Rapid Response RN

The shock worked. The rhythm converted. And then V-fib came right back. Now what?

Part two of this series explores the physiology and pharmacology driving recurrent V-fib so you can respond confidently when shocks aren’t enough.

You'll learn how the body's sympathetic nervous system response keeps the heart unstable, why epinephrine can both help and hurt, when to reach for lidocaine over amiodarone, and what the research says about the emerging role of esmolol to target the storm itself (not just the arrhythmia).

Topics discussed in this episode:

This special episode was recorded and released on the Nurse Gwenny Podcast. We talked about some of those early signs of deterioration that are often missed and how we can speak up and advocate before the patient crashes.

Check out this episode and so many more over at the Nurse Gwenny Podcast

And, you can join the Nurse Gwenny Library to earn CE credits for listening to the show!

Use code: rapidresponsern

to get a discount on your membership:

https://library.nursegwenny.com/bundles/nurse-gwenny-library-membership

Sometimes V-fib doesn't respond to the shock at all. Sometimes it converts and comes right back. Those are two completely different problems.

In this episode, Sarah breaks down the science behind why defibrillation fails, how to recognize the difference between refractory and recurrent V-fib, and respond when shocks aren't working. You'll learn how to start approaching the electrical storm at the bedside — that means understanding transthoracic impedance, optimizing your pad placement, and knowing when to reach for double sequential defibrillation.

Topics discussed in this episode:

American Heart Association. (2025). 2025 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation.

Cheskes, S., Dorian, P., Feldman, M., McLeod, S., Scales, D. C., Pinto, R., Turner, L., Morrison, L. J., Drennan, I. R., & Verbeek, P. R. (2020). Double sequential external defibrillation for refractory ventricular fibrillation: The DOSE VF pilot randomized controlled trial. Resuscitation, 150, 178–184.https://doi.org/10.1016/j.resuscitation.2020.02.010

D. Hasegawa, A. Sharma, Y. I. Lee, & R. Sato. (2023). A systematic review and meta-analysis of esmolol for refractory ventricular fibrillation and pulseless ventricular tachycardia. Chest, 164(4 Suppl.), A1568. https://doi.org/10.1016/j.chest.2023.07.1077

International Liaison Committee on Resuscitation. (2025). 2025 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR).

Imagine being able to cut your hospital's code blue events outside of critical care in HALF in just six months. That's exactly what happened when Sarah built her hospital's rapid response team from the ground up.

Nurse Gwenny takes over the show to find out how she did it, from the pitch that got the program started to the skills that actually matter on rapid response teams. She also shares what disqualifies a candidate even when the resume is perfect, why so few resources exist for rapid response training, and how she’s filling that gap herself.

Whether you're hoping to start a rapid response program at your hospital or just want to feel more confident the next time you call one, this episode is for you.

Topics discussed in this episode:

Join the Nurse Gwenny Library to earn CE credits for listening to the show!

Use code: rapidresponsern

to get a discount on your membership:

https://library.nursegwenny.com/bundles/nurse-gwenny-library-membership

We all know the many challenges facing the Nursing profession today. Nursing takes so much from us… but it also has so much to offer.

Recorded live at NurseCon at Sea, Sarah sits down with two nurses who hit their breaking point and found a way to keep showing up. This episode goes deep into the messy reality of nursing burnout, from the struggle to put yourself first to the boundaries, mindset shifts, and support systems that keep nurses in the game.

You don't have to manage burnout alone, so don’t miss this one.

Topics discussed in this episode:

Learn more about NurseCon at Sea:

https://nurseconatsea.com/

Getting ROSC is not always the win we sometimes think it is. It's what we're looking for the entire resuscitation, but the real challenge begins once we get it… and what we do in the next few hours has a major impact on patient outcomes.

In this episode, Sarah shares a real rapid response case to walk through the physiology, decision-making, and advocacy of post-arrest care. The 2025 AHA post resuscitation guidelines have brought important shifts to post-ROSC management, from how aggressively to oxygenate to when it's safe to prognosticate. Don't miss the full breakdown!

Topics discussed in this episode:

Check out the new Post Resuscitation Guidelines:

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001375

Listen to episode 73 — Resuscitate Before You Intubate: How to NOT KILL YOUR PATIENT When You Intubate: https://podcasts.apple.com/us/podcast/73-resuscitate-before-you-intubate-how-to-not-kill/id1535997752?i=1000630431016

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

The AHA just updated the playbook on acute pulmonary embolism. The old classification system is gone. Heparin drips are no longer the default. And if your instinct is to push for intubation, that could be the thing that makes your patient worse.

In this episode, Dr. Mark Creager, lead author of the 2026 AHA Multi-Society Guideline on Acute Pulmonary Embolism, breaks down exactly what's changed, how the new guidelines help teams make better decisions faster, and what nurses need to know about frontline PE management.

Learn what the data says about oxygen therapy, anticoagulation, vasopressors, and the decisions that matter most when your PE patient starts to slide.

Topics discussed in this episode:

And you can check out the full AHA/ACC 2026 updated PE guideline here:

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001415

"There has to be a better way." We've all thought it. This episode is proof that nurses can be the ones to make it happen.

In this episode, Sarah is joined by Kat Siaron, rapid response nurse and co-author of the RRT STAR study that shows what happens when nurses are empowered to act before a clear stroke diagnosis is made. They walk through a patient case that exposed a dangerous gap in inpatient stroke response, traps like sedation hangover that mask stroke presentations, and how the nurse-led Code Stroke process has drastically improved time to crucial intervention.

You'll hear about the step-by-step workflow, where rapid response nurses and physicians fit in, and how you can advocate for change in your hospital.

Topics discussed in this episode:

Read Kat’s article, “Use of Rapid Response Teams to Expedite Imaging and Treatment for Inpatients With Acute Stroke:”

https://aacnjournals.org/aacnacconline/article-abstract/36/4/317/32912/Use-of-Rapid-Response-Teams-to-Expedite-Imaging?redirectedFrom=fulltext

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

The stroke guidelines just changed and it’s exciting and nuanced! What you do in the first 30 minutes could drastically change your patient's outcome. In this episode, Dr. Shyam Prabhakaran, neurologist and chief writer of the new 2026 AHA Stroke Guidelines, explains what's changed and how these guidelines are changing practice at the bedside.

Stroke treatment decisions are getting faster, more nuanced, and more imaging-driven. Inclusion/exclusion criteria and whether to give thrombolytics, who is a candidate for thrombectomy, and when to touch the blood pressure have all been updated. Know the updates before your next stroke alert!

Topics discussed in this episode:

Introducing the classic extended window patient caseThrombolytics vs. thrombectomy explainedEMS destination decision: Choosing primary vs. comprehensive stroke centerHow reperfusion time windows have changedAdvanced imaging: ASPECTS and thrombectomy eligibilityTreatment options for patients presenting outside of the 4.5 hr windowBlood pressure management recommendationsWhat nurses should do in the first 15-30 minutesLVO red flags at the bedsidePediatric ischemic stroke

Check out the new AHA Stroke Guidelines:

https://newsroom.heart.org/news/new-guideline-expands-stroke-treatment-for-adults-offers-first-pediatric-stroke-guidance

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

ARDS is one of the more complex syndromes we manage in critical care. More than just pulmonary edema, we are battling stiff lungs, refractory hypoxemia, rising pressures, and frequently making decisions that can either protect the lung or make things worse.

In this episode, I’m joined by respiratory therapist Melody Bishop for a deep dive into ARDS ventilator management through the lens of physiology, evidence, and real bedside practice. We break down what’s actually happening in the lung, why some long-held practices have fallen out of favor, and how nurses and RTs can work together to make more precise, lung-protective decisions.

If ARDS has ever felt like guesswork, this episode will help it make sense.

Topics discussed in this episode:

What ARDS looks like at the alveolar level and why surfactant loss changes everythingHow inflammation leads to stiff lungs, poor compliance, and refractory hypoxemiaWhy lung-protective ventilation is about avoiding harm, not chasing perfect numbersMoving beyond tidal volume: how driving pressure reframes vent managementHow RTs use compliance trends to judge whether lungs are improving or failingPEEP selection: why tables are a guide, not the final answerThe physiology behind proning and why it’s one of the few ARDS interventions that saves livesWhy recruitment maneuvers fell out of favor (and what works instead)What nurses should be watching on the ventilator to catch deterioration early

Connect with Melody and download her free book:

https://melodybishoprt.com/

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra

A transplant saves a life… but can also make the body attack itself. That's what Graft Versus Host Disease (GVHD) does, and why nurses need to catch it early. You may have never seen it before, but this episode will tell you what it looks like at the bedside and the early clues you can’t afford to miss.

Through a real patient case, Anthony, RN explains why GVHD is easy to overlook, how to think through common differentials, and what matters most when it comes to helping patients stabilize and recover.

Topics discussed in this episode:

CCOT's rapid response modelThe patient’s condition weeks after allogenic transplantAnthony's assessment and what raised red flagsWhy early symptoms can get misread or minimizedHow Graft Versus Host Disease developsWhy emotional support is crucial to recoveryAcute vs. chronic Graft Versus Host DiseaseImportant early clues of Graft Versus Host DiseasePriority interventions for Graft Versus Host DiseaseHow Anthony’s app can help bedside nurses

You can connect with Anthony or learn more about his apps here:

https://thehumblenurse.com/

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra

You know those moments when something just “feels off?” That’s when you should trust your instincts and speak up because timing can completely change a patient’s outcome.

In this episode, Sarah is joined by Dr. Oscar Mitchell, Associate Director of the Center for Resuscitation Science and Director of the Medical Rapid Response Team at the Hospital of the University of Pennsylvania. They break down one septic shock case across two timelines: first, when rapid response is called early and there's still time to intervene, and later, when the patient is already crashing.

You’ll hear what a calm, collaborative rapid response call looks like, which signs of deterioration should never be ignored, and how to effectively share your concerns with a provider. This episode is for anyone who might call a rapid response AND for those who respond to emergencies.

Topics discussed in this episode:

Introduction to the patient and the 5PM timelineWhat the ideal provider–nurse collaboration looks likeEarly signs of deterioration that were missedWhy some nurses hesitate to call rapid responseThe patient’s vitals at 10AM and why rapid response was calledWhy the documented respiratory rate might not be reliableWhy blood pressure can be misleadingSBAR and CUS frameworks for escalationDr. Mitchell’s research on delays in RRT activation and mortalityEarly warning signs you should never ignore

Register for the REVIVE Conference and use code RAPID50 to get $50 off!

https://www.revive-conference.com/

Check out Dr. Mitchell's research here:https://pubmed.ncbi.nlm.nih.gov/36349290/

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra

The science is finally catching up to what clinicians have long known: more fluids aren't always the answer to septic shock. In this episode, host Sarah Lorenzini and Jaclyn Bond MSN-LM, MBA-HM explain what the ANDROMEDA-SHOCK 2 trial reveals about physiology-guided sepsis resuscitation and why fixed-volume fluid strategies can lead to avoidable harm.

They break down how dynamic fluid responsiveness testing helps teams stop guessing, and how tools like FloPatch support real-time assessment of carotid flow time and stroke volume. You'll leave with a clearer idea of when to give fluids, when to stop, and how to justify the decision.

Topics discussed in this episode:

The purpose and key findings of the ANDROMEDA-SHOCK 2 studyWhy dynamic measures of fluid responsiveness matter more than static vitalsWhat recent meta-analysis data shows about physiology-guided fluid strategiesCarotid flow time: what it is, how it’s measured, and how it guides decisionsHemodynamic assessment and bedside limitationsHow FloPatch supports real-time assessment so you can make individualized fluid decisionsSEP-1 2026 guideline updates and why it’s better for patientsHow to apply these principles to your workflow

Website: www.flosonicsmedical.com

See FloPatch in action: https://hubs.ly/Q03-68Hg0

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra

Pulmonary embolisms don’t always announce themselves... sometimes they ambush.

One minute your patient is walking with physical therapy, the next they’re hypotensive, hypoxic, and coding. This re-released early episode dives deep into why PE patients can look deceptively stable… right up until they aren’t.

In this episode, I revisit one of my earliest case-based teachings on pulmonary embolism, updated with an added segment on vasopressin use in obstructive shock from PE. Through real bedside stories from my time as a rapid response and ER nurse, we break down the physiology behind PE-related collapse, why intubation isn’t always the answer, and how to think through management when the right ventricle is failing in front of you. This is a sobering but essential refresher on one of the most dangerous diagnoses we encounter.

Topics discussed in this episode:

Why pulmonary embolism is a common cause of in-hospital cardiac arrest (even if it’s not common overall)Classic and subtle PE presentations and why they’re often missedA real-time rapid response case: stable to crashing in minutesRisk factors for PE and the anticoagulation double-edged swordObstructive shock explained: what’s actually killing the patientRight ventricular failure, septal bowing, and the spiral of deathWhy intubation can worsen outcomes in massive PEVasopressors in PE: norepinephrine, epinephrine, and vasopressinThe unique benefits of vasopressin in obstructive shockThrombolysis vs. thrombectomy: when TPA helps — and when it’s deadlyBedside echo findings that point to massive PEWhy PE patients can crash during transport (and what to always bring)Nursing vigilance, rapid escalation, and activating help earlyWhen perfect care still isn’t enough and the heart of nursing in end-of-life moments

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra

Some of the most common respiratory myths are still showing up at the bedside. But it's not your fault — most of us were never taught what an oxygenation problem versus a ventilation problem looks like in real time.

In this episode, Melody Bishop RT explains how respiratory therapists think through oxygenation and ventilation to choose the right intervention and recognize when a patient is ready to breathe on their own. We’re calling out the old dogma and myths that can delay treatment and worsen patient outcomes!

Topics discussed in this episode:

Ventilation vs. oxygenation: the core building blocksV/Q mismatch explainedABG findings for low-flow vs. high-flow vs. BiPAPWhen CO₂ is the problem and the benefits of BiPAPKey indicators it’s time to intubate and the dangers of waitingThe myth of resting patients on ventilationHow to accurately assess spontaneous breathing trialsCOPD, oxygen, and the hypoxic drive mythWhat nurses should know about working with RTs

Connect with Melody:

https://melodybishoprt.com/

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra

Rural nursing is anything but simple. They have limited resources, fewer specialists, and often have to send patients hours away from their families for a higher level of care. But all that is changing as new tech like Zeto brings monitoring right to the bedside and keeps more patients close to home.

In this episode, ICU nurse leader Kristen RN shares how point-of-care EEG has empowered her team to catch subclinical seizures sooner and make faster, more informed clinical decisions. From buy-in to implementation, you'll hear how she advocated for her community and successfully integrated this technology into a small ICU. If you work in a rural or resource-limited facility, don't miss this one!

Topics discussed in this episode:

Learn more about Zeto here:

https://zeto-inc.com/

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra

Your pneumonia patient is hypotensive, tachycardic, and not responding to fluids… what did you miss? It could be sepsis-induced cardiomyopathy, a common under-recognized shock state you could see at the bedside.

In this episode, Dr. Mahmoud Ibrahim MD and host Sarah Lorenzini use a case study to highlight how nurses, intensivists and the ICU team can work together to recognize the signs of sepsis-induced cardiomyopathy early and give patients a better chance at recovery. You'll learn the diagnostic clues that your patient’s heart is in trouble, how to approach controversial treatments like sodium bicarb, and what has to happen before intubation in a dual shock state.

Topics discussed in this episode:

Connect with Dr. Ibrahim:

Instagram: https://www.instagram.com/icuboy_meded/

Facebook: https://www.facebook.com/share/1Dg1ZTyfsN/

TikTok: https://www.tiktok.com/@icuboy_meded

Threads: https://www.threads.com/@icuboy_meded

X: https://x.com/icuboy_meded

Learn more about the different phenotypes in sepsis induced cardiomyopathy:

https://journal.chestnet.org/article/S0012-3692(25)05143-8/abstract

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra

Every five years, resuscitation guidelines get a refresh. This year, a few have changed, many have stayed the same, and some are creating major controversy.

In this episode, Dr. Ashish Panchal, Chair of the AHA Emergency Cardiovascular Care Committee, helps us unpack what’s new, what might surprise you, and the science behind each decision. You'll learn why there’s serious debate around epinephrine dosing, what changes matter most for the bedside, and how these updates will change the way you and your team respond to the next code!

Topics discussed in this episode:

Listen to E140 with Dr. Ashish Panchal:

https://healthpodcastnetwork.com/episodes/rapid-response-rn/140-resuscitation-then-and-now-how-evidence-shapes-every-beat-with-guest-dr-ashish-panchal-md-phd/

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Differential diagnosis is part physiology, part detective work. Especially in heart failure, where similar vital signs can mean very different things.

In this episode, Natalie RN is back on the show to break down two pediatric cases that looked almost identical on arrival to the ED but their workups led to two very different treatment plans. She shares the assessment findings, diagnostics, and clinical clues that helped them uncover what was really going on.

Learn how to connect the dots and find the right intervention when presentations look identical!

Topics discussed in this episode:

Connect with Natalie:

https://www.instagram.com/chatwithnat_rn/

Listen to Chat with Nurse Nat on Spotify:

https://open.spotify.com/show/7Jh2qe44KipudVKkdXFwWH

Listen to Chat with Nurse Nat on Apple Podcasts:

https://podcasts.apple.com/us/podcast/chat-with-nurse-nat/id1815541418

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Every trauma nurse knows this feeling: your stable patient suddenly starts to decompensate and instinct tells you there’s more to the story. Today’s case starts with a stable, post-arrest patient and ends in a full-blown tension pneumothorax.

Hear why this patient went from stable to crashing in minutes, how delayed recognition changed the course of care, what diagnostics and assessments could have caught earlier. Trauma Pete breaks down the tell-tale signs, how it differs from a simple pneumothorax, and why it's so easy to miss in trauma patients.

In this episode, you’ll learn which patients are the most at risk, how to spot tension pneumothorax early, and why having a systematic approach to decompression make all the difference!

Topics discussed in this episode:

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

This is one of those cases that tests you in every way as a nurse. A toddler is pulled out of a pool and rushed to the ER, unresponsive and deteriorating fast. Today, Nurse Amber walks us through the critical moments that followed and how this case inspired her to turn her grief into a positive resource for nurses.

We discuss what was going on at the alveolar level in this patient, the interventions Amber and her team performed, and the emotional aftermath of working on critical pediatric patients. You’ll learn what to prioritize, the signs of deterioration that can show hours after rescue, and how to recognize what Sarah calls the “inflammatory cascade of awfulness.”

This episode is an honest breakdown of both the science and humanity of drowning care. Don’t miss this story!

Topics discussed in this episode:

Learn more about the Get Vitals app:

Website - www.getvitals.care

Instagram -@getvitalsnow

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Some conditions hide in your genes, without any symptoms. One of these conditions is genetic arrhythmogenic cardiomyopathy, an inherited condition that can lead to sudden cardiac arrest — even if you feel completely fine.

In this episode, Sarah and Leslie talk about their shared diagnosis of FLNC cardiomyopathy — from how this gene mutation affects the function of the heart to how they're managing this rare condition. You'll hear how Leslie's ICD has saved her life more than once, how it feels to be shocked back to life, and the resilience that's helped them move forward.

This is a raw, real, emotional episode about living with a genetic heart condition. Tune in to learn the signs to watch for, when to get tested, and where to find support!

Topics discussed in this episode:

Find support or volunteer with WomenHeart:

https://www.womenheart.org/

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

What happens when a trauma patient isn’t just a trauma patient? In today’s episode, we’re diving into “Trauma Plus” — those high-stakes situations where comorbidities, medications, environmental exposures, or underlying medical emergencies complicate recognition of decompensation and change everything about how we care for our patients.

I’m joined by Flight Nurse Gwenny, who brings her expertise from the field to walk us through three complex trauma cases where things aren’t what they first appear to be. You’ll hear her real-time thought process as she navigates evolving scenarios and shares her assessment priorities, differential diagnoses, and critical interventions.

If you’ve ever cared for a trauma patient and thought, “Something doesn’t add up,” this episode will help sharpen your assessment skills and give you a framework for approaching the next challenging trauma case.

Topics discussed in this episode:

Connect with Nurse Gwenny:

Youtube:

https://www.youtube.com/channel/UCLhEo_HaDEkPFA_cpQPAz2w

Instagram:

https://www.instagram.com/nursegwennyrn/

TikTok:

https://www.tiktok.com/@nurse.gwenny?_t=8qUUMwXhv5P&_r=1

Purchase her books:

https://www.nursegwenny.com/shop

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Why would a healthy newborn suddenly stop eating and start vomiting? When a fussy baby comes into the ER, it's easy to assume it's nothing urgent — like colic or gas. But in today's case, there were small signs that pointed to something more.

This episode unpacks the high-risk condition and treatment of neonatal cardiogenic shock with Natalie Pleiman, pediatric nurse and clinical coach. From the early (often misleading) signs to critical assessments, you'll learn what makes cardiogenic shock different in neonates (specifically ductal dependent lesions), what to look for in patient labs, and how to manage the risks of treatment.

Tune in for insights that will help you on your next pediatric cardiac emergency!

Topics discussed in this episode:

Connect with Natalie:

https://www.instagram.com/chatwithnat_rn/

Listen to Chat with Nurse Nat on Spotify:

https://open.spotify.com/show/7Jh2qe44KipudVKkdXFwWH

Listen to Chat with Nurse Nat on Apple Podcasts:

https://podcasts.apple.com/us/podcast/chat-with-nurse-nat/id1815541418

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

One unstable patient, three departments, and every nurse on alert... Let's break down what really happens during a high-risk STEMI. This episode follows the case of a 62-year old patient from ER to the Cath Lab to the ICU. Nurses Sarah Vance and Caitlyn Nichols help us explore the role of nurses in each stage of care, from stabilizing the patient to placing an Impella device.

We cover everything from IV placement and medications to monitoring patients through each phase of care. Learn how to prepare patients for the Cath Lab, manage complications like V-fib and bleeding post-PCI, and support the next team during handoffs. This is a must-listen for nurses involved in cardiac care!

Topics discussed in this episode:

Connect with Sarah Vance:

https://www.instagram.com/iseeu_nurse/

Connect with Caitlyn Nichols:

https://www.instagram.com/icunursingnotesbycaitlyn/

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Often, the first symptom of hypertrophic cardiomyopathy is sudden death. But sometimes, we get a warning— and that’s where clinical judgment at the bedside saves lives.

Today, Sarah goes over the case of her patient Ben, a 20-year-old experiencing syncope and chest pain. As his condition quickly deteriorated, the team had to carefully manage the patient before reaching a diagnosis of hypertrophic cardiomyopathy. Hear what pointed them to this diagnosis, why some standard interventions can be dangerous in HCM cases, and the critical decisions made during his treatment.

Listen now for a deep dive into the pathophysiology and treatment of hypertrophic cardiomyopathy!

Topics discussed in this episode:

Listen to episode 98, “Broken Heart Syndrome” aka Takotsubo Cardiomyopathy, here: https://healthpodcastnetwork.com/episodes/rapid-response-rn/98-broken-heart-syndrome-aka-takotsubo-cardiomyopathy/

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Remember when we used to use stacked shocks for ventricular arrhythmias or load patients up with high doses of epinephrine and bicarb? Over the last 25 years, resuscitation guidelines have evolved and it’s our job to stay updated on the current protocols.

Here to help us break down what’s changed and what still works is Dr. Ashish Panchal, Chair of Emergency Cardiovascular Care for the AHA and host of the In the Heart of Care podcast. We discuss how a common cardiac arrest scenario would be treated from 2000 to today, highlighting key guideline changes like the shift to neuroprotective strategies, high-quality CPR, and post-arrest care.

Tune in to stay current and hear how science continues to shape the way we save lives!

Topics discussed in this episode:

Check out the In the Heart of Care Podcast here:

https://rqipartners.com/podcast/

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Think of a case where you ignored your intuition, leaned on your training, and followed protocol… but something still felt off. Today, we're talking about how to balance evidence-based practice with those gut instincts that can change patient outcomes.

Dr. Vicki Good, DNP and Andrea Schmitt, hosts of the Voices in Nursing Podcast, share stories that highlight why intuition is just as important as clinical data and why nurses need to confidently speak up. You’ll learn how to develop your own intuition, teach others to trust their instincts, and the value of hindsight wisdom in building a database of red flags for patient decline.

Listen now and start tapping into your nursing wisdom!

Topics discussed in this episode:

Connect with Vicki and Andrea:

vicki.good@aacn.org

andrea.schmitt@aacn.org

Check out the Voices in Nursing Podcast:

https://www.aacn.org/education/podcast-series

Rapid response teams provide so much more than reducing morbidity and mortality!  Think about how quickly things can spiral without the support of RRTs.

As the former director of specialty teams, Jaclyn Bond MSN-LM, MBA-HM has seen how a rapid response program can improve outcomes while also improving nursing job satisfaction and promoting retention. We talk about the MANY benefits of rapid response teams, including fewer code blues, more confident nurses, and their impact on hospital culture.

Learn how to advocate for these teams at your facility, collect data that will help you build your case, and start a program with limited resources!

Topics discussed in this episode:

Jaclyn’s article on the nurse-led sepsis response:

https://pubmed.ncbi.nlm.nih.gov/39526100/

Download Jaclyn’s SBAR template to help you make the case for rapid response teams:

https://drive.google.com/file/d/12ltxvEfblwBh-ezaxyTNhU7m2p_tw9GZ/view?usp=sharing

Jaclyn Bond’s views expressed on this podcast are her own and do not reflect the views of any organizations or entities.

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

You’re 30,000 feet in the air when you hear, “Is there a medical professional onboard?” Answering that call is a little more complicated than you might think.

In this episode, Alexandra Jabr, PhD, EMT-P joins Sarah to discuss what happened during their first in-flight medical emergencies — what surprises came up, what resources they had, and how they responded with limited supplies. They share what they learned about caring for patients mid-flight, from the most common in-flight emergencies to the legal considerations of volunteering. Tune in to find out how you can prepare and respond if you ever hear that call in the air!

Topics discussed in this episode:

Connect with Alex:

https://www.emergencyresilience.com/

https://www.instagram.com/emergencyresilience

Check out the list of FAA mandated medical supplies on every flight:

https://mobile.fpnotebook.com/ER/Pharm/FMndtdEmrgncyMdclKt.htm

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

The flight team may be on the way, but your work isn’t done yet. Flight medic Sam, host of the Nine One One Nonsense podcast, shares what the ideal patient handoff looks like between hospital staff and flight crews, and why those final moments at the bedside matter more than you think. You’ll hear real-life examples of where in-hospital care teams often go wrong and how you can help create a safer, smoother transfer.

Sam also shares what it’s really like to be part of a flight crew — the challenges, team dynamics, and common misconceptions that affect patient care. No matter your role, this episode will help nurses and flight crews understand their role and how to better work together!

Topics discussed in this episode:

Check out Sam's podcast, Nine One One Nonsense, here:

https://podcasts.apple.com/us/podcast/nine-one-one-nonsense/id1673565406

Connect with Sam on Instagram: https://www.instagram.com/911nonsense/

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

What began as a stroke alert turned into a different kind of emergency: aortic dissection. Today's patient case study follows a series of clinical decisions that saved an elderly man from a fatal misdiagnosis. Christian Guzman APRN walks us through the case — from the patient’s misleading symptoms to the diagnostic tests that showed something more was going on.

We dive into the anatomy, pathophysiology, and clinical signs of aortic dissection, including how the location of tears changes the presentation of symptoms. From emergency treatment strategies to post-op care, you’ll learn how to navigate the nuances of managing this complex condition!

Topics discussed in this episode:

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

One minute she was the nurse—then she became the emergency. Today, Shenell RN of the All One Nurse podcast shares her story of a ruptured ectopic pregnancy that sent her into emergency surgery on shift — and the second ectopic pregnancy that followed just a year later.

We talk through the symptoms she felt that day, how methotrexate treatment impacted her recovery, and the range of symptoms that can make it hard to tell what’s really going on. Shenell also opens up about the emotional toll of pregnancy loss, her journey to have her rainbow baby, and how her experience gave her deeper insight into the kind of support patients really need.

This episode is a firsthand account of what compassionate care really looks like—and how nurses can better support patients during reproductive emergencies.

Topics discussed in this episode:

Connect with Shenell RN:

https://www.instagram.com/allonenurse_shenell/

Listen to the All One Nurse Podcast featuring Sarah Lorenzini:

https://podcasts.apple.com/us/podcast/navigating-rapid-response-nursing-with-sarah-lorenzini/id1755700754?i=1000693458288

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Rapid response nurses don’t just handle codes — they help prevent them from happening. Contrary to popular belief, Rapid Response Nursing is not just sprinting from code blue the next and neither is ER nursing.  While there are a lot of similarities between these two specialties in Nursing, there are a lot of differences too. In this episode, Aidan RN shares what it was like to transition from the fast-paced ER to the world of rapid response.

We discuss what sets rapid response apart, the mindset shifts that helped him make the switch, and break down cases where their quick action made all the difference — including a subdural hematoma caught just in time, a STEMI with an unusual presentation, and a patient whose only symptom was neck pain.

Whether you’re calling rapid response or considering the role yourself, don't miss this conversation on the skills and challenges that define rapid response nursing!

Topics discussed in this episode:

Learn more about what it’s like to be a Rapid Response Nurse!

https://www.aacn.org/blog/exploring-the-world-of-rapid-response-nurses

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Imagine working as a nurse, but you must stay attached to battery packs to stay alive. That’s the reality for Tiffany Davis Cannon, RN—full-time nurse, mother, and LVAD patient. After being diagnosed with peripartum cardiomyopathy, she had to adapt to life with an LVAD—but it’s been anything but easy.

In this episode, Tiffany candidly shares the emotional and physical challenges of living with an LVAD, how her experience changed her approach to nursing, and what she wants other nurses to know about caring for LVAD patients. Tune in to hear how she’s embraced her new normal and turned her experience into an opportunity to advocate for patients!

Topics discussed in this episode:

Hear more from Tiffany:

FB: https://www.facebook.com/tiffany.cannon.397/

IG: https://www.instagram.com/tiffany_cannon90/

Email: Tiffany.cannonjourney@gmail.com

Purchase her book, A Journey Through Supernatural Healing!

https://a.co/d/av53sri

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Would you know how to identify a blood transfusion reaction? This is one of those nightmare cases because we just expect that when we give blood transfusion, the patient will get better… but what about when they get worse?

In this reboot episode, host Sarah Lorenzini shares evidence-based research to shed some light and insight into this very rare, but potentially life threatening situation.

In today’s episode, Sarah goes over a case study of one of a rapid response patient she dealt with where she discovered there was a blood transfusion reaction when it wasn’t readily apparent. You will hear how the patient was reacting, how she assessed the situation, and how the patient was treated.

You will also hear Sarah’s cliff notes from what she researched detailing what kind of blood transfusion reactions to look out for, their treatment, what TACO and TRALI stand for along with their symptoms and treatment.

This episode is full of information that you may not learn in nursing school, but is SO useful when treating a patient that is having a blood transfusion reaction.

Tune in to hear this and more!

Topics discussed in this episode:

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

What makes some teams work in sync and others fall into chaos? During emergencies, team dynamics are just as important as clinical skills for saving lives. Let’s dive into what it takes to create a work culture that encourages collaboration, where mistakes are as learning opportunities, and kindness builds trust!

This episode outlines the do’s and don’ts of leading a team during emergencies, covering everything from fostering a safe environment to breaking down barriers that keep people from speaking up. Tune in for insights that will help you provide the best patient care even in high-stress emergencies!

Topics discussed in this episode:

Listen to episode 62, “Resuscitation Leadership: Beyond the ABCs of CODE BLUE:”

https://podcasts.apple.com/us/podcast/62-resuscitation-leadership-beyond-the-abcs-of-code-blue/id1535997752?i=1000621879820

Listen to episode 123, “What Makes for a Great Resuscitationist?:”

https://podcasts.apple.com/us/podcast/123-what-makes-for-a-great-resuscitationist/id1535997752?i=1000670934458

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

What makes sickle cell disease so challenging to manage? It’s not just the pain — it’s the complications, stigma, and the need for fast, effective care. In this episode, Morgan Taylor, RN helps us unpack the science behind sickle cell crisis and how nurses can address both the medical and emotional needs of their patients.

Learn how to recognize early warning signs of severe complications like acute chest syndrome, balance efficacy and safety in treatment, and help patients prevent a sickle cell crisis. Morgan also shares five key insights that will give you the tools and confidence to provide the best care to your next sickle cell patient. Tune in to this can’t-miss episode now!

Topics discussed in this episode:

You can learn more about Morgan here:

https://www.linkedin.com/in/morgan-clark-taylor/

Find out everything Archer Review has to offer here:

https://www.linkedin.com/company/archerreview/

Mentioned in this episode:

Listen to the In The Heart of Care Podcast

https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7

Once called pseudoseizures, psychogenic non-epileptic seizures can confuse even seasoned clinicians — until you know the signs. These seizures mimic epilepsy but have entirely different causes, requiring a unique approach to care. In this episode, we explore how to distinguish PNES from epilepsy, the psychological factors that trigger attacks, and steps in the diagnostic process.

Learn how you can identify these episodes, provide compassionate care, and educate patients and their families about this misunderstood condition!

Topics discussed in this episode:

Learn more about psychogenic non-epileptic seizures here:

https://www.epilepsy.com/stories/truth-about-psychogenic-nonepileptic-seizures

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Do you feel confident recognizing status epilepticus? When a seizure doesn’t stop on its own, knowing the signs of this high-stakes emergency is the first step to preventing complications and even death. This episode breaks everything you need to know about status epilepticus — the warning signs, critical action steps, and the interventions that save lives.

In this deep dive for Epilepsy Awareness Month, Sarah unpacks the role of nurses to take quick action and advocate for patients in status epilepticus. From what happens in the brain during prolonged seizures to proper use of benzodiazepines and anti-epileptic drugs, we get into the nitty gritty of managing this life-threatening condition. 

Topics discussed in this episode:

No power, no water, no communication. How do healthcare teams provide care during disasters? In this episode, host Sarah Lorenzini and Brooke MSN, RN, CCRN, NE-BC share their experiences working as disaster response nurses after the hurricanes in Asheville, NC and Tampa, FL.

Get a glimpse into the challenges, collaboration, and determination that define hurricane relief nursing, as well as the unity and resilience shown by patients and communities in recovery. Listen to learn about the realities of crisis care, from deployment to being an effective nurse leader in a chaotic environment!

Topics discussed in this episode:

Check out Accuryn for yourself:

https://accuryn.com/why-accuryn/

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

You never forget your most embarrassing nursing moment — especially when it happens in the middle of a critical situation. In this episode, Sarah recounts an unforgettable, cringe-worthy blunder during a rapid response call for a COPD patient in respiratory distress. Discover how she managed the patient’s COPD exacerbation and advocated for the patient’s care despite a lack of urgency from some on the medical team.

Sarah also dives into the pathophysiology of COPD and intervention strategies, evaluating the pros and cons of the various oxygen delivery modalities like non-rebreather masks and BiPAP. Curious how an awkward moment turned into a valuable lesson for COPD care? Tune in now!

Topics discussed in this episode:

Caring for patients withdrawing from alcohol can be challenging to say the least. In this episode, host Sarah Lorenzini shares a case of a patient recovering from emergency surgery, and highlights the subtle but critical signs of alcohol withdrawal—like anxiety, tremors, confusion, tachycardia, and hypertension—that often go unrecognized until symptoms escalate.

Key topics covered in this episode include:

Tune in to learn how to recognize and manage alcohol withdrawal, keep patients safe, and provide the compassionate care they need during this vulnerable time.

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Bringing calm to chaos is an underrated skill in medicine. During her talk at the ResusX Conference, Sarah explored this concept and the importance of guiding teams through high-stress situations. In today’s episode, you’ll hear what happened when Sarah responded to a bloody code blue that ended in tears and defeat. This patient story is a prime example of why being a great resuscitationist requires more than clinical skills, and how leadership and communication can make or break a team’s performance under pressure.

So, what makes for a great resuscitationist? Tune in as Sarah breaks down three areas you should focus on to become a better resuscitationist leader!

Topics discussed in this episode:

Behind every POTS diagnosis is a patient who had to fight for answers. Postural orthostatic tachycardia syndrome (POTS) is often misdiagnosed because its symptoms mimic so many other conditions. In fact, it is often dismissed as “just anxiety”, but anxiety is a secondary side effect of the fact that the patient keeps having syncopal episodes without explanation.

To dig deeper into its diagnosis and treatment challenges, Sarah turned to Dr. Alexis Cutchins, cardiologist and co-author of a key article on the management of POTS. In this episode, Dr. Cutchins breaks down the symptoms, possible causes and contributing factors of this complex and misunderstood disorder. She also explores treatment strategies and new research that could improve patient outcomes.

Tune in to hear Dr. Cutchins’ insights into how healthcare professionals can better recognize POTS and advocate for patients!

Topics discussed in this episode:

Read Dr. Cutchins' article, Narrative Review of Postural Orthostatic Tachycardia Syndrome: Associated Conditions and Management Strategies: https://www.uscjournal.com/articles/narrative-review-postural-orthostatic-tachycardia-syndrome-associated-conditions-and

POTS patients can find more information and resources here:

https://www.dysautonomiainternational.org/

Print this guide to plan for POTS emergencies with your physician!

https://supertmastcell.org/wp-content/uploads/2024/04/SuperT-PatientReferenceGuide-2024.pdf

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Pee might be the key to saving your patient’s life. In this episode of Rapid Response RN, we dive into the critical yet often overlooked early sign of clinical deterioration — urine output. Join us as Tom Colabro, MNS-HCSM, RN, NEA-BC, shares his expert insights on why accurate urine output can be a cost-effective biomarker in patient care.

Tom introduces the Accuryn Monitoring System, which not only identifies AKI up to 33.4 hours faster than traditional methods but also features Active Drain Line Clearance, significantly reducing the risk of CAUTI. You’ll learn how this innovative technology both eases the nursing workload and improves patient outcomes.

From a patient case study to practical tips, this episode covers everything you need to know about the development and prevention of AKI. Tune in for an engaging discussion on the importance of early detection through urine output monitoring!

Topics discussed in this episode:

Starting in October 2024, CMS is including AKI as a reportable measure under the IPPS eCQMS Patient Safety reporting. Mandatory reporting of AKI Stage 2 and greater will begin by 2026. Click here to learn more: 

https://accuryn.com/why-accuryn/

Burned out by hospital life? For Becca RN, serving a two-year mission with Mercy Ships reignited her passion for nursing and introduced her to a global community of volunteers. Her experience as a nurse on a hospital ship in West Africa went beyond traditional patient care, allowing her to play a role in both the physical and emotional healing of her patients.

In this episode, she shares what daily life is like on Mercy Ships, talks about the diverse education and team-focused work environment, and reflects on the personal growth that came from living and working in a multicultural setting aboard Mercy Ships.

Tune in to learn how Mercy Ships provided life-changing opportunities for both patients and volunteers!

Topics discussed in this episode:

Mercy Ships is a global charity that operates the world’s largest hospital ships. Since its founding in 1978, Mercy Ships has brought hope and healing to Africa through surgical care, education, training, community development, and health programs. The life-changing work of our hospital ships is made possible all because of our vibrant community of volunteers from around the world. Whether you are a Perioperative, Critical Care, Ophthalmology, or a Pediatric Nurse, there is a place on board for you! Find your place and join Mercy Ship as a volunteer to help change the lives of people in great need.   

Follow Mercy Ships:  

Facebook: https://www.facebook.com/MercyShips

Instagram: https://www.instagram.com/mercyships/

LinkedIn: https://www.linkedin.com/company/mercy-ships/

Learn more:

https://opportunities.mercyships.org/volunteer-now/

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

When Michelle discovered her patient was paralyzed, it surprised the whole medical team. This patient who was previously mobile and recovering from septic shock was now paralyzed and ultimately diagnosed with spinal cord ischemia, but could early intervention have changed the outcome?

In this episode, we discuss the causes, signs, diagnosis and treatment of spinal cord ischemia. Michelle shares powerful insights from her work in neurocritical care, including a technique for detecting easy-to-miss neurological changes.

Tune in to find out how you can improve patient outcomes when managing spinal cord ischemia!

Topics discussed in this episode:

Connect with Michelle:

https://www.michellededeo.com/

https://www.instagram.com/michellededeo/

Listen to Michelle’s podcasts, the SCRN Prep Podcast and Narrative Nurse Project Podcast!

Get 20% off Michelle’s Stroke Review Bootcamp with code RAPIDRN20!

https://www.nicolekupchikconsulting.com/booksAndCourses/online-courses/61/stroke-review-bootcamp-case-studies-in-optimizing-care

This week, we are talking about every cardiac nurse’s worst nightmare: cardiac tamponade. Host Sarah Lorenzini is joined by Brian McCain RN to share a crazy case of cardiac tamponade where quick intervention made all the difference. In this episode, they discuss the critical signs, symptoms and pathophysiology of cardiac tamponade.

Brian and Sarah cover clinical findings like Beck’s triad and dampened arterial line waveforms, assessment techniques for patients who rapidly decline versus those with a gradual buildup of symptoms, and the nurse’s role in preparing patients for an open arrest.

Tune in to learn how to recognize and manage this cardiac emergency! 

Topics discussed in this episode:

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

A patient arrives at the ER, complaining of chest pain that dramatically worsens when she lies down. What could this clue reveal about her condition? In this episode, host Sarah Lorenzini recounts her experience caring for her first pericarditis patient and the subtle yet critical signs that distinguish it from more common cardiac emergencies.

Sarah dives into the tricky nature of chest pain, sharing how the PQRST pain assessment and an EKG played a critical role in uncovering the patient’s condition. She also outlines the diagnostic criteria that help differentiate pericarditis from more serious conditions like myocardial infarction, emphasizing the symptoms that can make diagnosis challenging.

Listen to the episode for insights on recognizing the easily mistaken signs of pericarditis, diagnosing the condition, and providing effective treatment!

Topics discussed in this episode:

Learn more by reading this Brady et al article about ECG morphology in pericarditis:

https://pubmed.ncbi.nlm.nih.gov/11581081/

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Clinical Nurse Specialists are more than just experts in their field.  They are advanced practice nurses who are driven to make system wide changes for both nurses and their patients.

This episode sheds light on the critical role of Clinical Nurse Specialists, the extensive education and experience needed to enter the field, and their unique responsibilities compared to other nursing positions. Nicole openly shares the impact she’s been able to make as a CNS, the challenges she’s faced — and even mistakes she's made along the way. We also discuss the worrying decline in CNS programs, and what nurses can do to secure a CNS position in today's healthcare environment.

Tune in to learn more about what it takes to be a Clinical Nurse Specialist and decide if it's the right fit for you!

Topics discussed in this episode:

Head to Nicole’s website to get 20% off ALL courses and educational materials with code RAPIDRN20!

https://www.nicolekupchikconsulting.com/?ref=30065

Connect with Nicole Kupchik:

https://www.instagram.com/nicolekupchik/

https://www.tiktok.com/@nicolekupchik

https://www.facebook.com/NicoleKupchikConsultingEducation

https://www.linkedin.com/in/nicole-kupchik-mn-rn-ccrn-530b8710/

https://www.youtube.com/channel/nicolekupchik5959

This week's case study features a 5-week trauma injury, a critical care transport, and a pediatric patient with a surprise sepsis diagnosis. Critical Care Transport Nurses Erik and Nykole join host Sarah Lorenzini to discuss the complexities of managing a young patient with an unexpected empyema.

In this episode, you’ll hear Erik's initial assessment of the patient, how the diagnosis of empyema was ultimately reached, and the actions taken to keep the patient stabilized during transport. They cover important topics like fluid overload in pediatric patients, re-expansion pulmonary edema, and therapeutic presence.

Erik and Nykole also share their journey to becoming critical care transport nurses and offer insights on caring for pediatric patients. Listen to this conversation for a behind-the-scenes look at pediatric critical care transport!

Topics discussed in this episode:

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

This mystery case kept everyone guessing, and now it’s time to reveal Mr. James’ surprising diagnosis: serotonin syndrome! But how did he end up with this rare condition? In this episode, host Sarah Lorenzini reviews Mr. James’ case, explains what led him to develop serotonin syndrome, and the signs that pointed to this diagnosis.

If you were stumped by this case, don’t sweat it! Serotonin syndrome is hard to diagnose, but Sarah breaks down its pathophysiology and shares effective treatment methods. Discover key factors that contribute to serotonin syndrome, such as serotonergic medications, and the myriad of symptoms that can affect the patients' autonomic system, neuromuscular system, and mental state.

Tune in now to learn more about serotonin syndrome!

Topics discussed in this episode:

Watch this video to learn how to assess patients for clonus:

https://youtu.be/4SrhgjGIZ30

Read the article about SSRIs exacerbating sleep apnea: Selective serotonin reuptake inhibitor use is associated with worse sleep-related breathing disturbances in individuals with depressive disorders and sleep complaints: a retrospective study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927326/#:~:text=Conclusions%3A,be%20confirmed%20by%20prospective%20studies

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Can you guess what was Mr. James' diagnosis?

Why was he having periods of apnea?

Why was he tachycardic?

Why was he hypertensive?

Why was he so rigid?

Why wouldn't he wake up?

Tune in Friday for Episode 114 to hear the reveal of the diagnosis and breakdown of the pathophysiology and how to treat Mr. James' condition

Awesome nurses don’t always make great preceptors. So what does it take to nurture new talent into capable and confident professionals? This episode delves into fundamental qualities, mindset and teaching strategies necessary to excel in the role of a preceptor.

Host Sarah Lorenzini reflects on her experiences with both good and bad preceptors, sharing insights on how to create a supportive and empowering learning environment that encourages independence. From setting expectations and goals to dealing with difficult trainees, she outlines proven methods to help nurses become an effective mentor. You’ll learn techniques for providing constructive criticism, building up critical thinking skills, promoting self-efficacy in trainees, and more!

Tune in to learn how to become an exceptional preceptor and make a positive impact on the next generation of nurses!

Topics discussed in this episode:

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

The summer heat brings fun in the sun, relaxing days, and even the threat of heat stroke. In this episode, host Sarah Lorenzini explores the spectrum of heat-related illnesses, highlighting the crucial differences between heat stroke and heat exhaustion. She recounts an emergency case of a young man with all the classic symptoms of heat stroke — and the highest temperature of any patient she’s ever seen.

Sarah delves into the complications that can arise from heat stroke and effective treatment protocols for cooling down patients. You’ll learn about the factors that increase the risk of heat stroke, the danger zone of hyperthermia, and how to prevent hypothermia during the treatment of heat stroke.

Listen to this episode to learn more about recognizing and managing heat stroke!

Topics discussed in this episode:

Check out the EM Cases episode about heat stroke:

https://emergencymedicinecases.com/em-quick-hits-september-2021/

Read Dr. Swaminathan's article on environmental hyperthermia:

https://coreem.net/core/environmental-hyperthermia/

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

When the diseased liver is unable to filter out neurotoxins like ammonia, we can see a spectrum of the neuropsychiatric symptoms of hepatic encephalopathy.  For the final installment in our liver failure series, host Sarah Lorenzini highlights a complicated case of hepatic encephalopathy where critical thinking and interdisciplinary teamwork were key to preventing further complications.

She examines the common signs and symptoms of hepatic encephalopathy, factors that trigger or exacerbate the condition, and challenges nurses face in the diagnostic process. This episode also dives into treatment strategies and how to differentiate between hepatic encephalopathy and alcohol withdrawal.

Tune in to learn how cirrhosis can lead to hepatic encephalopathy, the effect of neurotoxins in the brain, and how you, as a nurse, can manage patient care!

Topics discussed in this episode:

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Managing liver failure often means walking a tightrope with kidney function. This episode explores what happens when the kidneys begin to fail due to liver disease, a condition known as hepatorenal syndrome. Host Sarah Lorenzini sheds light on this common but severe complication of cirrhosis, sharing a critical case that exemplifies the challenges of diagnosing and treating hepatorenal syndrome.

Tune in to gain a better understanding of the pathophysiology of hepatorenal syndrome, the importance of early intervention, and effective treatment strategies. Listen to part three of this liver failure series now!

Topics discussed in this episode:

A cirrhosis patient has stable vitals, but then starts vomiting blood. What do you do next? This episode delves into a case study that highlights the urgent management of esophageal varices in liver failure patients. Host Sarah Lorenzini reveals how a rapid response call quickly spiraled into a life-threatening emergency, and the critical steps taken to stabilize the patient.

Sarah explains the pathophysiology of cirrhosis and the development of esophageal varices, detailing the pharmacological and procedural interventions that can make the difference between life and death. You’ll get a comprehensive overview of evidence-based treatment strategies, how to manage complications, and the crucial role of nurses in patient care.

Tune in to arm yourself with the knowledge to handle this critical liver emergency!

Topics discussed in this episode:

Listen to Episode 77, “The Trauma, Diamond of Death:” https://podcasts.apple.com/us/podcast/77-the-trauma-diamond-of-death-4-treatment-priorities/id1535997752?i=1000633582257

To learn more about balloon tamponade, check out this breakdown of the procedure: https://first10em.com/balloon-tamponade-of-massive-gi-bleeding/

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

No matter your specialty, every nurse cares for patients with liver failure. Host Sarah Lorenzini starts off this four-part series on liver failure by sharing the story of a rapid response call that featured classic complications of cirrhosis: ascites, jaundice, and hypotension. Exacerbating the patient’s terminal condition was a suspected diagnosis of spontaneous bacterial peritonitis.

In this episode, Sarah details how her team managed this case and breaks down the pathophysiology of cirrhosis, including why liver failure leads to so many complications. She covers how to assess and care for patients with cirrhosis, emphasizing the important role of nurses in educating families on liver failure.

Tune in for critical insights into the management of liver failure and its complications!

Topics discussed in this episode:

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

NTI 2024 brought together critical care nurses from across the country, and this episode highlights over 10 of their most heartwarming and unforgettable stories. Host Sarah Lorenzini speaks to ICU nurses and nurse educators who share tales of human connection, critical thinking, and compassionate care. From navigating crazy shifts to creating new patient programs, their stories showcase the incredible impact nurses have on patients’ lives and the healthcare system.

Tune in to celebrate the dedication, empathy, and resiliency of today's nurses!

Connect with Maddi Flanagan:

https://www.instagram.com/nurse.maddi/

Connect with Michael DeFrancisco:

https://www.instagram.com/camp_competency

Connect with Nicole Kupchik:

https://www.instagram.com/nicolekupchik/

Connect with Nick McGowan:

https://www.instagram.com/critical_care_academy/

Connect with Kali Dayton:

https://www.instagram.com/daytonicuconsulting/

Nursing care plans are the bane of many a nursing student’s academic experience. They are seen as an unnecessary burden to their already heavy workload. But they play an important role in the nursing process, and nurses put these plans into clinical practice every day — whether they realize it or not.

In this episode, Nurse Gwenny, an ER and flight nurse turned EMS educator, speaks with host Sarah Lorenzini about the relevancy and value of nursing care plans. She shares real-life examples of the impact these plans have on critical care thinking and decision-making, especially in high-pressure environments. Nurse Gwenny also discusses her passion for teaching, and how she leverages her experience and insights in her role as an educator.

Sarah and Nurse Gwenny also explore the “green flags” of nursing practice, diving into notable traits like a positive attitude, desire to learn from mistakes, and more.

Tune in to learn how to embrace care plans, improve patient care and your nursing skills!

Topics discussed in this episode:

Connect with Nurse Gwenny:

https://www.instagram.com/nursegwennyrn/

https://www.tiktok.com/@nurse.gwenny/

Check out Gwenny's book, BUT WHY?: Going Beyond the What So You Can Understand the Why of Critical Care Transport: https://a.co/d/28tLpjP

Nursing educators may not hold the most glamorous position, but they are undoubtedly the backbone of the profession. Nurse Educator Patrick McMurray exemplifies this by bringing creativity and inclusivity into nursing education, supporting nurses at every stage of their career.

In this episode, host Sarah Lorenzini talks to Patrick about his approach to teaching complex concepts and preparing students to succeed beyond the classroom. Using interactive learning strategies and holistic methods, Patrick helps nurses deepen their understanding of nursing practices and effectively apply their knowledge in clinical settings.

Patrick also offers a glimpse into a day in the life of a nursing educator, and discusses the profound impact nursing educators have on the future of nursing. His insights will help you determine if a transition to nursing education is the right next step in your career.

Join us for part two of the “So You Want to Go Back to School” series with Patrick McMurray!

Topics discussed in this episode:

Learn more about Patrick and find free educational resources on his website!

https://www.patmacrn.com/

Connect with Patrick McMurray:

https://www.instagram.com/patmacrn/

https://twitter.com/nursepatmacrn

https://www.tiktok.com/@patmacrn

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Obstructive shock may be the least common type of shock, but it’s no less critical. As part of Nurse PodCrawl 2024, Bryan Boling and Brandon Oto from the Critical Care Scenarios podcast join host Sarah Lorenzini in this episode to talk about the critical care management of obstructive shock. Together, they walk nurses through a patient scenario, detailing the diagnostic process of obstructive shock due to pulmonary embolism.

Sarah, Bryan and Brandon review the three main causes of obstructive shock: pulmonary embolism, tension pneumothorax, and cardiac tamponade. They also discuss the importance of clinical assessments and diagnostic tools like ultrasound to distinguish between each cause, as well as considerations for treatment.

This episode is the perfect resource for nurses who want to deepen their understanding of obstructive shock. Tune in now to hear insights from three experienced pros!

Topics discussed in this episode:

Check out the rest of Nurse PodCrawl 2024 episodes around cardiogenic, hypovolemic, and distributive shock!

Critical Care Scenarios: https://podcasts.apple.com/us/podcast/critical-care-scenarios/id1491559787

How Not to Kill Your Patient: https://podcasts.apple.com/us/podcast/how-not-to-kill-your-patient/id1612099061

Nurse Dose Podcast: https://podcasts.apple.com/us/podcast/nurse-dose-podcast/id1486427611

The Q Word Podcast: https://podcasts.apple.com/us/podcast/the-q-word-podcast/id1407523803

Straight A Nursing: https://podcasts.apple.com/us/podcast/straight-a-nursing-study-for-nursing-school-exams-nclex/id1210975738

Up My Nursing Game: https://podcasts.apple.com/us/podcast/up-my-nursing-game/id1527032817

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Which side of the debate do you fall on?  Should families be present during resuscitation or escorted to a quiet area to wait? Among those advocating for family presence are nursing researchers, Margo Halm, APRN-BC, PhD, FAHA, NEA-BC and Jessica Sexton, MSN, RN, CPEN. During their conversation with host Sarah Lorenzini, they explain why family presence is so important in patient-centered care and how nurses can facilitate a shift towards embracing this practice in their hospital.

Despite being backed by research, the concept of family presence during resuscitation is still debated by many healthcare professionals. Margo and Jessica address the common misconceptions that surround this controversial topic, provide insights on navigating institutional resistance, and share best practices of a family presence facilitator (FPF).

This episode also features powerful stories on the impact of family presence, tips on how to have important conversations with families and patients, and more. Tune in now!

Topics discussed in this episode:

Read more in the AACN Practice Alert, Facilitating Family Presence During Resuscitation and Invasive Procedures Throughout the Lifespan:

https://aacnjournals.org/ccnonline/article/44/2/e1/32253/Facilitating-Family-Presence-During-Resuscitation

Learn more about Margo and Jessica’s session at the 2024 NTI Conference:

https://www.aacn.org/conferences-and-events/events-calendar/national-events/event-sessions/national-teaching-institute---2024/c60m296/family-presence-during-resuscitation-and-invasive-procedures-updates-to-the-aacn-pract

Contact Margo Halm at margohalm@gmail.com!

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

We’ve talked about hyponatremia, but what do you know about Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) and Diabetes Insipidus (DI)? In this episode, host Sarah Lorenzini and Nick McGowan RN, MSN dive into these diseases that develop from complex hormonal responses that manage the body’s water and sodium.

They explore the pathophysiology of both conditions, contrasting the excessive water retention in SIADH with the excessive water loss in DI and how this impacts diagnostic and treatment approaches. Nick identifies which labs and assessments are crucial to accurately diagnose and treat patients, highlighting the importance of neurologic assessments and best practices for correcting sodium.

Sarah and Nick also touch on the debate around cerebral salt wasting, and share interesting facts about the history of these conditions. Tune in to hear key lessons on recognizing and  treating these conditions from an experienced ICU nurse!

Topics discussed in this episode:

Check out Nick's course over at Critical Care Academy!

🔗 https://www.ccrnacademy.com?ref=sarahlorenzini

Connect with Nick McGowan:

https://www.instagram.com/critical_care_academy/

https://www.youtube.com/@criticalcareacademy8312

https://www.facebook.com/CCRNacademy

https://www.tiktok.com/@criticalcareacademy

On this special PodSwap Episode, you will be hearing from Nurse Mo from the Straight A Nursing Podcast! She does an amazing job breaking down all the pharmacology of medications we use for Rapid Sequence Intubation or RSI.

Rapid sequence intubation, a procedure performed to emergently intubate a patient with an intact gag reflex in cases of acute respiratory failure and/or cardiovascular collapse. As a nurse working in the emergency department or ICU, you will be obtaining and may be administering the medications used to perform a rapid sequence intubation. Please be aware of your scope of practice and facility protocol regarding the administration of these medications. In some cases, the medications can only be administered by a physician.

Which combination of medications the physician chooses will vary depending on a variety of factors including the patient’s condition and physician preference. A common combination is a sedative with a short-acting paralytic, though analgesics may also be utilized. This episode provides an overview of the medications commonly utilized for RSI:

___________________

You can check out the following from Nurse Mo:

Full Transcript – Read the article and view references

FREE CLASS – If all you’ve heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES…you can thrive in nursing school without it taking over your life!

Study Sesh – Change the way you study with this private podcast that includes dynamic audio formats that help you review and test your recall of important nursing concepts on-the-go. Free yourself from your desk with Study Sesh!

Fast Pharmacology – Learn pharmacology concepts in 5 minutes or less in this audio based program. Perfect for on-the-go review!

Pharmacology Success Pack – Want to get a head start on pharmacology? Download the FREE Pharmacology Success Pack

Are you considering a career as a nurse practitioner? Do you want to go back to school to transition into an advanced practice nursing role? Join host Sarah Lorenzini and guest Dr. Sandra Pagenta, DNP, as they discuss opportunities available in nursing and how to decide if the nurse practitioner path is the right one for you.

Dr. Sandra Pagenta reflects on the evolution of her nursing career, from her early days as an RN to her current role as a nurse practitioner. She dives into the challenges and rewards of advancing your education and career, finding your niche, and achieving work-life balance.

In this episode, Dr. Sandra Pagenta also gives advice on how nurses can figure out their next career move and create the life they want. Tune in now!

Topics discussed in this episode:

Listen to Sandra's Podcast:

https://podcasts.apple.com/us/podcast/the-success-nps-podcast/id1566107516

Check out Sandra's Website:

https://successnps.com/

Follow Success NP's on Social Media:

YouTube: ⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/channel/UCYQYlS9d6m7HyMK7Z1BI5DA

Instagram: ⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/thesuccessnps

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Every day that you complete a shift is a day to celebrate because nursing is undoubtedly one of the hardest professions in the world, especially in the last few years. Burnout rates are extremely high, and for good reason, but there are ways to keep your passion for nursing even after decades in the field.

In this milestone 100th episode of Rapid Response RN, host Sarah Lorenzini celebrates 20 years of being a nurse and *still* loving it. It hasn’t been easy, but two decades of continuous learning and navigating the challenges of the job has taught her invaluable lessons on resilience, self-care, and humanity.

Sarah reflects back on her early mistakes and the hard-earned wisdom that’s kept her love for nursing alive, including connecting with patients, growth through education and mentorship, prioritizing physical and mental health, and MORE.

Tune in now to hear Sarah’s "not so secret sauce" for loving nursing after 20 years!

Topics discussed in this episode:

Listen to episode 38, Q&A: How to Effectively and Professionally Advocate For Your Patient… Even When the Provider is Intimidating, on Apple Podcasts!

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Treating hyponatremia, a condition characterized by low sodium levels in the blood, can be both complicated and quite risky.. Disruptions to the delicate balance of sodium in the body can lead to a spectrum of outcomes, from an asymptomatic presentation to life-threatening seizures, coma, and death.

Through the patient story of Mrs. Saltman, host Sarah Lorenzini explains the role of sodium in the body, breaking down the science of osmosis and electrolytes so nurses can better understand the causes of hyponatremia. She goes over the three levels of hyponatremia that are categorized by blood tonicity and volume status, and how each level impacts the diagnosis and management of hyponatremia. 

Sarah also dives into the nuances of treating hyponatremia, including the risks of rapid sodium correction, the importance of knowing a patient’s baseline, the underlying cause of their condition, and more.

This episode will provide nurses with the knowledge needed to recognize the signs of hyponatremia and navigate the risks of treatment. Tune in now!

Topics discussed in this episode:

Takotsubo cardiomyopathy, also known as “broken heart syndrome,” is hard to diagnose because its symptoms mimic more common conditions like acute coronary syndrome. This stress-induced cardiomyopathy presents a mysterious challenge to nurses, as you’ll hear in today’s patient story.

Host Sarah Lorenzini shares the case of a patient who went from experiencing shortness of breath and nausea to a serious cardiac emergency. She breaks down the patient’s initial presentation, their quick decline featuring hypoxia and flash pulmonary edema, and ultimate diagnosis of takotsubo cardiomyopathy.

In this episode, Sarah dives into the pathophysiology of takotsubo cardiomyopathy, covering how emotional or physical stress leads to the condition. She goes over its symptoms and treatment, as well as the role of nurses in managing the condition.

Tune in now to find out how you should be handling similar cardiac emergencies!

Topics discussed in this episode:

Listen to Episode 82: Sympathetic Crashing Acute Pulmonary Edema: That Time My Patient Went From Stable A-Fib RVR to Intubated in 30 Minutes! https://podcasts.apple.com/ca/podcast/82-sympathetic-crashing-acute-pulmonary-edema-that/id1535997752?i=1000637926574

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Part two of our crashing asthmatic series continues with a comprehensive look into what exactly happened in last week’s nightmare patient case. 

Host Sarah Lorenzini dives into the pathophysiology of status asthmaticus, explaining the physiological changes in the airways during severe asthma attacks and what makes these cases resistant to standard treatment. She also breaks down treat options for patients approaching the asthma spiral of death, from pharmacological interventions to last-resort interventions like ECMO.

This episode highlights the key role of nurses in the care of status asthmaticus, including the importance of recognizing the red flags like “silent chest” and managing patient anxiety.

Tune in to learn everything you need to know about caring for a crashing asthmatic!

Topics discussed in this episode:

Read this article that supports the use of magnesium for asthma:

https://pubmed.ncbi.nlm.nih.gov/24865567/

Read this article that shows magnesium does not help in asthma cases:

https://pubmed.ncbi.nlm.nih.gov/1536485/

....and there are so many more conflicting studies like these ☝️

Listen to Episode 73: Resuscitate Before You Intubate: How to NOT KILL YOUR PATIENT When You Intubate https://podcasts.apple.com/us/podcast/73-resuscitate-before-you-intubate-how-to-not-kill/id1535997752?i=1000630431016

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Severe asthma leads to cardiac arrest in today’s gripping patient story. Brooklyn, an ER Nurse joins host Sarah Lorenzini to discuss a nightmare case of a young asthmatic patient and her team’s desperate fight to stabilize him.

Despite various interventions, from albuterol, magnesium, BiPap, ketamine, and more, the patient's condition deteriorated, requiring intubation and ultimately transfer to an ECMO center to save the patient’s life. This episode highlights the challenges faced by smaller hospitals with fewer resources and the heroic care this patient received despite so many challenges.

Check out part one of our series on caring for the crashing asthmatic!

Topics discussed in this episode:

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Do you know how to recognize a wide or narrow pulse pressure and what each finding tells you about your patient? Following last week's discussion on the shock index, host Sarah Lorenzini introduces pulse pressure as another essential tool in the nurse's assessment arsenal.

In this episode, Sarah outlines how to measure and interpret pulse pressure. She shares two patient stories to illustrate how variations in pulse pressure can indicate different underlying conditions: The case study of Mrs. D highlights the implications of narrow pulse pressure, and the case study of Mr. S explores wide pulse pressure.

Through these examples, Sarah emphasizes how pulse pressure can be a key indicator in patient assessments while also clarifying its limitations. Listen in now!

Topics discussed in this episode:

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Looking at HR or Blood Pressure alone as determinants of how stable the patient is can lead us astray.  The Shock Index allows us to detect when patients are declining… while they are still compensating. Shock Index = HR/SBP… but how can we use this tool? 

A patient’s vital signs can appear normal, meanwhile they’re on the brink of shock. This was exactly the case of Mr. Fields, a patient admitted to the ER after falling off his tractor. Initially, his vitals didn't raise alarms but there were signs pointing to a more serious situation — including a shock index of greater than one.

In this episode, host Sarah Lorenzini dives into the critical role shock index plays in determining how sick patients are and improving their outcomes, especially in emergency settings. She breaks down the calculation of shock index, its limitations in screening for all types of shock, and practical applications in patient care.

Tune in now to explore how you can apply this vital tool in the assessment and treatment of patients!

Topics discussed in this episode:

Learn more about shock index: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698590/#:~:text=Shock%20index%20(SI)%20is%20defined,sepsis%2C%20and%20ruptured%20ectopic%20pregnancy

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Are you familiar with BRASH syndrome? The complex interplay of Bradycardia, Renal Failure, Atrioventricular Block, Shock, and Hyperkalemia forms a collection of clinical signs known as BRASH syndrome. One condition leads to another which leads to another, heightening the severity of symptoms. Fortunately, it’s easy to manage if you know what you are treating.

In this episode, Sarah Lorenzini breaks down the pathophysiology of BRASH syndrome as she examines a patient case study. Starting with its hallmark features and expanding into the synergistic effects of AV nodal blockers, hyperkalemia and renal failure, she provides insights on recognizing the signs of BRASH syndrome early and the importance of understanding the interplay among its components.

Sarah outlines the treatment priorities for BRASH syndrome and highlights the importance of identifying the root cause of symptoms to prevent a cascade of complications leading to shock.

Tune in to strengthen your knowledge of BRASH syndrome!

Topics discussed in this episode:

You can learn more about BRASH Syndrome at the Internet Book of Critical Care Website:

https://emcrit.org/ibcc/brash/

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Timing is everything when it comes to strokes because every second without treatment impacts patient outcomes. If you’ve ever wasted time debating whether or not to call a stroke alert, you don’t want to miss this episode with Dr. Eric Wilson RN, AGNP-C, DNP, NREMT-P!

During his conversation with host Sarah Lorenzini, Eric emphasizes the urgency of recognizing stroke symptoms early, highlighting unilateral deficits and speech issues as red flags for immediate action. He guides listeners through the assessment of patients using the NIH Stroke Scale, and dives into treatment options and diagnostic procedures.

Eric and Sarah also discuss the role of nurses during a stroke alert, including when one should be called and what nurses can expect. Tune in now to learn how you can rock your next stroke alert!

Topics discussed in this episode:

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Cardiac output equals heart rate times stroke volume… but what does that really mean and how does it apply to the bedside? This formula (CO = HR x SV) is crucial for nurses to understand in the application of vasopressors and inotropes, so why is it so difficult to memorize their role in improving cardiac output?

This episode is dedicated to breaking down these life-saving medications so you can not only memorize their expected effect on vital signs, but more importantly, understand how they work in the body. Host Sarah Lorenzini provides a comprehensive lesson in these three classes of medications: vasopressors, inopressors and inodilators. She covers how each affects heart rate and stroke volume, diving into the alpha and beta adrenergic receptors that impact cardiac output.

Sarah also shares memory aids to help you remember these concepts and apply them to your clinical decision making.

Tune in now to learn the basics of vasopressors and inotropes!

Topics discussed in this episode:

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Did you listen to Joey’s story in last week’s mystery episode? If you did and guessed rhabdomyolysis as his diagnosis, congratulations! Joey’s muscle injury from playing a little too hard at football camp resulted in a release of muscle proteins that ultimately caused his kidneys to shut down, which led to his diagnosis and treatment for rhabdomyolysis.

In this episode, host Sarah Lorenzini examines the complexities of the condition, from its pathophysiology to causes and treatment options. You’ll learn the hallmark signs of rhabdomyolysis, the not so obvious signs and symptoms to be aware of, and what to consider when caring for patients.

Tune in for a detailed exploration of rhabdomyolysis!

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Are you ready for some diagnosing fun?! In this episode, host Sarah Lorenzini will challenge your diagnostic skills with the mystery case of Joey, a 14-year-old patient who went from playing football at summer camp to being intubated in the ER.

Joey presented with an altered mental status, and was tachycardic, tachypneic and febrile. Once in the ER, he went into ventricular tachycardia, his blood pressure dropped significantly, and he required intubation. As Sarah shares more details on his presentation, labs results and medical history, you’ll get all the critical clues needed to solve this intriguing case.

So, think you can uncover what’s wrong with the patient? Check back next week when Sarah concludes Joey’s story and reveals his mystery diagnosis!

As host Sarah Lorenzini insightfully explains, “think of autonomic dysreflexia symptoms as the body's way of telling you something is wrong.” Autonomic dysreflexia is a medical emergency that occurs in patients with a spinal cord injury, but it can be hard to recognize because of the body’s confusing responses to stimulation. That’s why it’s crucial for nurses to understand this syndrome and prevent patients from developing any life-threatening complications.

In this episode, host Sarah Lorenzini gives listeners an inside look at a case of autonomic dysreflexia in a quadriplegic patient. She breaks down the patient’s symptoms, medical history and presentation, then shares what helped her recognize the signs of autonomic dysreflexia. As she dives into the pathophysiology of autonomic dysreflexia, you’ll gain a better understanding of this syndrome, including how to manage the symptoms and treat patients.

At first perplexed by this case, it was Sarah’s knowledge and critical thinking that led her to suspect autonomic dysreflexia. Tune in now and take notes so you can diagnose autonomic dysreflexia and deliver timely intervention the next time you encounter it!

Topics discussed in this episode:

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Goals of care discussions are among the most difficult to navigate as a nurse, BUT there are ways to provide both comfort and clarity to patients and their families in these emotionally charged situations.

In this episode, host Sarah Lorenzini and Hospice Nurse AJ share tips and insights on how to approach these challenging discussions with sensitivity and respect, all while keeping patient’s wishes at the forefront of treatment. From how to start the conversation to addressing concerns, they cover strategies for approaching family members in person or on the phone.

This episode explores not just the words and phrases nurses should employ, but also the compassion that patients and their families need as they step into the grieving process. AJ and Sarah also discuss how to handle various scenarios, including ones where the family is in disagreement or is struggling to make a decision on care.

After listening, you’ll have skills necessary to navigate the nuances of communicating effectively about goals of care and balancing clinical objectives with empathy. Tune in to learn how to have clear, compassionate goals of care discussions!

Topics discussed in this episode:

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Orienting as a new Nurse in the ICU is much like climbing your first big mountain — both require basic knowledge, passion, and the ability to learn quickly and adapt in a demanding environment. But without these attributes, you have an arduous, possibly insurmountable journey ahead of you.

In this episode, host Sarah Lorenzini and Sarah Vance RN delve into the controversial topic of new grads going straight into the ICU after graduation, exploring the challenges and opportunities it presents for new nurses. They discuss the essential skills and mindset needed to thrive in such an intense setting, emphasizing the crucial role of self-care and support for success in the ICU.

This episode answers common questions from Rapid Response RN listeners, including “what types of people do well in the ICU, and what types of people struggle? What can I do to prepare for a job in the ICU? What are the most common struggles of nurses in the ICU, and how can they mitigate those challenges?”

As a critical care nurse and educator, Sarah’s insights will help you assess your readiness for joining the exciting but challenging world of the ICU. Tune in now!

Topics discussed in this episode:

Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videos

Connect with Sarah Vance!

Instagram: https://www.instagram.com/iseeu_nurse/

TikTok: https://www.tiktok.com/@iseeu_nurse

Website: https://iseeunurse.com/

What’s your craziest, most shocking nursing story? In this episode, you’ll hear one of host Sarah Lorenzini’s most memorable stories as a rapid response nurse!

Sarah recounts her experience treating a severe case of a prolapsed rectum, describing the unconventional yet effective approach that not only resolved the medical dilemma but caught the attention of Rapid Response RN listeners, becoming the most shared episode of the podcast!

As Sarah delves into this case of rectal prolapse, she explains the science behind using sugar as treatment and important lessons learned from her experience with these rectal prolapse emergencies. Tune in now!

Topics discussed in this episode:

Mentioned in this episode:

RRA mid december ad 2023

If you want to learn more about the Rapid Response Academy: The Heart and Science of Caring for the Sick... you can click here https://www.rapidresponseandrescue.com/community to find out more and sign up.

Foreign objects in the bladder, urinary retention, priapism. These are just a few of the urological emergencies host Sarah Lorenzini is discussing with Dr. Shailen Sehgal!

Nurses are the first line of defense in treating emergencies and play an important role in managing their care. In this episode, Dr. Shailen Sehgal explores these emergencies and shares great tips and tricks to treat conditions like testicular torsion, assess for hematuria, and troubleshoot catheter insertions, bladder spasms, and more.

Sarah’s conversation with Dr. Shailen Sehgal highlights the pivotal role of nurses in treating urological emergencies that require quick intervention. After listening, you’ll have a deeper understanding of common urological challenges and better be able to decide when it’s time to stop troubleshooting and call the urologist.

Tune in now to learn from Dr. Shailen Sehgal’s expertise and insights!

Topics discussed in this episode:

Dr. Shailen Sehgal attended medical school at Cornell University and did his urology residency at the University of Pennsylvania. His fellowship in robotic/minimally invasive surgery was also completed at the University of Pennsylvania.  His clinical research fellowship was done at the National Institutes of Health.  He is board certified by the American Board of Urology. He practices urology and urologic surgery in Western Pennsylvania and West Virginia.

Dr. Shailen Sehgal, MD is one of the founders of UroCoach, a comprehensive library of urology education videos, free to the public. In these videos, urology topics are explained by practicing urologists in easy-to-understand language for patients, nurses, trainees, and anyone interested in urology!

https://youtube.com/@UroCoach

https://www.instagram.com/urocoaches/

https://www.tiktok.com/@urocoach

https://www.facebook.com/profile.php?id=100090540351025

Mentioned in this episode:

RRA mid december ad 2023

If you want to learn more about the Rapid Response Academy: The Heart and Science of Caring for the Sick... you can click here https://www.rapidresponseandrescue.com/community to find out more and sign up.

Snake bite care: where the cost and long-term complications can sting harder than the bite.

Managing snake bites requires quick intervention, making it crucial for nurses to understand how to navigate this type of emergency. So in this episode, host Sarah Lorenzini welcomes Sealy RN to share her firsthand experience of being bitten. As a nurse who has also treated snake bites, she has great insights on the challenges of snake bite care.

Sarah and Sealy discuss the use of antivenom, specifically the short and long-term risks of CroFab, what can happen if a snake bite is left untreated, and the role of nurses in snake bite management.

Sealy's story highlights the importance of prompt and informed treatment, taking charge of your own care and advocating for patients. Plus, you’ll find out what steps you should (and shouldn’t) take if you get bitten by a snake.

Tune in to learn everything you need to know from a nursing and patient perspective!

Topics discussed in this episode:

Download the SnakeBite 911 app:

https://crofab.com/crofab-resources/snakebite911

How does AFib RVR escalate into a life-threatening situation in just 30 minutes?

Join host Sarah Lorenzini as she reflects on a perplexing case of sympathetic crashing acute pulmonary edema, also known as flash pulmonary edema. This patient’s rapid deterioration led to an emergency intubation that perplexed the rapid response team, but the patient's true condition became clear in hindsight.

In this episode, Sarah walks us through the case, sharing the patient's presentation and medical history, how the team treated his symptoms, and why their initial interventions failed. She delves into the pathophysiology of SCAPE, the patient’s progression into sympathetic surge, and his ultimate treatment.

Tune in to learn from Sarah’s look back at this patient story!

Topics discussed in this episode:

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Host Sarah Lorenzini and Christian Guzman APRN are back to conclude this three-part heart failure series by examining the use of mechanical circulatory support for cardiogenic shock. This episode expands on the topics covered in previous parts, focusing on the application of mechanical circulatory support methods like the intra-aortic balloon pump, Impella, CentriMag, LVADs, and ECMO.

Christian and Sarah review the risks and benefits of each device, when to use them, and the key factors that impact these decisions. They also address the ethical challenges of ECMO, including the clinical judgment involved when determining who’s a good candidate and when to escalate care.

By the end of this episode, you’ll understand how these devices function, their critical role in managing cardiogenic shock in heart failure patients, and the value nurses bring to a multidisciplinary team.

Tune in for a knowledge-packed finale of this comprehensive heart failure series!

Topics discussed in this episode:

Connect with Christian Guzman APRN on Instagram:

https://www.instagram.com/thenerdynursepractitioner/

Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videos

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Nurses are trained to put their patients first, and that oftentimes results in forgoing their own needs. Skipping out on fundamental needs like sleeping and eating healthy meals lead nurses to feel emotionally and physically exhausted, eventually leading to burnout and loss of love for the job.

Nurses spend so much time advocating for patients but forget that it’s equally as important to advocate for themselves. As today’s guest will remind you, “what you resist persists.” Even if you have the ability to push your own needs to the side, they will always catch up with you, whether it’s in the form of an emotional breakdown or apathy towards other parts of your life.

Host Sarah Lorenzini is speaking with Nurse Burnout Coach Janna Holterman in a special two-part series! In this first episode, Janna shares her personal experience with burnout, the symptoms of burnout, and how she helps clients address them.

Janna and Sarah go over tools for overcoming burnout, and how to recognize you’re experiencing burnout and not just normal stress.

If you’re in search of the “perfect” nursing job, stop looking now because there isn’t one. However, YOU have the power to love nursing again and leave work with enough energy to live a happy, healthy life.

Tune in now to learn how to get started!

Topics discussed in this episode:

Learn more about Nurse Janna and her burnout coaching services on her website! www.jannaholterman.com

Connect with Nurse Janna on Instagram: https://www.instagram.com/jannaholtermancoaching/

Building on last week’s introduction to heart failure, this episode explores the nuances in the medical management of cardiogenic shock. Host Sarah Lorenzini and Christian Guzman APRN continue this three-part heart failure series by completing the case study of a patient in cardiogenic shock, and breaking down key treatment concepts and strategies.

They discuss goal-directed therapy to optimize heart function, with a specific focus on the vital aspects of contractility, afterload, and preload, and their pivotal roles in patient care. As their conversation progresses, they delve into the use of medical interventions, covering the pros and cons of medications used to treat heart failure at each stage from beginning to extremis.

Christian and Sarah go beyond what you’ll read from textbooks, shedding light on the challenges and clinical decision-making process of heart failure care by sharing real life examples and insights.

Tune in now to learn how to assess patients for cardiogenic shock and manage their care at every stage of heart failure!

Topics discussed in this episode:

Connect with Christian Guzman APRN on Instagram:

https://www.instagram.com/thenerdynursepractitioner/

Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videos

Mentioned in this episode:

Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the Sick

Click here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

This episode covers the two types of orthostatic syncope:

Neurally mediated orthostatic syncope (from conditions with autonomic dysfunction)

and

"non-neurally mediated" orthostatic syncope which is from medications or hypovolemia.

We discuss the diagnostic value and dangers of orthostatic vital signs and how to determine what type of orthostatic syncope your patient has had.

This is part 3 of a 4 part series on syncope so make sure you check out episode #32 and #33.

If you would like to check out the 1hr, 1 CE course, go to:

www.rapidresponseandrescue.com

you can use coupon code: PODCAST22

To get $22 off the cost of the course now until the end of 2022

Part 2 of a 4 part series on  syncope.

Syncope is one of the top reasons why a rapid response is called... but the question is, what precipitated the syncope?

In this episode we discuss a classic case of vasovagal syncope, in which Annie's patient had a six second pause on his ECG in response to some overwhelming news.  We break down why atropine might not be the best intervention for this patient and some of the treatment options for bradycardia.

This episode is Part 1 in a 4 part series on syncope.

Syncope and seizure can both present with unresponsiveness.  It can be difficult to differentiate between the two very different causes for an unresponsive episode.  Fortunately, there are some things to look for to help rule out seizure or confirm that it is the culprit... and they probably aren't the ones you thought you knew.