Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

In this engaging discussion, Dr. Bridget Marroquin, an OB anesthesiologist and Associate Professor at UNC, shares her unique journey from OB/Gyn to anesthesiology. She emphasizes the importance of a 'planning-for-worst' mindset in OB anesthesia and offers practical troubleshooting tips for epidurals. Dr. Marroquin advocates for clear communication in labor and delivery settings and highlights the need for fostering collaborative relationships. She also discusses future trends in OB anesthesia, including subspecialty overlaps and the pursuit of fulfilling careers.

Dr. Sam DeMaria, a professor and vice chair for research in anesthesiology at the Mount Sinai Health System, discusses his book, "The Invisible Cut." He reveals how incivility, often exacerbated by stress and burnout, negatively impacts patient safety. Sam highlights research linking verbal misconduct to poor medical outcomes and shares tactical empathy techniques to combat rudeness. He emphasizes the importance of creating a civil culture in healthcare through personal communication and collaborative strategies, aiming for a safer environment for both patients and staff.

Dr. Joyce Wahr, a cardiac anesthesiologist and patient safety advocate, discusses her journey and the vital importance of addressing cognitive errors in clinical practice. She shares insights on System 1 and System 2 thinking, illustrating how automatic behaviors can lead to mistakes, especially in medication administration. Joyce highlights the dangers of eyewitness reliability and inattentional blindness, alongside advocating for practical solutions like engineering fixes in anesthesia. She emphasizes that effective patient safety isn’t just about trying harder, but implementing systemic changes.

In this discussion, Dr. Dan Saddawi-Konefka, an anesthesiologist and president of the Emotional PPE Project, along with Dr. Christine U. Moutier from the American Foundation for Suicide Prevention and Dr. Jesse Ehrenfeld, a public health advocate, explore critical barriers to mental health care for physicians. They delve into unique challenges faced by medical professionals, the stigma surrounding help-seeking, and practical strategies to foster a supportive environment. The conversation emphasizes the importance of addressing mental health to protect both clinicians and patient care.

Dr. Joseph Cody, a cardiac anesthesiologist passionate about medical education, and Dr. Michael Essandoh, an expert in cardiovascular anesthesia, dive into the latest on Impella technology. They explore critical guideline changes that elevate Impella's status in treating cardiogenic shock. Listeners learn about device placement techniques, management strategies, and the compelling results from key trials. They also discuss when to still consider IABP and share personal recommendations for lighthearted entertainment.

Dr. Michaela Farber, the inaugural Chief of Obstetric Anesthesiology at Mass General Brigham and an associate professor at Harvard, shares insights from her extensive career in OB anesthesia. She discusses the importance of fellowship training for improving maternal care and outcomes, the impact of rising clinical complexity, and lessons learned from mentoring fellows. Notably, she emphasizes using music to alleviate preoperative anxiety and highlights critical interventions for hemorrhage management, including the importance of safety habits among clinicians.

Dr. Mike Hofkamp and Dr. Emily Sharpe, experts in obstetric anesthesia, delve into the challenges of pain management during cesarean deliveries. They discuss the shift away from general anesthesia due to historical concerns and legal risks, and emphasize the importance of setting patient expectations about pain. The duo addresses how to measure intraoperative pain and the factors influencing it. They also highlight techniques to optimize epidurals and when to convert to general anesthesia, advocating for better pain management and patient autonomy throughout the process.

Justin Harvey, a Certified Financial Planner and founder of APM Wealth, shares crucial financial insights for anesthesia providers. He discusses the rising compensation and job demand in the field, alongside the trade-offs of pursuing fellowships. Common early-career mistakes like contract oversights and lifestyle creep are highlighted. Justin emphasizes the advantages of term life insurance, effective use of 529 plans for college funding, and maximizing retirement accounts. He also provides an update on student loan forgiveness and recommends engaging reads to enhance financial literacy.

Dr. Tym Kajstura, a Doctor of Anesthesiology, returns to discuss vital concepts in airway anatomy and pharmacology. He dives into the structure and function of the respiratory system, spotlighting the complexities of laryngeal innervation and its clinical implications. The conversation highlights the importance of anatomical knowledge for intubation and explores how innovations in medical products are enhancing patient care. Practical applications and insights into respiratory mechanics make this a must-listen for anyone in the field.

Join experts Dr. Manoj Iyer, Dr. Jonathan Tang, and Dr. Jordan Holloway as they delve into the exciting world of leadless pacing technology. Discover the advancements in devices like the Micra and Avere, which are transforming cardiac care. They discuss the challenges and innovations in implantation techniques and the integration of subcutaneous ICDs with leadless pacemakers. Explore how these developments aim to enhance patient outcomes and address arrhythmia management, especially in younger patients.