Rapid Response RN

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/

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🎁 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