Do you want to go from dreading emergencies to feeling confident and ready to jump into action to rescue your patient? Well, this show will let you see emergencies unfold through the eyes of a Rapid Response Nurse. With real life stories from the frontlines of nursing, host Sarah Lorenzini MSN, RN, CCRN, CEN, a Rapid Response Nurse and educator, shares her experiences at rapid response events and breaks down the pathophysiology, pharmacology, and the important role the nurse plays during emergencies. If you want to sharpen your assessment skills and learn how to think like a Rapid Response Nurse, then Sarah is here to share stories, tips, tricks, and mindsets that will prepare you to approach any emergency. Every episode is packed full of exactly what you need to know to handle whatever crisis that could arise on your shift. It’s one thing to get the right answer on the test, but knowing how to detect when YOUR patient is declining and what to do when YOUR patient is crashing is what will make or break your day… and might just save your patient’s life.
The shock worked. The rhythm converted. And then V-fib came right back. Now what? Part two of this series explores the physiology and pharmacology driving recurrent V-fib so you can respond confidently when shocks aren’t enough. You'll learn how the body's sympathetic nervous system response keeps the heart unstable, why epinephrine can both help and hurt, when to reach for lidocaine over amiodarone, and what the research says about the emerging role of esmolol to target the storm itself (not just the arrhythmia). Topics discussed in this episode: The sympathetic nervous system and cardiac arrest Why epinephrine both helps and hurts Amiodarone vs. lidocaine: which is better? Key findings from the ROC-ALPS trial Why antiarrhythmics don't replace defibrillation The evidence behind esmolol in refractory V-fib 3 lessons for codes when ACLS isn't enough Mentioned in this episode: CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com
This special episode was recorded and released on the Nurse Gwenny Podcast. We talked about some of those early signs of deterioration that are often missed and how we can speak up and advocate before the patient crashes. Check out this episode and so many more over at the Nurse Gwenny Podcast And, you can join the Nurse Gwenny Library to earn CE credits for listening to the show! Use code: rapidresponsern to get a discount on your membership: https://library.nursegwenny.com/bundles/nurse-gwenny-library-membership
Sometimes V-fib doesn't respond to the shock at all. Sometimes it converts and comes right back. Those are two completely different problems. In this episode, Sarah breaks down the science behind why defibrillation fails, how to recognize the difference between refractory and recurrent V-fib, and respond when shocks aren't working. You'll learn how to start approaching the electrical storm at the bedside — that means understanding transthoracic impedance, optimizing your pad placement, and knowing when to reach for double sequential defibrillation. Topics discussed in this episode: Refractory vs. recurrent V-fib The physiology of ventricular fibrillation and re-entry tachycardias Misconceptions about defibrillation Transthoracic impedance and how to reduce it Anterior-lateral vs. anterior-posterior pad placement Double sequential defibrillation: evidence and objections Key findings from the DOSE VF trial American Heart Association. (2025). 2025 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care . Circulation. Cheskes, S., Dorian, P., Feldman, M., McLeod, S., Scales, D. C., Pinto, R., Turner, L., Morrison, L. J., Drennan, I. R., & Verbeek, P. R. (2020). Double sequential external defibrillation for refractory ventricular fibrillation: The DOSE VF pilot randomized controlled trial. Resuscitation, 150 , 178–184. https://doi.org/10.1016/j.resuscitation.2020.02.010 D. Hasegawa, A. Sharma, Y. I. Lee, & R. Sato. (2023). A systematic review and meta-analysis of esmolol for refractory ventricular fibrillation and pulseless ventricular tachycardia . Chest, 164 (4 Suppl.), A1568. https://doi.org/10.1016/j.chest.2023.07.1077 International Liaison Committee on Resuscitation. (2025). 2025 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) . Mentioned in this episode: CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com
Imagine being able to cut your hospital's code blue events outside of critical care in HALF in just six months. That's exactly what happened when Sarah built her hospital's rapid response team from the ground up. Nurse Gwenny takes over the show to find out how she did it, from the pitch that got the program started to the skills that actually matter on rapid response teams. She also shares what disqualifies a candidate even when the resume is perfect, why so few resources exist for rapid response training, and how she’s filling that gap herself. Whether you're hoping to start a rapid response program at your hospital or just want to feel more confident the next time you call one, this episode is for you. Topics discussed in this episode: How Sarah became a rapid response nurse The backstory behind the Rapid Response RN Podcast The impact of having a rapid response team How you can start a rapid response program Rapid response education and (lack of) resources Hiring red flags that override a strong resume Soft skills nursing school never teaches Trusting nursing intuition when vitals look fine Join the Nurse Gwenny Library to earn CE credits for listening to the show! Use code: rapidresponsern to get a discount on your membership: https://library.nursegwenny.com/bundles/nurse-gwenny-library-membership Mentioned in this episode: CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com
We all know the many challenges facing the Nursing profession today. Nursing takes so much from us… but it also has so much to offer. Recorded live at NurseCon at Sea, Sarah sits down with two nurses who hit their breaking point and found a way to keep showing up. This episode goes deep into the messy reality of nursing burnout, from the struggle to put yourself first to the boundaries, mindset shifts, and support systems that keep nurses in the game. You don't have to manage burnout alone, so don’t miss this one. Topics discussed in this episode: Self-care and resilience as a discipline The nursing choice: fracture or adapt Building a life that isn't fully defined by the institution Important things we don’t say to each other What patients actually need from their nurses Therapy, medication, and sleep as nursing tools An exercise to audit your cup-fillers vs. cup-drainers Why it’s so important to share your experience How leaders should respond when a nurse is nearing burnout Learn more about NurseCon at Sea: https://nurseconatsea.com/ Mentioned in this episode: CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com
Getting ROSC is not always the win we sometimes think it is. It's what we're looking for the entire resuscitation, but the real challenge begins once we get it… and what we do in the next few hours has a major impact on patient outcomes. In this episode, Sarah shares a real rapid response case to walk through the physiology, decision-making, and advocacy of post-arrest care. The 2025 AHA post resuscitation guidelines have brought important shifts to post-ROSC management, from how aggressively to oxygenate to when it's safe to prognosticate. Don't miss the full breakdown! Topics discussed in this episode: Oxygenation and ventilation: how to avoid hyperoxia and hypoxia Perfusion, pressors, and the limits of MAP Temperature management guidelines Sedation, analgesia, and the paralyzed-but-awake patient Diagnostics: timing, priorities, and what to rule out How to use neuroprognostication the right way How to talk to families without giving false hope Nursing priorities and how to advocate for your patients Check out the new Post Resuscitation Guidelines: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001375 Listen to episode 73 — Resuscitate Before You Intubate: How to NOT KILL YOUR PATIENT When You Intubate: https://podcasts.apple.com/us/podcast/73-resuscitate-before-you-intubate-how-to-not-kill/id1535997752?i=1000630431016 Mentioned in this episode: 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! CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com
The AHA just updated the playbook on acute pulmonary embolism. The old classification system is gone. Heparin drips are no longer the default. And if your instinct is to push for intubation, that could be the thing that makes your patient worse. In this episode, Dr. Mark Creager, lead author of the 2026 AHA Multi-Society Guideline on Acute Pulmonary Embolism, breaks down exactly what's changed, how the new guidelines help teams make better decisions faster, and what nurses need to know about frontline PE management. Learn what the data says about oxygen therapy, anticoagulation, vasopressors, and the decisions that matter most when your PE patient starts to slide. Topics discussed in this episode: The new A to E classification system and how to categorize patients Clinical signs that your PE patient is deteriorating Oxygen therapy: why intubation can be dangerous Vasopressor therapy and when to add vasopressin Low-molecular-weight heparin vs. unfractionated heparin PE response teams: when to activate and who should be on the team What you can do when your hospital has no PERT When to transfer by classification (and when it may be too late) The nurse's role in early recognition and escalation And you can check out the full AHA/ACC 2026 updated PE guideline here: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001415 Mentioned in this episode: Xshears are the best shears check em out here: https://xshear.com//discount/Rapid10 and you can use code RAPID10 to get 10% off your purchase CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com
"There has to be a better way." We've all thought it. This episode is proof that nurses can be the ones to make it happen. In this episode, Sarah is joined by Kat Siaron, rapid response nurse and co-author of the RRT STAR study that shows what happens when nurses are empowered to act before a clear stroke diagnosis is made. They walk through a patient case that exposed a dangerous gap in inpatient stroke response, traps like sedation hangover that mask stroke presentations, and how the nurse-led Code Stroke process has drastically improved time to crucial intervention. You'll hear about the step-by-step workflow, where rapid response nurses and physicians fit in, and how you can advocate for change in your hospital. Topics discussed in this episode: The patient case that led to Kat’s RRT STAR study Why inpatient stroke times lag behind ER stroke times The consequences of ordering stat CT instead of Code Stroke Symptoms and prognosis of basilar stroke The step-by-step Code Stroke process The rapid response team's role in stroke activation Results and impact of the study How they overcame pushback to drive institutional change Stroke mimics and what to do next How to advocate for a nurse-led stroke alert at your hospital Read Kat’s article, “Use of Rapid Response Teams to Expedite Imaging and Treatment for Inpatients With Acute Stroke:” https://aacnjournals.org/aacnacconline/article-abstract/36/4/317/32912/Use-of-Rapid-Response-Teams-to-Expedite-Imaging?redirectedFrom=fulltext Mentioned in this episode: CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com Listen to the In The Heart of Care Podcast https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7
The stroke guidelines just changed and it’s exciting and nuanced! What you do in the first 30 minutes could drastically change your patient's outcome. In this episode, Dr. Shyam Prabhakaran, neurologist and chief writer of the new 2026 AHA Stroke Guidelines, explains what's changed and how these guidelines are changing practice at the bedside. Stroke treatment decisions are getting faster, more nuanced, and more imaging-driven. Inclusion/exclusion criteria and whether to give thrombolytics, who is a candidate for thrombectomy, and when to touch the blood pressure have all been updated. Know the updates before your next stroke alert! Topics discussed in this episode: Introducing the classic extended window patient case Thrombolytics vs. thrombectomy explained EMS destination decision: Choosing primary vs. comprehensive stroke center How reperfusion time windows have changed Advanced imaging: ASPECTS and thrombectomy eligibility Treatment options for patients presenting outside of the 4.5 hr window Blood pressure management recommendations What nurses should do in the first 15-30 minutes LVO red flags at the bedside Pediatric ischemic stroke Check out the new AHA Stroke Guidelines: https://newsroom.heart.org/news/new-guideline-expands-stroke-treatment-for-adults-offers-first-pediatric-stroke-guidance Mentioned in this episode: CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com Listen to the In The Heart of Care Podcast https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7
ARDS is one of the more complex syndromes we manage in critical care. More than just pulmonary edema, we are battling stiff lungs, refractory hypoxemia, rising pressures, and frequently making decisions that can either protect the lung or make things worse. In this episode, I’m joined by respiratory therapist Melody Bishop for a deep dive into ARDS ventilator management through the lens of physiology, evidence, and real bedside practice. We break down what’s actually happening in the lung , why some long-held practices have fallen out of favor, and how nurses and RTs can work together to make more precise, lung-protective decisions. If ARDS has ever felt like guesswork, this episode will help it make sense. Topics discussed in this episode: What ARDS looks like at the alveolar level and why surfactant loss changes everything How inflammation leads to stiff lungs, poor compliance, and refractory hypoxemia Why lung-protective ventilation is about avoiding harm , not chasing perfect numbers Moving beyond tidal volume: how driving pressure reframes vent management How RTs use compliance trends to judge whether lungs are improving or failing PEEP selection: why tables are a guide, not the final answer The physiology behind proning and why it’s one of the few ARDS interventions that saves lives Why recruitment maneuvers fell out of favor (and what works instead) What nurses should be watching on the ventilator to catch deterioration early Connect with Melody and download her free book: https://melodybishoprt.com/ Mentioned in this episode: Rapid Response Academy Winter 2026 Cohort https://www.rapidresponseandrescue.com/rra CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com
A transplant saves a life… but can also make the body attack itself. That's what Graft Versus Host Disease (GVHD) does, and why nurses need to catch it early. You may have never seen it before, but this episode will tell you what it looks like at the bedside and the early clues you can’t afford to miss. Through a real patient case, Anthony, RN explains why GVHD is easy to overlook, how to think through common differentials, and what matters most when it comes to helping patients stabilize and recover. Topics discussed in this episode: CCOT's rapid response model The patient’s condition weeks after allogenic transplant Anthony's assessment and what raised red flags Why early symptoms can get misread or minimized How Graft Versus Host Disease develops Why emotional support is crucial to recovery Acute vs. chronic Graft Versus Host Disease Important early clues of Graft Versus Host Disease Priority interventions for Graft Versus Host Disease How Anthony’s app can help bedside nurses You can connect with Anthony or learn more about his apps here: https://thehumblenurse.com/ Mentioned in this episode: CONNECT 📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/ 📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore 🧑💻Check out my website: https://www.rapidresponseandrescue.com/ 📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login 🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern ✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541 SAY THANKS 💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752 💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE ⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST! This episode was produced by Podcast Boutique https://www.podcastboutique.com Rapid Response Academy Winter 2026 Cohort https://www.rapidresponseandrescue.com/rra
You know those moments when something just “feels off?” That’s when you should trust your instincts and speak up because timing can completely change a patient’s outcome. In this episode, Sarah is joined by Dr. Oscar Mitchell, Associate Director of the Center for Resuscitation Science and Director of the Medical Rapid Response Team at the Hospital of the University of Pennsylvania. They break down one septic shock case across two timelines: first, when rapid response is called early and there's still time to intervene, and later, when the patient is already crashing. You’ll hear what a calm, collaborative rapid response call looks like, which signs of deterioration should never be ignored, and how to effectively share your concerns with a provider. This episode is for anyone who might call a rapid response AND for those who respond to emergencies. Topics discussed in this episode: Introduction to the patient and the 5PM timeline What the ideal provider–nurse collaboration looks like Early signs of deterioration that were missed Why some nurses hesitate to call rapid response The patient’s vitals at 10AM and why rapid response was called Why the documented respiratory rate might not be reliable Why blood pressure can be misleading SBAR and CUS frameworks for escalation Dr. Mitchell’s research on delays in RRT activation and mortality Early warning signs you should never ignore Register for the REVIVE Conference and use code RAPID50 to get $50 off! https://www.revive-conference.com/ Check out Dr. Mitchell's research here: https://pubmed.ncbi.nlm.nih.gov/36349290/ Mentioned in this episode: Rapid Response Academy Winter 2026 Cohort https://www.rapidresponseandrescue.com/rra
The science is finally catching up to what clinicians have long known: more fluids aren't always the answer to septic shock. In this episode, host Sarah Lorenzini and Jaclyn Bond MSN-LM, MBA-HM explain what the ANDROMEDA-SHOCK 2 trial reveals about physiology-guided sepsis resuscitation and why fixed-volume fluid strategies can lead to avoidable harm. They break down how dynamic fluid responsiveness testing helps teams stop guessing, and how tools like FloPatch support real-time assessment of carotid flow time and stroke volume. You'll leave with a clearer idea of when to give fluids, when to stop, and how to justify the decision. Topics discussed in this episode: The purpose and key findings of the ANDROMEDA-SHOCK 2 study Why dynamic measures of fluid responsiveness matter more than static vitals What recent meta-analysis data shows about physiology-guided fluid strategies Carotid flow time: what it is, how it’s measured, and how it guides decisions Hemodynamic assessment and bedside limitations How FloPatch supports real-time assessment so you can make individualized fluid decisions SEP-1 2026 guideline updates and why it’s better for patients How to apply these principles to your workflow Website: www.flosonicsmedical.com See FloPatch in action: https://hubs.ly/Q03-68Hg0 Mentioned in this episode: Rapid Response Academy Winter 2026 Cohort https://www.rapidresponseandrescue.com/rra
Pulmonary embolisms don’t always announce themselves... sometimes they ambush. One minute your patient is walking with physical therapy, the next they’re hypotensive, hypoxic, and coding. This re-released early episode dives deep into why PE patients can look deceptively stable… right up until they aren’t. In this episode, I revisit one of my earliest case-based teachings on pulmonary embolism, updated with an added segment on vasopressin use in obstructive shock from PE. Through real bedside stories from my time as a rapid response and ER nurse, we break down the physiology behind PE-related collapse, why intubation isn’t always the answer, and how to think through management when the right ventricle is failing in front of you. This is a sobering but essential refresher on one of the most dangerous diagnoses we encounter. Topics discussed in this episode: Why pulmonary embolism is a common cause of in-hospital cardiac arrest (even if it’s not common overall) Classic and subtle PE presentations and why they’re often missed A real-time rapid response case: stable to crashing in minutes Risk factors for PE and the anticoagulation double-edged sword Obstructive shock explained: what’s actually killing the patient Right ventricular failure, septal bowing, and the spiral of death Why intubation can worsen outcomes in massive PE Vasopressors in PE: norepinephrine, epinephrine, and vasopressin The unique benefits of vasopressin in obstructive shock Thrombolysis vs. thrombectomy: when TPA helps — and when it’s deadly Bedside echo findings that point to massive PE Why PE patients can crash during transport (and what to always bring) Nursing vigilance, rapid escalation, and activating help early When perfect care still isn’t enough and the heart of nursing in end-of-life moments Mentioned in this episode: Rapid Response Academy Winter 2026 Cohort https://www.rapidresponseandrescue.com/rra
Some of the most common respiratory myths are still showing up at the bedside. But it's not your fault — most of us were never taught what an oxygenation problem versus a ventilation problem looks like in real time. In this episode, Melody Bishop RT explains how respiratory therapists think through oxygenation and ventilation to choose the right intervention and recognize when a patient is ready to breathe on their own. We’re calling out the old dogma and myths that can delay treatment and worsen patient outcomes! Topics discussed in this episode: Ventilation vs. oxygenation: the core building blocks V/Q mismatch explained ABG findings for low-flow vs. high-flow vs. BiPAP When CO₂ is the problem and the benefits of BiPAP Key indicators it’s time to intubate and the dangers of waiting The myth of resting patients on ventilation How to accurately assess spontaneous breathing trials COPD, oxygen, and the hypoxic drive myth What nurses should know about working with RTs Connect with Melody: https://melodybishoprt.com/ Mentioned in this episode: Rapid Response Academy Winter 2026 Cohort https://www.rapidresponseandrescue.com/rra
Rural nursing is anything but simple. They have limited resources, fewer specialists, and often have to send patients hours away from their families for a higher level of care. But all that is changing as new tech like Zeto brings monitoring right to the bedside and keeps more patients close to home. In this episode, ICU nurse leader Kristen RN shares how point-of-care EEG has empowered her team to catch subclinical seizures sooner and make faster, more informed clinical decisions. From buy-in to implementation, you'll hear how she advocated for her community and successfully integrated this technology into a small ICU. If you work in a rural or resource-limited facility, don't miss this one! Topics discussed in this episode: The unique challenges rural nurses and hospitals face Why keeping patients close to home matters How telemedicine and new tech are transforming rural healthcare Why subclinical seizures are hard to recognize How Zeto’s spot EEG helps nurses keep more patients close to home The positive impact on team confidence and patient care How you can advocate for the tools your community needs Learn more about Zeto here: https://zeto-inc.com/ Mentioned in this episode: Rapid Response Academy Winter 2026 Cohort https://www.rapidresponseandrescue.com/rra
Your pneumonia patient is hypotensive, tachycardic, and not responding to fluids… what did you miss? It could be sepsis-induced cardiomyopathy, a common under-recognized shock state you could see at the bedside. In this episode, Dr. Mahmoud Ibrahim MD and host Sarah Lorenzini use a case study to highlight how nurses, intensivists and the ICU team can work together to recognize the signs of sepsis-induced cardiomyopathy early and give patients a better chance at recovery. You'll learn the diagnostic clues that your patient’s heart is in trouble, how to approach controversial treatments like sodium bicarb, and what has to happen before intubation in a dual shock state. Topics discussed in this episode: What the initial bedside assessment says about the patient Treatment priorities for the intensivist and nurse Signs that point to more than just sepsis Why fluids aren’t always the answer Blood pressure management: vasopressors and inotropes Pathophysiology of sepsis-induced cardiomyopathy How a sepsis-induced cardiomyopathy diagnosis changes treatment The vasopressin debate for sepsis-induced cardiomyopathy Clues your intervention isn’t working and what to do next How to prepare the patient for high-risk intubation What you need to know about administering sodium bicarb Why collaboration matters at every step for patient recovery Connect with Dr. Ibrahim: Instagram : https://www.instagram.com/icuboy_meded/ Facebook : https://www.facebook.com/share/1Dg1ZTyfsN/ TikTok : https://www.tiktok.com/@icuboy_meded Threads : https://www.threads.com/@icuboy_meded X : https://x.com/icuboy_meded Learn more about the different phenotypes in sepsis induced cardiomyopathy: https://journal.chestnet.org/article/S0012-3692(25)05143-8/abstract Mentioned in this episode: Rapid Response Academy Winter 2026 Cohort https://www.rapidresponseandrescue.com/rra
Every five years, resuscitation guidelines get a refresh. This year, a few have changed, many have stayed the same, and some are creating major controversy. In this episode, Dr. Ashish Panchal, Chair of the AHA Emergency Cardiovascular Care Committee, helps us unpack what’s new, what might surprise you, and the science behind each decision. You'll learn why there’s serious debate around epinephrine dosing, what changes matter most for the bedside, and how these updates will change the way you and your team respond to the next code! Topics discussed in this episode: The history and development of the AHA Resuscitation Guidelines Key improvements: algorithms, clear language, and unified care Big, fundamental changes in the guidelines How choking management guidelines have changed The recommended approach for synchronized cardioversion New guidelines for post-resuscitation care Why there’s controversy around mechanical CPR and DSD IV vs. IO access: best practice and key takeaways The controversy around epinephrine dosing What these changes mean for nurses and code teams Listen to E140 with Dr. Ashish Panchal: https://healthpodcastnetwork.com/episodes/rapid-response-rn/140-resuscitation-then-and-now-how-evidence-shapes-every-beat-with-guest-dr-ashish-panchal-md-phd/ Mentioned in this episode: AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!
Differential diagnosis is part physiology, part detective work. Especially in heart failure, where similar vital signs can mean very different things. In this episode, Natalie RN is back on the show to break down two pediatric cases that looked almost identical on arrival to the ED but their workups led to two very different treatment plans. She shares the assessment findings, diagnostics, and clinical clues that helped them uncover what was really going on. Learn how to connect the dots and find the right intervention when presentations look identical! Topics discussed in this episode: Presentation of two pediatric patients with similar symptoms Differential diagnosis and early clinical clues What to look for in your clinical assessment Pathophysiology of pulmonary hypertension Pathophysiology of dilated cardiomyopathy Key physical exam and diagnostic differences Dilated cardiomyopathy interventions Why it’s hard to diagnose pulmonary hypertension in the ER Nurse priorities when managing patients in the CVICU Managing pulmonary hypertension crises and reducing PVR Pearls and pitfalls of treating these conditions Connect with Natalie: https://www.instagram.com/chatwithnat_rn/ Listen to Chat with Nurse Nat on Spotify: https://open.spotify.com/show/7Jh2qe44KipudVKkdXFwWH Listen to Chat with Nurse Nat on Apple Podcasts: https://podcasts.apple.com/us/podcast/chat-with-nurse-nat/id1815541418 Mentioned in this episode: AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!
Every trauma nurse knows this feeling: your stable patient suddenly starts to decompensate and instinct tells you there’s more to the story. Today’s case starts with a stable, post-arrest patient and ends in a full-blown tension pneumothorax. Hear why this patient went from stable to crashing in minutes, how delayed recognition changed the course of care, what diagnostics and assessments could have caught earlier. Trauma Pete breaks down the tell-tale signs, how it differs from a simple pneumothorax, and why it's so easy to miss in trauma patients. In this episode, you’ll learn which patients are the most at risk, how to spot tension pneumothorax early, and why having a systematic approach to decompression make all the difference! Topics discussed in this episode: Presentation of a stable, post-arrest patient The patient's rapid decline and first interventions Why they misread the signs of tension pneumothorax Pneumothorax in intubated vs. non-intubated patients The physiology of tension simple vs. tension pneumothorax Bedside clues and diagnostic signs of tension pneumothorax Early intervention and treatment priorities Emergent needle decompression: timing, technique, and follow-up Chest tube placement and management: tips, troubleshooting, and air leaks Mentioned in this episode: Listen to the In The Heart of Care Podcast https://link.cohostpodcasting.com/6598429e-e927-45b0-9b57-7dd34a09d803?d=seASyqjs7
