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:

1. The purpose and key findings of the ANDROMEDA-SHOCK 2 study
2. Why dynamic measures of fluid responsiveness matter more than static vitals
3. What recent meta-analysis data shows about physiology-guided fluid strategies
4. Carotid flow time: what it is, how it’s measured, and how it guides decisions
5. Hemodynamic assessment and bedside limitations
6. How FloPatch supports real-time assessment so you can make individualized fluid decisions
7. SEP-1 2026 guideline updates and why it’s better for patients
8. 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:

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

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:

1. Why pulmonary embolism is a common cause of in-hospital cardiac arrest (even if it’s not common overall)
2. Classic and subtle PE presentations and why they’re often missed
3. A real-time rapid response case: stable to crashing in minutes
4. Risk factors for PE and the anticoagulation double-edged sword
5. Obstructive shock explained: what’s actually killing the patient
6. Right ventricular failure, septal bowing, and the spiral of death
7. Why intubation can worsen outcomes in massive PE
8. Vasopressors in PE: norepinephrine, epinephrine, and vasopressin
9. The unique benefits of vasopressin in obstructive shock
10. Thrombolysis vs. thrombectomy: when TPA helps — and when it’s deadly
11. Bedside echo findings that point to massive PE
12. Why PE patients can crash during transport (and what to always bring)
13. Nursing vigilance, rapid escalation, and activating help early
14. When perfect care still isn’t enough and the heart of nursing in end-of-life moments

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...

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:

1. Ventilation vs. oxygenation: the core building blocks
2. V/Q mismatch explained
3. ABG findings for low-flow vs. high-flow vs. BiPAP
4. When CO₂ is the problem and the benefits of BiPAP
5. Key indicators it’s time to intubate and the dangers of waiting
6. The myth of resting patients on ventilation
7. How to accurately assess spontaneous breathing trials
8. COPD, oxygen, and the hypoxic drive myth
9. What nurses should know about working with RTs

Connect with Melody:

https://melodybishoprt.com/

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

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