Atomic Anesthesia

In this episode, we dive into the game-changing drug sugammadex—a powerful agent that rapidly reverses neuromuscular blockade caused by rocuronium and vecuronium. We explore its unique mechanism of action, pharmacokinetics, and pharmacodynamics, along with how it differs from traditional reversal agents like neostigmine. You'll gain clarity on proper dosing strategies across populations, including pediatrics, obese patients, and those with renal impairment. We also break down important administration details, adverse effects, and drug interactions—especially the one that could compromise hormonal contraceptives. If you want to know how to avoid recurrent paralysis and make the most of this revolutionary medication in your clinical practice, stay tuned until the end.

In this episode featuring Jeremy Heiner (Editor of the Nurse Anesthesia textbook), we dive into rapid-fire differential diagnosis and crisis management, tackling some of the most intense and high-stakes scenarios nurse anesthesia providers can face. From airway fires and venous air embolisms to anaphylaxis, malignant hyperthermia, and local anesthetic systemic toxicity, we break down ten real-time clinical situations, analyzing clues, discussing pathophysiology, and outlining critical management strategies. Whether you're a student learning to recognize subtle cues or a provider refining your response to emergencies, this episode sharpens your diagnostic instincts and clinical confidence. We also share practical insights on using crisis checklists, decision-making under pressure, and leading in high-stress OR environments. Stick around to the end to hear our breakdown of a tricky intraoperative myocardial infarction scenario—a case that might just change how you handle hemodynamic instability during surgery. You'll walk away better prepared for the unexpected.

In this episode, we dive deep into the basics of anesthesia pharmacology—perfect for ICU nurses starting CRNA school or senior residents needing a solid refresher. We break down foundational topics like pharmacodynamics, pharmacokinetics, and pharmacogenomics, and explain why understanding physiology is key to mastering pharmacology. You'll learn about drug targets like GABA and NMDA receptors, and the real mechanisms behind anesthetics, opioids, local anesthetics, and muscle relaxants. We also walk through “top drawer drugs” in the OR, including quick quizzes to reinforce your understanding of real-time drug decisions—like when to choose ephedrine over phenylephrine. This is a science-heavy episode, but one that sets the groundwork for more advanced content.

In this episode, Rhea Temmermand and Jeremy Heiner (editor of the Nagelhout Nurse Anesthesia textbook) dive deep into the under-discussed but vital topic of cognitive aids and crisis checklists in anesthesia. You'll learn how tools like the Stanford Emergency Manual and the Nurse Anesthesia Crisis Checklists can sharpen clinical decision-making during high-stress scenarios like anaphylaxis or hypotension. The episode explores how our brains make decisions under pressure, the difference between intuitive and deliberate thinking (System 1 vs. System 2), and how to develop better clinical heuristics. Plus, they walk through a real-world case of intraoperative anaphylaxis, using a step-by-step cognitive framework to manage the crisis. Stay tuned to the end to discover a powerful breathing technique Navy SEALs use that can also help anesthesia providers stay calm and focused under pressure.

In this episode of "Resident's Corner," we discuss the universal challenge of falling behind in didactics, particularly in demanding programs like CRNA school. Our anonymous resident shares her personal insights on recognizing the problem, managing overwhelm, and strategies for getting back on track. From creating concise calendars and prioritizing study time to adopting a mindset that treats quizzes like finals, we explore practical tools for recovery. We also discuss the emotional struggles of being behind, the importance of dedication and discipline, and how to prevent future setbacks by working ahead and embracing the learning journey. Tune in for a relatable and actionable conversation that will help you stay focused and motivated throughout your academic journey.

PART 2/2: In this must-listen episode, Professor Temmermand shares strategies for thriving during clinical rotations. Transitioning from didactics to clinicals can be challenging, so in this live webinar replay, we outline what to expect when beginning this new phase of your training, provide tips for success, and explore how to navigate this challenging but exciting phase of your journey.

PART 1/2: In this must-listen episode, Professor Temmermand shares strategies for thriving during clinical rotations. Transitioning from didactics to clinicals can be challenging, so in this live webinar replay, we outline what to expect when beginning this new phase of your training, provide tips for success, and explore how to navigate this challenging but exciting phase of your journey.

This episode details a comprehensive study plan designed to help nurse anesthesia residents prepare for the Self-Evaluation Examination (SEE) and the National Certification Examination (NCE) for CRNAs. We discuss a detailed 24-week schedule, study tips, healthy habits, and exam prep strategies. The plan outlines specific topics from the NCE outline to cover each week, along with recommended resources and textbook chapters. It also emphasizes the importance of self-reflection, consistent study habits, and maintaining a healthy lifestyle to reduce test-taking anxiety and prevent burnout. Download the plan below to follow along this episode!

In this mini-episode, Dr. Becky Motykiewicz, a pediatric CRNA specializing in cardiac anesthesia, unpacks the fascinating anatomical and physiological differences between pediatric and adult patients that make pediatric anesthesia a unique specialty. From the neonate's HR-dependent cardiac output and immature baroreceptor reflex to the challenges of managing a smaller, more compliant airway, this episode highlights the critical nuances of caring for young patients. Dr. Motykiewicz also discusses the underdeveloped CNS, immature liver and kidney functions, and the heightened metabolic demands of pediatric patients—all of which require precise dosing and proactive management. Whether you're a student or a seasoned provider, this episode offers valuable insights into the art and science of pediatric anesthesia.To contact Dr. Becky Motykiewicz for questions or to request new pediatric topics, email her at: beckymot@gmail.com

This episode explores starting and managing an anesthesia group, featuring James and Kendra Stockman, founders of Grasshopper Anesthesia Services. We not only explain the "how to" of creating your own group, but also we examine the benefits of joining a CRNA-owned group for those not yet ready to start their own, drawing from the Stockmans' extensive experience in rural and outpatient settings. James, a Texas Wesleyan University graduate with expertise in regional anesthesia and chronic pain management, and Kendra, a Newman University alumna specializing in outpatient and vascular anesthesia, share insights on various aspects of running an anesthesia business. Topics covered include securing contracts, choosing the right business structure, navigating billing and insurance enrollment, staffing considerations, malpractice insurance, quality assurance reporting, and strategies for business growth and development. This comprehensive discussion offers valuable guidance for CRNAs considering entrepreneurship in the field of anesthesia management.Want to get in touch with James & Kendra? Check out their website: GRASSHOPPER ANESTHESIA SERVICES james@grasshopperanesthesia.comKendra@grasshopperanesthesia.com Facebook and instagram handles grasshopperanesthesia

In this episode, we dive into the essential topic of time management for CRNA students, featuring a live recording from a recent webinar. Navigating the rigorous demands of advanced doctoral-level education can be overwhelming, but effective time management is the key to balancing academic, clinical, and personal responsibilities. We explore common challenges like procrastination, distractions, and multitasking, and discuss actionable strategies such as time blocking, prioritization techniques, and leveraging digital tools. You'll learn how to break down large tasks, set SMART goals, and establish healthy boundaries to prevent burnout. Whether you're struggling to stay organized or looking to optimize your routine, this episode offers practical tips and resources to help you thrive in CRNA school and beyond. ⚛️ FREE DOWNLOADS:

Do you understand the current CRNA job market? If you're a senior NAR or a recent graduate, you don't want to miss this recording from our recent Instagram LIVE with Joy Ademuyewo - Founder of the Lokum App. She's an expert on the economics of the CRNA job market and has designed this app that specializes in job matchmaking. Her goal is to match you with your perfect job directly without the middle-man (AKA the recruiter!). To build this app, Joy definitely had to take a DEEP DIVE into the CRNA market to understand all the nuances and stakeholders. She discusses what influences the CRNA job market, healthcare system trends, compensation trends, and tips for CRNAs to succeed in the job market. Our social media audience also submitted tons of questions that we answer during this episode. To reach Joy and learn more about Lokum:Email: info@lokumapp.comDownload Lokum App: [iOS] [Android]

This podcast episode covers doctoral degrees available to CRNAs, including DNP, DNAP, and different types of PhDs. This episode discusses their distinctions, application requirements, completion timelines, and associated costs. The conversation covers the challenges of balancing work, life, and advanced education, as well as the motivations for pursuing doctoral degrees in the CRNA profession. Listeners will gain valuable information about the impact of these degrees on daily practice and the broader significance of having doctorally-trained professionals in the field. The episode features Lukeythia Alice Bastardi, a CRNA with extensive experience and two doctoral degrees, who shares her unique perspective on the topic, making it an informative and engaging discussion for CRNAs considering further education.To get in touch with Dr. Lukeythia Bastardi, you can email her and check her out on social media: Email: Lukeythia@gmail.comFaceBook: https://www.facebook.com/lukeythiaIG: https://www.instagram.com/lukeythia/FREE RESOURCES TO HELP YOU ALONG YOUR JOURNEY:

In this episode, Professor Rhea Temmermand gives nurse anesthesia residents and aspiring CRNA students a introduction to the pharmacology of LOCAL ANESTHESIA. Discover the fundamental structure, classification, and mechanism of action of these essential drugs, including how they block voltage-gated sodium channels to prevent pain signal transmission. Learn about the critical concept of pKa and its impact on drug effectiveness, explore the pharmacokinetics of esters and amides, and understand key clinical considerations for various administration routes. Professor Temmermand also covers crucial safety aspects, including recognizing and managing local anesthetic systemic toxicity (LAST). Whether you're preparing for boards or enhancing your clinical practice, this episode provides invaluable insights into the pharmacology and practical application of local anesthetics in anesthesiology.[NEW] We're getting ready to launch our YouTube channel - Subscribe here! [NEW] LIVE Webinar Series for FREE - last Wednesday of every month! - Sign up here!CHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.comHave a topic you want to hear? Email Professor T at rhea@atomicanesthesia.com

In this episode, Professor Temmermand discusses the importance of effective communication and how it can make our break people's perception of you in the clinical setting. She also discusses characteristics to foster, how to develop a growth mindset, and tips on accepting feedback in a positive way. She also give some examples of questions to ask your preceptors that every student can be asking. This episode is an excellent listen not only for current anesthesia students but also for RNs getting ready to shadow in the OR, or who are getting ready to start CRNA school. Tune in! [NEW] We're getting ready to launch our YouTube channel - Subscribe here! Related Episodes: Resident's Corner "Overcoming the Pressure of Performance" CHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode of the Atomic Podcast, practicing CRNA Alex Gorman dives into the complexities of protamine, a critical medication used to reverse heparin's anticoagulant effects in cardiac and vascular procedures. Alex explains the types of protamine reactions, detailing their mechanisms, symptoms, and treatments. With a focus on vigilance and preparedness, he shares insights on recognizing and managing adverse reactions in the OR, emphasizing the importance of quick interventions and patient monitoring. CHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode, Atomic Anesthesia Co-Founder Rhea Temmermand dives into the critical and nuanced topic of managing pain in patients with substance use disorder (SUD). From understanding the pharmacology of medications like methadone and buprenorphine to crafting individualized pain management strategies, this discussion equips CRNAs and other healthcare professionals with essential tools for compassionate care. Explore the challenges and solutions for addressing acute and chronic pain while minimizing relapse risk. Don't miss this deep dive into one of the most complex issues in anesthesia practice today!CHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode of the Atomic Podcast, Alex Gorman, a practicing CRNA and cardiac anesthesia expert, introduces the "Two Heart Model," a unique approach to understanding cardiac physiology and pathophysiology. By visualizing the heart as two separate organs — the right heart and the left heart — this model helps clarify complex concepts like preload, afterload, and contractility. CHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode of the Atomic Podcast, practicing CRNA Alex Gorman discusses the dural puncture epidural (DPE), particularly in the obstetrical setting. By incorporating a spinal needle to confirm midline placement and epidural space entry, the DPE provides immediate objective feedback, reducing the likelihood of failed epidurals and improving patient outcomes. Alex highlights the technique's benefits, including faster analgesia onset and fewer complications like one-sided pain relief or hot spots, while addressing its risks. CHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this special short-form episode, practicing CRNA and Atomic Anesthesia content expert Alex Gorman dives into the use of liposomal Bupivacaine (Exparel) in regional anesthesia, highlighting its unique sustained-release properties and practical tips for effective use. CHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode, Rhea discusses Substance Use Disorder (SUD), it's prevalence, indications for anesthesia providers, and how we can best treat patients affected by this condition. CHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode, Rhea and Sam discuss what it was like being a parent in CRNA school. Sam gives shares her experiences, gives some excellent advice and encouragement. A must-listen for anyone planning or considering parenthood and CRNA school! Contact Sam at ssimmo20@jhmi.eduCHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HERE

In this episode, Jake Bevilacqua, President of The Incomologists, a group of healthcare insurance providers, breaks down some excellent financial tips for those embarking on the journey of CRNA school. Whether you're applying and wondering how to prepare and save, or are in school trying to manage a budge, this episode is for you! The Incomologist Website Here CHECK OUT OUR PHARM COURSE HERE[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode, Rhea and Dr. Gus Gesumaria, an ER physician, discuss the challenges of emergency airway management in the ER and how it differs from the controlled OR setting. Contact Dr. Gesumaria at gesumaria@gmail.comCHECK OUT OUR PHARM COURSE HERE: https://atomicanesthesia.com/pharm-course[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this new podcast segment called "Resident's Corner" we welcome Residents onto the show to openly (and anonymously if preferred) discuss roadblocks, concerns, or even talk through clinical scenarios or topics. The goal of these episodes are to help foster community amongst residents + CRNAs, share insight, and hopefully spread some encouragement in knowing you're not alone. In this particular episode, we discuss the mental stress of perfectionism, how to overcome self-doubt, and how to avoid the comparison game. Thank you to this anesthesia resident for your discussion! CHECK OUT OUR PHARM COURSE HERE: https://atomicanesthesia.com/pharm-course [FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode, Professor Temmermand and Dr. Daniel King discuss the cannabanoid system, the effects of cannabis on our bodies, and considerations for the anesthesia provider in regards to caring for the cannabis-using patient. [FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode, expert pediatric cardiac CRNA Dr. Becky Motykiewicz shares her insights and experiences caring for pediatrics and neonates. She gives tips and advice on how to best show up for your pediatric rotation, and how to best care for this unique (but resilient) population. [FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode, Professor Temmermand and Dr. Thomas Baribeault discuss opioid free anesthetic technique, it's importance, and keys for successful implementation in the surgical patient. Dr. Baribeault founded the Society for Opioid-Free Anesthesia (SOFA) which is a non-profit organization dedicated to education and research on opioid-free anesthesia and post-operative pain management.[SPECIAL DOWNLOAD]: Non-Opioid Analgesics Cheat Sheet[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.comSOFA: https://goopioidfree.com/

In this episode, Professor Temmermand discusses key non-opioid analgesics that are key players in delivering multimodal, opioid anesthesia. In this two part series, we lay the foundation to discuss opioid free anesthesia in next week's episode. [SPECIAL DOWNLOAD]: Non-Opioid Analgesics Cheat Sheet[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode, Rhea and Sachi discuss the most common vasopressors used in the OR, their indications, dose and mechanism of action. [FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

In this episode, Rhea and Cardiac CRNA Alex Gorman discuss how to best prepare for your cardiac anesthesia rotation, what to study before your first day, and how to show up prepared and ready to impress. Resources mentioned: Virtual Transesophageal Echocardiography - University of TorontoEMCRIT - central Lines site mentionedAlex Gorman's email: Gorman82@hotmail.com FREE Downloads: [FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_Anesthesia

In this episode, Rhea and Dr. Maiko Yamashita, Program Director at Rush University, discuss the perspective of a program director in regards to what makes a successful anesthesia resident and applicant. [FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_Anesthesia

GPCRs are challenging to understand but crucial to truly knowing how the drugs we use in the ICU and in the anesthesia world work. In this episode we break down this foundational concept, and you can grab the accompanying cheat sheet below! [FREE DOWNLOAD] FOR THE RN OR SRNA: GPCR CHEAT SHEET[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HERE

Let's break down how studying in CRNA schools is different than undergraduate school, and what are some tips you can deploy to be successful and actually retain what you're working so hard to learn. [FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_Anesthesia

Welcome! Let's dive into who we are and what Atomic Anesthesia is all about. Spoiler alert: If you like anesthesia education, are an applicant or current anesthesia resident, this is for you! [FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_Anesthesia