pharmacological alternatives to opioids and specific opioid-free anesthetic plans. You can also explore all of Cornerstone Anesthesia Conference’s offerings. We will be in San Antonio, Sonoma, Huston and New Orleans in the coming months… come check us out! Tom Baribeault, MSN, CRNA is the Chief CRNA at Lexington Surgery Center in Lexington, Kentucky. He completed his anesthesia training at Case Western Reserve University. Tom has a passion for teaching anesthesia providers and others on opioid-free anesthesia, enhanced recovery after surgery, ultrasound guided regional anesthesia and point of care ultrasound. He is the president and founder of the Society for Opioid Free Anesthesia and is a member of the American Association of Nurse Anesthetists and the Kentucky Association of Nurse Anesthetists. Jayme Reuter, MS, CRNA is the Program Director and founder of Cornerstone Anesthesia Conferences. She completed her anesthesia training at Baylor College of Medicine and practices at Houston Methodist Hospital, which is part of Texas Medical Center. She created Cornerstone Anesthesia Conferences in 2017 with a mission to be the foundation for excellence in continuing anesthesia education.

I had the pleasure of speaking with Major April Ritter, DNAP, CRNA, recently on the topic of operating room fires… which is a bit of a hot topic in the perioperative world. Dr Ritter completed her Masters of Nursing Science (MSN) and Doctorate of Nurse Anesthesia Practice at Virginia Commonwealth University. Dr Ritter is also a Major in the United States Army Reserves. Prior to becoming a CRNA, she served for eight years as an active duty commissioned officer in the Army with experience as a critical care Registered Nurse and flight nurse with the 82nd Airborne Dustoff medevac team. She served two combat tours prior to transferring to the Army Reserves and returning to school for her master’s and doctorate degrees in anesthesia. She was recently involved in an operating room procedure in which there was a fire. We discuss the case at length and then dive into the background on OR and airway fires including contributing factors, prevention, crisis management and the importance of critical incident debriefing. You don’t want to miss this red hot podcast… hopefully the lessons here will smolder in your memory moving forward and help you turn up the heat on your fire prevention practices! Resources: Anesthesia Patient Safety Foundation Fire Safety Video APSF Fire Safety Video Contributes to 44% Decrease in Intraoperative Fires Since 2011 Anesthesia e-Nonymous – Virginia Commonwealth University