Atomic Anesthesia

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

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

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

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 [email protected] or [email protected]: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:🩷 Subscribe to our YouTube channel💜 Follow us on Instagram💙 Follow us on TikTok📥 Have a topic you want to hear? Email Dr. Temmermand at [email protected]

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