{"id":4585,"date":"2026-08-15T01:55:04","date_gmt":"2026-08-15T01:55:04","guid":{"rendered":"https:\/\/nursehowie.net\/?p=4585"},"modified":"2026-08-15T01:55:09","modified_gmt":"2026-08-15T01:55:09","slug":"anesthesia-prep-plan","status":"publish","type":"post","link":"https:\/\/nursehowie.net\/?p=4585","title":{"rendered":"Anesthesia Prep Plan"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Absolutely. Given your ICU\/trauma background and biochemistry degree, I would <strong>not<\/strong> spend your pre-CRNA time relearning basic nursing. I\u2019d build the anesthesia foundation underneath what you already know.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>CRNA Pre-School Survival Curriculum<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The goal<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">By the time you start, you want to be able to hear:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u201cPatient with pulmonary hypertension, RV dysfunction, septic shock, and hypoxemia is being induced.\u201d<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2026and immediately start thinking about <strong>what can kill this patient and why<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You don\u2019t need to know the final answer yet. You need the physiology to make the answer understandable.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Tier 1 \u2014 The four subjects I\u2019d prioritize most<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>1. Cardiovascular physiology \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know these cold:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Preload<\/li>\n\n\n\n<li>Afterload<\/li>\n\n\n\n<li>Contractility<\/li>\n\n\n\n<li>Stroke volume<\/li>\n\n\n\n<li>Cardiac output<\/li>\n\n\n\n<li>SVR<\/li>\n\n\n\n<li>PVR<\/li>\n\n\n\n<li>MAP<\/li>\n\n\n\n<li>Venous return<\/li>\n\n\n\n<li>Frank-Starling relationship<\/li>\n\n\n\n<li>LV vs RV physiology<\/li>\n\n\n\n<li>Coronary perfusion<\/li>\n\n\n\n<li>Autoregulation<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">You should be able to explain:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>CO = HR \u00d7 SV<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">and:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>MAP \u2248 CO \u00d7 SVR<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">But more importantly:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If I decrease SVR, what happens to venous return, stroke volume, cardiac output, and coronary perfusion?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Master these conditions<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Aortic stenosis<\/li>\n\n\n\n<li>Aortic regurgitation<\/li>\n\n\n\n<li>Mitral stenosis<\/li>\n\n\n\n<li>Mitral regurgitation<\/li>\n\n\n\n<li>HFrEF<\/li>\n\n\n\n<li>HFpEF<\/li>\n\n\n\n<li>RV failure<\/li>\n\n\n\n<li>Pulmonary hypertension<\/li>\n\n\n\n<li>Hypertrophic cardiomyopathy<\/li>\n\n\n\n<li>Ischemic heart disease<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Target:<\/strong> Be able to describe the hemodynamic goals for each condition without looking them up.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>2. Respiratory physiology \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ventilation<\/li>\n\n\n\n<li>Alveolar ventilation<\/li>\n\n\n\n<li>Dead space<\/li>\n\n\n\n<li>V\/Q matching<\/li>\n\n\n\n<li>Shunt<\/li>\n\n\n\n<li>Compliance<\/li>\n\n\n\n<li>Resistance<\/li>\n\n\n\n<li>FRC<\/li>\n\n\n\n<li>Closing capacity<\/li>\n\n\n\n<li>Diffusion<\/li>\n\n\n\n<li>Hypoxic pulmonary vasoconstriction<\/li>\n\n\n\n<li>Oxygen content<\/li>\n\n\n\n<li>CO\u2082 transport<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The equation I would memorize:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>PaCO\u2082 \u221d VCO\u2082 \/ VA<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In other words:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>CO\u2082 production divided by alveolar ventilation determines PaCO\u2082.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then understand why that matters during mechanical ventilation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Master these conditions<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>COPD<\/li>\n\n\n\n<li>Asthma<\/li>\n\n\n\n<li>ARDS<\/li>\n\n\n\n<li>Pulmonary edema<\/li>\n\n\n\n<li>Pneumothorax<\/li>\n\n\n\n<li>Pulmonary hypertension<\/li>\n\n\n\n<li>Obesity<\/li>\n\n\n\n<li>Atelectasis<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>3. Acid-base \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You should be able to look at:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>pH 7.22<br>PaCO\u2082 28<br>HCO\u2083\u207b 12<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">and immediately recognize:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>metabolic acidosis with respiratory compensation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then go deeper.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Learn:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Henderson-Hasselbalch<\/li>\n\n\n\n<li>Anion gap<\/li>\n\n\n\n<li>Winter\u2019s formula<\/li>\n\n\n\n<li>Respiratory compensation<\/li>\n\n\n\n<li>Metabolic compensation<\/li>\n\n\n\n<li>Mixed disorders<\/li>\n\n\n\n<li>Lactate<\/li>\n\n\n\n<li>Renal compensation<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Your target<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Don\u2019t just identify the disorder.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ask:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u201cWhy does this patient have this acid-base abnormality?\u201d<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That\u2019s the CRNA mindset.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>4. Pharmacology \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Don\u2019t memorize 200 drugs individually.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Start with <strong>receptors<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u03b1\u2081<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u2191SVR \u2192 \u2191MAP<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u03b2\u2081<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u2191HR<\/strong><strong><br><\/strong><strong>\u2191contractility<br>\u2191CO<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u03b2\u2082<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>bronchodilation<br>vasodilation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>M\u2082<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u2193HR<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Muscarinic<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Think:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>parasympathetic<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then build the anesthesia drugs around those receptors.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Tier 2 \u2014 The anesthesia foundation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>5. Autonomic nervous system \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Understand:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Sympathetic vs parasympathetic<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u03b1\u2081<\/li>\n\n\n\n<li>\u03b1\u2082<\/li>\n\n\n\n<li>\u03b2\u2081<\/li>\n\n\n\n<li>\u03b2\u2082<\/li>\n\n\n\n<li>\u03b2\u2083<\/li>\n\n\n\n<li>M\u2081<\/li>\n\n\n\n<li>M\u2082<\/li>\n\n\n\n<li>M\u2083<\/li>\n\n\n\n<li>Nicotinic receptors<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Then connect them to anesthesia.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For example:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u03b1\u2082 agonism \u2192 \u2193central sympathetic outflow<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">which helps explain drugs like dexmedetomidine.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>6. IV induction agents \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Understand the major differences between:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Propofol<\/li>\n\n\n\n<li>Etomidate<\/li>\n\n\n\n<li>Ketamine<\/li>\n\n\n\n<li>Midazolam<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Don\u2019t just memorize:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cPropofol causes hypotension.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Understand <strong>why<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Think:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Propofol \u2192 \u2193SVR + venodilation \u00b1 myocardial depression \u2192 \u2193MAP<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then ask:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Would I want that in severe aortic stenosis?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Now you\u2019re thinking like an anesthetist.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>7. Opioids \u2b50\u2b50\u2b50\u2b50\u00bd<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Fentanyl<\/li>\n\n\n\n<li>Morphine<\/li>\n\n\n\n<li>Hydromorphone<\/li>\n\n\n\n<li>Remifentanil<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Understand:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u03bc receptors<\/li>\n\n\n\n<li>Analgesia<\/li>\n\n\n\n<li>Respiratory depression<\/li>\n\n\n\n<li>Bradycardia<\/li>\n\n\n\n<li>Chest wall rigidity<\/li>\n\n\n\n<li>Histamine effects<\/li>\n\n\n\n<li>Context-sensitive half-time<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Particularly important:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Remifentanil<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">because its pharmacokinetics are very different from many other opioids.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>8. Neuromuscular blockers \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Depolarizing<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Succinylcholine<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Nondepolarizing<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Rocuronium<\/li>\n\n\n\n<li>Vecuronium<\/li>\n\n\n\n<li>Cisatracurium<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Understand:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>onset<\/li>\n\n\n\n<li>duration<\/li>\n\n\n\n<li>metabolism<\/li>\n\n\n\n<li>organ dependence<\/li>\n\n\n\n<li>train-of-four<\/li>\n\n\n\n<li>fade<\/li>\n\n\n\n<li>reversal<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Then understand:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Sugammadex<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">vs<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Neostigmine<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>9. Inhaled anesthetics \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sevoflurane<\/li>\n\n\n\n<li>Desflurane<\/li>\n\n\n\n<li>Isoflurane<\/li>\n\n\n\n<li>Nitrous oxide<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Understand:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>MAC<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Blood\/gas solubility<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Uptake<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Distribution<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Emergence<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">And importantly:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Why does a low blood\/gas partition coefficient generally produce faster changes in anesthetic depth?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>10. Pharmacokinetics \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is where your <strong>biochemistry background should help you<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Master:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Volume of distribution<\/li>\n\n\n\n<li>Clearance<\/li>\n\n\n\n<li>Half-life<\/li>\n\n\n\n<li>Redistribution<\/li>\n\n\n\n<li>First-order elimination<\/li>\n\n\n\n<li>Zero-order elimination<\/li>\n\n\n\n<li>Context-sensitive half-time<\/li>\n\n\n\n<li>Effect-site concentration<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Eventually you\u2019ll encounter <strong>three-compartment models<\/strong> and things will start getting much more mathematical.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Don\u2019t panic.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Understand the concept first.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Tier 3 \u2014 Mechanical ventilation &amp; airway<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>11. Mechanical ventilation \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Tidal volume<\/li>\n\n\n\n<li>Minute ventilation<\/li>\n\n\n\n<li>Alveolar ventilation<\/li>\n\n\n\n<li>Respiratory rate<\/li>\n\n\n\n<li>PEEP<\/li>\n\n\n\n<li>FiO\u2082<\/li>\n\n\n\n<li>Peak pressure<\/li>\n\n\n\n<li>Plateau pressure<\/li>\n\n\n\n<li>Driving pressure<\/li>\n\n\n\n<li>Compliance<\/li>\n\n\n\n<li>Resistance<\/li>\n\n\n\n<li>Auto-PEEP<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Be able to interpret:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>High peak + normal plateau<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">vs.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>High peak + high plateau<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That\u2019s an extremely useful distinction.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>12. Airway management \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Mallampati<\/li>\n\n\n\n<li>Thyromental distance<\/li>\n\n\n\n<li>Mouth opening<\/li>\n\n\n\n<li>Neck mobility<\/li>\n\n\n\n<li>Dentition<\/li>\n\n\n\n<li>Upper airway anatomy<\/li>\n\n\n\n<li>Laryngoscopy<\/li>\n\n\n\n<li>Video laryngoscopy<\/li>\n\n\n\n<li>Supraglottic airways<\/li>\n\n\n\n<li>Bougie<\/li>\n\n\n\n<li>Fiberoptic techniques<\/li>\n\n\n\n<li>Awake intubation concepts<\/li>\n\n\n\n<li>Difficult airway algorithms<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">But the most important concept:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Always have Plan A \u2192 B \u2192 C \u2192 D.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The question isn\u2019t simply:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cCan I intubate?\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It\u2019s:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u201cWhat happens if I can\u2019t?\u201d<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>13. Respiratory mechanics \u2b50\u2b50\u2b50\u2b50\u00bd<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Understand:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Compliance<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Resistance<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Poiseuille\u2019s law<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Laplace\u2019s law<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Transpulmonary pressure<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Airway pressure<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You don\u2019t need to become a physicist.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">But anesthesia becomes much easier when you understand <strong>why<\/strong> the airway behaves the way it does.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Tier 4 \u2014 Specialty physiology<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>14. Neuroanesthesia \u2b50\u2b50\u2b50\u2b50\u00bd<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>CPP = MAP \u2212 ICP<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then understand:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>CBF<\/li>\n\n\n\n<li>ICP<\/li>\n\n\n\n<li>CPP<\/li>\n\n\n\n<li>autoregulation<\/li>\n\n\n\n<li>cerebral oxygen consumption<\/li>\n\n\n\n<li>PaCO\u2082 and CBF<\/li>\n\n\n\n<li>PaO\u2082 and cerebral physiology<\/li>\n\n\n\n<li>cerebral perfusion<\/li>\n\n\n\n<li>anesthetic effects on the brain<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">You\u2019ll eventually encounter:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>traumatic brain injury<\/li>\n\n\n\n<li>intracranial hemorrhage<\/li>\n\n\n\n<li>tumors<\/li>\n\n\n\n<li>aneurysms<\/li>\n\n\n\n<li>ischemic stroke<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>15. Renal physiology \u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>GFR<\/li>\n\n\n\n<li>renal blood flow<\/li>\n\n\n\n<li>filtration<\/li>\n\n\n\n<li>reabsorption<\/li>\n\n\n\n<li>secretion<\/li>\n\n\n\n<li>RAAS<\/li>\n\n\n\n<li>fluid balance<\/li>\n\n\n\n<li>potassium<\/li>\n\n\n\n<li>sodium<\/li>\n\n\n\n<li>calcium<\/li>\n\n\n\n<li>magnesium<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">And understand why renal dysfunction changes anesthetic management.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>16. Obstetric anesthesia \u2b50\u2b50\u2b50\u2b50\u00bd<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know the physiologic changes of pregnancy:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Cardiovascular<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2191 blood volume<br>\u2191 cardiac output<br>\u2193SVR<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Respiratory<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2191 oxygen consumption<br>\u2193FRC<br>\u2191minute ventilation<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>GI<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2191 aspiration risk<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then learn the major emergencies.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>17. Pediatric physiology \u2b50\u2b50\u2b50\u2b50\u00bd<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Focus on:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>airway anatomy<\/li>\n\n\n\n<li>oxygen consumption<\/li>\n\n\n\n<li>FRC<\/li>\n\n\n\n<li>cardiac physiology<\/li>\n\n\n\n<li>temperature regulation<\/li>\n\n\n\n<li>fluid management<\/li>\n\n\n\n<li>weight-based dosing<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">One of the biggest concepts:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Children are not simply small adults.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Their physiology changes the anesthetic strategy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>18. Regional anesthesia \u2b50\u2b50\u2b50\u2b50\u00bd<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Learn:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>spinal<\/li>\n\n\n\n<li>epidural<\/li>\n\n\n\n<li>peripheral nerve blocks<\/li>\n\n\n\n<li>dermatomes<\/li>\n\n\n\n<li>local anesthetic mechanisms<\/li>\n\n\n\n<li>sensory vs motor blockade<\/li>\n\n\n\n<li>sympathetic blockade<\/li>\n\n\n\n<li>LAST<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Understand the physiologic consequences of a <strong>high spinal<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Tier 5 \u2014 The stuff that makes you dangerous if you don\u2019t understand it<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>19. Crisis management \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Eventually you\u2019ll need to recognize patterns such as:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Sudden hypotension<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Think:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u2193SVR<\/li>\n\n\n\n<li>\u2193preload<\/li>\n\n\n\n<li>\u2193contractility<\/li>\n\n\n\n<li>\u2193CO<\/li>\n\n\n\n<li>bleeding<\/li>\n\n\n\n<li>anaphylaxis<\/li>\n\n\n\n<li>obstruction<\/li>\n\n\n\n<li>arrhythmia<\/li>\n\n\n\n<li>excessive anesthetic depth<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Sudden hypoxemia<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Think:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>tube problem<\/li>\n\n\n\n<li>bronchospasm<\/li>\n\n\n\n<li>atelectasis<\/li>\n\n\n\n<li>aspiration<\/li>\n\n\n\n<li>pneumothorax<\/li>\n\n\n\n<li>pulmonary edema<\/li>\n\n\n\n<li>V\/Q mismatch<\/li>\n\n\n\n<li>equipment failure<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Sudden high airway pressure<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Think:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>DOPE<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>D<\/strong>isplacement<\/li>\n\n\n\n<li><strong>O<\/strong>bstruction<\/li>\n\n\n\n<li><strong>P<\/strong>neumothorax<\/li>\n\n\n\n<li><strong>E<\/strong>quipment<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>20. Fluid, blood &amp; transfusion management \u2b50\u2b50\u2b50\u2b50\u2b50<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Know:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>crystalloid vs colloid<\/li>\n\n\n\n<li>preload responsiveness<\/li>\n\n\n\n<li>hemorrhagic shock<\/li>\n\n\n\n<li>permissive hypotension concepts<\/li>\n\n\n\n<li>transfusion thresholds<\/li>\n\n\n\n<li>massive transfusion<\/li>\n\n\n\n<li>calcium<\/li>\n\n\n\n<li>potassium<\/li>\n\n\n\n<li>temperature<\/li>\n\n\n\n<li>coagulation<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Understand the relationship between:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>hemorrhage \u2192 \u2193preload \u2192 \u2193SV \u2192 \u2193CO \u2192 \u2193MAP<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">and how anesthesia can accelerate that deterioration.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Your actual study order<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have several months before starting, I\u2019d do it like this:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Month 1<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Cardiovascular physiology<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Spend most of your time here.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2193<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Month 2<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Respiratory physiology + mechanical ventilation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2193<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Month 3<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Acid-base + renal + electrolytes<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2193<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Month 4<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Autonomic pharmacology + vasoactive drugs<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2193<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Month 5<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Anesthetic pharmacology<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2193<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Month 6<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Airway + anesthesia machine + ventilation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2193<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Month 7+<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Start integrating:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Cardiac + respiratory + pharmacology + clinical scenarios<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The study method I\u2019d recommend for you<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Don\u2019t read a textbook for six hours and highlight everything.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Instead, repeatedly ask yourself:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u201cWhat happens if\u2026?\u201d<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For example:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What happens if I give propofol?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2192 \u2193SVR<br>\u2192 venodilation<br>\u2192 \u2193preload<br>\u2192 possible myocardial depression<br>\u2192 \u2193MAP<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What if the patient is hypovolemic?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Now the hypotension may be much worse.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What if the patient has severe aortic stenosis?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Now maintaining adequate preload, sinus rhythm, contractility and coronary perfusion becomes especially important.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What if the patient also has pulmonary hypertension?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Now you\u2019ve got another set of competing hemodynamic goals.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>That is exactly the kind of mental exercise I\u2019d want you doing before CRNA school.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Your \u201cCRNA readiness\u201d test<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Before school starts, I\u2019d want you to be able to answer these <strong>without notes<\/strong>:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Why does induction cause hypotension?<\/li>\n\n\n\n<li>Why does PEEP decrease venous return?<\/li>\n\n\n\n<li>Why can excessive PEEP be dangerous in RV failure?<\/li>\n\n\n\n<li>Why does hypoventilation increase PaCO\u2082?<\/li>\n\n\n\n<li>Why does hyperventilation decrease PaCO\u2082?<\/li>\n\n\n\n<li>Why does hypercapnia increase cerebral blood flow?<\/li>\n\n\n\n<li>Why is severe aortic stenosis a difficult anesthetic?<\/li>\n\n\n\n<li>Why can propofol cause significant hypotension?<\/li>\n\n\n\n<li>Why is ketamine different hemodynamically?<\/li>\n\n\n\n<li>Why does phenylephrine increase BP but potentially decrease HR?<\/li>\n\n\n\n<li>Why can norepinephrine be preferable in some forms of shock?<\/li>\n\n\n\n<li>Why does succinylcholine increase potassium?<\/li>\n\n\n\n<li>Why does rocuronium last longer in some patients?<\/li>\n\n\n\n<li>How does sugammadex reverse rocuronium?<\/li>\n\n\n\n<li>What does MAC actually mean?<\/li>\n\n\n\n<li>What determines anesthetic uptake?<\/li>\n\n\n\n<li>What\u2019s the difference between peak and plateau pressure?<\/li>\n\n\n\n<li>What\u2019s the difference between shunt and dead space?<\/li>\n\n\n\n<li>How does pregnancy change respiratory physiology?<\/li>\n\n\n\n<li><strong>A patient suddenly becomes hypotensive, tachycardic and hypoxemic after induction\u2014what are you thinking?<\/strong><\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">If you can reason through those rather than simply recite memorized answers, you\u2019re building the right foundation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>One final recommendation for you<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Because you\u2019ve already spent significant time in <strong>ICU\/trauma and have a biochemistry background<\/strong>, I would make your preparation <strong>physiology-heavy rather than anatomy-heavy<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Your biggest return on investment is:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Cardiovascular physiology \u2192 respiratory physiology \u2192 acid-base \u2192 autonomic pharmacology \u2192 anesthetic pharmacology \u2192 integrated cases.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That\u2019s the foundation I\u2019d build before walking into your first CRNA lecture.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Absolutely. Given your ICU\/trauma background and biochemistry degree, I would not spend your pre-CRNA time relearning basic nursing. I\u2019d 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: \u201cPatient with pulmonary hypertension, RV dysfunction, septic shock, and&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_uag_custom_page_level_css":"","_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4585","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.0.1 - aioseo.com -->\n\t<meta name=\"description\" content=\"Absolutely. 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Given your ICU\/trauma background and biochemistry degree, I would not spend your pre-CRNA time relearning basic nursing. I\u2019d build the anesthesia foundation underneath what you already know. 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Given your ICU\/trauma background and biochemistry degree, I would not spend your pre-CRNA time relearning basic nursing. I\u2019d 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: \u201cPatient with pulmonary hypertension, RV dysfunction, septic shock, and","og:url":"https:\/\/nursehowie.net\/?p=4585","article:published_time":"2026-08-15T01:55:04+00:00","article:modified_time":"2026-08-15T01:55:09+00:00","twitter:card":"summary_large_image","twitter:title":"Anesthesia Prep Plan - nursehowie.net","twitter:description":"Absolutely. Given your ICU\/trauma background and biochemistry degree, I would not spend your pre-CRNA time relearning basic nursing. I\u2019d build the anesthesia foundation underneath what you already know. 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