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Atomic Anesthesia

Rhea Temmermand, PhD, CRNA & Sachi Lord, MSN, CRNA

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 break 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.

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S1 · E123
Yesterday · 20 min
PACEMAKERS AND AICDS, TO MAGNET OR NOT TO MAGNET │ EP123
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. Letter codes, electrocautery, and a magnet that does something different depending on the device. Pacemakers and ICDs show up in almost every OR, and on boards. In Week 3 of our 12-week SEE/NCE series, we boil it down to two questions: what is this device doing for the patient, and what will electrical noise do to it? In this episode: Pacemaker vs ICD, plus resynchronization, leadless and subcutaneous devices The pacemaker code letter by letter, and the modes you'll actually see (AAI, VVI, DDD, DOO) Why pacemaker dependence is the most important question you can ask What electrocautery does to pacemakers and ICDs, and monopolar vs bipolar cautery What a magnet does to a pacemaker vs an ICD, with board-style scenarios Preoperative device evaluation and the intraoperative and postoperative plan 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter.
S1 · E122
Monday · 27 min
CABG ANESTHESIA FROM PUMP TO PROTAMINE │ EP122
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. The pump, the cannulas, the cardioplegia, the drips. CABG can feel like too many moving parts to keep straight for boards. In Week 3 of our 12-week SEE/NCE series, we tie every step of the case back to one idea, myocardial oxygen supply versus demand, so the decisions finally make sense. In this episode: Coronary perfusion pressure, the coronary territories and why tachycardia is the enemy Preoperative medications, monitoring and the hemodynamic goals for induction Cardiopulmonary bypass basics, heparin dosing, ACT targets and protamine, plus why you never draw up protamine ahead of time Cardioplegia: how it stops the heart, and antegrade vs retrograde delivery Separating from bypass, vasoplegia and post-bypass ventricular dysfunction The major complications, from bleeding and tamponade to stroke and AKI 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter.
S1 · E121
Friday · 4 min
EKG AND DYSRHYTHMIAS WITHOUT SKIPPING A BEAT (PREMIUM) │ EP121
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. A lot of EKG questions are really measurement questions in disguise, and a scary strip on the monitor is sometimes just a loose lead. In this members-only Week 2 episode of our 12-week SEE/NCE series, we walk through 18 rhythm strips on the study sheet with one system you can use every time, so you can name the rhythm and know when it actually needs treatment in the OR. In this episode: Reading the grid, two quick heart rate methods, and a seven-step system for every strip Sinus rhythms and their most common intraoperative causes Atrial fibrillation, atrial flutter, SVT and the Wolff-Parkinson-White trap PVCs, ventricular tachycardia, torsades de pointes and VF, plus synchronized cardioversion vs defibrillation All four AV blocks, with a memory trick for each Electrolyte and ischemia changes, and three questions to ask before you treat any new rhythm 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter.
S1 · E120
October 14 · 23 min
ANTICOAGULANTS AND REVERSAL IN ONE CLEAN CASCADE │ EP120
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. Strange suffixes, different labs, different hold times and a different antidote for every drug. Anticoagulants are where a lot of board points get lost. In Week 2 of our 12-week SEE/NCE series, we organize every anticoagulant around one question: where in the coagulation cascade does it hit? Answer that, and you can predict the lab, the risks and the reversal. In this episode: A simple map of the coagulation cascade and which lab tests which pathway (PT/INR, aPTT, ACT) Unfractionated heparin, heparin resistance, ACT targets for bypass, and protamine dosing and reactions Heparin-induced thrombocytopenia: why it's a clotting problem, not a bleeding problem Low-molecular-weight heparin, fondaparinux and the neuraxial hold times you need to know Warfarin, the "1972" factors, and when to reach for vitamin K, four-factor PCC or FFP The DOACs and their antidotes (idarucizumab and andexanet alfa), antiplatelet agents, and balancing bleeding against thrombosis 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter.
S1 · E119
October 12 · 24 min
VALVULAR HEART DISEASE WITHOUT THE HEARTACHE │ EP119
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. Valvular heart disease feels like a memorization topic, but the table of arrows in every review book isn't random. In Week 2 of our 12-week SEE/NCE series, we show you how two questions (pressure or volume problem, systole or diastole) let you rebuild the hemodynamic goals for every valve lesion in the middle of your exam. In this episode: The shortcut: stenosis is full, slow and tight; regurgitation is full, fast and forward Aortic stenosis: severe AS numbers, the atrial kick, why phenylephrine is the go-to and why CPR rarely works Aortic regurgitation: acute vs chronic, why neuraxial is well tolerated, and the balloon pump contraindication Mitral stenosis: protecting the right heart, avoiding PVR triggers, and why wedge pressure overestimates LVEDP Mitral regurgitation: the large v wave and why phenylephrine can worsen the leak A rapid-fire board review of every lesion, plus how to handle mixed valve disease 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. Mentioned in this episode: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E118
October 9 · 3 min
ADME UP: A COMPREHENSIVE REVIEW OF PHARMACOKINETIC CONCEPTS (PREMIUM) │ EP118
In this premium episode, we’re breaking down pharmacokinetics, the concepts that explain what happens to a drug after it enters the body. From distribution and protein binding to metabolism, clearance, and context-sensitive half-time, we’ll connect the equations and terminology to how anesthetic drugs actually behave in the OR and focus on the high-yield concepts you need to know for the SEE/NCE. In this episode: Volume of distribution, protein binding, and drug distribution Clearance, elimination, and half-life First-order vs. zero-order kinetics Hepatic extraction ratio and factors that affect drug metabolism Context-sensitive half-time and continuous infusions High-yield pharmacokinetic concepts for the SEE/NCE This episode is part of our 12-week SEE/NCE podcast series, designed to follow the Atomic Anesthesia SEE/NCE Study Plan week by week. Want to study along with the episode? Join the Atomic Anesthesia learning platform to get the accompanying worksheet, plus access to our members-only podcast episodes and additional SEE/NCE study resources. FREE RESOURCE FOR THIS EPISODE: SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free. WANT THE FULL PLATFORM? Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs: 800 lessons, 10,000 quiz questions, flashcards, and interactive features. Join at atomicanesthesia.com.
S1 · E117
October 7 · 17 min
SEDATION SHOWDOWN: BARBITURATES VS. BENZODIAZEPINES │ EP117
In this episode, we’re covering barbiturates and benzodiazepines, two drug classes that both act at the GABA-A receptor but have important differences in their pharmacology, clinical effects, and reversal. In this episode: How barbiturates and benzodiazepines modify the GABA-A receptor Why barbiturates increase chlo ride channel duration while benzodiazepines increase frequency Methohexital, thiopental, midazolam, diazepam, and lorazepam Key pharmacokinetic and clinical differences between the major drugs Flumazenil reversal and the board-relevant risks you need to remember This episode is part of our 12-week SEE/NCE podcast series, designed to follow the Atomic Anesthesia SEE/NCE Study Plan week by week. Want to study along with the episode? Join the Atomic Anesthesia learning platform to get the accompanying worksheet, plus access to our members-only podcast episodes and additional SEE/NCE study resources. FREE RESOURCE FOR THIS EPISODE: SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free. WANT THE FULL PLATFORM? Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs: 800 lessons, 10,000 quiz questions, flashcards, and interactive features. Join at atomicanesthesia.com. Mentioned in this episode: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E116
October 5 · 39 min
BLOCK PARTY: NEUROMUSCULAR BLOCKERS (PARALYTICS) FOR THE SEE/NCE │ EP116
Neuromuscular blockers are packed with high-yield SEE/NCE material and knowing the drug names isn’t enough. In this episode, we break down the pharmacology you need to understand so you can apply it to board-style questions and clinical scenarios. In this episode: Depolarizing vs nondepolarizing neuromuscular blockade Succinylcholine pharmacology, contraindications & major complications Rocuronium, vecuronium & cisatracurium Pseudocholinesterase deficiency & the dibucaine number Factors that potentiate or cause resistance to neuromuscular blockade Reversal, residual blockade & high-yield board pearls This episode is part of our 12-week SEE/NCE podcast series, designed to follow the Atomic Anesthesia SEE/NCE Study Plan week by week. Want to study along with the episode? Join the Atomic Anesthesia learning platform to get the accompanying worksheet, plus access to our members-only podcast episodes and additional SEE/NCE study resources. FREE RESOURCE FOR THIS EPISODE: SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free. WANT THE FULL PLATFORM? Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs: 800 lessons, 10,000 quiz questions, flashcards, and interactive features. Join at atomicanesthesia.com. Mentioned in this episode: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E115
September 29 · 11 min
CAROTID ENDARTERECTOMY: PROTECTING THE BRAIN ONE CLAMP AT A TIME │ EP115
Carotid endarterectomy is a critical procedure requiring careful management to protect cerebral perfusion, especially during cross-clamping. This episode delves into essential intraoperative considerations, particularly mean arterial pressure (MAP) targets, and strategies to maintain cerebral blood flow through monitoring and potential shunting. Preoperative assessment and baseline establishment Intraoperative monitoring techniques and A-line importance MAP target calculation and cerebral autoregulation adjustments Induction and maintenance anesthesia specifics Strategies for smooth emergence and minimizing complications FREE RESOURCE FOR THIS EPISODE: SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free. MORE FREE STUDY RESOURCES: Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference WANT THE FULL PLATFORM? Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs — lessons, quizzes, flashcards, and more. Join at atomicanesthesia.com.
S1 · E114
September 23 · 29 min
THE TWITCHING HOUR: TRAIN-OF-FOUR EXPLAINED │ EP114
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.com In this episode: Train-of-four basics, including what the twitches actually represent and how to interpret your TOF count TOF count vs TOF ratio, understanding fade, and why four twitches does not necessarily mean full recovery Post-tetanic count, depth of neuromuscular blockade, and when to use different stimulation patterns Ulnar vs facial nerve monitoring, Phase I vs Phase II succinylcholine blockade, and qualitative vs quantitative monitoring Using TOF to guide neostigmine and sugammadex reversal, plus high-yield SEE/NCE concepts and practice board questions 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. GPCR Cheat Sheet — The G-protein coupled receptor mechanisms behind the alpha antagonists, beta blockers, and signaling pathways that show up in every OR vasodilator conversation. SEE/NCE Study Plan — A structured plan to help you prepare for the SEE and NCE without burning out — hypertension treatment is a high-yield topic. Non-Opioid Pharmacology Cheat Sheet — Propofol, ketamine, dexmedetomidine, and the rest of the non-opioid sedation toolkit on one page. 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea & Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. Mentioned in this episode: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E113
September 11 · 11 min
VASODILATORS IN THE OR: WHEN THE PRESSURE NEEDS TO DROP NOW │ EP113
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.com In this episode: The three mechanism buckets every OR vasodilator falls into — nitric oxide donors, calcium channel blockers, alpha antagonists — and why the bucket tells you the side effect profile before you ever look up the drug The full NO → cGMP → PKG → smooth muscle relaxation cascade behind nitroglycerin and nitroprusside, and why one drops preload while the other balanced-dilates Cyanide toxicity and coronary steal with nitroprusside — when to use it, when to cap it, and when to pick something else Clevidipine vs nicardipine vs hydralazine — which drug fits which case, and why hydralazine is falling out of favor for tight OR control Controlled hypotension for neuro cases, afterload management in cardiac surgery, and hypertensive emergencies including aortic dissection and pheochromocytoma 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. GPCR Cheat Sheet — The G-protein coupled receptor mechanisms behind the alpha antagonists, beta blockers, and signaling pathways that show up in every OR vasodilator conversation. SEE/NCE Study Plan — A structured plan to help you prepare for the SEE and NCE without burning out — hypertension treatment is a high-yield topic. Non-Opioid Pharmacology Cheat Sheet — Propofol, ketamine, dexmedetomidine, and the rest of the non-opioid sedation toolkit on one page. 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Dr. Temmermand at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you're a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That's where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we're a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we'll get started! — Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E112
September 8 · 22 min
DECODING DEXAMETHASONE'S ANTIEMETIC EFFECT (MECHANISM EXPLAINED) │ EP112
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.com In this episode: Exactly how PONV happens in the brain, no vague "vomiting center" hand waving All 5 real mechanisms behind how dexamethasone actually stops nausea and vomiting The practical dosing, timing, and combination strategy that gets the best PONV prevention References: Chu CC, Hsing CH, Shieh JP, Chien CC, Ho CM, Wang JJ. The cellular mechanisms of the antiemetic action of dexamethasone and related glucocorticoids against vomiting. Eur J Pharmacol. 2014;722:48-54. Horn CC, Wallisch WJ, Homanics GE, Williams JP. Pathophysiological and neurochemical mechanisms of postoperative nausea and vomiting. Eur J Pharmacol. 2014;722:55-66. Ho CM, Wu HL, Ho ST, Wang JJ. Dexamethasone prevents postoperative nausea and vomiting: benefit versus risk. Acta Anaesthesiol Taiwan. 2011;49(3):100-104. 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. Mentioned in this episode: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E111
September 4 · 19 min
THE DIFFICULT AIRWAY ALGORITHM, STEP-BY-STEP │ EP111
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.com In this episode: The three decisions that shape every airway plan: awake or asleep, noninvasive or invasive, and preserve or ablate spontaneous ventilation The most important fork in the algorithm, can you oxygenate or not, and how it sends you down the non-emergency pathway or the emergency pathway Managing the cannot intubate, cannot oxygenate crisis, including front-of-neck access and the scalpel-bougie-tube technique 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. Mentioned in this episode: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E110
September 1 · 26 min
10 HIGH-YIELD SEE/NCE BOARD QUESTIONS EXPLAINED │ EP110
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.com In this episode: Ten challenging SEE/NCE board questions, one from every corner of the NBCRNA blueprint, each read in full board style with a breakdown of why the right answer wins and why every distractor was built to fool you High-yield pharmacology and physiology traps, including Hofmann elimination for the organ-failure patient, shifting the oxyhemoglobin dissociation curve, and the MAC family from MAC-awake to MAC-BAR The clinical-reasoning questions that show up at the bedside, from autonomic hyperreflexia and infant bradycardia to coronary perfusion pressure and reading the capnograph waveform A local anesthetic maximum-dose calculation and a full walk-through of recognizing and treating local anesthetic systemic toxicity 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. Mentioned in this episode: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E109
August 21 · 10 min
PREECLAMPSIA AND THE OB PATIENT: PATHOPHYSIOLOGY THAT SAVES LIVES │ EP109
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.com In this episode: The cardiovascular, pulmonary, renal, and coagulation changes of normal pregnancy you need to know before you can recognize what's broken in preeclampsia Why preeclampsia is fundamentally a placenta problem that becomes a vascular endothelium problem — sFlt-1, soluble endoglin, VEGF neutralization, and the cascade that drives every symptom HELLP syndrome — microangiopathic hemolysis, hepatic involvement, and how it changes your anesthetic plan Magnesium sulfate pharmacology — NMDA antagonism, the dosing regimen, toxicity ladder, and why you must cut your non-depolarizing NMB dose by 30 to 50 percent Neuraxial vs general anesthesia in the severe preeclamptic — when neuraxial is safe, how to manage platelet thresholds, and how to blunt the catecholamine surge of laryngoscopy when general is unavoidable 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — OB pharm and physiology is high-yield on the exam — this plan tells you exactly where it fits in your prep timeline. Non-Opioid Pharmacology Cheat Sheet — Multimodal pain management options including the non-opioids that show up in OB anesthesia plans. GPCR Cheat Sheet — The receptor pharmacology behind the pressors and antihypertensives you'll be running on these patients. 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Dr. Temmermand at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter. 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you're a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That's where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we're a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we'll get started! — Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E108
August 14 · 18 min
CRNA WORKFORCE CHANGES: DO THESE THINGS TO LAND YOUR PERFECT JOB │ EP108
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.com In this episode: Why the anesthesia staffing shortage has created one of the strongest job markets ever for new CRNAs What chief CRNAs are actually looking for during interviews and how to stand out as a candidate How to evaluate your first CRNA job based on pay, location, flexibility, autonomy, and most importantly, culture Why you have more leverage than you think when choosing a job, plus one simple interview strategy that can make you unforgettable To contact Braden Clark, CRNA you can email him at: bradenmclark6@gmail.com 💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets. SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia 💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter.
S1 · E107
August 13 · 14 min
REGIONAL ANESTHESIA 101: BLOCKS EVERY CRNA SHOULD KNOW │ EP107
Regional anesthesia is one of the highest-yield, most heavily tested areas on the boards, but most review content buries the clinically useful details under anatomy that never gets asked. This episode breaks down the brachial plexus approaches boards actually tests, the truncal and lower extremity blocks showing up in modern multimodal protocols, and the complication patterns examiners use as answer traps. In this episode: The four brachial plexus approaches and why phrenic nerve risk drops as you move from interscalene to axillary Why adductor canal block has replaced femoral nerve block for TKA, and the volume myths that trip up test-takers The LAST risk hierarchy by injection site, and the Exparel interaction rules boards loves to test FREE RESOURCES: SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia. Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference WANT 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.
S1 · E106
August 7 · 13 min
THE 5 OPIOIDS YOU ACTUALLY USE IN THE OR │ EP106
Understanding opioid selection in the OR is all about recognizing pharmacokinetics and how they align with surgical needs and patient factors, rather than focusing solely on receptor effects. This episode explores the five opioids you use most—morphine, fentanyl, sufentanil, remifentanil, and hydromorphone—and offers a framework for choosing optimally among them. Opioid receptor mechanisms and their clinical outcomes Lipid solubility's role in opioid kinetics Pharmacokinetics of morphine, fentanyl, sufentanil, remifentanil, and hydromorphone Managing side effects like respiratory depression and opioid-induced hyperalgesia Guidelines for opioid selection based on case specifics and patient renal function Resources Atomic Anesthesia Platform — In-depth lessons and quizzes on each opioid. 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 boards Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference WANT 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: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E105
July 31 · 13 min
COMPLEX I, SEVOFLURANE, AND THE VENEZUELAN MITOCHONDRIAL VARIANT │ EP105
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 injury The mitochondrial mechanism behind it, and why some patients have zero reserve capacity to absorb the hit Why TIVA with propofol becomes the clear anesthetic choice once you understand what spares Complex I Source: 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 boards Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference WANT 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: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)
S1 · E104
July 28 · 12 min
PROPOFOL: THE DRUG YOU THINK YOU KNOW │ EP104
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 modulation Pharmacokinetics and context-sensitive half-time Cardiac and respiratory effects Risk and management of propofol infusion syndrome Handling egg allergy concerns Strategies to reduce pain on injection 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 boards Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference WANT 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: 💜 PARTNERS: The Incomologists® https://theincomologists.com/ You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in. Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future. We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)

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