Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

In this 345th episode I welcome Dr. Matt O'Hara, Professor of History at UC Santa Cruz, to the show to discuss his book about the history of curare.

In this 344th episode I go over what you need to know about how the body deals with allergic responses to prepare you for the boards and for clinical practice.

In this 343rd episode I welcome Dr. Tym Kajstura back to the show for another ABA Keyword episode. We discuss the high yield topics that fall under General Anesthesia.

In this 342nd episode I welcome Dr. Tara Ramaswamy to the show to discuss her work looking at the benefits of having anesthesiologists run rapid response teams. We discuss how best to organize these teams, how to train and prepare them, and what the future holds. 

In this 341st episode I welcome Drs. Alia El-Mowafy and Rachel Tobis to the show to discuss how to prepare for and handle difficult airways and airway emergencies in the office-based setting. 

In this 340th episode I welcome Dr. Tym Kajstura back to the show for another ABA keyword episode. We discuss the high yield, much tested topic of Respiratory Physiology.

In this 339th episode I welcome Dr. Eric Wang to the show to discuss some of the most highly tested autonomic nerve blocks and what you need to know to get these questions right on your exams. 

In this 338th episode I welcome Dr. Michelle Humeidan to the show to discuss post-op delirium. We discuss the prevalence, risk factors, how we can try to prevent it, and her exciting work with cognitive prehabilitation.

In this 337th episode I welcome Dr. Andreas Plackis to the show. Dr. Plackis is the creator and host of the TEE Time Podcast and a cardiac anesthesiologist. We talk about TEE for the non-cardiac anesthesiologist, how it can be used and how to go about learning it. 

In this 336th episode I host an episode of the new, fantastic, Medical Safety Podcast hosted by Adam Shehata and Amir Hamid. This episode discusses 3 major airline disasters, how they were handled, what was learned, and what we can learn about how to improve our approach to safety in medicine.

In this 335th episode I welcome Dr. Tym Kajstura back to the show for another ABA Keyword Episode. We cover what they call common complications in anesthesia, a grab bag of high yield board topics. 

In this 334th episode I welcome Dr. Phil Adams to the show for another master clinician episode. Dr. Adams is a pediatric cardiac anesthesiologist and transplant anesthesiologist at University of Pittsburgh and we discuss his lessons learned and tips and tricks from his clinical career and life. 

In this 333rd episode I welcome Dr. Tiffany Moon to the show to discuss her wide ranging career and life as a mother, wife, anesthesiologist, author, entrepreneur, reality TV star and more. 

In this 332nd episode I welcome Dr. Tom Hickey to the show to discuss Buprenorphine. We discuss it's pharmacology, safety, use in OUD, Chronic pain, acute perioperative pain, we address some common myths and we talk about future directions. 

In this 331st episode I welcome Dr. Connor Schmenk, a dental anesthesiologist, to the show to discuss the ins and outs of performing anesthesia in the dental office. We discuss the training that dental anesthesiologists have and the ways to make sure you are prepared to keep your patients safe in a dental office or any similar environment.

In this 330th episode I welcome Dr. Tym Kajstura back to the show for another ABA Keyword episode. We cover the anatomy of the brain, spine and spinal cord. 

In this 329th episode I welcome Dr. Tyler Jones, founder of the Anesthesia Thoughts Blog, to the show to discuss management of SGLT2 inhibitors and GLP1 receptor agonists. We discuss the evidence for and against holding them before surgery and what you need to know to manage patients on them.

In this 328th episode I welcome AnesthesiaGawd to the show to discuss his incredibly successful instagram page which has over 270.000 followers and gets 16 million views every month. We discuss how he started the page, some of the joys and challenges, all time favorite memes, the impact it has allowed him to have on other people's lives, and where he might take it in the future.

In this 327th episode I welcome Drs. Rebecca Minehart and Lon Setnik to the show to discuss the framework Name/Claim/Aim--a way to quickly and effectively organize teams and find your voice in a crisis.

In this 326th episode I welcome Dr. Tym Kajstura back to the show for another ABA Keyword episode. We discuss the extra topics that don't fall under any other category including ethics, substance abuse, licensure and certification, and patient safety.

In this 325th episode I welcome Drs. Elliot Higgins and Amy Vinson to the show to discuss the development of the Well-Being Influencers Survey for Healthcare (WISH) inventory and how it is changing the way we think about, study and improve well-being in medicine. 

In this 324th episode I welcome Dr. Bridget Marroquin to be our 10th Master Clinician. We discuss her switch from OB/Gyn to Anesthesiologist and her accumulated wisdom about OB Anesthesiology. 

In this 323rd episode I welcome Dr. Sam DeMaria to the show to discuss his new book "The Invisible Cut: Incivility's Silent Toll on Healthcare". We discuss why incivility is so common in healthcare, how to address it in the moment, and how we can build a more civil culture in the future.

In this 322nd episode I share the recording from our live podcast at the Anesthesiology Annual Meeting in San Antonio Texas. I interview Dr. Joyce Wahr about her work with patient safety and her interest in cognitive errors. We discuss why we make these errors and how to prevent them.

In this 321st episode I welcome Drs. Saddawi-Konefka, Ehrenfeld and Yu Moutier to the show to discuss how we can reduce barriers to mental health care for physicians and other health care providers, why this is so important, and concrete steps that leaders and institutions can take today. 

In this 320th episdode I welcome Drs. Essandoh and Cody back to the show to discuss the latest data and guidelines around the use of the Impella device and how it compares to IABP and ECMO.

In this 319th episode I welcome another master clinician to the show. Dr. Michaela Farber is the inaugural Mass General Brigham Chief of OB Anesthesiology and a world expert in OB Anesthesia and OB Fellowship training. We talk about the lessons she has learned, often alongside her fellows, over the years.

In this 318th episode I welcome Dr. Mike Hofkamp and Dr. Emily Sharpe back to the show to discuss the problem of inadequate analgesia during c-sections. We discuss the issues that came up in The Retrievals Podcast, how to prevent pain, how to treat it if it happens, and how and when to convert to GA.

In this 317th episode I welcome Justin Harvey, CFP, back to the show to discuss what's new in the financial world for anesthesia providers in 2025. We discuss trends in compensation, the employment outlook, the pros and cons of doing a fellowship, the most common financial mistakes he sees people make, what different practice settings have to offer, and an update on student loan forgiveness. 

In this 316th episode I welcome Dr. Kajstura back to the show to discuss the high yield topics of airway anatomy and pharmacology. 

In this 315th episode I welcome Drs. Jon Tang, Jordan Halloway and Manoj Iyer to the show to discuss the latest updates on leadless pacemakers and ICDs.

In this 314th episode I welcome Thomas Piraino and Brandon Oto to the show to discuss how we can optimize PEEP in the ICU. We talk about why it matters, different ways to estimate ideal PEEP, and what the research tells us. 

In this 313th episode I welcome Dr. Alexis Motz to the show as she finishes her residency in anesthesiology. We discuss the lessons she learned along the way about how to get the most out of the experience and be the best resident, and all around physician, possible. We also discuss her interest in social media use in the residency application process. 

In this 312th episode I welcome Drs. Franklin Cladis, Meredith Kingeter and Bridget Marroquin to the show to discuss the Society for Education in Anesthesia (SEA). We discuss how it has been an important part of our careers and how it has a lot to offer to anyone interested in anesthesiology education. 

In this 311th episode I welcome Dr. Mark Nelson to the show to discuss his management aid that helps clinicians easily figure out how to handle all types of AICDs and Pacers in the perioperative period. 

In this 310th episode I welcome Dr. Annemarie Thompson, head of the working group that put out the new AHA/ACC Guidelines for the perioperative cardiovascular management for noncardiac surgery, and Drs. Jochen Steppan and Giancarlo Suffredini, cardiac anesthesiologists, to talk about the new iteration of the guidelines. We go through the algorithm in detail and talk about the evidence behind it and how to use biomarkers. 

In this 309th episode I welcome Dr. Mimi Wynn to another Master Clinician interview. We discuss her career as a world expert in cardiac and vascular anesthesia with a deep focus in thoraco-abdominal aneurysms. We discuss how to develop an area of expertise, how to keep learning, how to overcome imposter syndrome, how to deal with failure, and much more. 

In this 308th episode I welcome Dr. Tim Kajstura back to the show for another ABA Keyword episode. We cover Ambulatory Anesthesia. 

In this 307th episode I welcome Commander Dr. Mark Cannon, Commander Dr. Nick Pulos, Lieutenant Dr. Joey Sieker and Lt. Commander Erika Spencer to the show to discuss military reserve options for residents and attendings. 

In this 306th episode I welcome Dr. Beth Wilson to the show to discuss Early Allograft Dysfunction (EAD) after liver transplantation and what anesthesiologists can do to prevent or mitigate it. 

In this 305th episode I welcome Dr. Eric Busch to the show as our next Master Clinician. He has been practicing anesthesiology at Oschner in New Orleans for 35 years and has done everything from Chronic Pain to Cardiac. We discuss what he's learned over the years and some of his favorite things to teach his trainees. 

In this 304th episode I welcome Drs. Meyhoff and Breteler to the show to discuss continuous vital sign monitoring for patients on the floor and at home after surgery. We talk about the pros and cons of this kind of monitoring, what the future holds, and how Anesthesiologist and Intensivists can play an important role. Dr. Meyhoff is the founder of the WARD Clinical Support System which is awaiting FDA clearance.

In this 303rd episode I welcome Drs. Stahl and Saddawi-Konefka to the show to discuss how busy people can start using AI tools in their everyday lives to save time and make things easier. 

In this 302nd episode I interview Dr. David Broussard, a cardiac anesthesiologist and Chair of Anesthesiology at Ochsner Medical Center in New Orleans. We discuss his approach to preparing for, and dealing with, adverse events and how to communicate about them to patients and families in a way that builds trust. 

In this 301st episode I welcome Dr. Scott Licata to the show as the next master clinician in our series. He is a pediatric anesthesiologist and we go through a case from preop to intraop to postop and hear his tips and tricks for success. 

In this 300th episode, at the request of our listeners, I ask Dr. Dave Stahl to take the host's chair and interview me. We discuss some reflections on 8 years and 300 episodes of ACCRAC and some clinical and life based tips and tricks that I have picked up over the years. 

In this 299th episode I welcome Dr. David Stahl to the show to be our next master clinician.

In this 298th episode I welcome Dr. John Pizzuti to our series of interviews with master clinicians. Dr. Pizzuti was identified by multiple members of his private practice group as someone who, despite being relatively early in his career, is a true master clinician. He is someone others go to for help and advice all the time, including those much more senior in their careers. 

In this 297th episode I welcome Dr. Tym Kajstura back to the show for another ABA Keyword episode. We cover high yield topics of PE and Hyper and Hypoparathyroidism. 

In this 296th episode I welcome Dr. Mike Essandoh to do another master clinician episode. We discuss Dr. Essandoh's tips for being successful clinically, in research, in leadership, in innovation and in technology. 

In this 295th episode I discuss the kinds of statistical questions that come up on board exams and what you need to know to get them right.

In this 294th episode I play the live recording from my interview with Dr. Valerie Arkoosh who is the Secretary of Human Services for the State of Pennsylvania.

In this 293rd episode I interview Dr. Keith Baker in another master clinician episode. Dr. Baker is a professor at Harvard Medical School, the Vice Chair for Education at MGH and was formerly the residency program director there for 15 years.

In this 292nd episode I play the audio from the live episode we did at the Northeast Anesthesia Resident Conference in Boston on 9/14/24. I interviewed Aalok Agarwala, Associate CMO at MGH, Joanne Conroy, President and CEO of Dartmouth Health, and Sunil "Sunny" Eappen, CEO of UVM Health. We discuss their careers, and their tips for aspiring leaders in healthcare. 

In this 290th episode I welcome Drs. Finan and Ehrenkranz to the show to discuss the data on using psilocybin and other psychedelics for treating chronic pain and depression as well as their ongoing study on the topic. 

In this 290th episode I welcome Dr. Mike Grant back to the show to discuss post-op care for patients having cardiac surgery.

In this new series on master clinicians I will be interviewing people who have been identified by their colleagues and trainees as "master clinicians", people who others go to for advice and clinical guidance, people who are masters of their craft. In this episode I welcome Dr. Dave Berman back to the show to discuss how he has, in a relatively short time, become one of these master clinicians and what advice he has for all of you.

In this 288th episode I welcome Dr. Tym Kajstura to the show to do an ABA keyword episode. We discuss considerations for electroconvulsive therapy (ECT) and transfusion reactions.

In this 287th episode I welcome Drs. Kyle Sanchez and Dan Ellis to the show to discuss the perioperative care of transgender and gender-diverse Patients. We discuss terminology, different medications and surgeries that you may see, preop, intraop and postop considerations.

In this 286th episode I welcome Dr. Elisa Walsh to the show to discuss Central Venous Catheters. We discuss where they can be placed, what can go wrong, how to teach people how to place them safely and how to confirm placement. 

In this 285th episode I welcome Dr. Andrea Dutoit back to the show to discuss the most recent data on program signaling and what we know about how it affected applicants' chances of getting and interview and matching. 

In this 284th episode I welcome Drs. Sparling and Agarwala to the show to discuss the importance of, and evidence for, perioperative hand-offs. We discuss what hand-offs are, what kinds of handoffs occur during the perioperative period, why they matter, how they can cause harm when poorly done, and how implementing good hand-offs can reduce harm. 

In this 283rd episode I introduce a new podcast from University of Cincinnati Department of Anesthesiology hosted by Dr. John Crowe. This episode is about Primate Anesthesia and John interviews one of his colleagues who does some anesthesia for primates at the local zoo. I think they're doing great work on this podcast and look forward to more episodes to come!

In this 282nd episode I welcome Dr. Tricia Pendergrast to the show to discuss how to navigate the process of applying for residency in anesthesiology. We discuss how to set yourself up for success, how to figure out how competitive you are, when to consider an away rotation, when to consider dual applying, and how to figure out how to best use your signals.

In this 281st episode I welcome our SICU pharmacist, Traci Grucz, to the show to discuss glycemic management of critical ill patients. 

In this 280th episode I share the shocking and tragic news that Dr. Gillian Isaac died suddenly and unexpectedly a few weeks ago. She was an incredible human being, teacher, doctor, wife and mother. She will be missed more than I can say by more people than we can possibly count. I know that she would want us to continue with these keyword episodes that she loved doing and so I am going to try. I know they will never be the same, but they will be dedicated to her memory. Today I address the keyword of shock states and discuss the 4 types of shock and how they may be covered on your exams. I miss you, Gillian.

In this 279th episode I welcome Dr. Phil Carullo back to the show to discuss what, exactly, an anesthesiologist does and how we fit into the perioperative experience for patients.

In this 278th episode I discuss what you need to know about liver physiology for your exams.

In this 277th episode I welcome Dr. Gillian Isaac back for another ABA keyword episode. We discuss Adrenal Diseases and the questions you're likely to see about them on your exams. 

In this 276th episode I welcome pediatric anesthesiologist Dr. rita Saynhalath to the show to discuss how to manage kids presenting for surgery with a recent URI. We discuss the evidence for proceeding versus postponing, whether the type of virus matters, and how to handle COVID infections. 

In this 275th episode I welcome Chef Myles Snider to the show to discuss how busy professionals can cook tasty, healthy meals for themselves and their families. 

In this 274th episode I welcome Dr. Jonathan Kay (JK) to the show to discuss perioperative hypersensitivity reactions. We focus on the diagnosis and treatment of anaphylaxis and also discuss antibiotic allergies and how to deal with the ever present allergy to PCN. 

In this 273rd episode I welcome Dr. Caitlin Sutton to the show to discuss Anesthesia for fetal surgical procedures. We discuss some common procedures, how the anesthesia is done and why, what can go wrong and how to prepare, and what the future holds.

In this 272nd episode I welcome Dr. Kinza Berical to the show to discuss her work developing support systems for mothers who practice anesthesiology. We discuss navigating pregnancy and prenatal care, breastfeeding, mentorship around pregnancy loss, IVF and childcare. 

In this 271st episode I welcome Dr. Gillian Isaac back to the show for another ABA keyword episode. We discuss lower extremity nerve blocks.

In this 270th episode I welcome Drs. Michael Douglas and Leonard Soloniuk to the show to discuss the use of dexmedetomidine in spinals, epidurals and nerve blocks.

In this 269th episode I welcome Dr. Jeanna Blitz to the show to discuss the newest, most evidence based approach to preoperative assessment and optimization of patients. We discuss the use of biomarkers, alternatives to RCRI and using METS alone and assessment and optimization of frailty, nutritional status, anemia, psychological status and functional status. 

In this 268th episode I welcome Drs. Carullo, Kostibas, Isaac, Banks and Segna to the show. They are our peds, cardiac, OB, critical care and regional fellowship directors and we discuss the state of fellowships in anesthesiology.

In this 267th episode I welcome Dr. Alli Bechtel to the show to discuss the Anesthesia Patient Safety Foundation where she works as their podcast host. We discuss the APSF top 10 priorities, what they include and what guidance clinicians can get from them. 

This special 266th episode was recorded before a live audience at the Anesthesiology 2023 Annual Meeting in San Francisco. I interviewed Dr. Deb Culley about post-op delirium and Dr. John Eichorn about the history and future of patient monitoring.

In this 265th episode I welcome Dr. Gillian Isaac back to the show to do another ABA Keyword episode. We follow up on the last one by discussing Nitroprusside, Nitroyglycerin and their effect on hemoglobin

In this 264th episode I welcome Dr. Mimi Wynn to the show to discuss anesthesia for TAAA repair. We discuss preoperative concerns, intraoperative management, postoperative concerns especially spinal cord ischemia, and how to reduce the risk of that dreaded complication. 

In this 263rd episode I welcome Dr. Mahesh to the show to discuss radiation safety for anesthesia providers in the OR and procedure suites.  

In this 262nd episode I welcome Dr. Evan Kharash to the show to discuss the use of methadone perioperatively instead of more commonly used opioids such as fentanyl and dilaudid. We discuss the safety of methadone, how it works, and the evidence for superiority in terms of pain control, total opioid use, and patient satisfaction.

In this 261st episode I welcome professional commercial pilot and safety expert Matt Renz to the show to discuss aviation safety and how it can apply to medicine. 

In this 260th episode I welcome Dr. Dave Berman back to the show to discuss malignant hyperthermia. Dr. Berman is a volunteer with the MH hotline and he discussed the history, epidemiology, genetics, testing, prevention and management of MH and then we discuss some cases.

In this 259th episode I welcome Dr. Gillian Isaac back to the show to discuss another set of ABA key words. We discuss the pulse oximeter and some hemoglobinopathies that can affect its readings. 

In this 258th episode I welcome Dr Emily Sharpe and Dr. Mike Hofkamp back to the show to have a pro-con debate about what to do when a woman in labor with an epidural in place has to go unexpectedly for c-section. Dr. Hofkamp argues for removing the epidural and doing a second neuraxial technique while Dr. Sharpe argues for using the existing epidural. 

In this 257th episode I welcome Dr. Cara Esser back to the show to discuss the ins and outs of transsphenoidal pituitary surgery and what to keep in mind preoperatively, intraoperatively and postoperatively. 

In this 256th episode I welcome Dr. Cara Esser to the show to discuss neuromuscular diseases that are important to know for Anesthesia and Critical Care. 

In this 255th episode I welcome Drs. Dutoit and Teeter to the show to discuss the changes to the ERAS application system including program signals, geographic preferences, experiences, and general advice. We answer questions submitted by the ASA Medical Student Component.

In this 254th episode I welcome Dr. Gillian Isaac back to the show for another ABA Keyword episode. We discuss muscular dystrophies and trisomy 21.

In this 253rd episode I welcome Drs. Segna, Rayaz, Jaremko and Barnhart to the show to discuss the acute pain service, how to formulate a multimodal acute pain regimen for a patient, and how to think about the various medications involved.

In this 252nd episode I welcome Dr. Tim Poore, a palliative care physician, to the show to discuss palliative care in general and in the ICU in particular. He gives us some concrete tools to use when having difficult, end of life conversations with patients and families. 

In this 251st episode I welcome Dr. Emily Vail and Dr. Varun Goyal to the show to discuss the Anesthesiologist's role in organ donation.

In this 250th episode I welcome back Drs. Essandoh and Cody and, for the first time, Dr. Kjome, to discuss different career settings in anesthesiology. We discuss academics, the military and private practice.

In this 249th episode I welcome Dr. Gillian Isaac back to the show for another ABA Keyword episode. We discuss retrobulbar blocks and the oculocardiac reflex.

In this 248th episode I welcome Dr. Samir Gautam to the show. Dr. Gautam is a nephrologist specializing in AKI in the ICU and we talk about the diagnosis, causes, treatment and prognosis of AKI.

In this 247th episode I welcome Kali Dayton back to the show to discuss her work helping ICUs around the country learn how to get their intubated patients awake and up and walking and implement the ABCDEF bundle.