Our guests in this episode are Christian Falyar, DNAP, CRNA, FAANA and Nicolette Hooge, DNP, CRNA, FAANA from the Middle Tennessee School of Anesthesia. They are some of the top educators of regional anesthesia in the country, and direct the only Acute Surgical Pain Management Fellowship for CRNAs. They literally are the rock stars of regional anesthesia! Jeremy had the opportunity to sit down with them and talk about the state of the state regarding ultrasound-guided regional anesthesia education.

You can find more information about them and the Acute Surgical Pain Management Fellowship at Middle Tennessee School of Anesthesia at this link: https://mtsa.edu/admissions/fellowship/

References

1. Nurse Anesthesia 7th edition

About The Nurse Anesthesia

We provide continuing education for CRNAs and RNs, and our goal is to build a commUNITY of learning in anesthesia and critical care! We’re seasoned educators and clinicians who know anesthesia. We literally write the textbook! We have the clinical expertise, educational experience, and practical know how to give you the most current and relevant anesthesia content available. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available!

CRNAs and RN’s get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia Podcastis for educational and informational purposes only. It does not constitute medical. We continuously strive for accuracy, however, medicine is constantly evolving, and clinical decisions should always be made based on current guidelines, institutional policies, and individual patient considerations. The views expressed are those of the hosts and guests, and Do NOT necessarily reflect the opinions of any affiliated institutions. Listeners should consult their own healthcare providers before making any medical decisions.

Music by Alex Grohl

Mixed & Edited by Next Day Podcast

info@nextdaypodcast.com

In this episode Jeremy talks about a powerful dual-technique for intubation that blends two modern airway tools — the video laryngoscope and the single-use flexible intubating scope — into a single, coordinated approach.

He calls this method Videolaryngoscopy Including Flexible Intubation, or VIFI. This airway technique combines the visibility of the videolaryngoscope with the precision of the flexible intubating scope.

During this episode Jeremy talks about some patient conditions and situations where VIFI may be useful as well as a step-by-step description on how to perform this technique. This is one you definitely should check out!

References

1. Hu, Hui-Zhong et al. “A visual laryngoscope combined with a fiberoptic bronchoscope improves intubation outcomes in patients with predicted difficult airways in thoracic surgery.” BMC pulmonary medicine vol. 24,1 558. 7 Nov. 2024, doi:10.1186/s12890-024-03369-z

2. Ottoveggio, Gaetano et al. “Combined videolaryngoscope and fiberoptic intubation for difficult airways in head and neck surgery: A prospective observational study.” Current problems in surgery vol. 70 (2025): 101852. doi:10.1016/j.cpsurg.2025.101852

3. Strayer RJ, Caputo N. “How to Use Video-Assisted Flexible Endoscopic Intubation.” ACEP Now: The Official Voice of Emergency Medicine. November 11, 2022. https://www.acepnow.com/article/how-to-use-video-assisted-flexible-endoscopic-intubation/?singlepage=1

4. Stein, M L et al. “Efficacy of a hybrid technique of simultaneous videolaryngoscopy with flexible bronchoscopy in children with difficult direct laryngoscopy in the Pediatric Difficult Intubation Registry.” Anaesthesia vol. 78,9 (2023): 1093-1101. doi:10.1111/anae.16049

About The Nurse Anesthesia

We provide continuing education for CRNAs and Nurses which the goal of building a commUNITY of learning in anesthesia and critical care! We’re seasoned educators and clinicians who know anesthesia. We literally write the textbook! We have the clinical expertise, educational experience, practical know how to give you the most current and relevant anesthesia content available. We’re here for you!

For anyone who wants to learn or if you just review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you want to be. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available!

CRNAs and RNs get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia Podcast is for educational and informational purposes only. It does not constitute medical or professional advice. While we strive for accuracy, medicine is constantly evolving, and clinical decisions should always be made based on current guidelines, institutional policies, and individual patient considerations. The views expressed are those of the hosts and guests, and Do NOT necessarily reflect the opinions of any affiliated institutions. Listeners should consult their own healthcare providers before making any medical decisions.

Music by Alex Grohl

Mixed & Edited by Next Day Podcast

info@nextdaypodcast.com

In this episode of The Nurse Anesthesia Podcast, Jeremy, Sass, Mark, and Chloe Gomez discuss the evolution of Topical Thunder for Awake Intubation. They examine how this topical technique for anesthetizing the airway was developed, and talk about each of their unique experiences with Topical Thunder for awake intubation.

Topical Thunder is a technique that uses only topical lidocaine to anesthetize the airway in preparation for awake intubation. It consists of three steps:

Step 1 is spraying the oral and hypo-pharyngeal structures with atomized 4% lidocaine solution.

Step 2 utilizes 5% lidocaine paste to anesthetize the posterior tongue and vallecular structures.

Step 3 involves spraying the hypopharyngeal and periglottic structures with atomized 4% lidocaine solution.

This is an episode you absolutely do not want to miss, because when it comes to awake intubation…it really is…GO TIME!

Resources/information discussed in podcast

Check out the My Favorite Learners Podcast on your favorite podcatcher and on YouTube! https://www.youtube.com/@myfavoritelearners/search

About The Nurse Anesthesia

We are building a commUNITY of learning in anesthesia and critical care! We are seasoned educators and clinicians who know anesthesia. We literally write the textbook! We have the clinical expertise, educational experience, practical know how to give you the most current and relevant anesthesia content available. We’re here for you!

For anyone who wants to learn or if you just want to review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you want to be. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available!

RN’s get CE credits when they purchase this series.

Learn more about it at www.thenurseanesthesia.com

Follow us on Instagram @thenurseanesthesia

Legal Disclaimer

The Nurse Anesthesia Podcastis for educational and informational purposes only. It does not constitute medical or professional advice. While we strive for accuracy, medicine is constantly evolving, and clinical decisions should always be made based on current guidelines, institutional policies, and individual patient considerations. The views expressed are those of the hosts and guests, and Do NOT necessarily reflect the opinions of any affiliated institutions. Listeners should consult their own healthcare providers before making any medical decisions.

Music by Alex Grohl