Atomic Anesthesia

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making. ⚠️ SIGN UP FOR OUR FREE NEWSLETTER: [NEWSLETTER SIGN-UP] Topics included in this episode: What current research shows about long-term cognitive effects of general anesthesia, including key findings from the MAAS study How perioperative neurocognitive disorders present, who is at risk, and how common they are The pathophysiology behind postoperative cognitive decline, focusing on neuroinflammation and anesthetic-related brain stress Practical, evidence-based strategies to protect brain health before, during, and after surgery Why brain health must be a shared, institution-wide priority across perioperative care teams 💜 LIVE WEBINAR: Save your seat on our monthly, free webinars. Replays are sent to your inbox and you get access to all of our previous webinars. [WEBINAR SIGN UP] 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. [SEE/NCE STUDY PLAN] [RN ICU DRUG CHART] 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Dr. Temmermand at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. [NEWSLETTER SIGN-UP] [INSTAGRAM] [TIKTOK] [YOUTUBE]

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making. ⚠️ SIGN UP FOR OUR FREE NEWSLETTER: [NEWSLETTER SIGN-UP] Topics included in this episode: Hemodynamic goals and risks during induction in severe aortic stenosis​ Limitations and hypotensive effects of propofol in aortic stenosis patients​ Pharmacology and potential advantages of cipepofol (ciprofol) as a propofol derivative​ Key findings of the JAMA Surgery randomized trial comparing cipepofol vs propofol in severe AS​ Practical induction strategies and future implications for managing severe AS patients under anesthesia ARTICLE: Hemodynamic Impact of Cipepofol vs Propofol During Anesthesia Induction in Patients With Severe Aortic Stenosis 💜 LIVE WEBINAR: Save your seat on our monthly, free webinars. Replays are sent to your inbox and you get access to all of our previous webinars. [WEBINAR SIGN UP] 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. [SEE/NCE STUDY PLAN] [RN ICU DRUG CHART] 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Dr. Temmermand at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. [NEWSLETTER SIGN-UP] [INSTAGRAM] [TIKTOK] [YOUTUBE]

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making. ⚠️ SIGN UP FOR OUR FREE NEWSLETTER: [NEWSLETTER SIGN-UP] Topics included in this episode: Why a full anesthesia machine check matters​ How to perform a systematic pre-use machine checkout​ Understanding and testing safety features and failure modes​ Checking ventilation, leak integrity, and waste gas handling​ Using structured tools to build a fast, reliable habit 💜 LIVE WEBINAR: Save your seat on our monthly, free webinars. Replays are sent to your inbox and you get access to all of our previous webinars. [WEBINAR SIGN UP] 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. [SEE/NCE STUDY PLAN] [RN ICU DRUG CHART] 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Dr. Temmermand at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. [NEWSLETTER SIGN-UP] [INSTAGRAM] [TIKTOK] [YOUTUBE]

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making. Topics included in this episode: Academic anchor habits for SRNAs and new CRNAs Deliberate clinical practice, including “one skill per shift” and quick weekly case debriefs.​ Mindset strategies like a “wins log” to fight imposter syndrome.​ Professional growth through scary-but-safe opportunities, CRNA business basics, and exploring fellowship prerequisites.​ Personal boundaries around sleep, non‑anesthesia hobbies, and phone/social media use to prevent burnout.​ Early burnout recognition and proactive check-ins with mentors or a therapist. 💜 LIVE WEBINAR 💜 Save your seat on our monthly, free webinars. Replays are sent to your inbox and you get access to all of our previous webinars. [WEBINAR SIGN UP] 💜 FREE DOWNLOADS 💜 Grab your copy of customized study plans & worksheets. [SEE/NCE STUDY PLAN] [GPCR WORKSHEET] [NON-OPIOID ANALGESICS WORKSHEET] [RN ICU DRUG CHART] 💜 CONNECT 💜 📥 Email questions, comments or topic suggestions to Dr. Temmermand at hello@atomicanesthesia.com, follow us on social media, and sign up for our launch newsletter. [NEWSLETTER SIGN-UP] [INSTAGRAM] [TIKTOK] [YOUTUBE]

Ketamine is a dissociative anesthetic that provides powerful analgesia while preserving spontaneous ventilation, airway reflexes, and sympathetic tone, which makes it especially valuable in trauma, bronchospasm, difficult airways, and in patients with high opioid tolerance. As a phencyclidine derivative with a chiral center, it exists as two enantiomers, with S-ketamine roughly twice as potent as R-ketamine and associated with fewer unpleasant emergence reactions, while its pKa and balanced water–lipid solubility allow rapid CNS penetration and redistribution-limited offset. Its multimodal mechanism centers on noncompetitive NMDA antagonism but also includes opioid receptor modulation, catecholamine reuptake inhibition, AMPA receptor effects, ion channel blockade, muscarinic antagonism, and anti-inflammatory actions, all of which underpin clinical dosing strategies for induction, maintenance, procedural sedation, and analgesic infusions as well as key considerations around emergence delirium, secretions, cardiovascular status, and ICP. Want to learn more? Grab our Cardiac Pharm Course --> [HERE] ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this reflective episode of the Atomic Anesthesia Podcast, we explore how perspective shifts with experience and how nurse anesthesia residents can study more effectively not just for exams, but for lasting clinical mastery. The episode outlines twelve lessons the host would apply if starting grad school again—from focusing on physiology over perfectionism, to using memory maps instead of endless notes, to treating organization as a core learning strategy rather than an afterthought. Listeners will hear why prioritizing long-term understanding, questioning clinical conventions, and building strong professional networks early can transform both their education and their future practice. Practical, honest, and experience-driven, this episode reminds anesthesia trainees that true competence comes from depth, connection, and curiosity—not from chasing straight A’s. Want to learn more? Grab our Cardiac Pharm Course --> [HERE] ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

This episode of the Atomic Anesthesia Podcast focuses on dexmedetomidine (Precedex), a highly selective α2-adrenergic agonist that provides cooperative, arousable sedation, analgesia, anxiolysis, and sympatholysis with minimal respiratory depression for perioperative and ICU care. Aimed at nurse anesthesia residents, it reviews dexmedetomidine’s α2-selective pharmacology, rapid distribution and hepatic metabolism, and its ability to mimic non-REM sleep via locus coeruleus inhibition while significantly reducing MAC and opioid requirements. Listeners learn practical dosing strategies for OR, ICU, and procedural sedation, common indications such as awake fiberoptic intubation, MAC cases, withdrawal management, and pediatric emergence delirium, and key safety considerations including bradycardia, hypotension, transient hypertension with rapid loading, and the ongoing need for vigilant airway and hemodynamic monitoring when incorporating dexmedetomidine into multimodal anesthetic plans. Want to learn more? Grab our Cardiac Pharm Course --> [HERE] ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, host Dr. Rhea Temmermand speaks with Michael Hoess, CRNA and Lead CRNA for Education at Cooper University Hospital, about the crucial role of CRNAs in austere and tactical medical environments. Drawing on over a decade of trauma and resuscitation experience, Mike shares how CRNAs contribute to training military and government medical teams operating in resource-limited or remote conditions. The discussion explores how core anesthesia principles adapt when blood banks, ventilators, or full surgical teams aren’t available, emphasizing the importance of airway control, hemodynamic management, and damage control resuscitation in the field. Mike also discusses building resilience through high-stress simulations, developing adaptive leadership skills, and fostering mission readiness for both seasoned CRNAs and students. Listeners gain insight into how these lessons from austere medicine can strengthen everyday anesthesia practice and prepare clinicians for the challenges of modern conflict and disaster response. If you want to reach out to Michael, you can contact him at michael.p.hoess@gmail.com or hoess-michael@cooperhealth.edu Articles: Austere Resuscitative and Surgical Care Teams: Supporting Far-Forward Trauma Care on the Future Battlefield Military and Civilian Surgery Partner for Innovation, Effectiveness A Western trainer says talk of 'golden hour' would be laughable to Ukrainian forces. Want to learn more? Grab our Cardiac Pharm Course --> [HERE] ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, we’re talking to future nurse anesthetists who’ve just crushed the biggest milestone yet — getting accepted into CRNA school. Between acceptance and day one, there’s often a long waiting period, and this episode is your roadmap for using that time strategically. From tackling financial readiness and creating a solid academic foundation to preparing your family, refining your clinical skills in the ICU, and strengthening your mindset, we cover every step of the “Pre‑CRNA School Survival Checklist.” You’ll learn how to simplify your finances, refresh your physiology and pharmacology knowledge, set up realistic support systems, and mentally prepare for the demands ahead. Whether you start in a few months or next year, this episode gives you a clear, actionable plan to transition smoothly from RN to SRNA with confidence and focus. Want to learn more? Grab our Cardiac Pharm Course --> [HERE] ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

This episode of the Atomic Anesthesia Podcast features guest Cori James, DNP, CRNA, for a candid and practical discussion on what not to do when working with CRNA preceptors. Designed for nurse anesthesia residents, this conversation highlights the most common pitfalls students unknowingly fall into during clinical rotations—from over-socializing and being unprepared to showing poor teachability, lacking situational awareness, or demonstrating unsafe habits in the OR. Cori shares firsthand insights on maintaining professionalism, demonstrating initiative, and developing adaptability across different teaching styles. The episode also explores critical aspects of communication, infection control, and teamwork that can make or break a student’s clinical experience. Whether you’re just beginning your first rotation or refining your professional presence, this episode equips you with the self-awareness and mindset needed to build strong preceptor relationships and thrive in the clinical setting. If you want to contact Cori, follow her on TikTok @corijamess or IG at @coricrna. You can also email her at corijames@gmail.com Want to learn more? Grab our Cardiac Pharm Course --> [HERE] ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, host Dr. Rhea Temmermand provides a detailed pharmacology review of propofol, the main IV sedative hypnotic used for induction, maintenance, and procedural sedation in anesthesia practice. The episode covers propofol’s drug class and chemistry, its lipid emulsion formulation and infection risk, and key physicochemical properties including high lipophilicity and protein binding. Listeners learn the mechanism of action at the GABA A receptor, translating into CNS effects, cardiovascular and respiratory depression, and no analgesia. The discussion walks through pharmacokinetics and context‑sensitive half‑time in a clinically practical way, tying concepts to infusion planning and dosing strategies for various cases. Major adverse effects, toxicity including propofol infusion syndrome, allergy and infection‑control practices, and drug synergies are highlighted, with high‑yield clinical pearls on patient selection, hemodynamics, and airway rescue. REFERENCES: Nagelhout JJ, Elisha S, Heiner JS, eds. Nurse Anesthesia. 7th ed. Elsevier; 2022. Flood P, Rathmell JP, Urman RD, eds. Stoelting’s Pharmacology & Physiology in Anesthetic Practice. 6th ed. Wolters Kluwer; 2021. Katzung BG, ed. Basic & Clinical Pharmacology. 14th ed. McGraw-Hill Education; 2018. Want to learn more? Grab our Cardiac Pharm Course --> [HERE] ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

This episode of the Atomic Anesthesia Podcast unpacks the real clinical risk of adrenal suppression after a single dose of etomidate, challenging common debates every anesthesia resident faces. Drawing on the latest studies, listeners will discover exactly which patient groups—cardiac, septic, trauma, pediatric, and elective—are actually vulnerable to etomidate’s effects, and when transient adrenal suppression matters for outcomes. The discussion highlights the drug’s unique origins, why its hemodynamic stability often outweighs risks in routine cases, and why infusions are off the table. Tune in for practical guidance on using etomidate safely, tips for steroid coverage in critically ill patients, and a sneak peek at promising new etomidate analogs. Whether you’re prepping for exams or your next high-stakes induction, this episode helps you make smarter, evidence-based choices in the OR.. Want to learn more? Create a FREE account at www.atomicanesthesia.com ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, pediatric CRNA and educator Dr. Becky Motykiewicz presents a comprehensive guide for nurse anesthesia residents preparing for their pediatric anesthesia rotation. From preoperative communication strategies with parents and pediatric patients to practical tips for inhalational induction, airway management, and safe emergence, Dr. Motykiewicz shares her real-world advice. The discussion covers essential topics such as age-appropriate communication, preoperative assessment, differences in pediatric and adult induction, critical emergency drugs and dosages, IV equipment considerations, and safe practices for emergence and extubation. Lists of must-know calculations, including formulas for endotracheal tube size, IV fluids, and emergency drugs, are highlighted along with recommendations for trusted resources. Emphasizing preparation, humility, and patient-centered care, this episode equips listeners with actionable steps and practical wisdom to approach pediatric anesthesia rotations with confidence and curiosity. Want to learn more? Create a FREE account at www.atomicanesthesia.com ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, we talk with Dr. Hallie D. Evans, DNP, CRNA, APRN, CNE, a nationally recognized nurse anesthesia educator and clinician, about what it takes for CRNAs to step into the world of teaching. Dr. Evans discusses how her journey from clinical anesthesia to academic leadership began, the personal qualities that make an effective educator, and how to determine if you have the right temperament for academia. Listeners will learn the practical steps to becoming a nurse anesthesia educator, essential skills to develop when transitioning from the OR to the classroom, and what to expect in terms of salary, schedule, and sacrifices. With over 15 years of anesthesia experience and more than a decade in education, Dr. Evans shares her insights on balancing clinical practice with teaching, building innovative programs, and fostering future generations of CRNAs through mentorship and evidence-based pedagogy. Want to learn more? Create a FREE account at www.atomicanesthesia.com ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, we tackle the complex reality of caring for patients under the influence of drugs or alcohol, a frequent challenge for nurse anesthesia residents and CRNAs. Covering the physiological effects and anesthetic implications of acute and chronic intoxication with alcohol, benzodiazepines, hallucinogens (such as LSD, PCP, and MDMA), cocaine, and cannabinoids, this episode offers fast, practical guidance for optimizing perioperative care and minimizing patient risk. Listeners will learn how substance use alters anesthetic requirements, impacts drug metabolism, and poses unique airway and hemodynamic risks, while also receiving actionable tips for drug class-specific management like when to use or avoid certain agents, the importance of invasive monitoring, and strategies for handling withdrawal or overdose. Tune in for a high-yield rundown that will help you make safer decisions when handling intoxicated patients in the OR. Want to learn more? Create a FREE account at www.atomicanesthesia.com ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, we connected with Dr. David Warren, DNP, CRNA, NP to discuss the unique journey of transitioning from nurse practitioner to nurse anesthesiologist. Dr. Warren shares insights from his clinical practice, case mix, and favorite patient populations while reflecting on how his background as an NP shaped his approach to anesthesia. Listeners will learn how previous advanced practice experience can both prepare and challenge those entering CRNA training, the advantages it can bring to clinical practice, and the mindset needed to succeed in this career shift. Dr. Warren also talks about his own podcast and social media presence, explaining how he uses these platforms to educate and inspire other clinicians. The conversation concludes with valuable advice for NPs considering the leap to anesthesia, making this episode a motivating and practical listen for aspiring CRNAs. Want to learn more? Create a FREE account at www.atomicanesthesia.com ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, host Dr. Rhea Temmermand is joined by vascular anesthesia expert Rick Heuermann, DNP, MBA, CRNA, to unravel the complex pathophysiology of peripheral vascular disease (PVD) and its impact on anesthetic management. Together, they break down healthy versus diseased arterial function, highlight why patients with PVD present unique challenges in the OR, and provide practical, evidence-based strategies for optimizing hemodynamics and minimizing perioperative risks in vascular surgery. Whether a seasoned clinician or a student navigating CRNA school, listeners will gain clinical insight and case-based wisdom for safer, more effective care of patients with PVD. Want to learn more? Create a FREE account at www.atomicanesthesia.com ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, host Dr. Rhea Temmermand is joined by vascular anesthesia expert Rick Heuermann, DNP, MBA, CRNA, to unravel the complex pathophysiology of peripheral vascular disease (PVD) and its impact on anesthetic management. Together, they break down healthy versus diseased arterial function, highlight why patients with PVD present unique challenges in the OR, and provide practical, evidence-based strategies for optimizing hemodynamics and minimizing perioperative risks in vascular surgery. Whether a seasoned clinician or a student navigating CRNA school, listeners will gain clinical insight and case-based wisdom for safer, more effective care of patients with PVD. Want to learn more? Create a FREE account at www.atomicanesthesia.com ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

In this episode of the Atomic Anesthesia Podcast, nurse anesthesia residents are guided through the pivotal moments of emergence and extubation—recognized as one of the riskiest steps in the operating room. Listeners will gain practical strategies for timing and executing a safe, efficient wake-up following general anesthesia, including the choice between restoring spontaneous breathing early for extremity and head or neck surgeries, or precisely titrating off anesthetics and using nitrous oxide during abdominal and thoracic procedures. The episode breaks down emergence criteria, ventilatory and hemodynamic parameters, medication effects, and the consequences of mixing techniques, all illustrated with clear, experience-based teaching points drawn from years of practice. CRNAs at all levels are invited to reflect, share their own perspectives, and incorporate these actionable insights to optimize patient safety, comfort, and workflow in the perioperative environment. Want to learn more? Create a FREE account at www.atomicanesthesia.com ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com

This is a joint episode recorded with Dr. Chloe Gomez of the My Favorite Learner podcast. This episode explores the foundational concepts of pharmacogenetics and its impact on drug responses during anesthesia, highlighting how genetic, genomic, and epigenetic variations shape individual reactions to commonly used medications in perioperative care. Designed for nurse anesthesia residents, the show walks through the scenarios of variable drug response, the roles of metabolizing enzymes, transport molecules, and molecular targets, as well as the influence of environmental factors and polymorphisms such as single-nucleotide variants and ethnic differences in metabolism. Key topics include disease-specific considerations like G6PD deficiency, acute intermittent porphyria, long QT syndrome, Brugada syndrome, atypical pseudocholinesterase, and malignant hyperthermia, with a focus on clinical implications for personalized medicine, precision dosing, and ethical issues surrounding genetic testing, privacy, and patient equity. Practical advice covers vigilant monitoring, individualized dosing, preoperative assessment for genetic risk, and strategies for documenting and communicating findings for safer anesthesia practice. Want to learn more? Create a FREE account at www.atomicanesthesia.com ⚛️ CONNECT: 🩷 Subscribe to our YouTube channel 💜 Follow us on Instagram 💙 Follow us on TikTok 📥 Have a topic you want to hear? Email Dr. Temmermand at hello@atomicanesthesia.com