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The Anesthesia Playbook

The Anesthesia Playbook

Dr. Blake Forkey

The Anesthesia Playbook is a modern, case-based anesthesia podcast designed to help you think like an anesthesiologist. Each episode walks through real clinical scenarios, breaking down physiology, pathology, pharmacology, and high-yield decision-making in a clear, practical way. Built for anesthesia residents, CRNAs, and practicing clinicians preparing for cases, written exams, oral boards, and daily practice. So you can understand more, hesitate less, and master anesthesia one case at a time.

8 - 7. From Sedation to Crisis | Managing an Unprotected Airway
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  • 8 - 7. From Sedation to Crisis | Managing an Unprotected Airway

    What could go wrong during a routine sedation case?

    A patient presents for a seemingly straightforward procedure. She’s appropriately fasted, has no obvious aspiration risk factors, and the plan is simple: propofol sedation, spontaneous ventilation, and local anesthesia from the surgeon.

    Then everything changes.

    In this episode of The Anesthesia Playbook, we work through a case inspired by a real event and put you in the anesthesiologist’s seat as the situation evolves.

    What would you do next—and more importantly, why?

    Follow along, commit to your decisions, and see how your approach compares as the case unfolds.

    Understand more. Memorize less.

    Want more TAP?

    Get the weekly TAP Case of the Week delivered to your inbox and test your clinical decision-making with a new case each week.

    Follow The Anesthesia Playbook on Instagram, TikTok, YouTube, and Facebook for more anesthesia cases, clinical discussions, and quick teaching.

    🔗 Newsletter, social channels, and more: [Click TAP link]

    Sat, 19 Sep 2026 - 29min
  • 6 - 6. The Hyperthyroid Airway | Awake Intubation, Thyroid Storm & Post-Op Emergencies

    A 45-year-old woman with poorly controlled Graves disease presents for thyroidectomy with a massive goiter, positional dyspnea, and subtle stridor. The question isn’t just how you’re going to secure the airway—it’s what could happen if you take away the things currently keeping it open.

    In this episode of The Anesthesia Playbook, we work through the case from pre-op evaluation to the PACU. We’ll reason through the difficult airway, awake intubation, anesthetic planning, thyroid physiology, and the recognition and treatment of thyroid storm. Then, just when the case seems finished, new postoperative problems force us to rethink the differential: hoarseness, neck swelling, and stridor.

    Along the way, we’ll tackle the kinds of questions that matter both in the OR and on oral boards:

    Would you sedate this patient? Would you induce general anesthesia before securing the airway? How would you recognize thyroid storm—and distinguish it from malignant hyperthermia? What would you do if she developed an expanding neck hematoma after surgery?

    This isn’t about memorizing a list of answers. It’s about understanding the physiology, anticipating what could happen next, and making a defensible clinical decision.

    Follow The Anesthesia PlaybookInstagram / TikTok / YouTube: @TheAnesthesiaPlaybookWebsite: TheAnesthesiaPlaybook.com

    Understand more. Memorize less.

    The Anesthesia Playbook is intended for education only and does not replace clinical judgment, institutional protocols, or appropriate supervision.

    Wed, 09 Sep 2026 - 43min
  • 5 - 5. Aortic Stenosis Patient | Shoulder Surgery, Beach Chair, Hemodynamics, Airway, Complications

    In this episode of The Anesthesia Playbook, we walk through a real-world case of aortic stenosis anesthesia for a patient undergoing shoulder arthroplasty in the beach chair position.

    This case highlights the critical importance of hemodynamic management, myocardial oxygen supply and demand, and cerebral perfusion in patients with fixed outflow obstruction.

    We break down:

    How to manage aortic stenosis in the ORChoosing and performing an interscalene block + superficial cervical plexus blockAirway considerations including diabetic stiff joint syndrome and difficult intubationWhy phenylephrine is the pressor of choiceUnderstanding stroke volume, preload, afterload, and contractilityThe role of atrial kick and sinus rhythm in cardiac outputMyocardial ischemia from tachycardia and hypotensionRisks of the beach chair position, including cerebral hypoperfusionCerebral autoregulation and why chronic hypertension shifts the curveManaging Bezold-Jarisch reflex in shoulder surgery

    This episode is designed for anesthesia residents, CRNAs, and practicing anesthesiologists who want a clear, case-based understanding of complex physiology without memorizing textbooks.

    If you want to better understand how physiology applies in real cases and how to stay ahead of complications in the OR this episode is for you.

    Mon, 13 Apr 2026 - 25min
  • 4 - 4. Preeclampsia Explained | OB Anesthesia, Scoliosis, and Preeclampsia Management

    On this episode of The Anesthesia Playbook, we break down one of the most important and high-yield patients in obstetric anesthesia: the preeclamptic patient.

    This case-based episode walks through a real-world scenario, from labor epidural placement to urgent Cesarean section, while teaching the physiology, anesthetic decision-making, and complication management you need to understand to take care of these patients safely.

    We cover:

    The pathophysiology of preeclampsia (and why it’s more than just hypertension)Key pregnancy physiology that drives anesthetic managementEpidural vs spinal vs CSE in preeclamptic patientsPlatelet thresholds and neuraxial anesthesia considerationsPractical epidural tips in patients with scoliosisBlood pressure goals and vasopressor managementMagnesium sulfate: mechanism, benefits, and anesthetic implicationsFluid management and risk of pulmonary edemaIntraoperative management for Cesarean sectionPostoperative complications including respiratory distress and lower extremity weakness

    This episode is designed for anesthesia residents, CRNAs, and practicing anesthesiologists who want a clear, physiology-based understanding of preeclampsia and how to manage it in real clinical scenarios.

    If you’ve ever wondered:

    “Is it safe to place an epidural with low platelets?”“Why can fluids worsen preeclampsia?”“What’s the safest anesthetic for a C-section in these patients?”

    This episode answers those questions and more.

    Sat, 04 Apr 2026 - 24min
  • 3 - 3. Obesity and Robotic Hysterectomy| PEEP, FRC, and Why Patients Become Hypoxic

    Studies showing benefit of using "individualized PEEP" which is often higher than convention.

    Another study showing benefit of individualized PEEP in abdominal surgeries.

    In this episode, we walk through a real-world case of an obese patient undergoing a robotic hysterectomy,and why these cases can quickly become a ventilation challenge.

    Obesity, pneumoperitoneum, and steep Trendelenburg create a perfect storm for decreased functional residual capacity (FRC), increased closing capacity, and worsening lung compliance. If you don’t anticipate these changes early, you’ll spend the entire case trying to catch up.

    We break this case down step by step, just like you should in the OR:

    • Identifying your biggest concerns in an obese patient undergoing robotic surgery
    • Defining your anesthetic goals for ventilation and oxygenation
    • Understanding how obesity and positioning affect FRC and closing capacity
    • How pneumoperitoneum and Trendelenburg worsen compliance
    • Using PEEP effectively to prevent atelectasis and improve oxygenation
    • Interpreting airway pressures, including plateau pressure and driving pressure
    • Recognizing and managing hypoxia in the PACU

    You’ll be challenged with questions throughout the episode, forcing you to pause, think, and apply what you know in real time.

    Because that’s how you train your mind to respond under pressure.

    We also highlight key patterns you’ll see again and again:

    Obesity + anesthesia → decreased FRC and rapid atelectasis
    Closing capacity exceeding FRC → airway closure and hypoxia
    Laparoscopy + Trendelenburg → decreased compliance and increased airway pressures
    Poor ventilatory strategy → postoperative hypoxia

    By the end of this episode, you’ll have a clear framework for managing ventilation in obese patients undergoing robotic surgery—and a better understanding of how to stay ahead of the physiology.

    This episode is especially relevant for anesthesia residents and is commonly tested on written and oral board exams.

    The goal isn’t to give you more to memorize.

    It’s to change how you think.

    Understand more. Hesitate less.


    Tue, 31 Mar 2026 - 28min
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