Beyond The Mask: Innovation & Opportunities For CRNAs

Cricothyrotomy is what’s known as a High Acuity Low Occurrence (HALO) procedure. Meaning anesthesia providers do not often perform this procedure, but when the clinical situation calls for a cricothyrotomy…it can be extremely stressful! In this episode, Jeremy reviews the anatomy of the larynx, talks about preparation for the procedure itself, and then goes over a surgical cricothyrotomy technique called the Bougie-Assisted Cricothyrotomy (otherwise known as Scalpel-Finger-Bougie). This is certainly one episode you will not want to miss!   Here are some of the things you’ll learn on this show: A last-ditch effort to provide life-saving ventilation. 4:11 Reviewing the anatomy first. 7:25 Identifying the cricothyroid membrane. 12:27 The potential hardest part of the procedure. 14:26 Walking through the surgical cricothyrotomy technique. 15:51 Things to keep in mind if you’re ever doing this procedure. 23:34   About our hosts: https://www.kpsan.org/school/people/ Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf   We're excited to share that Beyond The Mask has been recognized in the 18th Annual People's Choice Podcast Awards. We're nominated in two prestigious categories: the coveted 'People's Choice Award' and 'Best Healthcare Podcast.' We're asking you to vote for us in the People's Choice Podcast Awards. Your vote not only helps us win but also spreads the word about our mission to demystify our corner of the healthcare industry, one story at a time. Cast your vote here: https://www.podcastawards.com/

We're excited to share that Beyond The Mask has been recognized in the 18th Annual People's Choice Podcast Awards. We're nominated in two prestigious categories: the coveted 'People's Choice Award' and 'Best Healthcare Podcast.' We're asking you to vote for us in the People's Choice Podcast Awards. Your vote not only helps us win but also spreads the word about our mission to demystify our corner of the healthcare industry, one story at a time. Cast your vote here: https://www.podcastawards.com/   Most of the financial conversations we’ve had on the podcast recently have been geared toward retirees, but today we want to focus on the financial planning process. So whether you’re a new graduate or a CRNA with over 20 years of experience, we want to share some planning things that everyone needs to make sure aren’t left incomplete.   Here are some of the things you’ll learn on this show: Why you might have too much cash in the bank.  4:01 Why you should keep 3-6 months of expenses in an emergency fund.  7:48 The reasons you need disability insurance and life insurance. 10:56 Budgeting and tracking your cash flow. 19:33 The technique we use to help people pay off debt. 22:55 Why you need to be planning for higher taxes in the future. 30:40 How to prepare for medical costs that are increasing faster than inflation. 32:46   Support Team Emma Kate Brekken: https://grouprev.com/HALOSWALK2023-grant-brekken  Learn more about CRNA Financial Planning: http://crnafinancialplanning.com Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

We're excited to share that Beyond The Mask has been recognized in the 18th Annual People's Choice Podcast Awards. We're nominated in two prestigious categories: the coveted 'People's Choice Award' and 'Best Healthcare Podcast.' We're asking you to vote for us in the People's Choice Podcast Awards. Your vote not only helps us win but also spreads the word about our mission to demystify our corner of the healthcare industry, one story at a time. Cast your vote here: https://www.podcastawards.com/   Today we’re excited to bring on two special guests for a compelling conversation. Sharon convinced her husband, Mike, to be a guest co-host on the show while visiting the mid-year assembly in Washington D.C, and they are joined by former Chief of the Aurora (Illinois) Police Department Kristen Ziman. She wrote a book about her experiences – good and bad – in the law enforcement profession and the leadership lessons she learned. You’ll be surprised by how many parallels there are between her career and the careers of CRNAs and this episode will have some powerful messages to share.    Here are some of the things you’ll learn on this show: A little background on her experience in law enforcement that led to her writing a book and becoming a speaker. 4:11 What she feels are the core tenets of leadership. 8:16 Finding your purpose each day to make yourself feel proud. 13:16 How to become a disruptor in your profession to help improve the culture. 16:13 Why it’s important to allow members of your team to be vulnerable. 23:21 The three things that drive human performance. 30:23 The greatest freedom we have is to choose the way we respond to a specific stimulus. 35:20 The importance of surrounding yourself with a ‘personal board of directors.’ 43:33   Support Team Emma Kate Brekken: https://grouprev.com/HALOSWALK2023-grant-brekken  About our guest: https://kristenziman.com/ Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

Even though awake intubations are rare, this procedure is still relevant. In fact, this is an anesthesia airway management technique that continues to be recommended for known difficult airways in every single difficult airway algorithm. In this episode, Jeremy and Sass talk about a specific technique for anesthetizing the airway they call “TOPICAL THUNDER” in preparation for an awake intubation. This is cutting edge, tip of the spear stuff that you won’t want to miss.   Here are some of the things you’ll learn on this show: Reviewing the target nerves that innervate the airway. 3:55 Equipment you’ll need for this. 7:44 Reasons why we don’t like to use nebulized lidocaine. 9:39 Important patient prep to consider. 10:40 The different type of injection nerve blocks. 12:58 What forms of lidocaine will you need? 18:07 The potential for lidocaine toxicity. 25:07   Support Team Emma Kate Brekken: https://grouprev.com/HALOSWALK2023-grant-brekken  About our hosts: https://www.kpsan.org/school/people/ Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf  

Today we bring you another wonderful conversation from our trip to the mid-year assembly in Washington D.C. Sharon and Tracy Castleman, DNP, CRNA, APN-A, FAANA were on hand when Kris Rohde, CRNA received the AANA’s Daniel D. Vigness Federal Political Director Award. Afterward, we invited her to join the show to hear her story, talk about the role the FPD plays in each state, and share why the sacrifice has been well worth it.   Here are some of the things you’ll learn on this show: The role the Federal Political Director plays. 4:37 How she ended up in the role of FPD in Nebraska. 8:49 The role mentoring played in her career and helped her grow. 11:40 The importance of relationships with lobbyists. 17:25 Her legislative work with people in DC. 27:22 Has the sacrifices she’s had to make been worth it? 29:52 The message she’d share with other FPDs or rising FPDs who want to be successful. 35:27   Support Team Emma Kate Brekken: https://grouprev.com/HALOSWALK2023-grant-brekken  About our guest: https://www.aana.com/news/kris-rohde-receives-aanas-daniel-d-vigness-federal-political-director-award/ Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

During our trip to the mid-year assembly recently, Sharon and Tracy Castleman, CRNA were having a conversation about declining student membership at the AANA when they met Haley Johnson and Kelby Stanko, who are both students at Saint Vincent College Excela Health School of Nurse Anesthesia. We decided to spend time with both of these bright, young ladies to learn more about their experience attending this AANA event, being part of the mentorship program, and how they plan to help spread that positive message with other students.   Here are some of the things you’ll learn in this episode: What they’ve learned at the assembly and what’s been their reaction to what they’ve experienced. 3:19 The students explain how they didn’t get the value of the AANA until attending the assembly. 8:57 How they’ll share what they’ve learned on the trip with their classmates? 12:54 The story behind the mentorship program and Haley’s experience with it so far. 17:11 The students leave us with a final message. 29:59   Support Team Emma Kate Brekken: https://grouprev.com/HALOSWALK2023-grant-brekken  Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

In today’s episode Jeremy & Sass talk about the flexible intubation technique and some troubleshooting tips that may help you while placing an ETT in an awake patient using the flexible intubation scope. Previously known as “fiberoptic intubation”, this is an infrequent anesthesia technique that is still pertinent today! Also, if you are attending the AANA annual congress in Seattle in August, you can sign up to practice the flexible intubation technique with Jeremy in the Airway Simulation Lab. Details are on the AANA Annual Congress sign-up page: https://www.aana.com/meetings/aana-annual-congress    Here are some of the things you’ll learn on this show: A little history related to fiber optic intubation. 3:55 Why it’s tougher to perform when a patient is under general anesthesia rather than awake. 6:26 Indications and contraindications of an awake intubation procedure. 7:45 Setup process and equipment needed. 10:21 Running through the patient preparation checklist. 14:38 The hand and wrist movements you need to use during the procedure.  18:35 Similarities and differences in oral intubation and nasal intubation. 21:52 Troubleshooting techniques to utilize if needed. 24:49   About our hosts: https://www.kpsan.org/school/people/ Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

In part two, we'll go on an exploration to uncover the untold chapters of Dagmar’s post trial years and witness how her victory reshaped the landscape of nurse anesthesia, breaking down barriers and paving the way for countless nurse anesthetists who followed in her footsteps. Join us as we delve into part two of our conversation about Dagmar Nelson with show historians Nancy and Sandy.   Here are some of the things you’ll learn in this episode: What happened to the profession right after the trial? 1:58 What happened to Dagmar Nelson after the trial? 9:22 Hunt’s murder in 1943 and her death 15 years later. 11:52 What her legacy and that trial means today for anesthesia. 17:35 How anesthesia has changed and what has stayed the same. 20:13 The battle over money and control in the industry. 29:08 Hope for the future of anesthetists. 33:35   Support Team Emma Kate Brekken: https://grouprev.com/HALOSWALK2023-grant-brekken  Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

Most people know about Dagmar Nelson in terms of her being involved in the only court trial ever to test the legality of nurses administering anesthesia, but there’s much more to her than just that. We’ll lean on Nancy Bruton-Maree, CRNA, and Sandy Ouellette, CRNA to learn more about how amazing she was as a woman and what happened at the trial.   Here are some of the things you’ll learn in this episode: Details on her early life and education. 4:38 How she got her anesthesia training. 9:08 What the beginning of her career as an anesthetist was like. 14:02 California physicians were trying to get rid of nurse anesthetists when she moved out there. 23:54 Details of the trial as it got started in 1934. 30:52 The testimony that was given on behalf of the physicians. 41:17 Here’s what the defense argued. 43:52 What the judge said when he handed down the decision. 51:22 Support Team Emma Kate Brekken: https://grouprev.com/HALOSWALK2023-grant-brekken  Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

In this episode, Jeremy and Sass review the high points of an article published in the April 2023 AANA Journal by Barry Swerdlow, MD and Lisa Osborne-Smith, PhD, CRNA titled “A Cognitive Template for Management of Perioperative Adverse Events”. This is an episode you won’t want to miss!   Here are some of the things you’ll learn on this show: What is metacognition? 2:29 Six step cognitive checklist 7:31 Step 1: Verifying information is correct. 9:21 Step 2: Generic response 9:45 Step 3: Identification of precipitating event  10:36 Step 4: Formulation of broad differential diagnosis 13:13 Step 5: Formation of a narrowed differential diagnosis 15:14 Step 6: Selection of targeted response(s) 17:28 Let’s use this six-step process on a case study. 18:37   Additional Resources:  Swerdlow B, Osborne-Smith L. A Cognitive Template for Management of Perioperative Adverse Events. AANA J. 2023 Apr;91(2):137-143. PMID: 36951843.   About our hosts: https://www.kpsan.org/school/people/ Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf