It's Airway Adventure time! In this episode of The Nurse Anesthesia Podcast, Jeremy dives into Volume II of Airway Management Adventures with four senior nurse anesthesia students. He discusses with each of them, their airway adventure from locations that include the ICU to the Operating Room. Each case illustrates critical decision-making under challenging circumstances, where key actions by both the nurse anesthesia student and CRNA are essential.

The cases include information on videolaryngoscopy including flexible intubation (VIFI), preparing for an awake intubation…but then suddenly changing the plan, how to manage a massive goiter, and what it feels like to save the airway in the ICU.

Buckle up, because it’s AIRWAY TIME!

Resources/information discussed in podcast

· Anesthesia Patient Safety Foundation – Emergency Tracheostomy Management: https://www.apsf.org/article/keeping-patients-safe-during-emergency-tracheostomy-management/

· National Audit Project 4 (NAP 4): https://www.rcoa.ac.uk/research/research-projects/national-audit-projects-naps/nap4-major-complications-airway-management

· Get your free The Nurse Anesthesia Crisis Checklists at www.thenurseanesthesia.com

· Sign up for our Crisis Management Video Series. You’ll get 10 different crisis management videos packed with the most up-to-date information.

· Nurse Anesthesia Residents…you will receive a steep discount on our Crisis Management Video Series. Simply email us at info@thenurseanesthesia.com tell us what nurse anesthesia program you’re in, and we’ll send you a discount code.

About The Nurse Anesthesia

We provide continuing education for CRNAs and RNs.

Our goal is provide the very best in anesthesia education and to build a commUNITY of learning in anesthesia and critical care!

We’re seasoned educators and practicing CRNAs who know anesthesia. We literally write the textbook! We have the clinical expertise, educational experience, and practical know how to give you the most current and relevant anesthesia content available. We are here for you.

For anyone who wants to learn or if you just want to review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you want to be. Let's do this together. It's Go Time!

Visit us at www.thenurseanesthesia.com

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia Podcastis for educational and informational purposes only. It does not constitute medical. We continuously strive for accuracy, however, medicine is constantly evolving, and clinical decisions should always be made based on current guidelines, institutional policies, and individual patient considerations. The views expressed are those of the hosts and guests, and Do NOT necessarily reflect the opinions of any affiliated institutions. Listeners should consult their own healthcare providers before making any medical decisions.

Music by Alex Grohl

In this episode of The Nurse Anesthesia Podcast, host Jeremy Heiner, is joined by co-host Mark Gabot, and special guest Zohn Centimole, PhD, CRNA, for a practical discussion about moving “beyond the BIS Index number” and using electroencephalography (EEG) to better understand the brain’s response to anesthesia. The conversation explores how raw and processed EEG can provide anesthesia professionals with a real-time window into the organ they are actually anesthetizing—the brain.

Jeremy, Mark, and Zohn then break down the characteristic EEG frequencies encountered during anesthesia. They talk about burst suppression, the density spectral array (DSA), and how recognizing patterns may allow clinicians to titrate anesthetics more thoughtfully and individualize care rather than relying exclusively on MAC values, vital signs, or traditional dosing strategies.

The takeaway is simple: let’s start looking at the EEG! Put the monitor on, observe the changes from induction through emergence, correlate the patterns with anesthetic interventions, and begin developing the skills necessary to use brain monitoring as another tool for individualizing anesthesia care.

References

1. Aldecoa C, Bettelli G, Bilotta F, et al. Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients. Eur J Anaesthesiol. 2024;41(2):81-108. doi:10.1097/EJA.0000000000001876

2. Jegarl AM, Walline MC, Goldstein PA, Safavynia SA. Is Electroencephalographic Burst-Suppression Good, Bad, or Indifferent for Brain Health? Context Matters. Anesth Analg. 2026;142(6):1169-1179. doi:10.1213/ANE.0000000000007739

3. Purdon PL, Sampson A, Pavone KJ, Brown EN. Clinical Electroencephalography for Anesthesiologists: Part I: Background and Basic Signatures. Anesthesiology. 2015;123(4):937-960. doi:10.1097/ALN.0000000000000841

4. Xu A, Arnaout B, Scott DA, McGuigan S. Intraoperative electroencephalogram-derived measures and their association with postoperative delirium: a systematic review and meta-analysis. Br J Anaesth. 2025;135(6):1684-1703. doi:10.1016/j.bja.2025.08.038

About The Nurse Anesthesia

We provide continuing education for CRNAs and RNs.

Our goal is provide the very best in anesthesia education and to build a commUNITY of learning in anesthesia and critical care!

We’re seasoned educators and practicing CRNAs who know anesthesia. We literally write the textbook! We have the clinical expertise, educational experience, and practical know how to give you the most current and relevant anesthesia content available. We are here for you.

For anyone who wants to learn or if you just want to review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you want to be. Let's do this together. It's Go Time!

Visit us at www.thenurseanesthesia.com

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available! Advanced Anatomy, Physiology, and Pathophysiology is coming soon.

CRNAs & RN’s get CE credits when they purchase & complete this series.

Resident Registered Nurse Anesthesiologists get a steep discount! Email us at info@thenurseanesthesia.com to get your discount code.

Learn more about our courses at www.thenurseanesthesia.com

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia Podcastis for educational and informational purposes only. It does not constitute medical. We continuously strive for accuracy, however, medicine is constantly evolving, and clinical decisions should always be made based on current guidelines, institutional policies, and individual patient considerations. The views expressed are those of the hosts and guests, and Do NOT necessarily reflect the opinions of any affiliated institutions. Listeners should consult their own healthcare providers before making any medical decisions.

Music by Alex Grohl

Hypotension can occur during surgery and anesthesia in patients with a history of hypertension who take angiotensin converting enzyme inhibiting (ACEI) or angiotensin receptor blocking (ARB) medications. In this episode Jeremy and Mark talk about what the current evidence says about holding or allowing patients to take their ACEI or ARB on the day of surgery. This has been a hot topic in the anesthesia community with no clear guidelines…until now. Tune in to find out!

References

• Giannas E, et al. Perioperative management of renin-angiotensin system inhibitors in patients undergoing elective major noncardiac surgery: a mixed model investigation using systematic review, meta-analysis, multicentre service evaluation, and national survey. Br J Anaesth. 2025;135:861–869.

• 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery. Circulation. 2024. DOI: 10.1161/CIR.0000000000001285. [Supersedes 2014 ACC/AHA Guideline]

• Kidney Disease: Improving Global Outcomes (KDIGO) 2024 CKD Guideline — perioperative RAS inhibitor management recommendations. https://kdigo.org/guidelines/ckd-evaluation-and-management/

• Keshock M, et al. Hold ACE inhibitors and ARBs before noncardiac surgery? Emerging evidence suggests a patient-specific approach. Cleve Clin J Med. 2025;92(10):619–626.

About The Nurse Anesthesia:

We provide continuing education for CRNAs and RNs.

Our goal is provide the very best in anesthesia education and to build a commUNITY of learning in anesthesia and critical care!

We’re seasoned educators and practicing CRNAs who know anesthesia. We literally write the textbook! We have the clinical expertise, educational experience, and practical know how to give you the most current and relevant anesthesia content available. We are here for you.

For anyone who wants to learn or if you just want to review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you want to be. Let's do this together. It's Go Time!

Visit us at: www.thenurseanesthesia.com

Sign up for The Nurse Anesthesia Courses:

Our CRISIS MANAGEMENT SERIES is currently available!

CRNAs & RN’s get CE credits when they purchase & complete this series.

Resident Registered Nurse Anesthesiologists get a steep discount! Email us at info@thenurseanesthesia.com to get your discount code.

Learn more about our courses at www.thenurseanesthesia.com

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia Podcastis for educational and informational purposes only. It does not constitute medical. We continuously strive for accuracy, however, medicine is constantly evolving, and clinical decisions should always be made based on current guidelines, institutional policies, and individual patient considerations. The views expressed are those of the hosts and guests, and Do NOT necessarily reflect the opinions of any affiliated institutions. Listeners should consult their own healthcare providers before making any medical decisions.

Music by Alex Grohl