Absolutely. Given your ICU/trauma background and biochemistry degree, I would not spend your pre-CRNA time relearning basic nursing. I’d build the anesthesia foundation underneath what you already know.
CRNA Pre-School Survival Curriculum
The goal
By the time you start, you want to be able to hear:
“Patient with pulmonary hypertension, RV dysfunction, septic shock, and hypoxemia is being induced.”
…and immediately start thinking about what can kill this patient and why.
You don’t need to know the final answer yet. You need the physiology to make the answer understandable.
Tier 1 — The four subjects I’d prioritize most
1. Cardiovascular physiology ⭐⭐⭐⭐⭐
Know these cold:
- Preload
- Afterload
- Contractility
- Stroke volume
- Cardiac output
- SVR
- PVR
- MAP
- Venous return
- Frank-Starling relationship
- LV vs RV physiology
- Coronary perfusion
- Autoregulation
You should be able to explain:
CO = HR × SV
and:
MAP ≈ CO × SVR
But more importantly:
If I decrease SVR, what happens to venous return, stroke volume, cardiac output, and coronary perfusion?
Master these conditions
- Aortic stenosis
- Aortic regurgitation
- Mitral stenosis
- Mitral regurgitation
- HFrEF
- HFpEF
- RV failure
- Pulmonary hypertension
- Hypertrophic cardiomyopathy
- Ischemic heart disease
Target: Be able to describe the hemodynamic goals for each condition without looking them up.
2. Respiratory physiology ⭐⭐⭐⭐⭐
Know:
- Ventilation
- Alveolar ventilation
- Dead space
- V/Q matching
- Shunt
- Compliance
- Resistance
- FRC
- Closing capacity
- Diffusion
- Hypoxic pulmonary vasoconstriction
- Oxygen content
- CO₂ transport
The equation I would memorize:
PaCO₂ ∝ VCO₂ / VA
In other words:
CO₂ production divided by alveolar ventilation determines PaCO₂.
Then understand why that matters during mechanical ventilation.
Master these conditions
- COPD
- Asthma
- ARDS
- Pulmonary edema
- Pneumothorax
- Pulmonary hypertension
- Obesity
- Atelectasis
3. Acid-base ⭐⭐⭐⭐⭐
You should be able to look at:
pH 7.22
PaCO₂ 28
HCO₃⁻ 12
and immediately recognize:
metabolic acidosis with respiratory compensation
Then go deeper.
Learn:
- Henderson-Hasselbalch
- Anion gap
- Winter’s formula
- Respiratory compensation
- Metabolic compensation
- Mixed disorders
- Lactate
- Renal compensation
Your target
Don’t just identify the disorder.
Ask:
“Why does this patient have this acid-base abnormality?”
That’s the CRNA mindset.
4. Pharmacology ⭐⭐⭐⭐⭐
Don’t memorize 200 drugs individually.
Start with receptors.
α₁
↑SVR → ↑MAP
β₁
↑HR
↑contractility
↑CO
β₂
bronchodilation
vasodilation
M₂
↓HR
Muscarinic
Think:
parasympathetic
Then build the anesthesia drugs around those receptors.
Tier 2 — The anesthesia foundation
5. Autonomic nervous system ⭐⭐⭐⭐⭐
Understand:
Sympathetic vs parasympathetic
Know:
- α₁
- α₂
- β₁
- β₂
- β₃
- M₁
- M₂
- M₃
- Nicotinic receptors
Then connect them to anesthesia.
For example:
α₂ agonism → ↓central sympathetic outflow
which helps explain drugs like dexmedetomidine.
6. IV induction agents ⭐⭐⭐⭐⭐
Understand the major differences between:
- Propofol
- Etomidate
- Ketamine
- Midazolam
Don’t just memorize:
“Propofol causes hypotension.”
Understand why.
Think:
Propofol → ↓SVR + venodilation ± myocardial depression → ↓MAP
Then ask:
Would I want that in severe aortic stenosis?
Now you’re thinking like an anesthetist.
7. Opioids ⭐⭐⭐⭐½
Know:
- Fentanyl
- Morphine
- Hydromorphone
- Remifentanil
Understand:
- μ receptors
- Analgesia
- Respiratory depression
- Bradycardia
- Chest wall rigidity
- Histamine effects
- Context-sensitive half-time
Particularly important:
Remifentanil
because its pharmacokinetics are very different from many other opioids.
8. Neuromuscular blockers ⭐⭐⭐⭐⭐
Know:
Depolarizing
Succinylcholine
Nondepolarizing
- Rocuronium
- Vecuronium
- Cisatracurium
Understand:
- onset
- duration
- metabolism
- organ dependence
- train-of-four
- fade
- reversal
Then understand:
Sugammadex
vs
Neostigmine
9. Inhaled anesthetics ⭐⭐⭐⭐⭐
Know:
- Sevoflurane
- Desflurane
- Isoflurane
- Nitrous oxide
Understand:
MAC
Blood/gas solubility
Uptake
Distribution
Emergence
And importantly:
Why does a low blood/gas partition coefficient generally produce faster changes in anesthetic depth?
10. Pharmacokinetics ⭐⭐⭐⭐⭐
This is where your biochemistry background should help you.
Master:
- Volume of distribution
- Clearance
- Half-life
- Redistribution
- First-order elimination
- Zero-order elimination
- Context-sensitive half-time
- Effect-site concentration
Eventually you’ll encounter three-compartment models and things will start getting much more mathematical.
Don’t panic.
Understand the concept first.
Tier 3 — Mechanical ventilation & airway
11. Mechanical ventilation ⭐⭐⭐⭐⭐
Know:
- Tidal volume
- Minute ventilation
- Alveolar ventilation
- Respiratory rate
- PEEP
- FiO₂
- Peak pressure
- Plateau pressure
- Driving pressure
- Compliance
- Resistance
- Auto-PEEP
Be able to interpret:
High peak + normal plateau
vs.
High peak + high plateau
That’s an extremely useful distinction.
12. Airway management ⭐⭐⭐⭐⭐
Know:
- Mallampati
- Thyromental distance
- Mouth opening
- Neck mobility
- Dentition
- Upper airway anatomy
- Laryngoscopy
- Video laryngoscopy
- Supraglottic airways
- Bougie
- Fiberoptic techniques
- Awake intubation concepts
- Difficult airway algorithms
But the most important concept:
Always have Plan A → B → C → D.
The question isn’t simply:
“Can I intubate?”
It’s:
“What happens if I can’t?”
13. Respiratory mechanics ⭐⭐⭐⭐½
Understand:
Compliance
Resistance
Poiseuille’s law
Laplace’s law
Transpulmonary pressure
Airway pressure
You don’t need to become a physicist.
But anesthesia becomes much easier when you understand why the airway behaves the way it does.
Tier 4 — Specialty physiology
14. Neuroanesthesia ⭐⭐⭐⭐½
Know:
CPP = MAP − ICP
Then understand:
- CBF
- ICP
- CPP
- autoregulation
- cerebral oxygen consumption
- PaCO₂ and CBF
- PaO₂ and cerebral physiology
- cerebral perfusion
- anesthetic effects on the brain
You’ll eventually encounter:
- traumatic brain injury
- intracranial hemorrhage
- tumors
- aneurysms
- ischemic stroke
15. Renal physiology ⭐⭐⭐⭐
Know:
- GFR
- renal blood flow
- filtration
- reabsorption
- secretion
- RAAS
- fluid balance
- potassium
- sodium
- calcium
- magnesium
And understand why renal dysfunction changes anesthetic management.
16. Obstetric anesthesia ⭐⭐⭐⭐½
Know the physiologic changes of pregnancy:
Cardiovascular
↑ blood volume
↑ cardiac output
↓SVR
Respiratory
↑ oxygen consumption
↓FRC
↑minute ventilation
GI
↑ aspiration risk
Then learn the major emergencies.
17. Pediatric physiology ⭐⭐⭐⭐½
Focus on:
- airway anatomy
- oxygen consumption
- FRC
- cardiac physiology
- temperature regulation
- fluid management
- weight-based dosing
One of the biggest concepts:
Children are not simply small adults.
Their physiology changes the anesthetic strategy.
18. Regional anesthesia ⭐⭐⭐⭐½
Learn:
- spinal
- epidural
- peripheral nerve blocks
- dermatomes
- local anesthetic mechanisms
- sensory vs motor blockade
- sympathetic blockade
- LAST
Understand the physiologic consequences of a high spinal.
Tier 5 — The stuff that makes you dangerous if you don’t understand it
19. Crisis management ⭐⭐⭐⭐⭐
Eventually you’ll need to recognize patterns such as:
Sudden hypotension
Think:
- ↓SVR
- ↓preload
- ↓contractility
- ↓CO
- bleeding
- anaphylaxis
- obstruction
- arrhythmia
- excessive anesthetic depth
Sudden hypoxemia
Think:
- tube problem
- bronchospasm
- atelectasis
- aspiration
- pneumothorax
- pulmonary edema
- V/Q mismatch
- equipment failure
Sudden high airway pressure
Think:
DOPE
- Displacement
- Obstruction
- Pneumothorax
- Equipment
20. Fluid, blood & transfusion management ⭐⭐⭐⭐⭐
Know:
- crystalloid vs colloid
- preload responsiveness
- hemorrhagic shock
- permissive hypotension concepts
- transfusion thresholds
- massive transfusion
- calcium
- potassium
- temperature
- coagulation
Understand the relationship between:
hemorrhage → ↓preload → ↓SV → ↓CO → ↓MAP
and how anesthesia can accelerate that deterioration.
Your actual study order
If you have several months before starting, I’d do it like this:
Month 1
Cardiovascular physiology
Spend most of your time here.
↓
Month 2
Respiratory physiology + mechanical ventilation
↓
Month 3
Acid-base + renal + electrolytes
↓
Month 4
Autonomic pharmacology + vasoactive drugs
↓
Month 5
Anesthetic pharmacology
↓
Month 6
Airway + anesthesia machine + ventilation
↓
Month 7+
Start integrating:
Cardiac + respiratory + pharmacology + clinical scenarios
The study method I’d recommend for you
Don’t read a textbook for six hours and highlight everything.
Instead, repeatedly ask yourself:
“What happens if…?”
For example:
What happens if I give propofol?
→ ↓SVR
→ venodilation
→ ↓preload
→ possible myocardial depression
→ ↓MAP
Then:
What if the patient is hypovolemic?
Now the hypotension may be much worse.
Then:
What if the patient has severe aortic stenosis?
Now maintaining adequate preload, sinus rhythm, contractility and coronary perfusion becomes especially important.
Then:
What if the patient also has pulmonary hypertension?
Now you’ve got another set of competing hemodynamic goals.
That is exactly the kind of mental exercise I’d want you doing before CRNA school.
Your “CRNA readiness” test
Before school starts, I’d want you to be able to answer these without notes:
- Why does induction cause hypotension?
- Why does PEEP decrease venous return?
- Why can excessive PEEP be dangerous in RV failure?
- Why does hypoventilation increase PaCO₂?
- Why does hyperventilation decrease PaCO₂?
- Why does hypercapnia increase cerebral blood flow?
- Why is severe aortic stenosis a difficult anesthetic?
- Why can propofol cause significant hypotension?
- Why is ketamine different hemodynamically?
- Why does phenylephrine increase BP but potentially decrease HR?
- Why can norepinephrine be preferable in some forms of shock?
- Why does succinylcholine increase potassium?
- Why does rocuronium last longer in some patients?
- How does sugammadex reverse rocuronium?
- What does MAC actually mean?
- What determines anesthetic uptake?
- What’s the difference between peak and plateau pressure?
- What’s the difference between shunt and dead space?
- How does pregnancy change respiratory physiology?
- A patient suddenly becomes hypotensive, tachycardic and hypoxemic after induction—what are you thinking?
If you can reason through those rather than simply recite memorized answers, you’re building the right foundation.
One final recommendation for you
Because you’ve already spent significant time in ICU/trauma and have a biochemistry background, I would make your preparation physiology-heavy rather than anatomy-heavy.
Your biggest return on investment is:
Cardiovascular physiology → respiratory physiology → acid-base → autonomic pharmacology → anesthetic pharmacology → integrated cases.
That’s the foundation I’d build before walking into your first CRNA lecture.