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    analgesia

    Explore " analgesia" with insightful episodes like "SCCM Pod-454 PCCM: PANDEM Guidelines", "Ep 82: Veterinary Nursing & Motherhood With Lou Northway", "‘Ask the Experts’: California’s Fight Over Pediatric Dental Anesthesia Care With Rita Agarwal, MD", "‘Ask the Experts’: How One Startup Is Transforming Non-OR Anesthesia" and "‘On the Case’: The Secret to Unusual Cases With Elizabeth Frost, MD" from podcasts like ""SCCM Podcast", "Veterinary Ramblings", "Anesthesiology News Presents", "Anesthesiology News Presents" and "Anesthesiology News Presents"" and more!

    Episodes (46)

    Ep 82: Veterinary Nursing & Motherhood With Lou Northway

    Ep 82: Veterinary Nursing & Motherhood With Lou Northway

    *Please note, this episode was recorded last year during coronavirus lockdowns and restrictions, however, we had such a fantastic time recording this wonderful conversation with Lou that we still really want to share it with you all!*

    *Lou's views are her own and do not represent or reflect the views of the BVNA*

    This week we're thrilled to present our episode with the fantastic Lou Northway whom many of you know as Lou The Vet Nurse!

    We begin this week's episode by delving into Lou's childhood experiences of visiting the vets, how that inspired her to become a veterinary nurse and how her weekend job developed into her lifelong career.

    We discuss how the roles of a veterinary surgeon and a veterinary nurse complement each other, depend on one another and by working together, improve animal welfare for our patients. Lou shares her views on analgesia, how it could be improved by giving vet nurses more responsibility in practice and her passion for clinical auditing.

    We discuss a period of huge change for Lou that took place over 2020/2021 with her pregnancy and the subsequent birth of her baby during COVID. Lou shares her experiences of being a new mother and offers advice for any veterinary nurses that are considering having a baby.

    Lastly, she does an awesome 60-second CPD about quality improvement in human factors and we discuss the importance of fostering a no-blame culture in the workplace.

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    ‘Ask the Experts’: California’s Fight Over Pediatric Dental Anesthesia Care With Rita Agarwal, MD

    ‘Ask the Experts’: California’s Fight Over Pediatric Dental Anesthesia Care With Rita Agarwal, MD

    In this episode of “Ask the Experts,” Rita Agarwal, MD, joins the show to discuss the efforts in California to pass legislation to change anesthesia delivery in pediatric dental anesthesia cases. Agrawal has played an important role in advising and promoting the need for improved practices in the state, especially when it comes to the sole-operator model of anesthesia delivery.

    Agarwal is a clinical professor of anesthesiology at Stanford University School of Medicine, in California. She is also the past president of the Society for Pediatric Pain Medicine. She has been working on the efforts to pass legislation on dental anesthesia delivery since 2015.

    “Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

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    ‘Ask the Experts’: How One Startup Is Transforming Non-OR Anesthesia

    ‘Ask the Experts’: How One Startup Is Transforming Non-OR Anesthesia

    In this episode of “Ask the Experts,” we talk with Navin Goyal, MD, a co-founder of OFFOR Health, and Saket Agrawal, the CEO of OFFOR Health, about their company’s success in building a mobile anesthesia service aimed at providing office-based anesthesia for dental procedures.

    Goyal is an anesthesiologist from Columbus, Ohio. He started OFFOR Health to address the problems with patient access to anesthesia care in his community. Agrawal, who is also a Columbus native, spent 10 years working in Silicon Valley gaining experience in building startup-style companies. Goyal and Agrawal now run OFFOR Health and SmileMD, which provide office-based anesthesia care in Ohio, Illinois, Kentucky and Tennessee.

    “Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

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    ‘On the Case’: The Secret to Unusual Cases With Elizabeth Frost, MD

    ‘On the Case’: The Secret to Unusual Cases With Elizabeth Frost, MD

    In this episode of “On the Case,” James Prudden interviews Elizabeth A.M. Frost, MD, about some of this most unique and memorable cases of her career.

    Frost was the original clinical editor of The Frost Series, which bears her name in honor of her contributions to the art of the case study. And she will be the guest editor of the series again in the May and June issues.

    In preparation for her return to editing the series, Prudden, our editorial director, caught up with Frost to discuss some of the highlights of her career in treating and writing about unusual cases.

    “On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports about what it was like to experience those clinical situations and why they decided to write about them afterward.

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    ‘Ask the Experts’: ASA’s Difficult Airway Guidelines With William Rosenblatt, MD

    ‘Ask the Experts’: ASA’s Difficult Airway Guidelines With William Rosenblatt, MD

    In this episode of “Ask the Experts,” William Rosenblatt, MD, comes back on the show to discuss his work on the American Society of Anesthesiologists (ASA) Difficult Airway Guidelines. He also explains how it took years to build the Airway on Demand video library and why he does it.

    Rosenblatt is a professor of anesthesiology and otolaryngology at Yale School of Medicine, in New Haven, Conn. He developed the Airway on Demand program to provide educational resources on airway management. He was also a co-author of the ASA’s guidelines.

    “Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

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    ‘On the Case’: Comatose in the PACU? Check the Scopolamine Patch

    ‘On the Case’: Comatose in the PACU? Check the Scopolamine Patch

    “On the Case” is back for another season of in-depth interviews with the authors of the best case reports published in Anesthesiology News. The first episode of the year features L. Jane Stewart, MD, JD, MPH, who co-wrote the review titled “Comatose in the PACU? Remove the Scopolamine Patch” (Anesthesiology News Special Edition 2021;17:81-85).

    Stewart comes on the podcast to discuss the details behind the case as well as how she and her team were able to determine the right diagnosis despite the uniqueness of the case.

    Stewart is a senior instructor of anesthesiology at the Denver Health Medical Center, and the director of Diversity, Equity and Inclusion in the Department of Anesthesiology at the University of Colorado, Denver.

    “On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports about what it was like to experience those clinical situations and why they decided to write about them afterward.

    Link to listener survey!

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    New Episodes of ‘Anesthesiology News Presents’ Coming Soon

    New Episodes of ‘Anesthesiology News Presents’ Coming Soon

    Anesthesiology News will be publishing a new season of our popular podcast series, “On the Case” and “Ask the Experts.”

    “On the Case” is a review series that features the authors of our popular case report series. We hear the behind-the-scenes story on the most unique clinical case studies published in the magazine directly from the professionals who managed them. The first episode of this new season features an interview with L. Jane Stewart, MD, JD, MPH, who co-wrote a case report about a patient who experienced a unique complication from a scopolamine patch.

    “Ask the Experts” is an interview series that features leading anesthesia experts on topics ranging from airway management to medical mission work and the future of anesthesia practice models. The first episode of this new season will feature an interview with William Rosenblatt, MD, who was a co-author of the new American Society of Anesthesiologists difficult airway guidelines.

    These episodes will be published later this month. And new episodes from both of these new series will appear every month.

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    Transforming the experience of pain and anxiety in clinical settings

    Transforming the experience of pain and anxiety in clinical settings

    Pain and anxiety are some of the most common and distressing symptoms experienced by patients in all clinical settings.

     

    Research by Dr Elvira Lang and colleagues found that their self-hypnotic relaxation app, Comfort Talk®, is effective in reducing pain and anxiety in patients through short listening times in the waiting room. 

     

    Read their original article: https://doi.org/10.1097/01.RVI.0000185418.82287.72

     

    Read more in Research Outreach

    Ep 4: The Next Chapter of Anesthesiology (The Etherist, Season 3)

    Ep 4: The Next Chapter of Anesthesiology (The Etherist, Season 3)

    In this episode, we turn our focus to the present to see how recent research could be used to shape the future of anesthesiology.

    In previous episodes, we reviewed how the pioneers of anesthesia were able to successfully use ether and chloroform without the full knowledge of those drugs that we have today. In that spirit, we explore whether there is untapped potential in our current scientific expertise that could help improve the delivery of modern-day anesthesia.

    This season of the podcast began with the retelling of the origin story of anesthesia use. We revisited the classic tale of Ether Day with the benefit of hindsight and almost two centuries of clinical advances. But the stories about William T.G. Morton, Simpson Young and John Snow are also just chapters in a much larger story of medical progress. It is our story, too. While this season of The Etherist is ending, the story of anesthesia continues, as does the push for clinical progress. In this episode, we try to answer the question: What will be the next chapter in the story of anesthesiology?

    This is the fourth and final episode of season 3 of “Anesthesiology News presents The Etherist.”

    Sponsored by Masimo and Medtronic.

    Suggested Reading

    • Brown EN, Lydic R, Schiff ND. General anesthesia, sleep, and coma. _N Engl J Med_. 2010;363:2638-2650.
    • İnce R, Adanir SS, Sevmez F. The inventor of electroencephalography (EEG): Hans Berger (1873–1941). Childs Nerv Syst. 2021;37:2723–2724. https://doi.org/10.1007/s00381-020-04564-z
    • Gibbs FA, Gibbs LE, Lennox WG. Effects on the electroencephalogram of certain drugs which influence nervous activity. Arch Intern Med. 1937;60:154-166.
    • Glorfeld J. Hans Berger has a real brainstorm: accident inspires a career and the invention of EEG. Cosmos. November 20, 2020. Accessed November 16, 2021. https://cosmosmagazine.com/health/hans-berger-has-a-real-brainstorm/
    • Mets B. Waking Up Safer? An Anesthesiologist’s Record. SilverWood Books; 2018.
    • Purdon PL, Sampson A, Pavone KJ. Clinical electroencephalography for anesthesiologists part I: background and basic signatures. Anesthesiology. 2015;123(4):937-960. doi:10.1097/ALN.0000000000000841
    • Science News. Electric currents picked up from head show brain action. Science News Letter. 1935;719(27):35. Accessed November 16. https://www.sciencenews.org/archive/electric-currents-picked-head-show-brain-action
    • Sanders L. How Hans Berger’s quest for telepathy spurred modern brain science: instead of finding long-range signals, he invented EEG. Science News. July 6, 2021. Accessed November 16, 2021. https://www.sciencenews.org/article/hans-berger-telepathy-neuroscience-brain-eeg

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    Ep 3: The First Professional Anesthetist (The Etherist, Season 3)

    Ep 3: The First Professional Anesthetist (The Etherist, Season 3)

    In the previous episodes, we relived the incredible achievements of the discoverers of anesthesia in Davy, Morton, Simpson and Long. But another individual may be just as important to the progress of the specialty as those who discovered it.

    John Snow was a doctor and scientist in London when he first witnessed a demonstration of ether anesthesia. Even though he was not credited with the discovery of ether or chloroform, he became a leader in the advancement of modern medicine in England.

    In fact, it was Snow’s forward-thinking mentality that laid the foundation for the spirit of the specialty of anesthesiology: the idea that there is always a better answer to the problem than the one we have now. To do that, Snow developed the first ever anesthesia practice standards to guide his colleagues in the use of anesthesia.

    In this episode, we turn our attention to our future, and explore how understanding Snow’s original ether anesthesia practice standards was just the first chapter in a 175-year story of anesthesia innovation. We will also discuss the current outlook of our modern research into the development of more targeted anesthesia drugs and more.

    This is episode 3 of season 3 of “Anesthesiology News presents The Etherist.” The fourth and final episode of the season will be available on Nov. 23, 2021.

    Sponsored by Masimo and Medtronic.

    Suggested Reading

    • Fenster JM. _Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It._ Perennial; 2002.
    • Knight PR III, Bacon DR. An unexplained death: Hannah Greener and chloroform. Anesthesiology. 2002;96:1250–1253.
    • Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.
    • Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.
    • Richardson BW. Memoir of the Author: John Snow, Chloroform and Other Anaesthetics. London: John Chruchill; 1858.
    • Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.
    • Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

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    Ep 2: The Dreadful Discovery of Chloroform (The Etherist, Season 3)

    Ep 2: The Dreadful Discovery of Chloroform (The Etherist, Season 3)

    The discovery of chloroform was closely intertwined with ether anesthesia because of the relative closeness of their discoveries, but it did not take long for the early pioneers of anesthesia use to understand the enormous difference between the two anesthetic agents.

    From October 1846 to November 1847, anesthesia providers used ether to ease pain in surgery and it might have seemed as if a golden age in medicine was just beginning, but tragedy would eventually strike the growing specialty of anesthesiology. Hannah Greener’s experience with the use of chloroform anesthesia as a patient would mark a major crisis point for the early advocates of anesthesia.

    This season of the series is about revisiting the history of anesthesiology while also reimagining those events based on what we know today. But that story can’t be told without also diving into the dangers of the use of anesthesia. It is perhaps the most important piece of knowledge that we possess now, that those early anesthesiologists were not sufficiently aware of at the time.

    This is episode 2 of season 3 of “Anesthesiology News presents The Etherist.”

    Sponsored by Masimo and Medtronic.

    Suggested Reading

    • Fenster JM. _Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It._ Perennial; 2002.
    • Knight PR III, Bacon DR. An unexplained death: Hannah Greener and chloroform. Anesthesiology. 2002;96:1250–1253.
    • Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.

    • Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.

    • Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.

    • Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

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    Ep 1: October 16, 1846 (The Etherist, Season 3)

    Ep 1: October 16, 1846 (The Etherist, Season 3)

    On Friday, Oct. 16, 1846, William Thomas Green Morton changed the world of medicine with his demonstration of vaporized ether anesthesia at Massachusetts General Hospital, in Boston.

    The discovery and public demonstration of ether anesthesia was not a sudden achievement, though. In fact, it was the results of incremental scientific gains by dozens of scientists from Raymond Lully, the Spanish alchemist who first distilled sulfuric ether in 1275, to Joseph Priestly, the English researcher who developed nitrous oxide in 1774, and finally to Morton.

    But there is more to the story than those early pioneers could have known. This season we will be retelling and reimagining the story about the dawn of anesthesia use with a slight twist. We will also dive into the latest research into the mechanisms of anesthesia’s effects on the brain—knowledge the early innovators in anesthesia could not have realized in their time.

    This is episode 1 of season 3 of “Anesthesiology News presents The Etherist.” Episode 2 will be available on Oct. 26, 2021.

    Sponsored by Masimo and Medtronic.

    Suggested Reading

    • Fenster JM. Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It. Perennial; 2002.
    • Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.
    • Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.
    • Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.
    • Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

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    The Etherist—Season 3 Prologue: No Laughing Matter

    The Etherist—Season 3 Prologue: No Laughing Matter

    Before the discovery of ether anesthesia, surgery was an excruciating experience for patients, their loved ones and even the surgeons who performed the operations.

    In the 1840s, an important scientific breakthrough changed the course of medical history—the discovery of anesthesia. However, over several decades leading up to that historic discovery, the potential for less painful surgery existed without anyone managing to connect the dots between a series of scientific developments with nitrous oxide and the need for anesthesia in surgery. Those decades presented a stark missed opportunity for all surgery patients of the time, and a true conundrum affectionately known as “laughing gas.”

    In the prologue for season 3 of “Anesthesiology News presents The Etherist,” we delve into the decades-long conundrum of the coexistence of anesthesia—in the form of nitrous oxide and ether—and the continuation of painful surgery during the early 19th century.

    Episode 1 of The Etherist will be available on Oct. 16, 2021—175 years after the original demonstration of ether anesthesia, now known as Ether Day.

    Sponsored by Masimo and Medtronic.

    Suggested Reading

    • Fenster JM. Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It. Perennial; 2002.
    • Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.
    • Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.
    • Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.
    • Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

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    Anaesthesia & Analgesia in Hip Fracture

    Anaesthesia & Analgesia in Hip Fracture

    Anaesthetist Dr Richard Halliwell discusses the considerations for analgesia in the older hip fracture patient. Richard presents the research evidence, together with the risks and benefits for different anaesthetic and pain relief approaches. This is followed by a Q&A with ANZHFR Co-chair Prof Jacqui Close.

    NSW Agency for Clinical Innovation Fascia Iliaca Block guide found here: https://aci.health.nsw.gov.au/__data/assets/pdf_file/0004/285592/Fascia-Iliaca-Block-Guide.pdf

    Systematic Review of the Effects of Fascia Iliaca Compartment Block on Hip Fracture Patients Before Operation (2018): https://www.bjanaesthesia.org/article/S0007-0912(18)30041-2/fulltext

    Cochrane Review (2018) on EEG and delirium mentioned:
    https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011283.pub2/full




    The Etherist—Season 3 Trailer: Ether Day Revisited

    The Etherist—Season 3 Trailer: Ether Day Revisited

    In this new season of “Anesthesiology News presents The Etherist,” we celebrate the 175th anniversary of the original Ether Day by looking back at the origin of anesthesiology as a modern medical specialty.

    We will revisit those early days of discovery and innovation and the people who made it all possible, but we won’t stop with the history of anesthesia. This season we will also dive into the emergence of new research that has revealed the basic effects of how anesthetic drugs work in the first place.

    Join us on this journey into the past as we uncover what those early pioneers of anesthesia knew and didn’t know as they made one of the most significant medical discoveries in history.

    This new season of The Etherist will be available on Oct. 16, the 175th anniversary of Ether Day.

    Sponsored by Masimo and Medtronic.

    Suggested Reading

    1. Fenster JM. Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It. Perennial; 2002.
    2. Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.
    3. Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.
    4. Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.
    5. Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

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    ‘Anesthesiology News Presents’: An Exclusive Interview with Jodi Kuhlman, MD, on Her Recovery from Fentanyl Addiction

    ‘Anesthesiology News Presents’: An Exclusive Interview with Jodi Kuhlman, MD, on Her Recovery from Fentanyl Addiction

    In this exclusive feature of “Anesthesiology News Presents,” Jodi Kuhlman, MD, comes forward to share her story of fentanyl addiction and drug diversion for the very first time. Kuhlman’s story was first published anonymously in a feature in the women’s magazine Marie Claire, in 2019. She recently decided to come forward to share her story directly to bring more awareness about the dangers of drug abuse and addiction for anesthesiologists.

    Kuhlman is an anesthesiologist in Calhoun, Ga. She has also partnered with IntelliGuard in a joint effort to advocate for better drug diversion practices and awareness in hospitals around the United States.

    “Anesthesiology News Presents” is the podcast network for Anesthesiology News including “On the Case,” a behind-the-scenes look into the popular case reports published in the news magazine; “Ask the Experts,” an up-close and personal conversation series with some of the leading experts in the field; and “The Etherist,” the flagship series that delves into the key stories shaping the specialty in the past, present and future.

    Links Mentioned:

    Link to article in Marie Claire

    Link to panel discussion with Intelliguard

    Send us an email submit a case for The Frost Series

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    ‘Ask the Experts’: How to Write to Get Published With Sonia Vaida, MD

    ‘Ask the Experts’: How to Write to Get Published With Sonia Vaida, MD

    In this episode of “Ask the Experts,” Sonia Vaida, MD, comes on the show to explain her process for editing new reviews and case reports for “The Frost Series” every month in Anesthesiology News. She also shares her best advice on how to write reports to get them published for the first time.

    Vaida is the clinical editor of “The Frost Series” for Anesthesiology News. She is also a professor of anesthesiology and obstetrics and gynecology, the vice chair for research, and the director of obstetric anesthesia in the Department of Anesthesiology and Perioperative Medicine at Penn State Health Milton S. Hershey Medical Center.

    “Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

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    ‘On the Case’: The Kratom Problem and Some Considerations for Anesthesiologists

    ‘On the Case’: The Kratom Problem and Some Considerations for Anesthesiologists

    In this episode of “On the Case,” Peter J. Papadakos, MD, discusses a case report he wrote in the Journal of the American Academy of PAs (2021;34[4]:33-36) about a 54-year-old man who was transferred with a large right frontal intracerebral hemorrhage after ingesting kratom.

    Papadakos is a professor of anesthesiology, surgery, neurology and neurosurgery, and the director of critical care medicine at the University of Rochester, in New York. He is also a member of the Anesthesiology News editorial advisory board.

    “On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports about what it was like to experience those clinical situations and why they decided to write about them afterward.

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    ‘Ask the Experts’: The Greater Need for Dental Anesthesia With Peggy Seidman, MD

    ‘Ask the Experts’: The Greater Need for Dental Anesthesia With Peggy Seidman, MD

    In this episode of “Ask the Experts,” Peggy Seidman, MD, joins us to discuss dental anesthesia and the need for more qualified anesthesia providers for routine office-based dental procedures, especially in pediatric cases. She also shares her favorite section of The New York Times and one thing that has inspired her throughout her career.

    Seidman is a board-certified pediatric anesthesiologist, practicing in Cleveland. She partners with SmileMD, a mobile anesthesia services company founded by anesthesiologists, to provide anesthesia services for local dental procedures.

    “Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

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