Podcasts about Sedation

Send us a textImpact of Sedation on Ventilator-Induced Diaphragmatic Dysfunction in Extremely Preterm Infants.Hoshino Y, Arai J, Hirono K, Maruo K, Miura-Fuchino R, Yukitake Y, Kajikawa D, Kamakura T, Hinata A, Okada Y, Sato Y.Pediatr Pulmonol. 2025 May;60(5):e71126. doi: 10.1002/ppul.71126.PMID: 40365938Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In this episode of the PFC Podcast, Dennis and Doug discuss the critical aspects of analgesia and sedation in emergency and critical care settings. They emphasize the importance of patient safety, comfort, and effective communication among medical teams. The conversation covers decision-making processes for sedation, the types of medications used, and the significance of sedation wake-up trials to assess patient status. The hosts also address the management of over-sedation and the need for clear communication in patient assessments.TakeawaysKeep the patient alive as the top priority.Sedation may be necessary for patient safety.Decision-making for sedation involves assessing comfort and safety.Different medications serve specific purposes in sedation and analgesia.Light to moderate sedation can help minimize PTSD risks.Daily sedation wake-up trials are essential in critical care.Communication using standardized scales aids in patient assessment.Over-sedation management requires a systematic approach.Medazolam and Propofol are preferred sedatives in critical care.Start sedation at lower doses and adjust based on patient response.Chapters00:00 Priorities in Analgesia and Sedation04:16 Decision-Making for Sedation Needs07:47 Understanding Sedative Medications14:32 Guiding Sedation Management in Critical Care20:49 Sedation Wake-Up Trials26:46 Communication and Neuro Exam in Sedation31:25 Managing Over-Sedation and EmergenciesFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Are your patients saying no because they're scared, not because they can't afford it? For so many people, the thought of sitting through a long, painful appointment is enough to put their health on hold. In this episode, Kendall Hussein talks with Leah Zipperstein (Head of Strategy) and Clay Griffith (Head of Growth) from Vesper Institute about the real reason patients avoid care, especially when they need a lot of work. They explore how IV sedation can turn fear into relief, help patients finally say yes, and allow dentists to deliver the treatment their patients desperately need—while filling their schedule with fewer reschedules and more impact.  

Welcome back to Ditch the Lab Coat with Dr. Mark Bonta—a podcast where we cut through health hype with evidence, curiosity, and a good dose of scientific skepticism. In this special solo episode, Dr. Bonta takes a step back to reflect on what he's learned after recording over 70 episodes with experts across medicine, wellness, and psychology.Instead of chasing the latest biohacks and trendy do's, Dr. Bonta shares his take on the “don'ts” that could make the biggest difference to our health: don't load your pantry with ultra-processed foods, don't rely on fad diets without respecting your biology, don't ignore your mental resilience, don't keep screens in your bedroom, and don't underestimate the lifelong dangers of substance use—especially alcohol. Drawing from fascinating past guests and peppered with real-life anecdotes, this episode is packed with practical, evidence-based advice that's more about avoiding pitfalls than perfecting routines.So plug in as Dr. Bonta looks back, revisits his birthday reflections, and gives us a no-nonsense breakdown of the habits (and substances) to ditch for a healthier, happier life.Episode Highlights1. Courage to Lead Change — Courage is essential to make necessary healthcare changes; everyone knows what to do, but few are willing to go first. 2. Unlearning as Growth — Success requires letting go of outdated practices, even those we've clung to for decades. 3. Nurses Leading Change — Nurses are often the ones who recognize and push for better patient care, even in the face of resistance. 4. The Role of Clinical Experts — Real-time support from experts can turn ideas into action and prevent regression under pressure. 5. Listening to the Team — Culture change starts with listening to those on the frontlines and empowering their voice. 6. A Better Way to Wean Ventilators — Traditional weaning methods can fail; a spontaneous breathing trial may be more effective. 7. The Importance of Protocols — A clear process protects patients from inconsistency and ensures evidence-based care. 8. Sedation's Downside — Sedation can cause harm; it's time to shift from automatic comfort to mindful, minimal use. 9. The Awakening Moment — A pivotal story about witnessing patients walking while intubated—and the shift it sparked. 10. Belief Before Buy-In — Seeing isn't always believing. Sometimes you must believe there's a better way before you ever see it. 11. What's Possible in Patient Recovery — Awake and mobile patients can achieve more than we think—even while critically ill. 12. Learning From Others — Growth often begins by learning from those who've already done what we thought was impossible. 13. Walking While Intubated — Real-world proof that mobility while ventilated isn't just a theory—it's being done. 14. Staff Impact and Transformation — Watching patients improve has a lasting impact on the staff and the culture of care. 15. Changing ICU Culture — Creating an awake and walking ICU demands a mindset shift and persistent leadership. 16. Making It the New Normal — What was once considered extraordinary can become standard with the right support and structure. 17. The Ripple Effect — Positive change in one unit can influence an entire hospital—and beyond.Episode Timestamps01:00 — Podcast Reflections on Lifespan and Healthcare 04:59 — Living Well: Do's vs. Don'ts 08:33 — Avoid Junk, Embrace Healthy Eating 11:51 — Hormones, Dieting, and Healthy Habits 16:45 — Dangers of Ultra-Processed Foods 18:56 — Prioritize Sleep: Limit Bedroom Screens 23:43 — Breath Work and CBT for Anxiety 27:26 — Optimal Health: Focus on Don'ts 28:38 — Alcohol and Substance Use Dangers 31:43 — Reflections on Healthier LivingDISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 

Nurses Out Loud – A young woman with Down syndrome enters a hospital for COVID—and never returns home. Her family is silenced, a DNR is placed without consent, and powerful sedatives are given with no disclosure. I expose nursing breaches, ignored advocacy, and a legal system that failed to protect patient rights. This is the story of Grace Schara's fight for dignity...

Nurses Out Loud – A young woman with Down syndrome enters a hospital for COVID—and never returns home. Her family is silenced, a DNR is placed without consent, and powerful sedatives are given with no disclosure. I expose nursing breaches, ignored advocacy, and a legal system that failed to protect patient rights. This is the story of Grace Schara's fight for dignity...

This week on Dentistry Unmasked, David and Pam sit down with Dr. Richard Marn, a traveling anesthesiologist who brings sedation services directly into dental practices. In this powerful and eye-opening episode, Dr. Marn shares vital safety data, real-world insights, and practical recommendations to ensure you're prepared for medical emergencies before they happen. From response times to the importance of a trained team, his expertise could be the difference between a smooth procedure and a critical event. If you currently offer sedation or are thinking about it, this episode is a must-listen, it could truly save a life.

Interview with David Hui, MD, and Eduardo Bruera, MD, authors of Proportional Sedation for Persistent Agitated Delirium in Palliative Care: A Randomized Clinical Trial. Hosted by Vivek Subbiah, MD. Related Content: Proportional Sedation for Persistent Agitated Delirium in Palliative Care

Interview with David Hui, MD, and Eduardo Bruera, MD, authors of Proportional Sedation for Persistent Agitated Delirium in Palliative Care: A Randomized Clinical Trial. Hosted by Vivek Subbiah, MD. Related Content: Proportional Sedation for Persistent Agitated Delirium in Palliative Care

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Leverage Versus Abuse - Meredith Hodges - Lucky Three Ranch Learn the proper use of restraints.Chains are severe and can injure the nasal cartilage or the incisive bones when abrupt pressure is applied.Learn how to use the lead rope for a "Quick Twist."Old-time twitches can do great damage to the equine's sensitive upper lip. Selecting the correct hobbles for the task at hand. Sedation and tranquilizers can be very dangerous to the mule and donkey. Allow your equine to learn and grow in a logical, step-by-step process that will not overwhelm him with too much stimulus at any stage. Mule Talk is an Every Cowgirl's Dream production - www.EveryCowgirlsDream.Com www.MuleTalk.Net Meredith Hodges Interviews: www.LuckyThreeRanch.Com/Podcast-Appearances/

On this episode of Stinchfield, we expose a horrifying truth that’s been swept under the rug for far too long. Robert F. Kennedy Jr.'s Health and Human Services team has dropped a bombshell report uncovering major flaws—and potential criminality—within America’s organ donation system. Whistleblowers and researchers allege that in some cases, organs may be harvested before the donor is fully dead. That’s right—alive. It’s a gruesome betrayal of medical ethics and human rights, and it raises the question: who’s really benefiting from this multi-billion dollar industry? Plus, Tulsi Gabbard continues to lead the charge for truth and justice, laying out a damning case against the architects of the Russian Collusion hoax. The Dept. of Justice has announced a strike force has been created to explore the next legal steps to be taken against the culprits. And in a strange new twist, Gabbard confirmed that Hillary Clinton was medicated with tranquilizers during most of her political career, raising new concerns about her fitness, her judgment, and just how much of her public image was a pharmaceutical illusion. The truth is coming out. The elites are scrambling. Go to http://freegoldguide.com/grant or call 800 458 7356 for your free Colonial Metals Group retirement protection kit – created specifically for our listeners where you can get up to $7500 in free Silver. www.EnergizedHealth.com/Grant www.PatriotMobile.com/Grantwww.Get20Now.comTWC.Health/Grant Use "Grant" for 10% Off See omnystudio.com/listener for privacy information.

David Waldman and Greg Dworkin wish you all a joyous and/or contemplative Pioneer Day this year, along with the other 364. (Coincidentally, Jeffery Epstein's motto was “Bring ‘em young!”) Many questions remain unanswered following Epstein's untimely demise, but one thing is certain: Donald FN Trump's name is all over the Epstein files, and he knows it. Gops sneak out the back door and hope no one notices. Democrats follow them out and hope everyone notices. Thus, we are only about a week away from Ghislaine Maxwell's mysterious death in, or miraculous release from, prison. Sedation, stat! Donald's meds need to be upped. Tulsi Gabbard makes the US take one for Team Trump. Why supply evidence when the boss says you have proof? Is Trump's treason accusation a confession? Ya figure? Trump pulls a reverse-Jesus and sins so that his followers may live to sin. Gop Mike Lawler will hide in the House, barking, rather than challenge Governor Kathy Hochul. Donald K. Trump is… unpopular, especially among independents, but generally with everyone.

Loxapine is a first-generation (typical) antipsychotic with dopamine D2 receptor antagonism as its primary mechanism, though it also has affinity for serotonin 5-HT2A receptors, making its pharmacology somewhat atypical. Loxapine is available in multiple formulations, including oral capsules and an inhalation powder, the latter approved specifically for acute agitation in patients with schizophrenia or bipolar I disorder. Sedation and extrapyramidal symptoms (EPS), including dystonia, akathisia, and parkinsonism, are common adverse effects due to its potent dopamine blockade in the nigrostriatal pathway. Orthostatic hypotension can occur with loxapine due to its alpha-1 adrenergic blockade, requiring monitoring in elderly patients or those on antihypertensives.

Top 5 Topics:- “Wrong Tooth Extracted” — A $6,000 Mistake That Could Happen to Any Dentist- The Hidden Dangers of Dental Sedation—6 Deaths 6 Months Into This Year Alone- Dental School vs. Law School: Which One Is Harder?- How One Phone Call Could Have Prevented a Malpractice Lawsuit- Where You Live Could Decide Your Lawsuit: Dental Trial Outcomes by Zip CodeQuotes & Wisdom:“Dental school is more difficult by far.” (03:07)“If you've had lives in your hands before, law school is manageable.” (04:19)“I always made sure to have one day a week for family.” (04:56)“Sedation is a range… Sometimes you wander into general anesthesia.” (11:45)“The person holding the forceps is ultimately responsible.” (28:42)“If they want money, they'll need to get it from a jury.” (33:55)“Same judge, same case, different jury pool—different outcome.” (42:03)Questions: (00:00) How was your weekend? Do you have any kids? Happy Father's Day! (00:11) Can you introduce yourself—oral surgery background, law school?(00:59) Where did you go to dental school?(02:59) How was the bar exam compared to dental school and oral surgery boards?(09:19) You mentioned 6 sedation deaths this year—can you describe those?(09:47) Who was doing the sedation—oral surgeons or other specialties?(22:12) Which premolar was congenitally missing in the case?(24:57) What was MedPro's involvement after the mistake?(36:56) What's the average settlement when the wrong tooth is extracted? (40:47) What's the jury trend in Suffolk County? Favor plaintiff or defendant?(43:36) Does the title “Wrong Tooth Extracted” work for this episode?(45:16) Should the next case cover sedation in general or pediatric dentistry?Now available on:- Dr. Gallagher's Podcast & YouTube Channel- Dose of Dental Podcast #153My watch in this episode = Citizen Promaster Diver Day DateDr. Leffler's watch = Bvlgari Octo- 6.2025#podcast #dentalpodcast #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #doctorlife #dentistlife #oralsurgeon #doctorgallagher

The JournalFeed podcast for the week of July 7-11, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed:Targeting the 5th percentile mean blood pressure in pediatric septic shock resulted in similar 28-day mortality as targeting the 50th percentile - while reducing vasopressor use, side effects, and complications like ARDS.Friday Spoon Feed:This study shows that ketamine alone is a safe choice for pediatric sedation in the ED, with serious adverse events (AE) occurring rarely, primarily in older children or when opioids are coadministered.

In this episode of Equine Innovators, host Stephanie Church talks with Dr. Lori Bidwell—board-certified veterinary anesthesiologist and co-founder of East West Equine Sports Medicine—about how veterinarians use sedation to keep horses and handlers safe during procedures. Bidwell explains the difference between sedation and general anesthesia, offers examples of standing surgeries that once required full anesthesia, and shares how Dormosedan Gel has changed how owners manage stressful situations such as clipping or fireworks. She also offers practical tips on safety, storage, and monitoring, and describes recent innovations and where sedation practices are headed in the years to come.GUESTS AND LINKS – EPISODE 21:Host: Stephanie L. Church, editorial director at The Horse: Your Guide to Equine Health Care/TheHorse.com | @stephlchurch on Instagram | Email Stephanie (schurch@thehorse.com)Links: (Stories on sedation from TheHorse.com) Sedation for Standing Procedures | Open Up and Say Zzz: Why Horse Dental Exams Require Sedation | Horse Sedation with an Oral Gel (AAEP 2010–when The Horse reported the presented research on Dormosedan)Guest: Lori Bidwell, DVM, Dipl. ACVA, co-founder of East West Equine Sports Medicine | Facebook (@EastWestEquineVet) | Instagram (@EastWestEquineSportsMedicine)Link: Register for free newsletters from TheHorse.comPlease visit our sponsor, who makes this podcast possible: Zoetis Equine | @zoetisequine on Instagram and Facebook

In this episode of Equine Innovators, host Stephanie Church talks with Dr. Lori Bidwell—board-certified veterinary anesthesiologist and co-founder of East West Equine Sports Medicine—about how veterinarians use sedation to keep horses and handlers safe during procedures. Bidwell explains the difference between sedation and general anesthesia, offers examples of standing surgeries that once required full anesthesia, and shares how Dormosedan Gel has changed how owners manage stressful situations such as clipping or fireworks. She also offers practical tips on safety, storage, and monitoring, and describes recent innovations and where sedation practices are headed in the years to come.GUESTS AND LINKS – EPISODE 21:Host: Stephanie L. Church, editorial director at The Horse: Your Guide to Equine Health Care/TheHorse.com | @stephlchurch on Instagram | Email Stephanie (schurch@thehorse.com)Links: (Stories on sedation from TheHorse.com) Sedation for Standing Procedures | Open Up and Say Zzz: Why Horse Dental Exams Require Sedation | Horse Sedation with an Oral Gel (AAEP 2010–when The Horse reported the presented research on Dormosedan)Guest: Lori Bidwell, DVM, Dipl. ACVA, co-founder of East West Equine Sports Medicine | Facebook (@EastWestEquineVet) | Instagram (@EastWestEquineSportsMedicine)Link: Register for free newsletters from TheHorse.comPlease visit our sponsor, who makes this podcast possible: Zoetis Equine | @zoetisequine on Instagram and Facebook

Send us a textDiese Woche besprechen wir die Arbeit von Walsh et al aus dem JAMA: Walsh TS, Parker RA, Aitken LM, et al. Dexmedetomidine- or Clonidine-Based Sedation Compared With Propofol in Critically Ill Patients: The A2B Randomized Clinical Trial. JAMA. Published online May 19, 2025. doi:10.1001/jama.2025.7200Mit im Studio: Claudine Mutschler, wissenschaftliche Mitarbeiterin der Klinik für Anästhesiologie am UKHD

This episode originally aired on March 23rd, 2023. Dr. Michael Lanspa chats with Dr. Yahya Shehabi about his article, "Dexmedetomidine and Propofol Sedation in Critically Ill Patients and Dose Associated 90-day Mortality: A Secondary Cohort Analysis of a Randomized Controlled Trial (SPICE-III)."

What leads skilled doctors to make dangerous mistakes in OMS sedation, and what can we do to work towards putting a stop to it? In this episode, Dr. Steve Yun, a board-certified M.D. and dental anesthesiologist from Southern California, sheds light on the most high-risk sedative used in oral and maxillofacial surgery (OMS). If you want to better understand the risks, challenges, and how to improve safety in sedation practices, this is an episode you won't want to miss. As they delve into the conversation, you'll hear three real-life examples of OMS sedation cases gone wrong, including the tragic story of six-year-old Caleb Sears. Dr. Yun unpacks the research on ketamine, the fine print found on every manufacturer's box, and what's really happening when it's used as a rescue sedative. They also discuss the safest places for the sedation provider to be during any procedure, how Caleb's Law has reshaped sedation and anesthesia practices in California, and Dr. Yun shares details of the upcoming Snow & Sedation Conference in 2026. For all this and more, start listening now!Key Points From This Episode:Background, training, and current practice setup for Dr. Steve Yun.We dive into a discussion on the most dangerous sedatives in OMS sedation.Dr. Yun shares the first real-life practical example of an OMS sedation case.Case number two of a real-life OMS sedation case: losing the airway.The last example: the case of Caleb Sears, the death of a six-year-old boy.The most dangerous sedative in OMS sedation: Ketamine.Rethinking the effects of ketamine. Dr. Yun shares some research regarding the use and effects of ketamine.We look at the drug manufacturer's instructions on a box of ketamine: the small print.What's happening when you use ketamine as a rescue sedative.Dr. Yun shares his tennis analogy: the safest places for you to be during sedation. How Caleb's Law affects the practice of OMS sedation and anesthesia in California.Last words from Dr. Yun: Snow & Sedation Conference.Rapid-fire answers from Dr. Steve Yun.Links Mentioned in Today's Episode:Dr. Steve Yun, M.D. — https://www.dentalanesthesiamd.com/ Dr. Steve Yun, M.D. Email — yunsteve@gmail.com Premier Sedation — http://www.premiersedation.com Dental Board of California — https://www.dbc.ca.gov/ Snow & Sedation Conference 2026 — https://snowandsedation.com/ ‘The effect of low-dose ketamine on fentanyl-induced respiratory depression' — https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2044.1998.00519.x ‘Association of ketamine use during procedural sedation with oxygen desaturation and healthcare utilisation: a multicentre retrospective hospital registry study' — https://www.bjanaesthesia.org/article/S0007-0912(24)00204-6/abstract ‘Rethinking ketamine as a panacea: adverse effects on oxygenation and postoperative outcomes' — https://www.bjanaesthesia.org/article/S0007-0912(23)00747-X/pdf  UCLA Dentistry — https://dentistry.ucla.edu/ Caleb's Law — http://www.calebslaw.org/ James —

June 6, 2025 In this episode, Ray, Mark, and Scott welcome back Dr. John Lin to discuss topics brought up on the Thriving Urology Practice Facebook Group.1) Just got a call from ER. 19 year-old cannot get an erection...2) This notice came from the hospital last week regarding change in financial protocol about scheduled / elective surgical procedures.Increased Patient Responsibility:As is customary in the Phoenix market and in-line with other providers, we will move the down payment requirement to 50%. We will be increasing the required patient payment for deductibles and co-pays prior to the day of surgery from 20% to 50% of the estimated patient liability.3) Our office will be beginning PAE {prostatic artery embolization) for BPH in the near future. This will be performed in the office, POS 11 by an interventional radiologist, who will manage the sedation and the performance of the procedure. We have not had to bill for conscious sedation in the office before. I was hoping to get some guidance on what codes should be investigated for the anesthesia portion (administration, meds, etc.) so we can better prepare ourselves for what is to come.Bonus TopicI received an email from a surgery center recently which stated the following: Recently, we have been using a larger number of disposable ureteroscopes which are very costly to the Center. In order to capture the code C9761 for reimbursement of the disposable flexible ureteroscopes, we need your dictation to reflect the usage of that scope and that suction/aspiration was used.  A vendor's representative has provided a few examples from other physicians that have resulted in successful reimbursement of these scopes. Below are the examples. The op report documents a steerable and suction/aspiration was used. It says "A disposable single use flexible scope with steerable and suction/aspiration was used to improve stone-free rate."The op report documents only a scope using a suction feature. It says "A disposable flexible ureteroscope utilizing a suction feature was utilized for the procedure."   If you are not already, please have your dictation reflect that you are using a disposable flexible ureteroscope with suction so that we can bill for reimbursement. As always, we appreciate your help with cost containment and appropriate reimbursement for the Center. Please let me know if have any questions or concernsPRS Coding and Reimbursement HubAccess the HubJelmyto Coding and Reimbursement PageUpper Track Urothelial Cancer (UTUC) Coding and Reimbursement PageFree Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Pract

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Sedation is a common need for a segment of our patient base, even more so for children. In this episode, Dr. Marn gives us a quick rundown of what the appointments look like, what gear anesthesiologist need, the handoff from dental office to the anesthesiologist, post-op recovery, and more.  Resources: The online Medical Emergency Readiness Index/ Scorecard:  https://emergency.scoreapp.com/ * note: it was initially designed for pediatric dental practices, but the questions and actionable steps still apply to anyone concerned about their preparedness for a medical or sedation emergency in their dental practice.    New York Medical Anesthesia https://nymedicalanesthesia.com/ * mobile sedation service serving NY and NJ   Blue Pacific Medical Simulation https://bpmedsim.com/ * risk reduction company that improves team alignment for medical and sedation emergencies   LinkedIn to DM https://www.linkedin.com/in/richardmarn/   Direct email RMarn@BPMedSim.com

Sedation is a common need for a segment of our patient base, even more so for children. In this episode, Dr. Marn gives us a quick rundown of what the appointments look like, what gear anesthesiologist need, the handoff from dental office to the anesthesiologist, post-op recovery, and more.  Resources: The online Medical Emergency Readiness Index/ Scorecard:  https://emergency.scoreapp.com/ * note: it was initially designed for pediatric dental practices, but the questions and actionable steps still apply to anyone concerned about their preparedness for a medical or sedation emergency in their dental practice.    New York Medical Anesthesia https://nymedicalanesthesia.com/ * mobile sedation service serving NY and NJ   Blue Pacific Medical Simulation https://bpmedsim.com/ * risk reduction company that improves team alignment for medical and sedation emergencies   LinkedIn to DM https://www.linkedin.com/in/richardmarn/   Direct email RMarn@BPMedSim.com

What if the biggest growth opportunity in your practice was the 50% of patients no one else is talking to? In this episode, we sit down with Clay Griffith, Head of Marketing and Growth for Advanced Dentistry, and Leah Zipperstein, Head of Growth and Strategy at Vesper Institute, to unpack how fear-based patient behavior is actually a powerful opportunity for dentists ready to lead differently. You'll hear real strategies for tackling IV sedation, improving patient acceptance, and transforming fear into your competitive edge. If you're feeling stuck in high-volume, low-revenue chaos — this one's for you. Tune in to learn how Vesper Institute is reshaping what's possible in modern dentistry.

Meclizine is classified as a first-generation antihistamine. I discuss meclizine pharmacology, adverse effects, drug interactions, and much more. Meclizine is included on the Beers list due to its highly anticholinergic activity. Anticholinergic effects include constipation, dry eyes, dry mouth, urinary retention, and confusion. Sedation is an important adverse effect of meclizine. This adverse effect can be increased when used with other sedating medications such as opioids and benzodiazepines. Meclizine is primarily used for vertigo and motion sickness in clinical practice. The usual starting dose ranges between 12.5 to 25 mg. Meclizine is partially broken down by CYP2D6 so medications like bupropion can inhibit the breakdown of meclizine and lead to higher concentrations.

Benzo reversal has it's own consequences.Link to full podcast:⁠https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-Versed-and-Sedation-Mastery-e30s38g⁠Thank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

It is harder to get right than analgesia and the consequences are just as bad.Link to full podcast:https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-Versed-and-Sedation-Mastery-e30s38gThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

In this episode of the PFC Podcast, the discussion revolves around patient positioning during procedural sedation, the pharmacology and application of Versed (Midazolam), and the nuances of dosing in various clinical scenarios. The speakers emphasize the importance of having a plan for airway management, the physiological implications of patient positioning, and the amnestic effects of Versed in trauma and surgical settings. They share insights from their experiences in austere environments, highlighting the need for adaptability and careful consideration of patient responses to sedation. In this conversation, the speakers delve into the complexities of IV amnestics, particularly focusing on Propofol and Midazolam, and the challenges faced during sedation in anesthesia. They discuss the importance of monitoring patient comfort, the nuances of sedation versus analgesia, and the implications of using drugs like Ketamine and Versed. The conversation highlights the critical nature of assessing patient responses and the difficulties in managing sedation effectively, emphasizing that sedation is often more challenging than general anesthesia.TakeawaysPatient positioning is crucial during procedural sedation.Recovery position may enhance airway protection during sedation.Always have a plan for airway management in different positions.Versed is a GABA agonist that promotes sedation and amnesia.Dosing of Versed varies significantly based on patient condition.In trauma cases, lower doses of sedatives may be necessary.Communication with the patient is key when administering sedatives.Understanding the pharmacodynamics of Versed aids in effective use.Amnestic effects of Versed can be dose-dependent.Clinical experience plays a significant role in medication administration. IV amnestics like Propofol and Midazolam do not have a guaranteed amnestic dose.Sedation is one of the most challenging aspects of anesthesia.Monitoring vital signs is crucial during sedation to assess patient comfort.The physiological state of the patient significantly affects drug dosing.Ketamine is not considered an amnestic drug by some providers.Patient comfort is paramount, and sedation must be carefully managed.The use of narcotics can help manage discomfort during sedation.Understanding the patient's history, such as alcohol use, is important for dosing.Sedation requires constant assessment and adjustment of medications.The complexities of sedation often make it more difficult than general anesthesia.Chapters00:00 Introduction to Patient Positioning in Procedural Sedation09:57 Understanding Versed: Mechanism and Usage19:54 Dosing Strategies for Versed in Different Patient Scenarios29:54 Amnestic Effects and Clinical Considerations of Versed35:05 Understanding IV Amnestics: Propofol and Midazolam39:01 The Challenges of Sedation in Anesthesia45:26 Monitoring and Assessing Patient Comfort During Sedation51:27 Navigating the Complexities of Sedation and Analgesia57:55 The Role of Versed and Ketamine in Anesthesia01:01:39 Final Thoughts on Sedation Practices and Patient SafetyThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

Show notes at pharmacyjoe.com/episode1013. In this episode, I'll discuss inhaled sedation for ICU patients with acute respiratory distress syndrome. The post 1013: A Setback For the Use of Inhaled Sedation in the ICU appeared first on Pharmacy Joe.

You asked, and we delivered – here's a comprehensive episode on Basivertebral Nerve Ablation (BVNA) for vertebrogenic lumbar pain! In this episode of Backtable MSK, our host Dr. Christopher Beck is joined by Dr. Asad Baig, Director of Interventional Spine at Columbia University, to discuss BVNA patient selection and procedural techniques. --- SYNPOSIS Dr. Baig begins by sharing his journey from residency to his current role, including his initial exposure to spine procedures and the mentors who guided him. He offers examples of his workup for back pain, covering detailed patient history and key MRI findings. Dr. Baig emphasizes the importance of understanding risks and alternatives, as well as how to effectively counsel patients on these topics. Additionally, he walks through the BVNA procedure and shares his technical pearls. The episode concludes with Dr. Baig highlighting valuable resources for those interested in starting BVNA procedures and recognizing the supporting role of industry partners. --- TIMESTAMPS 00:00 - Introduction 10:14 - Patient Selection for BVNA 14:45 - Imaging Findings 19:38 - Consent Process and Risks 22:18 - Procedural Technique 28:32 - Sedation and Pain Management 34:03 - Post-Procedure Care and Follow-Up 37:09 - Challenges and Troubleshooting 40:34 - Resources and Mentorship

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Editor's Summary by JAMA Deputy Editors Linda Brubaker, MD, and Preeti Malani, MD, MSJ, for articles published from March 15-21, 2025.

ARDS, which is characterized by hypoxemic respiratory failure and inflammatory injury to the lungs, has a mortality rate of 30% to 40%. Balasubramanian Venkatesh, MD, of the George Institute for Global Health joins JAMA Deputy Editor Kristin Walter, MD, MS, to discuss the effects of inhaled sedation with sevoflurane for patients with moderate to severe ARDS. Related Content: Sevoflurane Sedation in Acute Respiratory Distress Syndrome Inhaled Sedation in Acute Respiratory Distress Syndrome

For years we have been taught at the bedside that sedation “improves ventilator asynchrony”. We have believed that patients must be sedated to be compliant with the ventilator. Is that true? What does the research show? Sylvia Stefanos, PharmD, BCCCP joins us armed with the evidence and ready to debunk the myths. Want to share the financial benefits of an Awake and Walking ICU with your leadership? Check out: Www.ABCDEFBundle.com Www.DaytonICUConsulting.com

Show notes at pharmacyjoe.com/episode1007. In this episode, I’ll discuss the SCCM’s updated guidelines on pain, agitation, delirium, immobility, and sleep and the new recommendation regarding melatonin. The post 1007: The New SCCM Sedation Guidelines Recommend Melatonin appeared first on Pharmacy Joe.

Host Dr. Joel Berg is joined by Rose Dodson, founder and CEO of Sedation Resources for this episode of little teeth, BIG Smiles. Dodson discusses the importance in a strong foundation for sedation management and how emergency training is an integral piece of a practitioner's overall skill set. She also delves into the latest updates in technology supporting safety. Guest Bio: Rose Dodson is the founder and CEO of Sedation Resource, a long-time Silver Sponsor of the AAPD. For over 20 years, Rose and her team have been dedicated to patient safety and supporting dental sedation practitioners. Rose has a Master's in Business Leadership and Management and a deep understanding of sedation equipment and emergency preparedness. She even developed an amplified Bluetooth pre-tracheal stethoscope to improve patient monitoring. Most recently, she collaborated with the "Ten Minutes Saves a Life" initiative to create the Simulation Toolkit, designed to help with emergency response training. Rose shares her expertise through presentations and articles, always focused on practical solutions for sedation practitioners, and she has been directly involved in the hands-on participation sessions at the AAPD's sedation courses. She also enjoys sharing insights on safety, innovation, and how she's working to support the pediatric dental community.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, including an update on the Corporate Transparency Act, a survey about Gen Z workers, a review of the requirements of RN Administered This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Non-Opioid Pain Medication FDA Approved: https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain Update on Corporate Transparency Act: https://fincen.gov/boi-faqs https://fincen.gov/boi/small-entity-compliance-guide Intelligent.com Articles about Gen Z Workers https://www.intelligent.com/1-in-5-managers-have-considered-quitting-due-to-stress-of-overseeing-gen-z-employees/ https://www.intelligent.com/1-in-6-companies-are-hesitant-to-hire-recent-college-graduates/ ASC Quality.org http://ascquality.org INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop  ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers.  More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers 

In this episode we dive into the quirks of daily life and the unexpected moments in medicine. We debate the merits of keeping texts unread—Will's inbox is chaos—before sharing our latest adventures in pet ownership, including the struggle to bond with our new kittens while preventing our dog from eating them. We also discuss the hilarious things patients say under light sedation. Takeaways: Unread texts can be a personality trait—Will has 400+, while Kristin reads every single one. Introducing cats and dogs takes patience (and some very careful planning). Flirting at the grocery store is apparently a thing—especially if you're Kristin. Doctors struggle with balancing documentation and patient interaction, especially when patients expect more eye contact. Patients under light sedation say the funniest things, and sometimes, that includes a marriage proposal. — We have an active survey going. Hope you participate here: http://glaucomflecken.com/survey To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit http://www.EyelidCheck.com for more information.  Today's episode is brought to you by DAX Copilot from Microsoft. DAX Copilot is your AI assistant for automating clinical documentation and workflows helping you be more efficient and reduce the administrative burdens that cause us to feel overwhelmed and burnt out. To learn more about how DAX Copilot can help improve healthcare experiences for both you and your patients visit aka.ms/knockknockhi. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Deepak Krishnan discusses the recent JOMS article on anesthesia, “Do Patients With Mental Illness Undergoing Office-Based Sedation Require an Increased Propofol Dosage?”. The purpose of the study was to measure the association between mental illness and the propofol dosage necessary to achieve a satisfactory level of anesthesia.  Disclaimer

When deep sedation is required, it can be challenging to implement due to the difficulty of scheduling dedicated anesthesia coverage in the IR suite. Dr. Amy Deipolyi (interventional radiologist and Division Chief at Charleston Area Medical Center, WY) joins host Dr. Ally Baheti to explain an alternative approach to deep sedation through the use of ketamine. --- This podcast is supported by: Medtronic Abre Stent https://www.medtronic.com/en-us/healthcare-professionals/products/cardiovascular/deep-venous-stents/abre-venous-self-expanding-stent-system.html --- SYNPOSIS Dr. Deipolyi begins by sharing how she built a dedicated, academic IR program at a level 1 trauma center in West Virginia. The doctors then discuss the advantages of ketamine for deep sedation in the IR suite, and how Dr. Deipolyi gained administrative approval and implemented the change to achieve an alternative approach to deep sedation for interventional procedures. The discussion also includes how ketamine compares to traditional agents such as fentanyl and Versed. The episode concludes with Dr. Deipolyi's practical advice to fellow IR's interested in providing their patients deep sedation via ketamine and her ongoing and future research and outreach efforts. --- TIMESTAMPS 00:00 - Introduction 02:04 - Dr. Deipolyi's Practice 14:32 - Overcoming Hurdles and Gaining Support 20:12 - Application and Patient Experiences 26:01 - Future of Deep Sedation in IR 28:55 - Conclusion

The OMS Foundation Daniel M. Laskin Award recognizes authors of the most outstanding article published in the Journal of Oral and Maxillofacial Surgery during the previous year. The Journal Editorial Board selected “Is Recreational Marijuana Use Associated With Changes in the Vital Signs or Anesthetic Requirements During Intravenous Sedation?”  Disclaimer 

Dr. Beckman's International Veterinary Dentistry Institute offers courses in all areas of vet dentistry.    Online & Live Courses for Vets and Techs https://veterinarydentistry.net/    To request an invitation to the VDP Program: https://ivdi.org/    Complications of Extractions or Oro-Nasal Fistula (ONF) Closure After Radiation in Humans and Dogs Introduction  Radiation therapy is a common treatment modality for certain cancers affecting the oral cavity in both humans and dogs. While effective for managing malignancies, radiation can lead to significant challenges in dental procedures, particularly tooth extractions and oro-nasal fistula (ONF) closures. This evaluation synthesizes literature discussing complications associated with these procedures in both species, highlighting parallels and species-specific differences.   Human Literature Osteoradionecrosis (ORN)  Pathophysiology: ORN is a major complication following extractions in irradiated fields. Radiation induces hypovascularity, hypocellularity, and fibrosis in the bone, reducing its ability to heal and resist infection. Incidence: Studies report ORN rates between 5% and 15% after dental extractions in irradiated patients. Risk Factors: Total radiation dose exceeding 60 Gy. Location: Mandible is more prone due to poorer vascular supply. Timing: Extractions performed within 6 months post-radiation have higher risks. Comorbidities: Diabetes, smoking, and poor oral hygiene exacerbate risks. Management: Prophylactic measures include hyperbaric oxygen therapy (HBOT). Surgical debridement or segmental resection may be necessary for severe ORN.  Soft Tissue Complications Delayed Healing: Radiation-induced fibrosis and reduced vascularity lead to delayed mucosal healing. Infections: Secondary infections, such as osteomyelitis, are common due to impaired immune response and reduced tissue integrity. Dehiscence: Closure of oro-nasal fistulas is often complicated by wound dehiscence due to tension at the suture site and poor healing capacity. ONF Closure Challenges: High recurrence rates due to radiation-induced tissue fragility. Limited availability of local tissue for flap reconstruction. Surgical Options: Use of pedicled flaps, such as buccal or palatal flaps, has been successful. Free tissue transfers (e.g., radial forearm free flap) are utilized for extensive defects. Tissue engineering with growth factors or stem cells is an emerging area of interest. Pre-Surgical Preparation: Hyperbaric Oxygen Therapy (HBOT): While not universally applied, HBOT is frequently recommended before surgical interventions in patients at high risk for ORN. Protocols often involve 20-30 preoperative dives (2.0-2.5 ATA for 90-120 minutes per session) and 10 postoperative dives. Antibiotics: Broad-spectrum antibiotics may be prescribed prophylactically to reduce the risk of infection. Nutritional Optimization: Ensuring the patient's nutritional status is optimized can improve surgical outcomes. Veterinary Literature (Dogs) Osteoradionecrosis (ORN)  Pathophysiology: Similar to humans, radiation in dogs leads to hypovascularity and reduced bone turnover. The mandible is the most commonly affected site. Incidence: Published reports indicate a lower incidence of ORN in dogs compared to humans, possibly due to differences in fractionation protocols and total radiation doses. Risk Factors: Total radiation dose (commonly > 50 Gy). Larger tumor burden and proximity to the bone. Management: Conservative treatment includes antibiotics and analgesics. Surgical intervention involves debridement or mandibulectomy in severe cases. Soft Tissue Complications Delayed Healing: Radiation reduces epithelial turnover and fibroblast activity, delaying healing of mucosal wounds. Fistula Formation: ONF formation is common after radiation and can be exacerbated by dental extractions, particularly in the caudal maxillary region. ONF Closure Challenges: Dogs often have limited tissue for local flap reconstruction. Radiation reduces the availability and viability of tissue for surgical manipulation. Surgical Options: Buccal mucosal advancement flaps and rotation flaps are commonly used. Palatal flaps are an alternative for larger defects. Advanced techniques, such as axial pattern flaps, have shown promise. Adjunctive Therapies: HBOT has been explored in veterinary medicine with anecdotal success, though systematic studies are limited.   Comparative Analysis Common Complications Delayed Healing: Both species exhibit delayed healing due to radiation-induced vascular and cellular changes. ORN: A significant risk in humans and dogs, although reported incidences and management strategies differ. Wound Dehiscence: Tissue fragility and tension at surgical sites are common across species.   Species-Specific Differences Risk Factors: Humans are more affected by lifestyle factors such as smoking and systemic conditions like diabetes. Dogs are less influenced by these factors but may have different radiation fractionation protocols affecting outcomes. Management: Free flap techniques and tissue engineering are more advanced in human medicine. Veterinary approaches often rely on local flaps and less invasive options due to cost and availability constraints.   Hyperbaric Oxygen Therapy (HBOT) Protocol Human Protocol  Hyperbaric oxygen therapy (HBOT) is commonly recommended presurgically for patients who have undergone radiation therapy, especially in the head and neck region, to reduce the risk of complications such as osteoradionecrosis (ORN) after oral surgery.   Typical HBOT Protocol for Pre-Surgical Cases: Presurgical Sessions: Number of Sessions: Usually 20-30 sessions. Duration of Each Session: Each session typically lasts 90 minutes at a pressure of 2.0 to 2.5 atmospheres absolute (ATA). Postsurgical Sessions: Additional 10-20 sessions may be recommended following the oral surgery to further promote healing and reduce the risk of complications. Scheduling: Presurgical HBOT is ideally started at least 3-4 weeks before the planned surgery to ensure adequate time to complete the prescribed sessions.   Why HBOT Helps: Increases oxygen delivery to tissues damaged by radiation. Promotes angiogenesis (growth of new blood vessels) in irradiated tissues. Enhances fibroblast function and collagen synthesis. Reduces infection risk by boosting tissue oxygen levels.   Important Notes: The specific number of sessions may vary depending on individual factors, such as the extent of prior radiation damage, the site of surgery, and the overall health of the patient. Close coordination between the oral surgeon, oncologist, and a hyperbaric medicine specialist is crucial for optimizing outcomes. Veterinary Protocol  The use of HBOT in dogs follows adapted protocols based on human medicine, with adjustments for size and species-specific factors. Presurgical Sessions: Number of Sessions: Typically 10-20 sessions are suggested. Duration of Each Session: Sessions last approximately 60-90 minutes at pressures of 1.5-2.0 atmospheres absolute (ATA). Postsurgical Sessions: Additional 5-10 sessions may be recommended depending on the dog's healing progress and surgical outcomes. Monitoring: Dogs should be carefully monitored for signs of oxygen toxicity or other adverse effects during HBOT. Sedation may be required for some patients. Future Directions Human Medicine: Further research into tissue engineering and stem cell therapies to improve healing. Optimization of prophylactic measures such as HBOT and pharmacologic agents. Veterinary Medicine: Development of standardized protocols for managing post-radiation complications, including recommendations for the use of hyperbaric oxygen therapy (HBOT) in veterinary medicine. Emerging guidelines suggest that HBOT can support pre-surgical preparation by improving tissue oxygenation, enhancing vascularization, and promoting healing. Typical protocols involve 10-20 sessions at 1.5-2.0 atmospheres absolute (ATA) for 60-90 minutes per session, with an additional 5-10 sessions postoperatively to ensure optimal healing. Further research is needed to validate these approaches and refine their application for specific conditions. Exploration of advanced reconstructive techniques and adjunctive therapies like HBOT in controlled studies. Cross-Species Insights: Comparative studies to assess shared pathophysiology and potential therapeutic strategies across species. Conclusion  Complications following extractions or ONF closures in irradiated fields pose significant challenges in both humans and dogs. While similarities in pathophysiology exist, differences in risk factors, management, and available interventions highlight the need for species-specific approaches. Continued research, particularly in cross-species translational medicine, is essential to improve outcomes for both populations.   Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

Today's sponsor is Freed AI! Freed's AI medical scribe listens, transcribes, and writes notes for you. Over 15,000 healthcare professionals use Freed and you should too! Learn more here! On this episode of the Top 200 Drugs Podcast, I cover medications 146-150. This podcast includes; sevelamer, dalteparin, sertraline, clonazepam, and irbesartan. Sevelamer is a phosphate binder that is used to treat hyperphosphatemia in patients with chronic kidney disease. Dalteparin is a low molecular weight heparin product that is used to prevent and treat blood clots. Sertraline is a commonly used SSRI that can be helpful in managing depression and anxiety. Clonazepam is a benzodiazepine that can be used for acute relief of anxiety. Sedation, confusion, and fall risk are potential adverse effects. Irbesartan is an ARB that can be used for hypertension. Hyperkalemia and angioedema are two adverse effects to be aware of.

Ho ho hold still! Let's talk about the 3 major complications that can happen with procedural sedation in the ED. All is Calm, Until It's Not. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 244. Sleigh the Complications: Sedation pitfalls. December 23th, 2024. Accessed [date].

In this episode of The Saving Lives Podcast, we explore Propofol Infusion Syndrome (PRIS), looking at this complication's incidence, laboratory, and clinical manifestations. Hat tip to the authors. The Vasopressor & Inotrope Handbook I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. Amazon: https://amzn.to/47qJZe1 (Affiliate Link) My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%) Citation: Li WK, Chen XJC, Altshuler D, Islam S, Spiegler P, Emerson L, Bender M. The incidence of propofol infusion syndrome in critically-ill patients. J Crit Care. 2022 Oct;71:154098. doi: 10.1016/j.jcrc.2022.154098. Epub 2022 Jun 17. PMID: 35724444. @eddyjoemd is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com Although great care has been taken to ensure that the information in this post is accurate, eddyjoemd, LLC shall not be held responsible or in any way liable for the continued accuracy of the information or for any errors, omissions, or inaccuracies or for any consequences arising therefrom. --- Support this podcast: https://podcasters.spotify.com/pod/show/eddyjoemd/support