Welcome to Atomic Anesthesia, the essential podcast for nurse anesthesia residents seeking to master both basic and clinical science education (and RNs looking to become CRNAs, too!). Join us as we breaking down tough science concepts and demonstrating their practical clinical application in real-world scenarios. Each episode of Atomic Anesthesia is crafted to provide comprehensive explanations of complex scientific principles, tailored specifically for the needs of nurse anesthesia residents or nurses preparing for graduate school. Whether you're grappling with pharmacology, physiology, or any other challenging subject, our expert hosts are here to guide you through every step of the learning process. But we don't stop there. Atomic Anesthesia goes beyond the classroom, inviting esteemed guests from both the scientific and CRNA communities to share their insights and experiences. From discussions on graduate school training to invaluable tips for navigating the complexities of clinical practice, our diverse range of topics ensures that every episode is packed with valuable knowledge and practical advice. Whether you're commuting to clinicals, hitting the gym, or simply relaxing at home, Atomic Anesthesia is the perfect companion for learning on the go. Tune in and empower yourself with the knowledge and skills you need to excel in your journey towards becoming a proficient and confident nurse anesthethesiologist.
Rhea Temmermand, PhDc, CRNA & Sachi Seaburn, MSN, CRNA
A recently identified genetic mutation, passed down on the maternal line, can cause otherwise healthy patients to develop severe and often permanent neurological injury after routine sevoflurane exposure. This episode breaks down the underlying mitochondrial mechanism, why TIVA with propofol is the safer anesthetic strategy, and the family history red flags every provider should be screening for.A newly identified genetic mutation that turns routine sevoflurane exposure into catastrophic, permanent neurological injuryThe mitochondrial mechanism behind it, and why some patients have zero reserve capacity to absorb the hitWhy TIVA with propofol becomes the clear anesthetic choice once you understand what spares Complex ISource: Sanz-Pons J, et al. "Effects of a Mitochondrial Genetic Variant on Sevoflurane Hypersensitivity." Anesthesiology 2026;144:1286–98.FREE RESOURCE FOR THIS EPISODE:GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia. Head to atomicanesthesia.com/freebies/gpcr-cheat-sheet to grab it free.MORE FREE STUDY RESOURCES:SEE/NCE Study Plan — A structured, week-by-week plan to pass your boardsNon-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one pageMalignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page referenceWANT THE FULL PLATFORM?Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs — lessons, quizzes, flashcards, and more. Start your free trial at atomicanesthesia.com.Mentioned in this episode:
Propofol, a cornerstone in anesthesia practice, functions as a positive allosteric modulator at the GABA-A receptor. This episode explores its receptor pharmacology, the mechanisms behind its dose-dependent clinical effects, and addresses common questions like propofol infusion syndrome and pain on injection.Receptor pharmacology and allosteric modulationPharmacokinetics and context-sensitive half-timeCardiac and respiratory effectsRisk and management of propofol infusion syndromeHandling egg allergy concernsStrategies to reduce pain on injectionFREE RESOURCE FOR THIS EPISODE:GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia. Head to atomicanesthesia.com/freebies/gpcr-cheat-sheet to grab it free.MORE FREE STUDY RESOURCES:SEE/NCE Study Plan — A structured, week-by-week plan to pass your boardsNon-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one pageMalignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page referenceWANT THE FULL PLATFORM?Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs — lessons, quizzes, flashcards, and more. Start your free trial at atomicanesthesia.com.Mentioned in this episode:
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.Want more content like this? Become a member of our learning platform: http://atomicanesthesia.comIn this episode:The critical distinction between high spinal and total spinal that everyone can define but few can actually tell apartWhy a negative aspiration on a labor epidural doesn't guarantee the catheter isn't sitting in CSFThe board favorite scenario where a spinal stacked on a failed epidural top off becomes one of the highest risk setups for total spinalWhy blood pressure stays normal in over half of total spinal cases and what the earliest reliable warning sign really is
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.Want more content like this? Become a member of our learning platform: http://atomicanesthesia.comIn this episode:Jake and Alex discuss The non-clinical conversations every preceptor should be having, including finances, the post-graduation credentialing gap, and disability insuranceWhy student wellbeing directly affects learning and the small ways preceptors can protect itThe difference between the right way, the wrong way, and just your wayWhy precepting is the highest-leverage thing you do as a CRNA and how one tip can ripple through generations of providers
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.Want more content like this? Become a member of our learning platform: http://atomicanesthesia.comIn this episode:Jake and Alex discuss the most important relationship in CRNA school and why the transition to preceptor happens before most new grads feel readyHow to set the right tone from day one, give students an appropriate leash, and know when to step inWhy letting students safely get into trouble is more powerful than telling them what not to doHow to deliver honest, constructive feedback, including praise in public, correction in private, and debriefs that students lead themselves
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.Want more content like this? Become a member of our learning platform: http://atomicanesthesia.comIn this episode:Why your biggest limitation is often your mindset, not your intelligence, work ethic, or backgroundHow to build real confidence through action, overcome self-doubt, and break through limiting beliefsWhy thinking bigger, embracing bold goals, and challenging your own ceiling creates new opportunitiesHow true success is measured by the impact you have on others and using your achievements to elevate your community
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.Want more content like this? Become a member of our learning platform: http://atomicanesthesia.comIn this episode:The major ventilation modes used on anesthesia machines, including volume control, pressure control, PCV-VG, and pressure support ventilationHow each mode works, what it guarantees, and the key advantages and limitations of eachHow to choose the right mode for common OR scenarios like obesity, laparoscopic surgery, Trendelenburg positioning, and LMA casesPractical ventilation pearls, including lung-protective tidal volumes, PEEP, airway pressures, and recognizing changes in pulmonary complianceA simple framework for understanding any ventilator mode without memorizing manufacturer-specific names or buttons
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.Want more content like this? Become a member of our learning platform: http://atomicanesthesia.comIn this episode:Why COPD is more than a lung problem — how alveolar destruction, V/Q mismatch, and cor pulmonale connect at the bedsideHow to ventilate a COPD patient intraoperatively: I:E ratios, PEEP strategy, and avoiding auto-PEEPThe pharmacology of bronchodilators — LABAs, LAMAs, and inhaled corticosteroids — and which ones to continue on the day of surgeryAnesthetic agent selection for reactive airways: why volatile agents help, why nitrous oxide doesn't, and when to consider TIVAPostoperative priorities: extubation to NIV, oxygen titration in CO2 retainers, and preventing reintubation
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.Want more content like this? Become a member of our learning platform: http://atomicanesthesia.comIn this episode:Why desflurane needs its own specialized Tec 6 vaporizer (and what its 22.8°C boiling point means for safe delivery)The four inhalational agents you need to know cold — sevoflurane, isoflurane, desflurane, nitrous oxide — with MAC values, blood:gas coefficients, and clinical trade-offsHow coronary steal actually works with isoflurane, and when it matters at the bedsideThe second gas effect explained at the alveolar level: concentrating effect + augmented inflowCompound A, carbon monoxide, methionine synthase inhibition — the metabolic pitfalls each agent brings to a caseTailoring agent choice for pediatric, geriatric, pregnant, neuro, and cardiac patients
Welcome to the Atomic Anesthesia podcast hosted by CRNA educators Rhea Temmermand and 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.Want more content like this? Become a member of our learning platform: http://atomicanesthesia.comIn this episode:Introduction to our new partners, Jake & John, from the IncomologistsLessons from John's experience as a flight paramedic that we can all apply to crisis management for anesthesia practice
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.Want more content like this? Become a member of our learning platform: http://atomicanesthesia.comIn this episode:Atomic Anesthesia platform 2.0 updates, including faster performance and new study features.Highlights from the World Congress of Nurse Anesthetists in BrisbaneOverview of International Federation of Nurse Anesthetists and global nurse anesthesia standards at IFNA.orgReflections on global anesthesia practice, patient safety, and international collaboration.
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.Want more content like this? Become a member of our learning platform.⚠️ SIGN UP FOR OUR FREE NEWSLETTER: [NEWSLETTER SIGN-UP]In this episode:Xenotransplantation is becoming clinically real, using genetic engineering to allow pig organs to function in humansRecent cases, including 271 days of pig kidney support, show potential as a bridge to human transplantKey challenges include chronic rejection, coagulation mismatch, and evolving immunosuppressionFor anesthesia, these patients bring unstable physiology, unpredictable hemodynamics, and increasing clinical relevance
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.Want more content like this? Become a member of our learning platform.⚠️ SIGN UP FOR OUR FREE NEWSLETTER: [NEWSLETTER SIGN-UP]In this episode:Why overthinking mistakes in CRNA school keeps you stuck instead of actually improvingThe difference between self-deprecation, reflection, and real growth (and why most students get this wrong)How small moments in sim and clinical turn into mental spirals and how to stop that cycleThree practical mindset shifts to stop replaying mistakes and actually move onReal clinical and classroom examples of mistakes and how to handle them without losing confidence
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]In this episode:How the larynx functions as a dynamic valve balancing ventilation, airway protection, and phonationFunctional airway anatomy of the supraglottic, glottic, and subglottic regions and why it matters during laryngoscopy and intubationHow laryngeal cartilages and joints (especially the cricoid and arytenoids) drive vocal cord movement and airway patencyClinical patterns of nerve injury (SLN vs RLN) and how they present as hoarseness, aspiration risk, or airway obstructionMechanisms, triggers, and stepwise management of laryngospasm in the perioperative setting
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]In this episode:Featuring SRNA Julie (“Grad School Jules”) discussing the emotional realities of CRNA school that students rarely talk aboutThe psychological phases of the CRNA journey from application anxiety to early-semester overwhelmWhy imposter syndrome is so common among SRNAs and how it affects high-achieving studentsUnrealistic expectations students bring into anesthesia school and what the learning curve actually looks likePractical mindset shifts to navigate stress, build resilience, and succeed during the CRNA training journey
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]In this episode:How opioids produce analgesia by decreasing synaptic transmission in central pain pathways rather than blocking nerve conduction μ, κ, and δ opioid receptor pharmacology and how Gi-coupled GPCR signaling alters calcium, potassium, and cAMP How opioids reduce pain by suppressing ascending nociceptive signaling and enhancing descending inhibitory pathways The physiologic basis of common opioid effects including respiratory depression, sedation, bradycardia, and GI effects
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]In this episode:Featuring Dr. Jerrol Wallace, DNP, CRNA, FAANA, FAAN, sharing firsthand insight into military nurse anesthesia training and deployment experienceMilitary CRNA training pathway and selection standardsOperational readiness and austere anesthesia environmentsTrauma intensity, deployment medicine, and prolonged field careAutonomy, leadership development, and high-stakes decision-making
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]
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]
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]
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]
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]
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]
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]In this episode:One-week launch countdown plus a behind-the-scenes tour of the new Atomic Anesthesia platform.Overview of current features: 150+ lessons, quiz builder with 2,000+ questions, and gamified learning with avatars, gems, and leaderboards.Breakdown of seven core pharmacology concepts to make drug questions predictable instead of pure memorization.Clinical-style thinking tips: using receptor logic, dose–response, onset, redistribution, protein binding, and context-sensitive half-time to anticipate drug behavior.
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]In this episode:Focus on studying smarter, not longer, for better results in anesthesia school.Learn eight proven study techniques that actually improve retention.Apply each strategy with real-life examples tailored to SRNAs.Organize and condense notes for more efficient learning.
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]In this episode:The 9 core physiology principles that explain most intraoperative instabilityWhy oxygen delivery matters more than a normal pulse ox readingV/Q mismatch, shunt vs. dead space, and managing real OR hypoxiaPreload, afterload, contractility, and what MAP actually meansAcid–base balance, CO₂ management, drug redistribution, and autonomic shifts in 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:How the clinical judgment model (CJM) helps SRNAs move beyond checklists to real‑time decision making in the OR.Four core phases of expert thinking: noticing, interpreting, responding, and reflecting.Practical OR examples to sharpen trend recognition, differentials, and prioritized responses.Quick update: Feb 23 launch of our 150‑lesson anesthesia platform with quiz builder, community, and live webinars.
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:Cirrhosis pathophysiology and portal hypertension.Compensated vs decompensated cirrhosis risk.Systemic effects: ascites, encephalopathy, coagulopathy, cardiomyopathy.Altered anesthetic drug metabolism and sensitivity.Anesthetic goals: preserve liver perfusion, avoid hypotension/bleeding.
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 myocardial ischemia is the main cause of perioperative collapse in severe aortic stenosisCore anesthetic goals: maintain preload, afterload, sinus rhythm, and controlled HRHow to choose anesthesia type and airway strategy in urgent noncardiac surgery with ASPractical induction tactics to avoid hypotension and sympathetic surgesIntraop and postop management strategies to preserve coronary perfusion and oxygen deliveryTo contact Alex Gorman, CRNA, you can email him at: gorman82@hotmail.com
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:Application of IV anesthetic pharmacology to real clinical case scenarios rather than just PK/PD theory How to choose between propofol, ketamine, etomidate, and dexmedetomidine based on patient and surgical factors Decision frameworks for managing high-risk situations like trauma, sepsis, cardiac disease, and difficult airways Common pitfalls with induction agents and how to prevent hypotension, apnea, and airway obstruction How anesthesia choices change across environments like OB, ICU, MRI, GI suite, and neurosurgery
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 studyHow perioperative neurocognitive disorders present, who is at risk, and how common they areThe pathophysiology behind postoperative cognitive decline, focusing on neuroinflammation and anesthetic-related brain stressPractical, evidence-based strategies to protect brain health before, during, and after surgeryWhy brain health must be a shared, institution-wide priority across perioperative care teams
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 stenosisLimitations and hypotensive effects of propofol in aortic stenosis patientsPharmacology and potential advantages of cipepofol (ciprofol) as a propofol derivativeKey findings of the JAMA Surgery randomized trial comparing cipepofol vs propofol in severe ASPractical induction strategies and future implications for managing severe AS patients under anesthesiaARTICLE: Hemodynamic Impact of Cipepofol vs Propofol During Anesthesia Induction in Patients With Severe Aortic Stenosis
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 mattersHow to perform a systematic pre-use machine checkoutUnderstanding and testing safety features and failure modesChecking ventilation, leak integrity, and waste gas handlingUsing structured tools to build a fast, reliable habit
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 CRNAsDeliberate 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.
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:
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:
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:
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.eduArticles:Austere Resuscitative and Surgical Care Teams: Supporting Far-Forward Trauma Care on the Future BattlefieldMilitary and Civilian Surgery Partner for Innovation, EffectivenessA Western trainer says talk of 'golden hour' would be laughable to Ukrainian forces.Want to learn more? Grab our Cardiac Pharm Course --> [HERE]⚛️ CONNECT:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
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:
This episode of the Atomic Anesthesia Podcast explores the emerging role of Suzetrigine, a novel non-opioid NaV1.8 channel inhibitor, in multimodal surgical pain management. Host Rhea and guest JR Phillips, a DNAP student, discuss the science, efficacy, and safety profile of Suzetrigine, its potential for opioid-sparing strategies, and its unique advantages over traditional opioids and sodium channel blockers. Listen in for an evidence-based look at how this new FDA-approved analgesic could reshape perioperative care, improve patient outcomes, and what its current limitations and future possibilities might be for anesthesia professionals and learners.To take a quiz about this topic, check out this link: [HERE]For references for this episode, click [HERE]Want to learn more? Create a FREE account at www.atomicanesthesia.com⚛️ CONNECT:
© 2020-2026 Ivy Podcast Discovery LLC
