When Michelle discovered her patient was paralyzed, it surprised the whole medical team. This patient who was previously mobile and recovering from septic shock was now paralyzed and ultimately diagnosed with spinal cord ischemia, but could early intervention have changed the outcome?

In this episode, we discuss the causes, signs, diagnosis and treatment of spinal cord ischemia. Michelle shares powerful insights from her work in neurocritical care, including a technique for detecting easy-to-miss neurological changes.

Tune in to find out how you can improve patient outcomes when managing spinal cord ischemia!

Topics discussed in this episode:

• Michelle’s passion for patient care and nurse advocacy
• Critical case study: discovering a spinal cord abscess
• How the patient developed spinal cord ischemia
• Pathophysiology and signs of spinal cord ischemia
• Neurological assessment tips
• Peripheral versus central nervous system assessments
• Diagnostic criteria and the diagnostic process
• Prognosis and patient recovery
• Treatment options and challenges
• The role of the ABCDEF bundle in critical care

Connect with Michelle:

https://www.michellededeo.com/

https://www.instagram.com/michellededeo/

Listen to Michelle’s podcasts, the SCRN Prep Podcast and Narrative Nurse Project Podcast!

Get 20% off Michelle’s Stroke Review Bootcamp with code RAPIDRN20!

https://www.nicolekupchikconsulting.com/booksAndCourses/online-courses/61/stroke-review-bootcamp-case-studies-in-optimizing-care

This week, we are talking about every cardiac nurse’s worst nightmare: cardiac tamponade. Host Sarah Lorenzini is joined by Brian McCain RN to share a crazy case of cardiac tamponade where quick intervention made all the difference. In this episode, they discuss the critical signs, symptoms and pathophysiology of cardiac tamponade.

Brian and Sarah cover clinical findings like Beck’s triad and dampened arterial line waveforms, assessment techniques for patients who rapidly decline versus those with a gradual buildup of symptoms, and the nurse’s role in preparing patients for an open arrest.

Tune in to learn how to recognize and manage this cardiac emergency! 

Topics discussed in this episode:

• What Brian loves about the nursing profession
• A classic case of cardiac tamponade
• Pathophysiology of cardiac tamponade
• The clinical findings of cardiac tamponade
• Assessment and diagnosis of cardiac tamponade
• Differentiating between cardiac tamponade and pericardial effusion
• Preparing the patient for an open arrest

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Managing liver failure often means walking a tightrope with kidney function. This episode explores what happens when the kidneys begin to fail due to liver disease, a condition known as hepatorenal syndrome. Host Sarah Lorenzini sheds light on this common but severe complication of cirrhosis, sharing a critical case that exemplifies the challenges of diagnosing and treating hepatorenal syndrome.

Tune in to gain a better understanding of the pathophysiology of hepatorenal syndrome, the importance of early intervention, and effective treatment strategies. Listen to part three of this liver failure series now!

Topics discussed in this episode:

• Case study of a patient with suspected hepatorenal syndrome
• Pathophysiology of hepatorenal syndrome
• Diagnostic and treatment strategies for hepatorenal syndrome
• Key takeaways for nurses

Lets talk through the pathophysiology of Atrial Fibrillation, why it's a problem, and how to treat it. Guest Dr. G the NP, a Cardiology Nurse Practitioner helps drop some knowledge about this very common arrhythmia

Ever wondered what you can do in a code? You are not alone! The most common question I receive regarding emergencies is, "What can I do to be helpful in a code blue situation? I don't want to get in the way". Well, there are a lot of important roles you can take on. In this episode we break down all the roles available and what is expected from each one.

A conversation with COVID ICU, PCU, and Med/Surg Nurses about their experiences during the pandemic. We discuss some of our memories from this challenging season, the lessons we have learned, and how it has changed us as nurses.

Two very different presentations of anaphylaxis help provide an introduction to how to make the diagnosis of anaphylaxis, what to expect from the clinical presentation and evolution towards shock, the pathophysiology of anaphylaxis, and how to treat it.

DKA is so complicated... especially when the patient presents with a normal blood glucose! This case really sets the stage for explaining all of the dangerous aspects of DKA and the multifactorial approach to treating it. Christian and Sarah discuss the pathophysiology... down to the cellular level... of what's happening when patients go into DKA, some of the tests used to diagnose DKA like ABGs, and the delicate balance of fluid status and electrolytes that must be maintained when correcting this metabolic acidosis.

What started as pancreatitis, turned into massive transfusion protocol and a visit to interventional radiology. In this episode, Sarah, Katleen, and Marissa discuss a case that took an unexpected turn for the worse. They break down the pathophysiology of pancreatitis, it's treatment, and the nurse's role in the patient's recovery.

Supraventricular tachycardia can present very stable, but this patient rapidly declined.  In this episode we explain what exactly is happening with SVT, and go through all the different treatment modalities from vagal maneuvers, to medications, to synchronized cardioversion.

Surprising case that initially sounded like septic shock, but upon further investigation, the patient had a huge abdominal aortic aneurysm that was dissecting.  Learn about the clinical presentation, emergent interventions, and the nurse's role in saving this patient's life. 

Pulmonary Embolisms can pop up out of nowhere.  This episode breaks down the pathophysiology of PE and what interventions are needed to stop the PE spiral of death.

Air embolism to the brain is one of those rare complications of having vascular access. But just like your professor warned you, if you don't pull out the central line properly, you could cause an air embolus!!! Joining me for this episode is Rapid Response Nurse Marissa sharing her experience responding to a patient with altered mental status who had a large cerebral embolus.

A cirrhosis patient has stable vitals, but then starts vomiting blood. What do you do next? This episode delves into a case study that highlights the urgent management of esophageal varices in liver failure patients. Host Sarah Lorenzini reveals how a rapid response call quickly spiraled into a life-threatening emergency, and the critical steps taken to stabilize the patient.

Sarah explains the pathophysiology of cirrhosis and the development of esophageal varices, detailing the pharmacological and procedural interventions that can make the difference between life and death. You’ll get a comprehensive overview of evidence-based treatment strategies, how to manage complications, and the crucial role of nurses in patient care.

Tune in to arm yourself with the knowledge to handle this critical liver emergency!

Topics discussed in this episode:

• Management of a cirrhosis patient with a GI bleed 
• How liver failure can lead to a bleeding esophagus
• Challenges of giving blood transfusions to liver failure patients
• Pharmacological interventions: octreotide, antibiotics, and beta-blockers
• Procedural interventions: endoscopic variceal ligation, TIPS procedure, and balloon tamponade

Listen to Episode 77, “The Trauma, Diamond of Death:” https://podcasts.apple.com/us/podcast/77-the-trauma-diamond-of-death-4-treatment-priorities/id1535997752?i=1000633582257

To learn more about balloon tamponade, check out this breakdown of the procedure: https://first10em.com/balloon-tamponade-of-massive-gi-bleeding/

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Young healthy momma gets COVID and becomes critically ill 3 days after her baby is born. But after weeks on the ventilator, she recovers and is re-united with her baby. This podcast breaks down the disease progression of COVID and oxygen delivery modalities at each level. It draws back the curtain to see a glimpse of what COVID nurses have been facing for almost 2 years, and reminds all healthcare workers of the reason we keep fighting for these patients... to see them recover!

Great story of a classic presentation of Tachy Brady Syndrome that highlights the important role the bedside nurse plays in monitoring and intervening on the patient's behalf.

My first encounter with a true emergency as a nursing student taught me so much about increased intracranial pressure and the valuable role the nurse plays in detecting changes in the patient. In this episode we discuss the signs and symptoms of increased intracranial pressure, including Cushing's triad.

What would you do if you found yourself on the catching end of a birth?  In this episode we will discuss what to do if you must deliver a baby with minimal resources outside of the birthing room.  Interview with Ronnie Jo, Certified Nurse Midwife to share her passion and expertise in birthing babies.

In this episode, we talk about the number one diagnosis that leads to mortality in hospitalized patients. Signs and symptoms of sepsis and how to treat it is something that every nurse needs to know about. Guest Yesha RN shares about a patient that she just "had a bad feeling about" who ended up going into septic shock and required transfer to the ICU.

Check out Dr. Josh Farkas' post about fluid selection and pH balanced fluid resuscitation for  a more in depth understanding of why normal saline isn't always your patient's best option for fluid resuscitation.

https://emcrit.org/ibcc/fluid/

To learn more about the haldane effect check out this great resource:

https://derangedphysiology.com/main/cicm-primary-exam/required-reading/respiratory-system/Chapter%201142/haldane-effect

and for more details on VQ mismatch check out this site:

https://derangedphysiology.com/main/cicm-primary-exam/required-reading/respiratory-system/Chapter%200732/effects-ventilation-perfusion-mismatch-gas-exchange

Part 1 of a two part episode about how I simultaneously embarrassed myself and effectively advocated for the patient.

A career first... pouring sugar on my patient's rectum... all in a day's work!

A brief summary of this episode

This patient had the trifecta of factors that can cause hypercapnia and the nurse recognized his somnolence as more than him just being due for a nap.

No matter your specialty, every nurse cares for patients with liver failure. Host Sarah Lorenzini starts off this four-part series on liver failure by sharing the story of a rapid response call that featured classic complications of cirrhosis: ascites, jaundice, and hypotension. Exacerbating the patient’s terminal condition was a suspected diagnosis of spontaneous bacterial peritonitis.

In this episode, Sarah details how her team managed this case and breaks down the pathophysiology of cirrhosis, including why liver failure leads to so many complications. She covers how to assess and care for patients with cirrhosis, emphasizing the important role of nurses in educating families on liver failure.

Tune in for critical insights into the management of liver failure and its complications!

Topics discussed in this episode:

• Initial assessment of a rapid response call for hypotension
• Pathophysiology of cirrhosis and its complications
• Management of spontaneous bacterial peritonitis
• Role of nurses in liver failure patient care

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

On this episode, the patient was having a huge myocardial infarction but downplayed her symptoms as "just anxiety." But the primary RN followed her intuition, advocated for her patient, and saved her life!

My very first rapid response call ever as a rapid response nurse. This patient developed the classic signs and symptoms of peritonitis and turned the corner rather quickly toward septic shock.

Just a quick introduction to who the host of the Rapid Response RN Podcast is and why she wanted to do a podcast for nurses.

NTI 2024 brought together critical care nurses from across the country, and this episode highlights over 10 of their most heartwarming and unforgettable stories. Host Sarah Lorenzini speaks to ICU nurses and nurse educators who share tales of human connection, critical thinking, and compassionate care. From navigating crazy shifts to creating new patient programs, their stories showcase the incredible impact nurses have on patients’ lives and the healthcare system.

Tune in to celebrate the dedication, empathy, and resiliency of today's nurses!

Connect with Maddi Flanagan:

https://www.instagram.com/nurse.maddi/

Connect with Michael DeFrancisco:

https://www.instagram.com/camp_competency

Connect with Nicole Kupchik:

https://www.instagram.com/nicolekupchik/

Connect with Nick McGowan:

https://www.instagram.com/critical_care_academy/

Connect with Kali Dayton:

https://www.instagram.com/daytonicuconsulting/

Nursing care plans are the bane of many a nursing student’s academic experience. They are seen as an unnecessary burden to their already heavy workload. But they play an important role in the nursing process, and nurses put these plans into clinical practice every day — whether they realize it or not.

In this episode, Nurse Gwenny, an ER and flight nurse turned EMS educator, speaks with host Sarah Lorenzini about the relevancy and value of nursing care plans. She shares real-life examples of the impact these plans have on critical care thinking and decision-making, especially in high-pressure environments. Nurse Gwenny also discusses her passion for teaching, and how she leverages her experience and insights in her role as an educator.

Sarah and Nurse Gwenny also explore the “green flags” of nursing practice, diving into notable traits like a positive attitude, desire to learn from mistakes, and more.

Tune in to learn how to embrace care plans, improve patient care and your nursing skills!

Topics discussed in this episode:

• The value of nursing care plans
• Bridging theory and practice in critical care education
• Utilizing care plans in during critical care scenarios
• Practicing critical care thinking and decision making
• Identifying key traits of exemplary nurses
• The importance of continuous learn and growth in nursing

Connect with Nurse Gwenny:

https://www.instagram.com/nursegwennyrn/

https://www.tiktok.com/@nurse.gwenny/

Check out Gwenny's book, BUT WHY?: Going Beyond the What So You Can Understand the Why of Critical Care Transport: https://a.co/d/28tLpjP

Nursing educators may not hold the most glamorous position, but they are undoubtedly the backbone of the profession. Nurse Educator Patrick McMurray exemplifies this by bringing creativity and inclusivity into nursing education, supporting nurses at every stage of their career.

In this episode, host Sarah Lorenzini talks to Patrick about his approach to teaching complex concepts and preparing students to succeed beyond the classroom. Using interactive learning strategies and holistic methods, Patrick helps nurses deepen their understanding of nursing practices and effectively apply their knowledge in clinical settings.

Patrick also offers a glimpse into a day in the life of a nursing educator, and discusses the profound impact nursing educators have on the future of nursing. His insights will help you determine if a transition to nursing education is the right next step in your career.

Join us for part two of the “So You Want to Go Back to School” series with Patrick McMurray!

Topics discussed in this episode:

• The appeal of nursing education as a career
• What it means to be a good educator
• Rewards and challenges of being a nursing educator
• Redefining nursing education
• A day in the life of a nursing educator
• Nursing education as an act of justice
• The future of nursing education

Learn more about Patrick and find free educational resources on his website!

https://www.patmacrn.com/

Connect with Patrick McMurray:

https://www.instagram.com/patmacrn/

https://twitter.com/nursepatmacrn

https://www.tiktok.com/@patmacrn

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Obstructive shock may be the least common type of shock, but it’s no less critical. As part of Nurse PodCrawl 2024, Bryan Boling and Brandon Oto from the Critical Care Scenarios podcast join host Sarah Lorenzini in this episode to talk about the critical care management of obstructive shock. Together, they walk nurses through a patient scenario, detailing the diagnostic process of obstructive shock due to pulmonary embolism.

Sarah, Bryan and Brandon review the three main causes of obstructive shock: pulmonary embolism, tension pneumothorax, and cardiac tamponade. They also discuss the importance of clinical assessments and diagnostic tools like ultrasound to distinguish between each cause, as well as considerations for treatment.

This episode is the perfect resource for nurses who want to deepen their understanding of obstructive shock. Tune in now to hear insights from three experienced pros!

Topics discussed in this episode:

• Patient assessment and key diagnostic tools
• Diagnosing obstructive shock due to pulmonary embolism
• Treating obstructive shock due to pulmonary embolism
• Treatment implications for major causes of obstructive shock
• Diagnosis and treatment of tension pneumothorax
• Treatment strategies for cardiac tamponade
• Key takeaways on obstructive shock management

Check out the rest of Nurse PodCrawl 2024 episodes around cardiogenic, hypovolemic, and distributive shock!

Critical Care Scenarios: https://podcasts.apple.com/us/podcast/critical-care-scenarios/id1491559787

How Not to Kill Your Patient: https://podcasts.apple.com/us/podcast/how-not-to-kill-your-patient/id1612099061

Nurse Dose Podcast: https://podcasts.apple.com/us/podcast/nurse-dose-podcast/id1486427611

The Q Word Podcast: https://podcasts.apple.com/us/podcast/the-q-word-podcast/id1407523803

Straight A Nursing: https://podcasts.apple.com/us/podcast/straight-a-nursing-study-for-nursing-school-exams-nclex/id1210975738

Up My Nursing Game: https://podcasts.apple.com/us/podcast/up-my-nursing-game/id1527032817

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Which side of the debate do you fall on?  Should families be present during resuscitation or escorted to a quiet area to wait? Among those advocating for family presence are nursing researchers, Margo Halm, APRN-BC, PhD, FAHA, NEA-BC and Jessica Sexton, MSN, RN, CPEN. During their conversation with host Sarah Lorenzini, they explain why family presence is so important in patient-centered care and how nurses can facilitate a shift towards embracing this practice in their hospital.

Despite being backed by research, the concept of family presence during resuscitation is still debated by many healthcare professionals. Margo and Jessica address the common misconceptions that surround this controversial topic, provide insights on navigating institutional resistance, and share best practices of a family presence facilitator (FPF).

This episode also features powerful stories on the impact of family presence, tips on how to have important conversations with families and patients, and more. Tune in now!

Topics discussed in this episode:

• Benefits of family presence for nurses, patients, and families
• Misconceptions of family presence during resuscitation
• The role of a family presence facilitator
• Best practices and avoiding common mistakes as a FPF
• Advocating for family presence in your hospital
• Stories that demonstrate the impact of family presence
• How to overcome resistance to family presence

Read more in the AACN Practice Alert, Facilitating Family Presence During Resuscitation and Invasive Procedures Throughout the Lifespan:

https://aacnjournals.org/ccnonline/article/44/2/e1/32253/Facilitating-Family-Presence-During-Resuscitation

Learn more about Margo and Jessica’s session at the 2024 NTI Conference:

https://www.aacn.org/conferences-and-events/events-calendar/national-events/event-sessions/national-teaching-institute---2024/c60m296/family-presence-during-resuscitation-and-invasive-procedures-updates-to-the-aacn-pract

Contact Margo Halm at margohalm@gmail.com!

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

We’ve talked about hyponatremia, but what do you know about Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) and Diabetes Insipidus (DI)? In this episode, host Sarah Lorenzini and Nick McGowan RN, MSN dive into these diseases that develop from complex hormonal responses that manage the body’s water and sodium.

They explore the pathophysiology of both conditions, contrasting the excessive water retention in SIADH with the excessive water loss in DI and how this impacts diagnostic and treatment approaches. Nick identifies which labs and assessments are crucial to accurately diagnose and treat patients, highlighting the importance of neurologic assessments and best practices for correcting sodium.

Sarah and Nick also touch on the debate around cerebral salt wasting, and share interesting facts about the history of these conditions. Tune in to hear key lessons on recognizing and  treating these conditions from an experienced ICU nurse!

Topics discussed in this episode:

• Symptoms and signs of SIADH and DI
• The pathophysiology of SIADH and DI
• Diagnostic approaches and key lab values
• Treatment and management of SIADH
• Treatment and management of DI
• Lessons from SIADH and DI patient stories

Check out Nick's course over at Critical Care Academy!

🔗 https://www.ccrnacademy.com?ref=sarahlorenzini

Connect with Nick McGowan:

https://www.instagram.com/critical_care_academy/

https://www.youtube.com/@criticalcareacademy8312

https://www.facebook.com/CCRNacademy

https://www.tiktok.com/@criticalcareacademy

On this special PodSwap Episode, you will be hearing from Nurse Mo from the Straight A Nursing Podcast! She does an amazing job breaking down all the pharmacology of medications we use for Rapid Sequence Intubation or RSI.

Rapid sequence intubation, a procedure performed to emergently intubate a patient with an intact gag reflex in cases of acute respiratory failure and/or cardiovascular collapse. As a nurse working in the emergency department or ICU, you will be obtaining and may be administering the medications used to perform a rapid sequence intubation. Please be aware of your scope of practice and facility protocol regarding the administration of these medications. In some cases, the medications can only be administered by a physician.

Which combination of medications the physician chooses will vary depending on a variety of factors including the patient’s condition and physician preference. A common combination is a sedative with a short-acting paralytic, though analgesics may also be utilized. This episode provides an overview of the medications commonly utilized for RSI:

• Propofol
• Succinylcholine
• Rocuronium
• Vecuronium
• Etomidate
• Ketamine
• Fentanyl
• Midazolam

___________________

You can check out the following from Nurse Mo:

Full Transcript – Read the article and view references

FREE CLASS – If all you’ve heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES…you can thrive in nursing school without it taking over your life!

Study Sesh – Change the way you study with this private podcast that includes dynamic audio formats that help you review and test your recall of important nursing concepts on-the-go. Free yourself from your desk with Study Sesh!

Fast Pharmacology – Learn pharmacology concepts in 5 minutes or less in this audio based program. Perfect for on-the-go review!

Pharmacology Success Pack – Want to get a head start on pharmacology? Download the FREE Pharmacology Success Pack

A patient arrives at the ER, complaining of chest pain that dramatically worsens when she lies down. What could this clue reveal about her condition? In this episode, host Sarah Lorenzini recounts her experience caring for her first pericarditis patient and the subtle yet critical signs that distinguish it from more common cardiac emergencies.

Sarah dives into the tricky nature of chest pain, sharing how the PQRST pain assessment and an EKG played a critical role in uncovering the patient’s condition. She also outlines the diagnostic criteria that help differentiate pericarditis from more serious conditions like myocardial infarction, emphasizing the symptoms that can make diagnosis challenging.

Listen to the episode for insights on recognizing the easily mistaken signs of pericarditis, diagnosing the condition, and providing effective treatment!

Topics discussed in this episode:

• Patient case study of a young woman with chest pain
• Assessment and diagnosis of pericarditis
• Pathophysiology of pericarditis
• Infectious vs. noninfectious causes of pericarditis
• The diagnostic criteria for pericarditis
• EKG characteristics in pericarditis vs. myocardial infarction
• Key takeaways on the diagnosis and treatment of pericarditis

Learn more by reading this Brady et al article about ECG morphology in pericarditis:

https://pubmed.ncbi.nlm.nih.gov/11581081/

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Are you considering a career as a nurse practitioner? Do you want to go back to school to transition into an advanced practice nursing role? Join host Sarah Lorenzini and guest Dr. Sandra Pagenta, DNP, as they discuss opportunities available in nursing and how to decide if the nurse practitioner path is the right one for you.

Dr. Sandra Pagenta reflects on the evolution of her nursing career, from her early days as an RN to her current role as a nurse practitioner. She dives into the challenges and rewards of advancing your education and career, finding your niche, and achieving work-life balance.

In this episode, Dr. Sandra Pagenta also gives advice on how nurses can figure out their next career move and create the life they want. Tune in now!

Topics discussed in this episode:

• Transitioning from RN to NP
• Pros and cons of working as a nurse practitioner
• Finding passion and alignment in your career
• Exploring a career as an NP 
• The flexibility of a nursing career

Listen to Sandra's Podcast:

https://podcasts.apple.com/us/podcast/the-success-nps-podcast/id1566107516

Check out Sandra's Website:

https://successnps.com/

Follow Success NP's on Social Media:

YouTube: ⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/channel/UCYQYlS9d6m7HyMK7Z1BI5DA

Instagram: ⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/thesuccessnps

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Every day that you complete a shift is a day to celebrate because nursing is undoubtedly one of the hardest professions in the world, especially in the last few years. Burnout rates are extremely high, and for good reason, but there are ways to keep your passion for nursing even after decades in the field.

In this milestone 100th episode of Rapid Response RN, host Sarah Lorenzini celebrates 20 years of being a nurse and *still* loving it. It hasn’t been easy, but two decades of continuous learning and navigating the challenges of the job has taught her invaluable lessons on resilience, self-care, and humanity.

Sarah reflects back on her early mistakes and the hard-earned wisdom that’s kept her love for nursing alive, including connecting with patients, growth through education and mentorship, prioritizing physical and mental health, and MORE.

Tune in now to hear Sarah’s "not so secret sauce" for loving nursing after 20 years!

Topics discussed in this episode:

• The importance of self-advocacy and self-care
• Celebrating your nursing wins
• Preventing burnout through learning
• Mentorship and driving change

Listen to episode 38, Q&A: How to Effectively and Professionally Advocate For Your Patient… Even When the Provider is Intimidating, on Apple Podcasts!

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Treating hyponatremia, a condition characterized by low sodium levels in the blood, can be both complicated and quite risky.. Disruptions to the delicate balance of sodium in the body can lead to a spectrum of outcomes, from an asymptomatic presentation to life-threatening seizures, coma, and death.

Through the patient story of Mrs. Saltman, host Sarah Lorenzini explains the role of sodium in the body, breaking down the science of osmosis and electrolytes so nurses can better understand the causes of hyponatremia. She goes over the three levels of hyponatremia that are categorized by blood tonicity and volume status, and how each level impacts the diagnosis and management of hyponatremia. 

Sarah also dives into the nuances of treating hyponatremia, including the risks of rapid sodium correction, the importance of knowing a patient’s baseline, the underlying cause of their condition, and more.

This episode will provide nurses with the knowledge needed to recognize the signs of hyponatremia and navigate the risks of treatment. Tune in now!

Topics discussed in this episode:

• Introduction to Mrs. Saltman’s case
• The pathophysiology of hyponatremia
• Causes of hyponatremia
• Types of hyponatremia: hypertonic, hypotonic, and isotonic
• Hyponatremia treatment strategies and their risks

Takotsubo cardiomyopathy, also known as “broken heart syndrome,” is hard to diagnose because its symptoms mimic more common conditions like acute coronary syndrome. This stress-induced cardiomyopathy presents a mysterious challenge to nurses, as you’ll hear in today’s patient story.

Host Sarah Lorenzini shares the case of a patient who went from experiencing shortness of breath and nausea to a serious cardiac emergency. She breaks down the patient’s initial presentation, their quick decline featuring hypoxia and flash pulmonary edema, and ultimate diagnosis of takotsubo cardiomyopathy.

In this episode, Sarah dives into the pathophysiology of takotsubo cardiomyopathy, covering how emotional or physical stress leads to the condition. She goes over its symptoms and treatment, as well as the role of nurses in managing the condition.

Tune in now to find out how you should be handling similar cardiac emergencies!

Topics discussed in this episode:

• Takotsubo cardiomyopathy: a patient case study
• The pathophysiology of takotsubo cardiomyopathy
• Diagnosing takotsubo cardiomyopathy
• How to effectively treat takotsubo cardiomyopathy
• Final takeaways for nurses

Listen to Episode 82: Sympathetic Crashing Acute Pulmonary Edema: That Time My Patient Went From Stable A-Fib RVR to Intubated in 30 Minutes! https://podcasts.apple.com/ca/podcast/82-sympathetic-crashing-acute-pulmonary-edema-that/id1535997752?i=1000637926574

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Part two of our crashing asthmatic series continues with a comprehensive look into what exactly happened in last week’s nightmare patient case. 

Host Sarah Lorenzini dives into the pathophysiology of status asthmaticus, explaining the physiological changes in the airways during severe asthma attacks and what makes these cases resistant to standard treatment. She also breaks down treat options for patients approaching the asthma spiral of death, from pharmacological interventions to last-resort interventions like ECMO.

This episode highlights the key role of nurses in the care of status asthmaticus, including the importance of recognizing the red flags like “silent chest” and managing patient anxiety.

Tune in to learn everything you need to know about caring for a crashing asthmatic!

Topics discussed in this episode:

• The pathophysiology of asthma
• Signs of asthma exacerbation
• Treating a progression of asthma symptoms
• The danger of silent chest
• Advanced interventions for status asthmaticus 
• Tips for sedation and intubation
• Understanding your role as a nurse

Read this article that supports the use of magnesium for asthma:

https://pubmed.ncbi.nlm.nih.gov/24865567/

Read this article that shows magnesium does not help in asthma cases:

https://pubmed.ncbi.nlm.nih.gov/1536485/

....and there are so many more conflicting studies like these ☝️

Listen to Episode 73: Resuscitate Before You Intubate: How to NOT KILL YOUR PATIENT When You Intubate https://podcasts.apple.com/us/podcast/73-resuscitate-before-you-intubate-how-to-not-kill/id1535997752?i=1000630431016

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Severe asthma leads to cardiac arrest in today’s gripping patient story. Brooklyn, an ER Nurse joins host Sarah Lorenzini to discuss a nightmare case of a young asthmatic patient and her team’s desperate fight to stabilize him.

Despite various interventions, from albuterol, magnesium, BiPap, ketamine, and more, the patient's condition deteriorated, requiring intubation and ultimately transfer to an ECMO center to save the patient’s life. This episode highlights the challenges faced by smaller hospitals with fewer resources and the heroic care this patient received despite so many challenges.

Check out part one of our series on caring for the crashing asthmatic!

Topics discussed in this episode:

• Initial treatment of Brooklyn’s asthma patient
• The patient’s escalating condition and challenges in care
• Unpacking every tool in the asthma treatment toolbox
• Managing complications from autopeep to pneumothorax to cardiac arrest
• Key takeaways from this patient case

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Do you know how to recognize a wide or narrow pulse pressure and what each finding tells you about your patient? Following last week's discussion on the shock index, host Sarah Lorenzini introduces pulse pressure as another essential tool in the nurse's assessment arsenal.

In this episode, Sarah outlines how to measure and interpret pulse pressure. She shares two patient stories to illustrate how variations in pulse pressure can indicate different underlying conditions: The case study of Mrs. D highlights the implications of narrow pulse pressure, and the case study of Mr. S explores wide pulse pressure.

Through these examples, Sarah emphasizes how pulse pressure can be a key indicator in patient assessments while also clarifying its limitations. Listen in now!

Topics discussed in this episode:

• The case study of Mrs. D
• Measuring and interpreting pulse pressure
• Causes of narrow pulse pressure
• Causes of wide pulse pressure
• The case study of Mr. S
• Limitations to pulse pressure
• Using pulse pressure as a diagnostic tool

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Looking at HR or Blood Pressure alone as determinants of how stable the patient is can lead us astray.  The Shock Index allows us to detect when patients are declining… while they are still compensating. Shock Index = HR/SBP… but how can we use this tool? 

A patient’s vital signs can appear normal, meanwhile they’re on the brink of shock. This was exactly the case of Mr. Fields, a patient admitted to the ER after falling off his tractor. Initially, his vitals didn't raise alarms but there were signs pointing to a more serious situation — including a shock index of greater than one.

In this episode, host Sarah Lorenzini dives into the critical role shock index plays in determining how sick patients are and improving their outcomes, especially in emergency settings. She breaks down the calculation of shock index, its limitations in screening for all types of shock, and practical applications in patient care.

Tune in now to explore how you can apply this vital tool in the assessment and treatment of patients!

Topics discussed in this episode:

• The case study of Mr. Fields
• Understanding shock index
• How to calculate shock index… the easy way
• Clinical applications of shock index
• Limitations of shock index

Learn more about shock index: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698590/#:~:text=Shock%20index%20(SI)%20is%20defined,sepsis%2C%20and%20ruptured%20ectopic%20pregnancy

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Are you familiar with BRASH syndrome? The complex interplay of Bradycardia, Renal Failure, Atrioventricular Block, Shock, and Hyperkalemia forms a collection of clinical signs known as BRASH syndrome. One condition leads to another which leads to another, heightening the severity of symptoms. Fortunately, it’s easy to manage if you know what you are treating.

In this episode, Sarah Lorenzini breaks down the pathophysiology of BRASH syndrome as she examines a patient case study. Starting with its hallmark features and expanding into the synergistic effects of AV nodal blockers, hyperkalemia and renal failure, she provides insights on recognizing the signs of BRASH syndrome early and the importance of understanding the interplay among its components.

Sarah outlines the treatment priorities for BRASH syndrome and highlights the importance of identifying the root cause of symptoms to prevent a cascade of complications leading to shock.

Tune in to strengthen your knowledge of BRASH syndrome!

Topics discussed in this episode:

• Case study analysis of a BRASH patient
• Components of BRASH Syndrome
• How BRASH developed in Sarah’s patient
• Treatment and management of BRASH Syndrome
• The role of calcium in treatment of BRASH

You can learn more about BRASH Syndrome at the Internet Book of Critical Care Website:

https://emcrit.org/ibcc/brash/

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Timing is everything when it comes to strokes because every second without treatment impacts patient outcomes. If you’ve ever wasted time debating whether or not to call a stroke alert, you don’t want to miss this episode with Dr. Eric Wilson RN, AGNP-C, DNP, NREMT-P!

During his conversation with host Sarah Lorenzini, Eric emphasizes the urgency of recognizing stroke symptoms early, highlighting unilateral deficits and speech issues as red flags for immediate action. He guides listeners through the assessment of patients using the NIH Stroke Scale, and dives into treatment options and diagnostic procedures.

Eric and Sarah also discuss the role of nurses during a stroke alert, including when one should be called and what nurses can expect. Tune in now to learn how you can rock your next stroke alert!

Topics discussed in this episode:

• Identifying stroke symptoms and calling a stroke alert
• Assessing the patient and preparing for a stroke alert
• The NIH Stroke Scale
• Criteria for thrombolytic treatment
• Who makes a good candidate for thrombectomy
• Treating patients who don’t qualify for a thrombolytic

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Clinical Nurse Specialists are more than just experts in their field.  They are advanced practice nurses who are driven to make system wide changes for both nurses and their patients.

This episode sheds light on the critical role of Clinical Nurse Specialists, the extensive education and experience needed to enter the field, and their unique responsibilities compared to other nursing positions. Nicole openly shares the impact she’s been able to make as a CNS, the challenges she’s faced — and even mistakes she's made along the way. We also discuss the worrying decline in CNS programs, and what nurses can do to secure a CNS position in today's healthcare environment.

Tune in to learn more about what it takes to be a Clinical Nurse Specialist and decide if it's the right fit for you!

Topics discussed in this episode:

• The importance of the CNS role in healthcare
• Differences between a CNS and other nursing roles
• Nicole’s experience implementing an award winning sepsis program
• The experience and skills required to succeed as a CNS
• Challenges of the CNS role
• The future of the CNS role
• Advice for aspiring Clinical Nurse Specialists

Head to Nicole’s website to get 20% off ALL courses and educational materials with code RAPIDRN20!

https://www.nicolekupchikconsulting.com/?ref=30065

Connect with Nicole Kupchik:

https://www.instagram.com/nicolekupchik/

https://www.tiktok.com/@nicolekupchik

https://www.facebook.com/NicoleKupchikConsultingEducation

https://www.linkedin.com/in/nicole-kupchik-mn-rn-ccrn-530b8710/

https://www.youtube.com/channel/nicolekupchik5959

Cardiac output equals heart rate times stroke volume… but what does that really mean and how does it apply to the bedside? This formula (CO = HR x SV) is crucial for nurses to understand in the application of vasopressors and inotropes, so why is it so difficult to memorize their role in improving cardiac output?

This episode is dedicated to breaking down these life-saving medications so you can not only memorize their expected effect on vital signs, but more importantly, understand how they work in the body. Host Sarah Lorenzini provides a comprehensive lesson in these three classes of medications: vasopressors, inopressors and inodilators. She covers how each affects heart rate and stroke volume, diving into the alpha and beta adrenergic receptors that impact cardiac output.

Sarah also shares memory aids to help you remember these concepts and apply them to your clinical decision making.

Tune in now to learn the basics of vasopressors and inotropes!

Topics discussed in this episode:

• The role of sympathomimetics to improve cardiac output
• Adrenergic and vasopressin receptors
• Vasopressor types and medications

Mentioned in this episode:

AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!

Did you listen to Joey’s story in last week’s mystery episode? If you did and guessed rhabdomyolysis as his diagnosis, congratulations! Joey’s muscle injury from playing a little too hard at football camp resulted in a release of muscle proteins that ultimately caused his kidneys to shut down, which led to his diagnosis and treatment for rhabdomyolysis.

In this episode, host Sarah Lorenzini examines the complexities of the condition, from its pathophysiology to causes and treatment options. You’ll learn the hallmark signs of rhabdomyolysis, the not so obvious signs and symptoms to be aware of, and what to consider when caring for patients.

Tune in for a detailed exploration of rhabdomyolysis!

Mentioned in this episode:

Rapid Response Academy Link

Wanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/community

Are you ready for some diagnosing fun?! In this episode, host Sarah Lorenzini will challenge your diagnostic skills with the mystery case of Joey, a 14-year-old patient who went from playing football at summer camp to being intubated in the ER.

Joey presented with an altered mental status, and was tachycardic, tachypneic and febrile. Once in the ER, he went into ventricular tachycardia, his blood pressure dropped significantly, and he required intubation. As Sarah shares more details on his presentation, labs results and medical history, you’ll get all the critical clues needed to solve this intriguing case.

So, think you can uncover what’s wrong with the patient? Check back next week when Sarah concludes Joey’s story and reveals his mystery diagnosis!