Rapid Response RN

Awesome nurses don’t always make great preceptors. So what does it take to nurture new talent into capable and confident professionals? This episode delves into fundamental qualities, mindset and teaching strategies necessary to excel in the role of a preceptor.Host Sarah Lorenzini reflects on her experiences with both good and bad preceptors, sharing insights on how to create a supportive and empowering learning environment that encourages independence. From setting expectations and goals to dealing with difficult trainees, she outlines proven methods to help nurses become an effective mentor. You’ll learn techniques for providing constructive criticism, building up critical thinking skills, promoting self-efficacy in trainees, and more!Tune in to learn how to become an exceptional preceptor and make a positive impact on the next generation of nurses!Topics discussed in this episode:Qualities of a good preceptorHow to promote self-efficacy in traineesThe importance of establishing expectationsEffective teaching strategiesGoal setting and building confidenceHow to handle difficult traineesWhy preceptors are crucial to the professionMentioned in this episode:Rapid Response Academy LinkWanna 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

The summer heat brings fun in the sun, relaxing days, and even the threat of heat stroke. In this episode, host Sarah Lorenzini explores the spectrum of heat-related illnesses, highlighting the crucial differences between heat stroke and heat exhaustion. She recounts an emergency case of a young man with all the classic symptoms of heat stroke — and the highest temperature of any patient she’s ever seen.Sarah delves into the complications that can arise from heat stroke and effective treatment protocols for cooling down patients. You’ll learn about the factors that increase the risk of heat stroke, the danger zone of hyperthermia, and how to prevent hypothermia during the treatment of heat stroke.Listen to this episode to learn more about recognizing and managing heat stroke!Topics discussed in this episode:Heat stroke case studyDifferentiating heat stroke from heat exhaustionSigns and symptoms of heat strokeEmergency steps for treating heat strokeRisk factors of heat strokeCheck out the EM Cases episode about heat stroke:https://emergencymedicinecases.com/em-quick-hits-september-2021/Read Dr. Swaminathan's article on environmental hyperthermia:https://coreem.net/core/environmental-hyperthermia/Mentioned in this episode:Rapid Response Academy LinkWanna 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

When the diseased liver is unable to filter out neurotoxins like ammonia, we can see a spectrum of the neuropsychiatric symptoms of hepatic encephalopathy.  For the final installment in our liver failure series, host Sarah Lorenzini highlights a complicated case of hepatic encephalopathy where critical thinking and interdisciplinary teamwork were key to preventing further complications.She examines the common signs and symptoms of hepatic encephalopathy, factors that trigger or exacerbate the condition, and challenges nurses face in the diagnostic process. This episode also dives into treatment strategies and how to differentiate between hepatic encephalopathy and alcohol withdrawal.Tune in to learn how cirrhosis can lead to hepatic encephalopathy, the effect of neurotoxins in the brain, and how you, as a nurse, can manage patient care!Topics discussed in this episode:Assessment of Sarah’s rapid response consult patientThe team’s interventions and patient outcomePathophysiology of hepatic encephalopathySigns and symptoms of hepatic encephalopathyDiagnostic challenges and aggravating factorsStrategies to manage hepatic encephalopathyHepatic encephalopathy versus alcohol withdrawalMentioned 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 syndromePathophysiology of hepatorenal syndromeDiagnostic and treatment strategies for hepatorenal syndromeKey takeaways for nurses

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 esophagusChallenges of giving blood transfusions to liver failure patientsPharmacological interventions: octreotide, antibiotics, and beta-blockersProcedural interventions: endoscopic variceal ligation, TIPS procedure, and balloon tamponadeListen 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=1000633582257To 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 LinkWanna 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

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 hypotensionPathophysiology of cirrhosis and its complicationsManagement of spontaneous bacterial peritonitisRole of nurses in liver failure patient careMentioned in this episode:Rapid Response Academy LinkWanna 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

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_competencyConnect 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 plansBridging theory and practice in critical care educationUtilizing care plans in during critical care scenariosPracticing critical care thinking and decision makingIdentifying key traits of exemplary nursesThe importance of continuous learn and growth in nursingConnect 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 careerWhat it means to be a good educatorRewards and challenges of being a nursing educatorRedefining nursing educationA day in the life of a nursing educatorNursing education as an act of justiceThe future of nursing educationLearn 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/nursepatmacrnhttps://www.tiktok.com/@patmacrnMentioned 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 toolsDiagnosing obstructive shock due to pulmonary embolismTreating obstructive shock due to pulmonary embolismTreatment implications for major causes of obstructive shockDiagnosis and treatment of tension pneumothoraxTreatment strategies for cardiac tamponadeKey takeaways on obstructive shock managementCheck 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/id1491559787How Not to Kill Your Patient: https://podcasts.apple.com/us/podcast/how-not-to-kill-your-patient/id1612099061Nurse Dose Podcast: https://podcasts.apple.com/us/podcast/nurse-dose-podcast/id1486427611The Q Word Podcast: https://podcasts.apple.com/us/podcast/the-q-word-podcast/id1407523803Straight A Nursing: https://podcasts.apple.com/us/podcast/straight-a-nursing-study-for-nursing-school-exams-nclex/id1210975738Up My Nursing Game: https://podcasts.apple.com/us/podcast/up-my-nursing-game/id1527032817Mentioned in this episode:Rapid Response Academy LinkWanna 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 familiesMisconceptions of family presence during resuscitationThe role of a family presence facilitatorBest practices and avoiding common mistakes as a FPFAdvocating for family presence in your hospitalStories that demonstrate the impact of family presenceHow to overcome resistance to family presenceRead 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-ResuscitationLearn 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-practContact Margo Halm at [email protected]!Mentioned in this episode:Rapid Response Academy LinkWanna 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 DIThe pathophysiology of SIADH and DIDiagnostic approaches and key lab valuesTreatment and management of SIADHTreatment and management of DILessons from SIADH and DI patient storiesCheck out Nick's course over at Critical Care Academy!🔗 https://www.ccrnacademy.com?ref=sarahlorenziniConnect with Nick McGowan:https://www.instagram.com/critical_care_academy/https://www.youtube.com/@criticalcareacademy8312https://www.facebook.com/CCRNacademyhttps://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:PropofolSuccinylcholineRocuroniumVecuroniumEtomidateKetamineFentanylMidazolam___________________You can check out the following from Nurse Mo:Full Transcript – Read the article and view referencesFREE 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

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 NPPros and cons of working as a nurse practitionerFinding passion and alignment in your careerExploring a career as an NP The flexibility of a nursing careerListen to Sandra's Podcast:https://podcasts.apple.com/us/podcast/the-success-nps-podcast/id1566107516Check out Sandra's Website:https://successnps.com/Follow Success NP's on Social Media:YouTube: ⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/channel/UCYQYlS9d6m7HyMK7Z1BI5DAInstagram: ⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/thesuccessnpsMentioned in this episode:Rapid Response Academy LinkWanna 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-careCelebrating your nursing winsPreventing burnout through learningMentorship and driving changeListen 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 LinkWanna 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 caseThe pathophysiology of hyponatremiaCauses of hyponatremiaTypes of hyponatremia: hypertonic, hypotonic, and isotonicHyponatremia 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 studyThe pathophysiology of takotsubo cardiomyopathyDiagnosing takotsubo cardiomyopathyHow to effectively treat takotsubo cardiomyopathyFinal takeaways for nursesListen 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=1000637926574Mentioned in this episode:Rapid Response Academy LinkWanna 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 asthmaSigns of asthma exacerbationTreating a progression of asthma symptomsThe danger of silent chestAdvanced interventions for status asthmaticus Tips for sedation and intubationUnderstanding your role as a nurseRead 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=1000630431016Mentioned in this episode:Rapid Response Academy LinkWanna 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 patientThe patient’s escalating condition and challenges in careUnpacking every tool in the asthma treatment toolboxManaging complications from autopeep to pneumothorax to cardiac arrestKey takeaways from this patient caseMentioned in this episode:Rapid Response Academy LinkWanna 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. DMeasuring and interpreting pulse pressureCauses of narrow pulse pressureCauses of wide pulse pressureThe case study of Mr. SLimitations to pulse pressureUsing pulse pressure as a diagnostic toolMentioned 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. FieldsUnderstanding shock indexHow to calculate shock index… the easy wayClinical applications of shock indexLimitations of shock indexLearn 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%20pregnancyMentioned in this episode:Rapid Response Academy LinkWanna 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 patientComponents of BRASH SyndromeHow BRASH developed in Sarah’s patientTreatment and management of BRASH SyndromeThe role of calcium in treatment of BRASHYou 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 LinkWanna 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 alertAssessing the patient and preparing for a stroke alertThe NIH Stroke ScaleCriteria for thrombolytic treatmentWho makes a good candidate for thrombectomyTreating patients who don’t qualify for a thrombolyticMentioned 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!

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 outputAdrenergic and vasopressin receptorsVasopressor types and medicationsMentioned 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 LinkWanna 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!

As host Sarah Lorenzini insightfully explains, “think of autonomic dysreflexia symptoms as the body's way of telling you something is wrong.” Autonomic dysreflexia is a medical emergency that occurs in patients with a spinal cord injury, but it can be hard to recognize because of the body’s confusing responses to stimulation. That’s why it’s crucial for nurses to understand this syndrome and prevent patients from developing any life-threatening complications.In this episode, host Sarah Lorenzini gives listeners an inside look at a case of autonomic dysreflexia in a quadriplegic patient. She breaks down the patient’s symptoms, medical history and presentation, then shares what helped her recognize the signs of autonomic dysreflexia. As she dives into the pathophysiology of autonomic dysreflexia, you’ll gain a better understanding of this syndrome, including how to manage the symptoms and treat patients.At first perplexed by this case, it was Sarah’s knowledge and critical thinking that led her to suspect autonomic dysreflexia. Tune in now and take notes so you can diagnose autonomic dysreflexia and deliver timely intervention the next time you encounter it!Topics discussed in this episode:The patient’s symptoms and initial assessmentIdentifying the problem and starting treatmentUnderstanding autonomic dysreflexiaCauses and management of autonomic dysreflexiaMentioned 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!

Goals of care discussions are among the most difficult to navigate as a nurse, BUT there are ways to provide both comfort and clarity to patients and their families in these emotionally charged situations.In this episode, host Sarah Lorenzini and Hospice Nurse AJ share tips and insights on how to approach these challenging discussions with sensitivity and respect, all while keeping patient’s wishes at the forefront of treatment. From how to start the conversation to addressing concerns, they cover strategies for approaching family members in person or on the phone.This episode explores not just the words and phrases nurses should employ, but also the compassion that patients and their families need as they step into the grieving process. AJ and Sarah also discuss how to handle various scenarios, including ones where the family is in disagreement or is struggling to make a decision on care.After listening, you’ll have skills necessary to navigate the nuances of communicating effectively about goals of care and balancing clinical objectives with empathy. Tune in to learn how to have clear, compassionate goals of care discussions!Topics discussed in this episode:How to start the conversation on goals of careThings to say to the family and things to avoidWhat DNR means for end of life careDealing with conflicting family opinionsCommunicating with family by telephonePreparing the family to see critically ill loved onesA nurse’s role in facilitating the family’s grieving processMentioned 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!

Orienting as a new Nurse in the ICU is much like climbing your first big mountain — both require basic knowledge, passion, and the ability to learn quickly and adapt in a demanding environment. But without these attributes, you have an arduous, possibly insurmountable journey ahead of you.In this episode, host Sarah Lorenzini and Sarah Vance RN delve into the controversial topic of new grads going straight into the ICU after graduation, exploring the challenges and opportunities it presents for new nurses. They discuss the essential skills and mindset needed to thrive in such an intense setting, emphasizing the crucial role of self-care and support for success in the ICU.This episode answers common questions from Rapid Response RN listeners, including “what types of people do well in the ICU, and what types of people struggle? What can I do to prepare for a job in the ICU? What are the most common struggles of nurses in the ICU, and how can they mitigate those challenges?”As a critical care nurse and educator, Sarah’s insights will help you assess your readiness for joining the exciting but challenging world of the ICU. Tune in now!Topics discussed in this episode:The debate around new grads joining the ICUWhat type of people who do well in the ICUChallenges new grads face in the ICUHow to prepare for a job in the ICUNavigating the common struggles of ICU nursesThe importance of learning from your mistakesWatch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videosConnect with Sarah Vance!Instagram: https://www.instagram.com/iseeu_nurse/TikTok: https://www.tiktok.com/@iseeu_nurseWebsite: https://iseeunurse.com/

What’s your craziest, most shocking nursing story? In this episode, you’ll hear one of host Sarah Lorenzini’s most memorable stories as a rapid response nurse!Sarah recounts her experience treating a severe case of a prolapsed rectum, describing the unconventional yet effective approach that not only resolved the medical dilemma but caught the attention of Rapid Response RN listeners, becoming the most shared episode of the podcast!As Sarah delves into this case of rectal prolapse, she explains the science behind using sugar as treatment and important lessons learned from her experience with these rectal prolapse emergencies. Tune in now!Topics discussed in this episode:How Sarah responded to a patient’s severe case of prolapsed rectumPathophysiology of rectal prolapseUsing sugar to reduce prolapseKey takeaways from Sarah’s experienceMentioned in this episode:RRA mid december ad 2023If you want to learn more about the Rapid Response Academy: The Heart and Science of Caring for the Sick... you can click here https://www.rapidresponseandrescue.com/community to find out more and sign up.

Foreign objects in the bladder, urinary retention, priapism. These are just a few of the urological emergencies host Sarah Lorenzini is discussing with Dr. Shailen Sehgal!Nurses are the first line of defense in treating emergencies and play an important role in managing their care. In this episode, Dr. Shailen Sehgal explores these emergencies and shares great tips and tricks to treat conditions like testicular torsion, assess for hematuria, and troubleshoot catheter insertions, bladder spasms, and more.Sarah’s conversation with Dr. Shailen Sehgal highlights the pivotal role of nurses in treating urological emergencies that require quick intervention. After listening, you’ll have a deeper understanding of common urological challenges and better be able to decide when it’s time to stop troubleshooting and call the urologist.Tune in now to learn from Dr. Shailen Sehgal’s expertise and insights!Topics discussed in this episode:Dr. Shailen Sehgal’s interesting urological casesThe role of nurses in urological emergenciesHow to diagnose and manage testicular torsionTroubleshooting Foley catheters and Coude cathetersTips for female catheter insertionDealing with catheter leakageContinuous bladder irrigation (CBI)Advice on caring for urology patientsDr. Shailen Sehgal attended medical school at Cornell University and did his urology residency at the University of Pennsylvania. His fellowship in robotic/minimally invasive surgery was also completed at the University of Pennsylvania.  His clinical research fellowship was done at the National Institutes of Health.  He is board certified by the American Board of Urology. He practices urology and urologic surgery in Western Pennsylvania and West Virginia.Dr. Shailen Sehgal, MD is one of the founders of UroCoach, a comprehensive library of urology education videos, free to the public. In these videos, urology topics are explained by practicing urologists in easy-to-understand language for patients, nurses, trainees, and anyone interested in urology!https://youtube.com/@UroCoachhttps://www.instagram.com/urocoaches/https://www.tiktok.com/@urocoachhttps://www.facebook.com/profile.php?id=100090540351025Mentioned in this episode:RRA mid december ad 2023If you want to learn more about the Rapid Response Academy: The Heart and Science of Caring for the Sick... you can click here https://www.rapidresponseandrescue.com/community to find out more and sign up.

Snake bite care: where the cost and long-term complications can sting harder than the bite.Managing snake bites requires quick intervention, making it crucial for nurses to understand how to navigate this type of emergency. So in this episode, host Sarah Lorenzini welcomes Sealy RN to share her firsthand experience of being bitten. As a nurse who has also treated snake bites, she has great insights on the challenges of snake bite care.Sarah and Sealy discuss the use of antivenom, specifically the short and long-term risks of CroFab, what can happen if a snake bite is left untreated, and the role of nurses in snake bite management.Sealy's story highlights the importance of prompt and informed treatment, taking charge of your own care and advocating for patients. Plus, you’ll find out what steps you should (and shouldn’t) take if you get bitten by a snake.Tune in to learn everything you need to know from a nursing and patient perspective!Topics discussed in this episode:Sealy’s snakebite storySnake bite treatment and the recovery processSnake bite symptoms and possible complicationsWhat to do when you’ve been bittenTakeaways from Sealy’s experienceDownload the SnakeBite 911 app:https://crofab.com/crofab-resources/snakebite911

How does AFib RVR escalate into a life-threatening situation in just 30 minutes?Join host Sarah Lorenzini as she reflects on a perplexing case of sympathetic crashing acute pulmonary edema, also known as flash pulmonary edema. This patient’s rapid deterioration led to an emergency intubation that perplexed the rapid response team, but the patient's true condition became clear in hindsight.In this episode, Sarah walks us through the case, sharing the patient's presentation and medical history, how the team treated his symptoms, and why their initial interventions failed. She delves into the pathophysiology of SCAPE, the patient’s progression into sympathetic surge, and his ultimate treatment.Tune in to learn from Sarah’s look back at this patient story!Topics discussed in this episode:Sarah’s complex A-Fib RVR patient storyReflecting on the patient’s treatment and hindsight lessonsThe progression of sympathetic crashing acute pulmonary edema (SCAPE)Causes of SCAPE and stopping the spiral towards deathManaging SCAPE (what to and not to use)Case summary and key takeawaysMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Host Sarah Lorenzini and Christian Guzman APRN are back to conclude this three-part heart failure series by examining the use of mechanical circulatory support for cardiogenic shock. This episode expands on the topics covered in previous parts, focusing on the application of mechanical circulatory support methods like the intra-aortic balloon pump, Impella, CentriMag, LVADs, and ECMO.Christian and Sarah review the risks and benefits of each device, when to use them, and the key factors that impact these decisions. They also address the ethical challenges of ECMO, including the clinical judgment involved when determining who’s a good candidate and when to escalate care.By the end of this episode, you’ll understand how these devices function, their critical role in managing cardiogenic shock in heart failure patients, and the value nurses bring to a multidisciplinary team.Tune in for a knowledge-packed finale of this comprehensive heart failure series!Topics discussed in this episode:The role of mechanical circulatory support devicesBenefits and risks of the intra-aortic balloon pump and Impella deviceHow to properly use Impella devicesCentriMag and Left Ventricular Assist Devices (LVADs)The evolution of permanent LVADsExtracorporeal Membrane Oxygenation (ECMO) for cardiac supportChallenges and ethical considerations of ECMOThe importance of nursing knowledge and confidenceConnect with Christian Guzman APRN on Instagram:https://www.instagram.com/thenerdynursepractitioner/Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videosMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Building on last week’s introduction to heart failure, this episode explores the nuances in the medical management of cardiogenic shock. Host Sarah Lorenzini and Christian Guzman APRN continue this three-part heart failure series by completing the case study of a patient in cardiogenic shock, and breaking down key treatment concepts and strategies.They discuss goal-directed therapy to optimize heart function, with a specific focus on the vital aspects of contractility, afterload, and preload, and their pivotal roles in patient care. As their conversation progresses, they delve into the use of medical interventions, covering the pros and cons of medications used to treat heart failure at each stage from beginning to extremis.Christian and Sarah go beyond what you’ll read from textbooks, shedding light on the challenges and clinical decision-making process of heart failure care by sharing real life examples and insights.Tune in now to learn how to assess patients for cardiogenic shock and manage their care at every stage of heart failure!Topics discussed in this episode:The treatment of last week’s patientGoal-directed therapy for heart failureMethods to increase contractilityPreload optimizationThe use of inotropes in heart failure managementAssessing patients for cardiogenic shockWhen to use beta blockers for heart failureWhen to pull the trigger for mechanical circulatory supportConnect with Christian Guzman APRN on Instagram:https://www.instagram.com/thenerdynursepractitioner/Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videosMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

During a normal day gardening, an active woman in her 60s was suddenly struck with chest tightness. Thinking it was just an asthma attack, she tried to let the pain pass. What she didn’t realize was that she was having a full blown myocardial infarction, and this was only the beginning of her journey.In this episode, host Sarah Lorenzini is joined by her friend, Christian Guzman APRN, to discuss this patient story and the pathophysiology of heart failure. As they go through this case study, Christian provides a comprehensive breakdown of the types of heart failure, the classifications of heart failure, and how chronic heart failure can lead into cardiogenic shock.Most importantly, you’ll learn the signs and symptoms of heart failure, including the subtle ones that are key for early detection, and find out what’s important to look at on an echocardiogram.This is just the first installment of a three-part series on heart failure, so be sure to not miss this opening episode. Tune in now!Topics discussed in this episode:Pathophysiology of heart failureCase study of Christian’s heart failure patientMyocardial infarction symptoms in womenTypes of heart failureSymptoms of right vs left heart failureThe difference between systolic vs diastolic heart failureHow chronic heart failure develops into cardiogenic shockEarly signs of heart failureSCAI classifications of cardiogenic shockConnect with Christian Guzman APRN on Instagram:https://www.instagram.com/thenerdynursepractitioner/Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videosMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Have you ever started a new and promising job, only to discover that it wasn’t the nurturing and supportive space you thought it was? In this episode, host Sarah Lorenzini, armed with nearly two decades of nursing experience in various departments and leadership roles, provides a guideline to spotting the red and green flags that can signal a healthy or hostile workplace.Sarah explores what makes a healthy work environment, beyond reputation and first impressions, as she does a deep dive into the American Association of Critical Care Nurses' (AACN) six pillars of a healthy work environment. From communication to authentic leadership, she equips both new and seasoned nurses with strategies to assess key characteristics of prospective employers and identify signs of a healthy culture.For those dedicated to their current organization but seeking a better work culture that allows them to grow in their role, Sarah also reveals how nurses can promote positive change in their current work environment.Tune in to hear the essential interview questions you should be asking to evaluate potential work environments and make an informed career decision!Topics discussed in this episode:The AACN's standards for a healthy work environmentExamples of an unhealthy work environmentHow leaders affect work cultureIdentifying red flags in potential work environmentsIdeas to improve your current work environmentCheck out the AACN’s Healthy Work Environments website: https://www.aacn.org/nursing-excellence/healthy-work-environmentsMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

You may already be familiar with the trauma triad… but in this episode, host Sarah Lorenzini is once again joined by her friend and critical care nurse and educator, Sarah Vance to break down a 4th component to trauma resuscitation. Last week, they discussed the treatment of a trauma patient with neuro and respiratory injuries, but today they’re getting into the “blood and guts” of trauma cases as Sarah Vance RN walks us through a multiple gunshot wound case study. Similar to last week’s patient, this case study highlights how the body’s systems all work together, and sometimes against each other, in trauma cases.Sarah’s GSW patient’s injuries resulted in massive blood loss, leading to rounds of MTP (massive transfusion protocol), but treating blood loss is more complex than just replacing blood so we’re diving into the pathophysiology of hypothermia, coagulopathy, hypocalcemia, and acidosis — all components of the trauma diamond of death.As a nursing educator, Sarah Vance RN is the best person to break down these challenging concepts and make them easy to understand. You’ll learn why they happen in trauma cases, how they impact each other, and what you can do to fix these issues and prevent death.By the end of this episode, you’ll have the knowledge you need to manage the treatment of a trauma patient with major blood loss. Tune in now!Topics discussed in this episode:Components of the trauma diamond of deathSarah’s trauma patient and his treatment MTP, or Massive Transfusion ProtocolWhat causes hypothermia in trauma patientsHow to support coagulopathy and why it’s importantHypocalcemia and the role of calcium in the bodyManaging calcium levels in trauma cases Acidosis and its place in the diamond of deathKey lessons from this patient’s caseWatch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videosConnect with Sarah Vance!Instagram: https://www.instagram.com/iseeu_nurse/TikTok: https://www.tiktok.com/@iseeu_nurseWebsite: https://iseeunurse.com/Mentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

If you hear “trauma” and immediately think of blood and guts, this episode with host Sarah Lorenzini’s friend, critical care nurse and educator Sarah Vance, will show you that there’s so much more to trauma cases. Because even localized injuries can affect the whole body, and issues can pile up and require conflicting treatments. That’s why trauma cases require an advanced level of assessment and critical thinking skills.During this episode, Sarah Vance RN tells the story of a patient who was admitted with a brain bleed, orthopedic, and cervical injuries after a motorcycle accident. Like many trauma cases, the patient’s condition got a lot more complicated as his injuries progressed and he sustained secondary injuries within the respiratory system. The patient had a long list of issues, including traumatic head injury, ARDS, fistulas, necrotizing pneumonia, and MORE.Sarah Vance also goes into more detail on his pathophysiological injuries, as well as how the ICU team assessed and treated his competing issues to lead the patient to a miracle recovery. Tune in to learn about the management of complex multisystem trauma cases!Topics discussed in this episode:Sarah’s career journey and why she took a break from nursingThe trauma patient’s injuries and the initial interventionsThe ICU team’s concerns and how his care evolved as more damage set inWhat prompted them to place an external ventricular drainHow the patient developed ARDSHow the ICU team treated the patient’s opposing issuesThe patient’s long journey to recoveryConnect with Sarah Vance!Instagram: https://www.instagram.com/iseeu_nurse/TikTok: https://www.tiktok.com/@iseeu_nurseWebsite: https://iseeunurse.com/Mentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Every nurse knows the havoc chemotherapy wreaks on the body, but most nurses aren’t as knowledgeable on how to treat chemo reactions as, say, chemo or oncology nurses. Even host Sarah Lorenzini is slightly intimidated by unpredictable reactions from chemotherapy! That’s why this episode is centered around those super scary chemotherapy reactions and how to treat them.To help us dive further into this topic, Sarah is speaking with another rapid response nurse, Montana RN. He has a dramatic patient story to share about rigors, a chemotherapy reaction that occurs as the body is trying to mount a febrile response to the medication. Not only was his patient visibly struggling, but he was hypoxic and there was no doctor available to prescribe medication to treat the reaction.As Montana and Sarah study this patient’s case, you’ll find out what type of reaction the patient was having and walk away with the knowledge of how to treat chemotherapy reactions and their symptoms, the use of desensitization procedures for reactions to chemo agents, and why it’s important to know your hospital’s chemo reaction protocol.There’s so much to learn about chemotherapy reactions and the nurse’s role in caring for this patient population during a really scary experience.Topics discussed in this episode:What led Montana to become a rapid response nurseHow the patient presented and his initial assessmentWhat rigors looks like and the pathophysiology behind this scary looking symptomTreatment options for rigorsWhy Montana had to bring the patient to the ERHow to treat a reaction and its symptomsThe patient’s treatment and outcomeMontana’s takeaways from this experienceMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

In this episode of Rapid Response RN, host Sarah Lorenzini is joined by Casey BSN, RN, CCRN-CMC, CFRN, CTRN, CEN, TCRN, CPEN, CNRN, NRP. And yes, you read her title right — Casey has a whopping eight certifications and is one of the few nurses with ALL five BCEN certifications. And she’s using her knowledge and skills to advocate for her patients and teach others.Today, Casey tells the story of a patient who came into the ER after a fall and was later diagnosed with a basilar skull fracture. Complicating the case even more is that the patient was a child under the age of 2, so it was more difficult to assess the signs of his injury. Casey’s hospital provider dismissed the fall as normal childhood injury, but she did what any good nurse would do and followed her hunch that something more was going on.Casey shares how the patient presented, how they arrived at the diagnosis and treated him. You’ll also learn the telltale signs and symptoms of basilar skull fracture, and how to check for signs of abuse if you see a pediatric head injury.Tune in for a lesson in pediatric basilar skull fractures, and advocating for your intuition as a new nurse!Topics discussed in this episode:Casey’s nursing journey to earn so many certificationsWhy Casey’s patient came into the ER and how he presentedWhat made her think something more was going onResults of the patient’s CT and their diagnosisClassic signs and symptoms of basilar skull fracturesHow to assess mental status in childrenDetermining if injury is a sign of child abuseHow they treated the patient for a basilar skull fractureWhat nurses need to prioritize when treating a basilar skull fractureConnect with Casey:https://www.instagram.com/criticalcarecasey/Mentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Intubation is a life-saving intervention, but it can also kill your patient! That’s why this follow-up episode to last week’s patient story is covering the process of intubation, what can go wrong and how nurses can mitigate risk factors to avoid bad outcomes like cardiac arrest.In part two of this intubation series, host Sarah Lorenzini details proper intubation preparation and the role of nurses during intubation. She walks through the entire process from assembling a team to what supplies and medications you need, and how to use them so that you reduce harm to the patient. You’ll hear about key factors to consider when giving patients sedative or paralytic agents, as well as how to prepare for a blood pressure drop after intubation.This episode is full of useful information that will help you during your next intubation, such as pre-oxygenation strategies, RSI (rapid sequence intubation) vs when to opt for DSI (delayed sequence intubation), and how to mitigate some of the negative side effects that go along with these drugs.Plus, find out how Sarah’s patient story from last week’s episode ends. Tune in for all this and more!Topics discussed in this episode:The dangers of intubation, such as peri-intubation cardiac arrestWhat it means to intubate and how to prepare for intubationWhy and how to preoxygenate your patientSupplies and equipment needed for intubationThe medications we use for intubation and what to expect once you push themThe pathophysiology of why BP drops after intubationHow to prepare for a drop in blood pressure post-intubationWhen to opt for delayed sequence intubationThe intubation story of last week’s patientMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Patients get intubated in every department of the hospital… not just the ICU.  So it’s important that every nurse know the signs and symptoms of when it’s time to intubate.Our host Sarah Lorenzini, has been asked the same type of questions about intubation multiple times this week, so we felt it was necessary to address them. Sarah’s extensive knowledge and experience in critical care and rapid response situations has prepared her to be able to provide expertise and insights on this topic, which she wants to share with all of you today!In this episode, Sarah addresses some common questions related to intubation: how to know when it's time to intubate a patient and what it means when a patient is not protecting their airway.She shares a story from her own experience to illustrate the importance of recognizing the signs that indicate the need for intubation and walks through some of the obvious, and not so obvious signs that it’s time to intubate.This episode is packed with experiential knowledge that you don’t want to miss. So tune in for this and more!Topics discussed in this episode:Signs to look for to determine when to intubateHow to recognize when a patient is not protecting their airwayWhat to do when patients are working too hard or not hard enough to improve their oxygen saturationRecognizing patients who cannot oxygenate or ventilate on their ownLooking beyond the vital signs and focusing on the clinical presentation to determine if a definitive airway is neededThis episode was produced by Podcast Boutique https://www.podcastboutique.comMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

September is Sepsis Awareness Month, so host Sarah Lorenzini is throwing it back to one of the earliest Rapid Response RN podcast episodes with guest Yesha APRN. This episode tells the story of a patient with sepsis, and it’s one of Sarah’s favorite episodes because it exemplifies all of the classic signs and symptoms of sepsis as well as the important role the nurse plays in caring for septic patients.Last week, you learned about fluid resuscitation and the potential harm of fluid overload in the treatment of sepsis. In this episode, you’ll hear how Sarah and Yesha’s patient responded to fluid boluses and what made them advocate for a different treatment approach.Sarah then goes deeper into the pathophysiology of sepsis, indicators of sepsis using SIRS criteria and the qSOFA score, and more indicators any nurse can test without a tool. You’ll also find out how to treat a patient with sepsis, which diagnostics to run, and what you can do to promote a return to homeostasis in your patient.Tune in to learn the signs and symptoms of sepsis and septic shock, and how to facilitate early detection. Plus, hear Yesha’s takeaways from this patient story that will benefit all nurses in their treatment of sepsis!Topics discussed in this episode:Yesha’s nursing journey and updates on her careerHow Yesha’s patient presented and his response to fluid administrationWhat made her decide to call a rapid response nurse, SarahSarah’s assessment of the patient and how they treated himThe pathophysiology of sepsisSIRS criteria and qSOFA score for prediction of sepsisWhat happens in the “septic inflammatory cascade of awfulness”How to detect sepsis earlyTreatment and management of a sepsis patientRead the article, “Fluid selection & pH-guided fluid resuscitation” by Dr. Josh Farkas, here:https://emcrit.org/ibcc/fluid/Mentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Often when a patient’s blood pressure has dropped, we administer fluids without truly knowing the exact reason for the change. Does the patient have low volume, were they vasodilating, or is their heart not squeezing effectively? Fluid resuscitation is not always the answer, but there’s no clear guideline to assess patients without advanced tools that take time and specialists. Enter the FloPatch from Flosonics, an innovative device that quickly measures blood flow in real time.Fluids can cause damage when given in excess, so it’s crucial for nurses to understand why blood pressure isn’t an adequate indicator of fluid responsiveness, and how a patient can show signs of fluid responsiveness but cardiac output is not increasing. That’s why host Sarah Lorenzini is speaking with Corinne RN to find out more about how Flosonics is helping nurses guide their fluid resuscitation using the portable FloPatch device.In this episode, Corinne shares patient stories to exhibit how FloPatch can improve patient outcomes, especially in those with sepsis. Corinne and Sarah also discuss the concept of Frank-Starling’s law, the components of stroke volume, and MORE.FloPatch can help you assess patients and provide precise care. Tune in to find out how it works, the benefits of the product, and why you want to use it at your hospital!Topics discussed in this episode:How Corrine RN became so passionate about fluid resuscitationWhy blood pressure isn’t the best tool for determining cardiac outputFactors that influence blood pressureThe relationship between preload, afterload, and contractilityThe consequences of fluid overloadExamples of how FloPatch can improve patient careFloPatch is a game-changing advancement in precision fluid management for critical care, particularly in the management of sepsis. As the world's first wireless, wearable Doppler ultrasound technology, it provides real-time, non-invasive assessments of arterial and venous blood flow. FloPatch empowers clinicians at the bedside to make rapid, data-driven decisions on fluid resuscitation, mitigating risks of complications such as pulmonary edema and acute kidney injury. FloPatch holds the potential to transform the way clinicians approach and manage hemodynamic assessments, paving the way for increased clinical confidence for more efficient, effective, and patient-centered care.Visit their website to learn more and request a demo: https://flosonicsmedical.com/Share this podcast episode with your colleagues to spread the word about FloPatch.Follow FloPatch on Instagram, Twitter and LinkedIn for the latest updates and clinical insight:Instagram: https://www.instagram.com/flopatch_/Twitter: https://twitter.com/Flosonics/LinkedIn: https://www.linkedin.com/company/flosonics-medicalHave questions for Corinn? Email her at [email protected] the Sepsis Alliance Summit 2023 during Sepsis Awareness Month! This virtual event is hosted on September 27th to 28th. Learn more here: https://learn.sepsis.org/virtual-conferenceMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

We often are looking for an acidosis when patients present with lethargy but what about when it’s an alkalosis!? In last week’s episode with Annie Fulton RN of the “Up My Nursing Game” podcast, she and host Sarah Lorenzini presented a patient story but left the diagnosis a mystery.  You heard why Annie’s patient was admitted and her initial assessment, what caused her to think something more was going on, and why she ruled out sepsis as a diagnosis. Now, find out what her diagnosis was and how she was treated! Hint: today, we’re talking all about diuretic induced metabolic alkalosis.To start off this episode, Annie recaps her patient’s story, walks us through the patient’s VBG results, and how they arrived at a diagnosis of metabolic alkalosis. Sarah then breaks down the pathophysiology of diuretic induced metabolic alkalosis, including what causes it at the cellular level and how to treat the condition. They specifically talk about contraction alkalosis, and how it’s possible for a patient to be both intravascularly dry but extravascularly still fluid volume overloaded.Sarah and Annie also discuss the patient’s mild leukocytosis, the clinician’s decision to NOT prescribe antibiotics after a positive urinalysis, and their thoughts on antibiotic stewardship and critical thinking in diagnostics.Listen to part two of this mystery series to find out how to treat metabolic alkalosis from diuretics, and find out if there’s anything you can do to look out for its symptoms! Topics discussed in this episode:How Annie’s patient presented and her initial treatmentThe results of the patient's VBGWhat can cause metabolic alkalosis and its symptomsIntravascular vs extravascular fluid volume statusContraction alkalosis and how to treat itHow Annie’s patient was treatedThe right time to stop and start diuresis on a patientWhy the patient’s clinician declined to give antibioticsThe debate on sepsis mimicsListen to Annie Fulton’s Up My Nursing Game Podcast: http://www.upmynursinggame.com/Connect with Annie Fulton on Instagram: https://www.instagram.com/upmynursinggame/Mentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/community

Can you guess what was causing this patient’s unexpected symptoms?This episode is a little different from the rest, thanks to you, our listeners, for submitting your suggestions and ideas for how these episodes should go, because we are all ears!One of our listeners suggested we do a mystery episode (thanks Shannon!), and we thought it was brilliant! So, on today’s episode, our host Sarah Lorenzini invites back, podcast host of Up My Nursing Game, registered nurse, friend, and former Rapid Response RN Podcast guest, Annie Fulton, to unravel a patient case study of one of Annie’s patients, but we won’t be revealing the diagnosis just yet.Sarah and Annie discuss why the patient was admitted to the hospital, Annie’s initial analysis of the patient, medications that were administered, the patient’s vital signs, and physical assessment findings, as well as when and why Annie became concerned for the patient and why she had ruled out sepsis from the diagnosis.In this mystery episode, we won’t be giving away the actual diagnosis.  Instead, for this week we will be leaving you all to try and guess what you think the diagnosis is, and we will reveal the answer in next week’s episode!Tune in to hear about Annie’s patient, and be sure to check out next week’s episode for the diagnosis reveal! Topics discussed in this episode:A little bit about Annie and how her and Sarah metWhat Annie’s patient was admitted forAnnie’s initial assessment of her patientWhat caused Annie to realize something was wrong with her patientThe patient’s vital signs and how she was flagged for SIRSWhy Annie didn’t think the patient had sepsisListen to Annie Fulton’s Up My Nursing Game Podcast: http://www.upmynursinggame.com/Connect with Annie Fulton on Instagram: https://www.instagram.com/upmynursinggame/

“If you look for the bad, you’ll always find it. If you look for the good, you’ll always find it.” - Sarah’s grandmotherIn the second part of our two part series on nursing burnout, our host Sarah Lorenzini continues her conversation with Nurse Burnout Coach Janna Holterman, where they discuss how to reframe your mindset as a nurse to deal with burnout.We go to nursing school because we want to help people who are suffering and provide care on a heart centered level, not just by fulfilling tasks and making sure patients are getting their medication on time. It’s easy to lose sight of that if you’ve been at it for a while, so reminding yourself to look for those special moments to create beauty in your job as a nurse, is crucial to avoiding burnout and staying fulfilled.This is what Sarah and Janna discuss in today’s episode to hopefully provide some insight for those who are experiencing burnout or are almost there. Being aware of burnout and how to deal with it is important, not only for you as a nurse to provide the best care possible, but for your own health, longevity, and overall quality of life.So tune in for a discussion on how to find the beauty in nursing again so you can be the much needed light in a dark room.Topics discussed in this episode:How to balance being passive vs. taking a stancePracticing feeling neutralThe need for nurses to see their patient get betterImportance of looking for the beauty in nursingThe difference between a life coach, therapist, counselor, and fitness trainerWhat Janna has to say to nurses who are burnt outLearn more about Nurse Janna and her burnout coaching services on her website! www.jannaholterman.comConnect with Nurse Janna on Instagram: https://www.instagram.com/jannaholtermancoaching/

Nurses are trained to put their patients first, and that oftentimes results in forgoing their own needs. Skipping out on fundamental needs like sleeping and eating healthy meals lead nurses to feel emotionally and physically exhausted, eventually leading to burnout and loss of love for the job.Nurses spend so much time advocating for patients but forget that it’s equally as important to advocate for themselves. As today’s guest will remind you, “what you resist persists.” Even if you have the ability to push your own needs to the side, they will always catch up with you, whether it’s in the form of an emotional breakdown or apathy towards other parts of your life.Host Sarah Lorenzini is speaking with Nurse Burnout Coach Janna Holterman in a special two-part series! In this first episode, Janna shares her personal experience with burnout, the symptoms of burnout, and how she helps clients address them.Janna and Sarah go over tools for overcoming burnout, and how to recognize you’re experiencing burnout and not just normal stress.If you’re in search of the “perfect” nursing job, stop looking now because there isn’t one. However, YOU have the power to love nursing again and leave work with enough energy to live a happy, healthy life.Tune in now to learn how to get started!Topics discussed in this episode:Janna’s nursing career and experiences with burnoutHow she dealt with her own burnout and became a coachStress versus burnoutSigns of burnoutHow to decide when it’s time to leave a jobThe first step to fighting burnout4 tools for burnout recovery and healingLearn more about Nurse Janna and her burnout coaching services on her website! www.jannaholterman.comConnect with Nurse Janna on Instagram: https://www.instagram.com/jannaholtermancoaching/

Welcome to part two of our series on benzodiazepines where we will be discussing the other side of benzodiazepines: the challenges of withdrawal.As healthcare providers, you are taught that benzodiazepines are in fact safe, but our host Sarah Lorenzini wants to offer a different perspective. Do we really need to be administering benzodiazepines as freely as we are taught in school? Of course for life or death situations it is a no brainer, but what about those moments when your patient is just anxious and can’t calm down?  Are there other ways to calm your patient down without giving them medication?These are the questions Sarah wants to explore in the second part of this series, as well as how severe benzodiazepine withdrawal can be. Sarah presents an example of a patient who was going through benzodiazepine withdrawal and how the symptoms were so severe it almost looked like the patient was experiencing a heart attack.Learn more about benzodiazepines and how you can play an important role in preventing benzodiazepine dependance.Tune in for this and more!Topics discussed in this episode:The signs and symptoms Sarah’s patient was experiencingHow Sarah concluded the patient was in benzo withdrawalMild, moderate, and severe benzodiazepine withdrawal symptomsSarah’s change of perspective on benzodiazepinesHow someone is weaned off of benzodiazepinesWhat to do if your patient is prescribed benzodiazepinesAlternative interventions to treat an anxious patient