Talking All Things Cardiopulm

Episode 107: From Residency to ICU innovation: Advancing Early Mobility & Verticalization with Jenna Hightower

Thu, 18 Dec 2025 07:00:00 -0600

Early mobility is not just a catch phrase. It’s activity that can change the trajectory of a patient’s condition, hospital stay and potentially life.

Join me as we welcome Dr. Jenna Hightower, PT, DPT, CCS, critical care physical therapist, and CVP Emerging Leader award recipient.

In this episode we learn about Jenna’s physical therapy journey and her evolution from an exercise physiologist in outpatient cardiac rehab to PT residency to her love and passion for the ICU setting.

Jenna learned early in her career that she could make tremendous impact in the ICU despite the level of complexity and ICU acquired weakness. Listen as we discuss the importance of interdisciplinary collaboration, knowledge sharing, physiologic benefits of in-bed verticalization and early mobility progression. With a little persistence, hard work and communication change can be made.

If you work in acute care, critical care, or are passionate about advancing ICU mobility, this episode is a must-listen!

In this Episode:

PT residency
Critical Care Culture
Bedrest & deconditioning
Proning & verticalization
ABCDEF Bundle
The Ramsey Protocol
Physiologic benefits of verticalization
Transition to a non-clinical role

Resources:

VitalGo Website

VitalGo Instagram

Tilt Talk Podcast: Apple. Spotify Youtube

Kayli Dayton website

Bio:

Dr. Hightower earned her Doctorate in Physical Therapy from Western Carolina University in 2017. Following this, she completed a Cardiovascular and Pulmonary Critical Care Residency through Mercer University at Piedmont Atlanta Hospital in 2018.

Dr. Hightower has served as a Critical Care Physical Therapist in multi-specialty intensive care units at both Piedmont Atlanta Hospital and Mayo Clinic Florida. Her expertise lies in early mobility interventions within the ICU, particularly for patients on advanced mechanical circulatory support devices such as ECMO, IABP, Impella, and LVAD, as well as those on various forms of mechanical ventilation. She specializes in managing complex cases involving multiple end-organ failure or shock requiring invasive support, with a particular passion for pre- and post-heart and lung transplant care. Dr. Hightower has frequently integrated the use of the Total Lift Bed into her patients' care plans to enhance outcomes, despite the complexity and acuity of their conditions.

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Episode 106: The MUSECLS Framework: A Roadmap for developing and sustaining an ECMO mobility program in the ICU

Thu, 11 Dec 2025 06:00:00 -0600

In this episode, Dr. Rachele Burriesci, PT, DPT, CCS, GCS sits down with Dr. Aaron Thrush, PT, DPT, MPH, CCS one of the lead authors behind the groundbreaking article “Development and Application of a Novel Framework for Mobility and Rehabilitation Under Support of Extracorporeal Life Support: The M-U-S-E-C-L-S Framework.” Together, they break down the first ever systems level roadmap designed to guide ICU teams in safely developing, implementing, and sustaining mobility programs for patients supported by ECMO and other mechanical circulatory devices.

In this episode we discuss:

Team members required for a successful ECMO mobility team
Including the patient in patient-centered care
Complementing existing clinical practice guidelines
Collaboration and communication required to sustain and succeed
Developing progressive and inclusive culture
Equipment needs, staffing considerations, competencies, and policies.

Access article here

Reach out to Aaron Thrush: ThrushA@ccad.ae

Aaron Thrush is a board-certified cardiovascular and pulmonary clinical specialist (USA) with expertise in acute and critical care rehabilitation. He is the Education Specialist and Manager of Inpatient Rehabilitation and Therapy at Cleveland Clinic Abu Dhabi, where he previously led ICU physical therapy. Aaron has published research on lung transplantation, cardiac rehabilitation, stroke recovery, and functional outcome measures, and serves as Director of Research & Evidence-Based Practice and Clinical Content Expert for the Academy of Cardiovascular and Pulmonary Physical Therapy (USA). An international speaker, he has presented across North America, Europe, and the Middle East.

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Episode 105: Part 2 An International PT Journey with Dr. Aaron Thrush

Thu, 04 Dec 2025 07:00:00 -0600

Lucky for us, I was able to get more time with Aaron to discuss his life abroad. We had some time after discussing his newest publication to dig further into the regular day life in Abu Dhabi and into to another world of culture and cultural competency.

Join us for an episode of common ground, laughs, food, and culture!

Stay tuned next week for our publication breakdown of the MUSECLS framework!

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Episode 104: An international PT Journey with Dr. Aaron Thrush

Sat, 15 Nov 2025 05:00:00 -0600

Have you ever wondered what it would be like to treat patients internationally as a physical therapist? Does that opportunity feel just out of reach? Have you considered being more involved in the APTA or the Cardiovascular & Pulmonary (CVP) Academy or other leadership roles and just don’t know where to start?

Join me in welcoming Dr. Aaron Thrush, who shares his inspiring journey from Philly to Abu Dhabi, from the neurologic population to a passion for CVP and from inpatient rehab to the ICU. Dr. Thrush takes us through his evolution from staff clinician to a respected leader in education, research and CVP physical therapy internationally.

If you’re a physical therapist interested in international practice, career growth, CVP physical therapy, or expanding your professional impact, this conversation is packed with insight and lived experience you won’t want to miss.

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Linked-In: Rachele Burriesci

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Episode 103: Welcome Back

Tue, 28 Oct 2025 09:00:00 -0500

Returning to the mic after a summer hiatus, Rachele recaps summer fun, garden woes, new collaborations and the joy of being in the room.

Follow PrO2:

Coupon Code for PrO2: ALLTHINGS15

(I do not receive commission just sharing a 15% off coupon code for a device that I believe in)

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Episode 102: Innovation, Invention and IMT with Ken Chatham

Tue, 09 Sep 2025 09:00:00 -0500

One word. Legacy.

When one looks back on their career they might question: did I do enough, did I make a difference, did I leave a legacy? There is no question in mind that Ken is a person that has left his mark on the respiratory muscle training world, with his passion for understanding and innovation to create the devices he needed to accomplish his goals, he has left us not only with a superior device to assess and train the respiratory muscles, but also a protocol to effectively make a difference.

30 years of research, trial and error and digging into root causes, Ken is a major reason why we know IMT is an effective training modality across the spectrum: from weaning off vents, to patients with COPD, pneumoconiosis, SCI, to training world class athletes on the pitch.

Not only did he help us understand how to assess and train respiratory muscles he also developed the device to do just that. Through multiple iterations and developments over 30 years we now have the PrO2 and the novel TIRE protocol.

Join me in this episode as we hear Ken take us through his life’s work and learn from his vast knowledge and experience.

Trial the PrO2 at the Academy of Cardiovascular and Pulmonary Physical Therapy Fall Conference Sept 13 @ the exhibitor table!

Get 20% off + no shipping.

If you won’t be heading to the fall conference I have a coupon code just for you:

Code: ALLTHINGS15 to save 15% on your PrO2 device!

https://www.pro2health.com/products-list

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Episode 101: Clinical Decisions in Orthostatic Hypotension

Tue, 13 May 2025 08:00:00 -0500

Orthostatic hypotension (OH) is a common finding in the acute care setting. So, the question is, are there any hard and fast rules surrounding orthostatic hypotension? Are there cut-offs for activity / exercise?

The quick answer is: it’s complicated and it depends. It requires knowledge, experience and clinical judgement every step of the way. Each case, each patient may have different symptoms and different levels of blood pressure dropping at different points in time.

One clear point is assessing vital sign response to position changes and activity are paramount. Assessing your patient and recognizing subtle changes are equally important. And lastly, trusting your gut/intuition has a role as well.

Join me as we discuss the definitions of OH, common symptoms and real case examples.

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Episode 100 of Talking All Things Cardiopulm

Sun, 27 Apr 2025 10:00:00 -0500

Happy 100th episode of Talking All Things Cardiopulm!

My mission from day one was to bring Cardiopulm to the forefront of conversation, to give clinicians tools to use in their own practice and to help bridge the gap between research and the clinician.

I created this podcast, because I felt like it needed to exist. I hope to continue going for as long as I can, to provide value and resources for you.

If you want to support Talking All Things Cardiopulm, share an episode with a colleague, repost it on your favorite social media platform and/or write a great review!

I appreciate you being here, for listening, for the support and for wanting to be a part of the Cardiopulm conversation!

💥 Event Dates: May 6–8 (Live Pre-Party: May 5 @ 8 PM EST)
🎯 Audience: PTs, OTs, and students focused on adult rehab
🧠 What’s Included: 20+ PT and OT expert-led sessions, documentation strategies, treatment ideas
⏰ Free Access: 24 hour access to the pre-recordings that day with a free ticket
🏆 Power Pass Upgrade: 1-year access + 20 contact hours (OT - AOTA approved provider) and 20 PT CEUs + workbook + exclusive prizes

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Episode 99: The Woes and Wows of Documentation

Sat, 12 Apr 2025 06:00:00 -0500

Documentation continues to be one of the biggest frustrations across physical therapy. Despite the many changes in technology over the past 20 years, it can still feel time consuming and an overall arduous task.

Shifting our perspective to an opportunity to showcase our clinical expertise and reasoning can be helpful. I like to look at documentation like an ESPN snapshot. Point out the highlights, the major turning points during the session, the gains, the losses and the why. Tell the story instead of clicking the box.

Looking to enhance your documentation skills? Join me and other experts at the Innovative Treatments Effortless Documentation Summit hosted by the Note Ninjas on May 6-8. This free virtual event offers valuable treatment strategies along with the option to earn 20 contact hours for PTs and OTs.

GET YOUR FREE TICKET

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Episode 98: Do Experts Know Everything?

Fri, 04 Apr 2025 22:00:00 -0500

What makes an expert an expert? Is it their experience? Is it their knowledge? Is it their ability to teach/mentor? I can argue that it’s a compilation of all of the above. But do experts know everything? Is it even possible?

I think the question is a set up for the most obvious answer. But maybe it’s not that obvious? A recent conversation spurred this discussion. Join me as tackle this question and take on a soap box or two

I'm so excited to share this 3-day event hosted by my friends The Note Ninjas.

The Innovative Treatments, Effortless Documentation Summit is coming May 6–8… and it's FREE!

They’ve brought together a powerhouse lineup of experts to help you:
✅ Streamline documentation
✅ Discover fresh treatment ideas
✅ Avoid burnout
✅ And reignite your passion for clinical care

Grab your free ticket here

*Upgrade to the Clinician Power Pass to earn 20 contact hours (OT) or 20 PT CEUs, plus some awesome bonuses!

🎁Plus, there's a Facebook group with prizes, community, and more!

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Episode 97: Measles Resurgence: The comeback no one needed

Fri, 07 Mar 2025 21:00:00 -0600

I love a good comeback story, and typically cheer for the underdog, but the Measles can go ahead and stay in the past. As cases continue to rise, it’s time to take a look at overall pathophysiology and transmission of this very contagious virus.

Join me as we discuss yet another virus taking the U.S. by storm.

At the time of this recording the data available was as of 2/28/25 with 164 cases of measles, 1 death and 20% hospitalization. 1 week later, as of 3/7/25 cases have increased to 222 cases (94% unvaccinated), 2 deaths, and a 17% hospitalization rate.

In this episode:

Pathogenesis of measles
Transmission of measles
Signs and symptoms of measles
Benefits of MMR vaccine
Incidence and history of the measles in the U.S.

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CDC Measles surveillance

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Episode 96: RSV is it Droplet? or Contact? or Both?

Wed, 26 Feb 2025 11:00:00 -0600

As the winter season comes to an end, we review 1 of the 4 major viruses that has been rampant this year. Though RSV is officially on the decline, it is still very present in our communities and hospitals.

Join us as we discuss virus transmission and possible precautions, that you may say in your setting. Is it Droplet or is it Contact? That seems to be a question these days and there seems to be some unclear writing on the wall. So let’s break it down.

In this episode:

Discuss pathophysiology of RSV
Transmission of RSV
Current precautions for RSV: Droplet vs. Contact
Signs and symptoms of RSV
Current treatment available for RSV
New vaccines available for RSV
PT considerations for treating a patient with RSV

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Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

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Episode 95: Influenza A Continues to Climb

Sat, 08 Feb 2025 06:00:00 -0600

Influenza cases and hospitalizations continue to be the leading respiratory disease nationwide this season. As of Jan 25, 2025, there have been 20 million illnesses, 250,000 hospitalizations, and 11,000 deaths (including 47 pediatric deaths). At the time of this recording Feb 6th, the CDC had not issued a weekly report in 2 weeks. I am happy to report that the CDC did release a weekly report on Feb 7th. Data continues to show an uptrend in Flu A.

Join me as we discuss the different types of influenza, including the most prevalent strains this season. Understand the transmission, signs and symptoms, antiviral meds available, use of vaccines, and precautions to help keep you safe this season.

In this episode:

Incidence of Influenza as of Jan 25, 2025
3 forms of transmission
Signs and symptoms of influenza
Anti-viral meds available in the US
Vaccine use and assistance from the WHO
Precautions to take to help prevent spread and keep yourself safe
PT assessment/treatment in the hospital setting

Join my email list, this ensures I can reach you if social media, podcasting or whatever changes and also keep you in the loop about any upcoming events.

Are you in the KCMO area? I’m presenting on Respiratory Muscle Training. Register for this CEU opportunity!! Feb 26th 4:30pm.

Register Here for KC Metro Therapy Hour:

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Episode 94: TB Outbreak – What you need to know

Sun, 02 Feb 2025 05:00:00 -0600

We currently have a tuberculosis (TB) outbreak across the US and Kansas recently made national news in this regard. I’m here to break down the pathology of TB, and review the incidence to give some assurance, as well as, real concerns with this diagnosis.

In this episode:

Incidence of TB in the US over the last 5 years
Current KC TB outbreak
Active vs. Latent TB
Signs and symptoms of TB
Transmission of TB
Airborne Precautions
PT exam findings

Join my email list, this ensures I can reach you if social media, podcasting or whatever changes and also keep you in the loop about any upcoming events.

Are you in the KCMO area? I’m presenting on Respiratory Muscle Training. Register for this CEU opportunity!! Feb 26th 4:30pm.

Register Here for KC Metro Therapy Hour:

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IG: @all_things_cardiopulm

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Episode 93: Is snow shoveling safe for the cardiac patient?

Fri, 17 Jan 2025 20:00:00 -0600

What might seem like a simple task in the winter months could lead to devastation without the right education. What do we need to consider to keep our patients with heart disease safe?

The concern lies in the compounding effect. The effect of cold weather on the cardiopulmonary system, age, comorbidities, and aerobic capacity all play a role in determining safety.

Join me as we dive into HR response, MET levels, predictive equations, and much more.

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Physical activity Compendium

Ego Power+ 1400
Multihead Snow Shovel
Ego Power + 4.0aH Battery

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

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Episode 92: Cold Weather’s Effect on the Cardiopulmonary System

Sat, 11 Jan 2025 10:00:00 -0600

As the temperature drops across the country it is important to understand the impact the cold air will have on the cardiopulmonary system. Similar to pipes in a house, the cold affects both the pipes in the lungs and body in the same way, constriction. Although these changes occur in healthy individuals, they have more profound impact on those with heart and lung conditions.

Join me as we discuss these changes, and some tips to help combat them.

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

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Episode 91: Value what we do

Wed, 01 Jan 2025 13:00:00 -0600

Leaving the last day of 2024 with a little spice. Since most of this audience is PTs, PTAs and PT(A) students, I just want to remind us to value what we do. Stand up for your skill set, educate others on the benefits and continue to advocate!

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

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Episode 90: Evaluating Diaphragm excursion via Dynamic MRI, an article review

Fri, 27 Dec 2024 06:00:00 -0600

Review of the literature brings us an article from Japan, evaluating diaphragm and chest wall excursion in four different positions in healthy adults. Dynamic MRI was utilized for excursion measurements throughout all four positions in quiet breathing. The initial hypothesis was disproved, allowing for deeper discussion of the effect of position on diaphragm movement.

Join me today as we discuss the impact of patient positioning on the diaphragm and add another tool to the toolbox.

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

Find me on:

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Episode 89: Have you seen the Nuss Bar Protocol?

Tue, 17 Dec 2024 06:00:00 -0600

Have you seen the Nuss Bar Protocol? If not, this will prepare you if you ever do. This procedure is more common in the pediatric population but is a growing surgical option for patients in their 40th and 50th decade of life. Though considered a “minimally invasive technique,” it is quite an extensive procedure that navigates around multiple primary organs and has several considerations post-surgically.

Join me as I discuss the evolution of the procedure and possible precautions you may need to consider.

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

Find me on:

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Episode 88: Tracheal Deviation, to the Left or to the Right?

Tue, 10 Dec 2024 11:00:00 -0600

Tracheal Deviation, to the Left, to the Right, which way does it go? This is probably one of the most common questions that I get from students studying for the NPTE. As it often does, the answer comes down to pressures.

Tune into this episode to learn ipsilateral vs. contralateral movement of the trachea.

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

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Episode 87: Considerations of the Automatic Blood Pressure

Fri, 29 Nov 2024 22:00:00 -0600

It would be unfair of me to dismiss automatic blood pressure measurements as they are used in most settings, including the ICU. It’s important to understand their normal guestimate error range and when you should consider taking a manual BP. Similar to manual blood pressures, there are a number of steps you can take to help increase their accuracy. Instead of avoiding the inevitable, let’s empower the clinician to understand their equipment.

Website to check for validated BP machines:
https://www.validatebp.org/devices

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Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

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Episode 86: Improving Accuracy with Blood Pressure Measurement

Tue, 26 Nov 2024 06:00:00 -0600

Want some tips to improve the accuracy of your blood pressure technique? I’ve got you covered. It all starts with a manual cuff, the obliteration technique and a few simple setup tips.

Join me in this episode as we break down the step-by-step technique of improving accuracy with blood pressure measurements.

In this episode:

Set up considerations prior to taking BP
Importance of cuff size
Positioning with BP measurements
How to perform the obliteration technique

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Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

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Episode 85: Assessing MIP and MEP

Sat, 16 Nov 2024 07:00:00 -0600

Respiratory muscle training is by far one of my favorite interventions and continues to show itself in research. Anytime RMT is added, you can hypothesize that your patient will improve in a number of different categories (gas exchange, respiratory strength, 6MWD, QOL scales, blood pressure, and the list continues). I honestly continue to be impressed by RMT.

But in order to incorporate RMT, you have to have an assessment tool that can show you a true pre-post for respiratory muscle strength. That assessment is MIP (maximal inspiratory pressure) and MEP (maximal expiratory pressure). Join me in this episode as we discuss devices, protocols, predictive equations and normative data, so you can assess MIP and MEP too.

In this episode:

How to assess MIP and MEP
Devices available to perform MIP and MEP
ATS/ERS and SEPAR protocols
Predictive equations for MIP and MEP

Resources:

Laveneziana P., Albuquerque A., Aliverti A., et al. Spengler CM, Vogiatzis I, Verges. ERS statement on respiratory muscle testing at rest and during exercise. Eur Respir J. 2019;53 doi: 10.1183/13993003.01214-2018.

· Highly recommend reading the “supplementary material”

Lista-Paz et al. Maximal Respiratory Pressure Reference Equations in Healthy Adults and Cut-off Points for Defining Respiratory Muscle Weakness. Arch Bronconeumol. 2023 Dec;59(12):813-820. English, Spanish. doi: 10.1016/j.arbres.2023.08.016. Epub 2023 Sep 29. PMID: 37839949.

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Episode 84: Breaking Down High-Flow O2 Devices

Wed, 06 Nov 2024 09:00:00 -0600

In today’s episode, we break down 3 of the most common high-flow oxygen devices that you may see in the hospital setting: typical high-flow nasal cannula, venturi mask, and heated high-flow nasal cannula devices. Each device varies on the level of flow and FiO2 available, as well as, how the FiO2 is achieved. Each device also has pros and cons for choice of use.

Join me today, as we discuss the difference between the more common high-flow oxygen devices available.

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Episode 83: Nomenclature Matters

Wed, 30 Oct 2024 08:00:00 -0500

Time and time again, across my career, whether I’ve been in the clinic or teaching, I have come across words in healthcare that are either used interchangeably, go by different names, or simply have changed over time.

Nomenclature issues can lead to confusion, errors, and miscommunication, while also limiting data collection for research.

Join me on this opinion piece about nomenclature and share your nomenclature nuances.

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Episode 82: Breaking Down Low Flow Oxygen Devices

Fri, 18 Oct 2024 06:00:00 -0500

Working with patients on oxygen can feel overwhelming with all the possible devices that can be utilized. Whether or not you are a clinician who helps in making those decisions or you are actively working with patients using these devices, it’s important to understand their range of use, the level of FiO2 available, pros and cons, as well as, special considerations for each device.

Join me today, as we break down the most common low-flow oxygen devices available so you can feel confident in your clinical practice.

In this Episode:

Difference between low-flow and high-flow devices
Devices: Nasal Cannula, Simple Face Mask, Partial Non-Rebreather, Non-Rebreather and Oxymask
Pros & Cons of each device
FiO2 and flow required for each

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Episode 81: Let’s Talk Oxygen Titration

Sat, 12 Oct 2024 07:00:00 -0500

There are many steps when dealing with oxygen titration. In this episode, we set the stage for what clinicians need to consider when dealing with a patient on oxygen, including our state practice act, MD orders, available devices, and titration concepts.

As PTs we can take an active role in education, and, oxygen titration to optimize safety and maximize patient outcomes.

In this episode:

PT State Practice Act
MD orders for oxygen titration
Understanding oxygen devices
Interdisciplinary collaboration
Oxygen Titration concepts

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Episode 80: ‘Mow’ your limits

Wed, 02 Oct 2024 08:00:00 -0500

An episode about mowing, MET levels, and knowing your (your patient’s) limitations. Have you ever been asked, “Can I get back to….?” How do you help your patients make these decisions? Do you consider MET levels, HR response, or overall aerobic capacity?

Using MET levels for a specific activity can be a great way to help educate patients on their current abilities or to assist in creating meaningful goals for future activities. It can be a great starting point to help determine the “it depends” answer. It provides objective information to help gauge the overall energy expenditure to complete a specific activity.

So, how do we determine METs for mowing or any other activity? Check out this episode as we discuss the heart rate and blood pressure response to MET levels and incorporate the physical activity compendium to your toolbox.

In this episode:

Define a MET
HR and BP response to 1 MET activity
Use of the physical activity compendium

Resources:

2024 Adult / Older Adult Compendium: https://pacompendium.com/

Youth Compendium: https://www.nccor.org/tools-youthcompendium/

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Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

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Episode 79: Ortho trauma case is a Cardiopulm Case in Disguise

Wed, 25 Sep 2024 08:00:00 -0500

Today we discuss a recent acute care evaluation of a 52yo male s/p motocycle crash, despite multiple orthopedic injuries, both the lung and the heart played a bigger role than the initial case synopsis would think.

Let’s dive into a cardiopulmonary assessment and treatment interventions for this fun and complex orthopedic case.

In this episode:

Lung Auscultation
Chest wall Assessment
Breathing exercises
Cough Techniques
Rib fractures
Transfer techniques

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Episode 78: Enhancing Breath Control with Lateral Costal Breathing

Wed, 18 Sep 2024 09:00:00 -0500

Lateral costal breathing exercise technique is a versatile approach that can be used to help improve lateral costal (side ribs) movement in a variety of patient populations. It is a go-to technique to improve motor control and expansion, as well as decrease anxiety and dyspnea.

Join me in this episode and give this breathing exercise a try.

In this episode:

How to perform lateral costal breathing technique
Discuss multiple variations of the approach
What patient diagnoses or conditions to utilize this approach
Benefits of using lateral costal breathing

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Episode 77: All Things Pulmonary Rehab

Fri, 13 Sep 2024 07:00:00 -0500

Join me today as we discuss all things pulmonary rehab, its structure, accepting diagnoses, benefits and even its continued underutilization.

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Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

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Episode 76: How to Improve an Ineffective Cough

Sat, 07 Sep 2024 12:00:00 -0500

There are a number of reasons why a cough may be ineffective. It all starts with assessing the four phases of a cough. Once the inefficiency is highlighted it’s time to work on improving it.

Pending which phase is most affected, depends on how you will approach the interventions. Whether you are utilizing posture, applying manual pressure or aiming for time, there is something beneficial for each person. More importantly are the consequences of this improvement.

Tune is as we break it all down.

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Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 75: New Semester, Same Advice

Sun, 01 Sep 2024 14:00:00 -0500

It’s that time of year, the start of a new semester. For some it’s their first-ever semester, for others, it may be their last. No matter where you are in your journey, my advice for the semester typically stays the same.

Tune in for some real-life tips and study advice, to make the most of your semester and prepare you for future exams.

In this Episode:
- Semester tips to set you up for success
- Study strategies
- White paper test technique

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Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 74: Managing Aspergillus Fungal Pneumonia: A PT perspective

Wed, 21 Aug 2024 06:00:00 -0500

In today’s episode, we break down the priorities of seeing a patient with Aspergillus pneumonia (PNA). When coughing and shortness of breath are the primary limitations, what should be your primary focus during your session? As much as mobility is a huge priority in the acute care setting, it is not the only thing to consider in this patient population. As physical therapists, we should be empowered to use our whole scope of practice to prioritize assessment techniques and interventions that cater to your patient’s primary concerns; in this case, breathing, mucus, and fatigue.

Join me as we tackle this case and discuss the real priorities of a chest assessment and subsequent interventions to make greater impact.

In this episode:

Basics of Aspergillus pneumonia diagnosis
Cavitation
Chest Assessment
Phases of a cough
Airway clearance techniques
Percussion/vibration
Huff cough technique
Functional Cough

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IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

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Linked-In: Rachele Burriesci

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Episode 73: COVID-19 Summer Surge & Variant Updates

Wed, 14 Aug 2024 15:00:00 -0500

As we cruise through August we are amidst the middle to end of the COVID summer surge. With each new surge comes a new variant. And with each new variant comes new info or old info updated.

Today we discuss the nomenclature of the newest variants, symptomatology, PPE, ongoing discussion of airborne vs droplet and updates on the vaccines.

In this episode:

COVID-19 newest variants KP.3.3.1, KP3, KP2 and LB.1
Most common symptoms of current variant
Droplet vs. airborne definitions
Update on vaccine

Home Test Expiration Dates:
https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/home-otc-covid-19-diagnostic-tests#list

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Episode 72: Preventing COVID in your own Home

Mon, 12 Aug 2024 11:00:00 -0500

Has COVID entered your home? Are you trying to prevent spreading COVID to your family members or are you trying to prevent getting COVID in your own home?
Four years in, I’m sure we are all well versed in COVID transmission and how to prevent spread, but what options do we have once it has entered the home? Is it a lost cause to try and prevent transmission? Are there strategies we can take?

This is one of the most common questions I get asked, usually once someone tests positive in the home. Although there are no guarantees, there are strategies we can take to decrease the risk of spread.

Join me as I discuss preventing the spread of COVID in your own home from a personal and clinical perspective.

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Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 71: Breaking Down the Respiratory Metaboreflex

Sat, 03 Aug 2024 18:00:00 -0500

Halfway through the year, have you checked in with your personal goals? I certainly have been sitting and reflecting on the speediness of the last 6months and setting some new intentions for the upcoming year.

But after a short dialogue about self-reflection, we jump back into all things Cardiopulm and break down the respiratory metaboreflex. What it is, when it kicks in, its overall impact on the body and the role in RMT to ward off its response. There is still a lot of unknown about the physiologic process but we will touch on what is known and what may impact your practice.

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Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 70: Understanding the Impact of Hypo and Hyperkalemia

Wed, 24 Jul 2024 09:00:00 -0500

Have you ever had to make a decision about seeing a patient with hypo or hyperkalemia? Have you been a part of the conversation? Do you want to be a part of that conversation? Do you want to understand the concerns that exist for both ends of the spectrum?

Join me as we break down the risks, causes and signs of both hypo and hyperkalemia.

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Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 69: The Deleterious Effects of Bed Rest

Thu, 18 Jul 2024 16:00:00 -0500

Has your patient ever been surprised by the level of debility that has occurred in such a short period of time?

The amount of change that occurs in such a short period is of no surprise but is still profound and can cause major changes in a person’s life, including but not limited to falls, weakness, cardiovascular changes and much more.

Tune into this episode to explore the physiologic changes that occur with “bed rest.”

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Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 68: Why you care about the ANS

Wed, 10 Jul 2024 11:00:00 -0500

Do not underestimate the value of foundational knowledge. Understanding the basics, the foundation allows you to piece together multiple complex diagnoses, medications, theories and much more.

Join me, as we break down the impact of intrinsic and extrinsic factors that impact the cardiopulmonary system. The autonomic system plays an intricate role in second-to-second adaptations of the heart and lungs to the environment, exercises, stressors, heat and even meds.

Understanding the why, will always give you more depth. Let’s get after it!

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Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 67: Who would benefit from a breathing assessment?

Wed, 03 Jul 2024 10:00:00 -0500

Who would benefit from a breathing assessment? Is it just patients in the hospital setting? Is it just patients with lung disease?

The answer is an overwhelming no. Breathing is for everyone. Even high-level athletes can benefit from a breathing assessment and definitely breathing interventions. What you will find may surprise you…

Tune into this episode to discuss the breathing mechanics of a soon-to-be D1 athlete.

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Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 66: Can Diaphragmatic Breathing Help Decrease Blood Pressure?

Mon, 01 Jul 2024 12:00:00 -0500

Hypertension (HTN) is known as the silent killer because of its silent damage over years and years, leading to the number one cause of death coronary artery disease. We know lifestyle change has significant effect on preventing and decreasing HTN, but pharmacologic management is typically the primary driver.

So what if there was another tool that could help decrease blood pressure in a non-pharmacologic way? What if we incorporate a breathing technique that will not only help BP control but also have other great physiologic improvements at the same time?

In this episode:

Mechanics of diaphragmatic breathing
Defining RMT
Benefits of diaphragmatic breathing on the heart
Discuss the role of respiratory metaboreflex
Discuss the role of the baroreflex
Discuss Sympathetic and Parasympathetic input on the heart

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

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Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci

. to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

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Episode 65: NPTE Prep - PAD Breakdown

Thu, 27 Jun 2024 14:00:00 -0500

Giving you the quick and dirty breakdown of PAD for your NPTE prep.

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Jane, is an all-in-one practice management software with helpful features to power your practice. Head to https://meet.jane.app/more-time?utm_medium=rachele_burriesci&utm_source=ambassador&utm_campaign=more_time_campaign&utm_content=podcast&utm_term=us_physio. to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 64: Navigating 3 Types of Anesthesia in the Acute Care Setting

Wed, 12 Jun 2024 07:00:00 -0500

Are you new to acute care, maybe a student ready to approach their first acute care rotation or maybe just an OG PT that wants to corroborate this story?

Post-op rehab can be very affected by the type of anesthesia that is used. The best way to deal with this as a PT is to understand the potential outcomes or common trends. The more you know, the better you will be able to anticipate what will/could happen aka look like you’re carrying a crystal ball.

Join me in this episode as we discuss common side effects of general anesthesia, spinal anesthesia and epidurals in the acute care setting and how it may affect your POD#0 or POD#1 evaluation.

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to https://meet.jane.app/more-time?utm_medium=rachele_burriesci&utm_source=ambassador&utm_campaign=more_time_campaign&utm_content=podcast&utm_term=us_physio. to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 63: What you did not know about RPE...

Wed, 05 Jun 2024 08:00:00 -0500

Are you familiar with the RPE scale? Do you have a preference on the 6-20 or 0-10 scale? Have you utilized this scale in your practice or teaching? Me too! And yes I 100% have a preference.

But did you know that this scale has been around since the 1960s and was created by Dr. Gunnar Borg and later updated with his daughter? Have you ever checked the original reference of the Borg scale you use? Is it in color? What words are assigned to the numbers? What instructions are given for use?

If you’re curious, join me in this episode while you watch me actively synthesize the rabbit hole I jumped in and more importantly learn the intent behind these well-validated scales!

In this episode:

Evolution of the Borg RPE scale
The intent behind the 6-20 RPE scale and CR-10 scale
Discuss instructions for each scale
Importance of utilizing the original scale

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

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Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

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Episode 62: Order of Operations for Optimizing Airway Clearance

Fri, 31 May 2024 21:00:00 -0500

Ever wonder if there is a more effective strategy for helping patients clear their secretions?

What you do and how you do that intervention matters, but what if when you did them, was even more important?

Join me in this episode, where we will break down the order of operations to optimize your treatment techniques and your patient’s mucus clearance.

In this episode:

Importance of assessment techniques
Order of techniques to optimize mucus clearance
Breathing exercises: inspiratory holds, stacked breathing, active cycle of breathing, autogenic drainage
Postural Drainage
Precautions and relative contradictions to postural drainage
Huff Cough
Functional cough
Medication management and interdisciplinary coordination

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 61: Atrial Fibrillation – Controlled vs. Uncontrolled, That is the question!

Sun, 26 May 2024 08:00:00 -0500

Atrial fibrillation is one of the most common arrhythmias you may see in practice. It can be both safe to work with and dangerous. Therefore, it’s important to understand the rhythm at its base and the concerns that exist with this rhythm.

Let’s break down a-fib at its core, identify its main characteristics on EKG, common symptoms, as well as, acute and long terms concerns. As a physical therapist, you may be the first person to identify this rhythm and you may have to make judgment calls about safety. We will differentiate safety with controlled vs uncontrolled rates, as well as, rapid ventricular rates.

In this episode:

Atrial fibrillation EKG characteristics
Signs and symptoms of afib
Differentiating between controlled vs uncontrolled vs RVR
Safety with exercise with uncontrolled rates
Using your clinical judgement

NPTE PREP Newsletter: https://allthingscardiopulm.ck.page/nptereadiness724

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 60: Optimizing NPTE Prep: Study Tips & Strategies for Success

Tue, 21 May 2024 21:00:00 -0500

The NPTE is too important of a test to try and wing it or attempt to cram. It’s a fine balance of attacking your weaknesses and using your strengths to develop momentum and confidence.

Prepping for the NPTE takes organization, planning, discipline and a dose of consistency.

Tune into this episode to learn how to set yourself up for success and learn about the new updates coming to the All Things Cardiopulm NPTE Prep Course.

Get on the wait list now! Just drop your email below!

In this Episode:

Discuss creating a timeline for studying
Importance of your scheduled test time
Daily Routines
Purposeful studying
Utilize exam questions to hit a variety of topics
Learn the concepts and benefits of white paper testing
Use of flash cards / quizlets

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 59: Patience and Pacing

Wed, 08 May 2024 08:00:00 -0500

Have you ever made dough from scratch? If you have, you know it’s all about the long game and a ton of patience. This is not a hobby that you can practice quickly, nor a skill you can rush through. It takes time to get it right and it takes patience to work through it.

Patience is not always an easy skill to master, especially if you feel short of breath, but it is a necessary skill to conquer to prevent the perpetual cycle of panic and recovery. In the world of pulmonary disease, patients don’t always have the privilege of reserves and typically rush to complete the task. Unfortunately, this response only leads to a further cycle of panic, tank, and recover. How can we help them through this? How can we change the cycle to help them go further, for longer?

Tune in for a dose of patience and pacing.

Join my newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 58: Part 4 Tackling the MOSC: Building your Case!

Wed, 01 May 2024 10:00:00 -0500

Are you procrastinating on completing your MOSC application or just feeling overwhelmed? Don’t worry I got you. Check out this 4 part series of tackling the MOSC to help you plan, prepare and successfully complete your specialty portfolio.

Learn from my mistakes along the way, and hit this application with efficiency and confidence!

In this episode, we get down to the nitty-gritty of building your case. Go through section by section, to describe what’s needed and ideas on how to use your ICF and patient-client management verbiage throughout.

Listen for future use OR dive in with me if you are actively completing this process. I promise this is one that you will be able to use for years to come.

MOSC Online Portal: https://abptsportal.apta.org/Learner/LearningPlan/List

MOSC Requirements: https://specialization.apta.org/maintain-certification/mosc-requirements

Join my newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Need further guidance on the MOSC?
Sign up for 1:1 mentoring session: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 57: Part 3 Tackling the MOSC - Investigating the Patient-Client Management Model

Wed, 24 Apr 2024 12:00:00 -0500

Time to dust off those cobwebs if you have been in the field for some time, and re-investigate the patient-client management model. Why do you care about this verbiage? Because you will need to overlay the ICF model and the patient-client management model when writing up your MOSC Case. Although they are separate entities they very much intertwine and share a common theme, with very different words.

Let’s make life easy by breaking down the verbiage up front, so you can tackle your case with ease.

MOSC Online Portal: https://abptsportal.apta.org/Learner/LearningPlan/List

MOSC Requirements: https://specialization.apta.org/maintain-certification/mosc-requirements

Join my newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Need further guidance on the MOSC?
Sign up for 1:1 mentoring session: https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 56: Part 2: What the MOSC is going on here?

Wed, 17 Apr 2024 06:00:00 -0500

Are you an ABPTs certified specialist? Are you knee-deep in the MOSC or are you not sure where to start?? Join me as I break down the MOSC application.

Learn from my early shortcomings and take advantage of the inside tips to take on your application cycle with ease.

Organization is key. Let me help lay the groundwork to set you up for success for years to come.

In this episode:

Direct qualifications for patient care hours
Discuss the 3 categories of professional development.
Number of MOSC credits required per category
Organization techniques to stay ahead of the curve

MOSC Online Portal: https://abptsportal.apta.org/Learner/LearningPlan/List

MOSC Requirements: https://specialization.apta.org/maintain-certification/mosc-requirements

Join my newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Need further guidance on the MOSC?
Sign up for 1:1 mentoring session: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 55: Part 1: Tackling the MOSC – First we must understand ICF

Wed, 10 Apr 2024 10:00:00 -0500

Are you a board-certified physical therapy specialist?

Have you started the MOSC process yet? MOSC is the Maintenance of Specialty Certification process utilized by the ABPTS to help PTs re-certify in their specialty area. It’s essentially a portfolio to showcase your competence in your specialty area.

Before I go into the ins and outs of the MOSC application I wanted to first tackle the ICF model as this will be integrated within the case application.

If you never learned about the ICF in school, it’s ok, me neither, there was a change in language sometime in the early 2000s, but clearly change takes time to make its way into practice.

I’m here to help break down the nomenclature within the ICF model and help you integrate it within your MOSC case, and maybe within your practice.

If you are still feeling overwhelmed by the MOSC process, Sign up for a 1:1 mentoring call and we can discuss your individual needs to get your MOSC completed and submitted. https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Are you on my newsletter? Interested in joining? Sign up here: https://allthingscardiopulm.ck.page/9bb2730421

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 54: Sternal Precautions: Is there a Standard?

Fri, 05 Apr 2024 09:00:00 -0500

In this episode Dr. Burriesci discusses the common question about sternal precautions: Is there a Standard? As simple as this question may seem, there is a ton of nuance and a ton of variation across the country, across hospital systems and across surgeons.

This is then followed up with the question: are these standards to restrictive? Are there other options? Should we be moving away from these “precautions”?

This is not a new question. We will go back to 2011 and discuss the evolution of this thought process.

In this episode:

- Typical Sternal Precautions and the variations that exist

- Discuss a more individualistic approach based on risk factors

- Break down 4 articles starting from 2011 addressing these exact questions

- Discuss Baylor’s protocol “Keep Your Move in the Tube”

Highly recommend reading these articles:

Cahalin LP, LaPier TK, and Shaw DK: Sternal Precautions: Is it time for change? Precautions versus restrictions – a review of literature and recommendations for revision. Cardiopulmonary Physical Therapy Journal 22(1), 2011, p 5-15 (on blackboard)
Adams J et al. An alternative approach to prescribing sternal precautions after median sternotomy, “Keep Your Move in the Tube.” Bayl Univ Med Cent. 2016 Jan;29(1)97-100.
Katijjahbe M et al. Sternal Management Accelerated Recovery Trial – standard restrictive v. modified sternal precautions following median sternotomy. Study Protocol for randomized control trial. April 2017;18:290. DOI 10.1186/s13063-017-1974-8
Gach R, Triano S, Ogola GO, et al. “Keep Your Move in the Tube” safely increases discharge home following cardiac surgery. PM&R. 2021;13:1321–1330. https://doi.org/10.1002/pmrj.12562

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Are you on my newsletter? Interested in joining? Sign up here: https://allthingscardiopulm.ck.page/9bb2730421

What to discuss how to implement protocols into your setting or disscuss a complex case. Sign up for a 1:1 mentoring call:
https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 53: When in Doubt, Pair it!

Wed, 27 Mar 2024 07:00:00 -0500

This episode starts with a little recap from the past week. The astrological world came in with a vengeance and Dr. B definitely felt the wild energy last week. We learn more about Remy, the cute pup you will likely see on her IG stories, and the highs, lows and plateaus of training. All is good, just a hiccup in time, a slight low after an appreciated plateau. But as we all know with anything we are going after, progress is not linear.

The same is true for breathing exercises and many times it comes with a learning curve. But it is worth it. Today we dive into paired breathing. It’s uses, benefits and a little how-to to get the ball rolling. Dr. Burriesci shares what population she loves to use paired breathing with and gives some inside tips on how to customize it to your patient.

Come join me on another episode of learning, insight and clinical tips.

In this episode:

- Definition of paired breathing

- Populations that may benefit from paired breathing

- How to perform paired breathing

- Clinical tips to adjust paired breathing to your patient.

Are you on my newsletter? Interested in joining? Sign up here: https://allthingscardiopulm.ck.page/9bb2730421

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

What to learn more about breathing exercises and how to implement them with your patient population? Sign up for a 1:1 mentoring call
https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 52: What does Mentorship mean to you?

Fri, 22 Mar 2024 06:00:00 -0500

Have you ever had a new job? Have you ever had an expectation of what the orientation process would look like? Ever expect mentorship and didn’t get it? Me too!

The primary reason I was in search of a residency 4 years into my career, was because I was search of mentorship. I wanted to be challenged, I wanted to be guided, I wanted to be a better mentor.

I truly believe mentorship is a progression and it should be structured and it should be evolving.

What does mentorship mean to you?

Tune in, to talk about mentorship, dig in to expectations and of course a bit of storytelling.

Interested in 1:1 mentoring with me? Book a call today...
https://www.allthingscardiopulm.com/m...

SMART goals podcast:
https://podcasts.apple.com/us/podcast...

Want to learn more about Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 51: The Rigors and Rewards of a Cardiopulmonary PT Residency

Tue, 12 Mar 2024 23:00:00 -0500

Have you ever wondered what a cardiopulmonary residency would look like? The pros, the cons, the real insights?

Join us today for our candid conversation about residency life, the rigors and the many rewards.

I am joined by two mentors from the VA Ann Arbor Residency program, Crystal and Jessica, who share their personal stories of choosing residency, their life within residency and their continued role post-residency.

If you are interested in cardiopulmonary residency, check out the VA Ann Arbor, and take a listen to this episode to find out why this may be the place for you!

In this Episode:

Discuss the benefits of a cardiopulmonary residency
Pros and Cons between a new-grad PT and a seasoned PT applying for residency
Expectations of the Residency Year
Benefits of choosing the Ann Arbor VA
Cardiopulmonary PT Residency Application process

About the Ann Arbor VA Residency:
https://www.va.gov/ann-arbor-health-care/work-with-us/internships-and-fellowships/cardiovascular-and-pulmonary-physical-therapy-residency/

How to apply to the Ann Arbor VA Cardiopulmonary Residency:
https://rfptcas.liaisoncas.com/applicant-ux/#/login

For further information, contact:
Stephanie Kostsuca PT, DPT, CCS
PT Residency Program Director: Stephanie.Kostsuca@va.gov

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 50: If You don’t Assess, Then You Don’t Know

Fri, 08 Mar 2024 22:00:00 -0600

It is as simple as that. Assessment is key. Taking vitals is paramount. Get those baseline values, so you know whether your person is tolerating or having an inappropriate response.

Join Dr. Rachele Burriesci, as she discusses the importance of vital sign assessment via case examples.’

Interested in Jane?
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 49: Are You Down with RMT?

Wed, 28 Feb 2024 11:00:00 -0600

RMT (respiratory muscle training) is a simple intervention with a lot of punch. Dr. Burriesci breaks down the benefits of utilizing an intervention like RMT with patients across the spectrum and with a wide variety of diagnoses. Breath training, specifically, resistance training can have a profound impact on the entire system.

Come join me on this episode as we define RMT, MIP, and MEP. Determine objective measures and devices available to measure MIP and MEP and devices that provide resistance with inspiration only, expiration only or both.

Find out which type Dr. Burriesci prefers and why.

In this episode:

Define RMT (respiratory muscle training)
Define IMT (inspiratory muscle training)
Define MIP & MEP (maximal inspiratory and expiratory pressure)
Discuss devices available to determine MIP/MEP
Discuss devices available to perform RMT
How to perform MIP/MEP
Benefits of RMT
FITT principles typically adopted for RMT

The Breather: https://amzn.to/49OZuw8
*As an Amazon Associate, I earn from qualifying purchases, at no cost to you.*

Interested in Jane?
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 48: Don't Sleep on Grip Strength

Thu, 22 Feb 2024 13:00:00 -0600

Welcome back from CSM, join Dr. Burriesci as she recaps her time at CSM. A dicey start with a near nor'easter, but all faired well as 16,000 people attended CSM in Boston. Whether you were there to present, learn, or enjoy an ultimate reunion, CSM brings energy and rejuvenation.

Switch gears to an objective measure that is sure to show benefit over time. Grip strength! What's the first thing you think of when you hear grip strength? Is it overall wellness or prediction of morbidity and mortality?

Tune in to hear the strength of grip strength in the literature.

Camry Digital Dynamometer: https://amzn.to/436pqBr
*As an Amazon Associate, I earn from qualifying purchases, at no cost to you.*

Interested in Jane?
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 47: Tracheostomy Case

Wed, 14 Feb 2024 07:00:00 -0600

Review a case with Dr. Rachele Burriesci, 76yo male s/p tracheostomy revision on heated humidified air at FiO2 21%. Join me as we break down fundamental chest exam techniques and findings present in this case. We will then navigate through breathing exercises and airway clearance techniques that will maximize his overall picture while building rapport and confidence in this patient.

Interested in Jane?
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 46: Airway Clearance - Who's Responsibility is it?

Thu, 08 Feb 2024 07:00:00 -0600

Join Dr. Rachele Burriesci as she welcomes you into her dining room to discuss a common question about airway clearance in the hospital setting. Who is responsible for "chest PT"?

Rachele breaks down the nuance of "chest PT" and dissects the potential underlying questions within the question. She is transparent about possible challenges met when introducing "new" techniques and is honest about the reality of making changes within existing cultures.

In this episode:
- defining "chest PT"
- responsibility for airway clearance across teams
- making changes in your current setting
- building organic relationships

Interested in Jane?
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 45: PT Management of the Tracheostomy

Mon, 29 Jan 2024 20:00:00 -0600

Have you ever worked with a patient with a tracheostomy (trach)? Do you want to feel more comfortable working with this population? Are you worried that you won’t know how to manage the trach itself? Are you not sure what cues to give?

Working with this patient population can be one of the most rewarding experiences, but it can also feel very overwhelming if you don’t know what to expect or understand how you can facilitate their progress.

Join me on this episode, as we break down the anatomy, physiology, and clinical implications of working with a patient with a trach. We will discuss the equipment that is utilized to support and progress the patient, as well as important interdisciplinary communication to enhance your patient’s outcomes.

Whether you are a seasoned physical therapist or a new grad, this episode will equip you with the knowledge and confidence to assess and treat your next patient with a trach.

In this episode:

Understanding equipment and anatomy of the tracheostomy
Progression from vent to trach collar
Mechanics of breathing with a tracheostomy
Role of the glottis
Effects of mechanical ventilation on the diaphragm
Collaborating with your interdisciplinary team
Breathing exercises appropriate for your patient

Interested in Jane?
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 44: Navigating Pulmonary Arterial Hypertension Case

Fri, 26 Jan 2024 06:00:00 -0600

In this episode, Dr. Burriesci, breaks down pulmonary arterial hypertension (PAH) via a young 22yo acute care case. We discuss the potential causes of pulmonary HTN, diagnostic findings and concerns regarding pulmonary hypertension-specific meds. Lastly, we discuss important components of PT treatment in this patient population.

In this episode:

Discuss PAH pathophysiology
Diagnostic criteria for PH
PAH meds
Interventions to help progress PH

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Interested in Jane?
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

Text at 913-308-4494

Episode 43: Complex Case Discussion - O2, COPD, Amputee & so much more

Wed, 17 Jan 2024 12:00:00 -0600

Join me on a complex case discussion, as we dive into assessment, intervention and rationale for a patient with COPD, prior amputation and new oxygen needs.

In this episode:

The acute care patient
COPD
Pulmonary HTN
Possible HF diagnosis
Implications of above-knee amputation
Oxygen titration

Find me on:

IG: @all_things_cardiopulm
Threads: @all_things_cardiopulm
Website: www.allthingscardiopulm.com
Twitter: @allcardiopulm
Linked-In: Rachele Burriesci
Text at 913-308-4494

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 42: Upper Body vs Lower Body Exercise Response

Fri, 12 Jan 2024 21:00:00 -0600

Welcome back and Happy New Year! It was not the start of year that I intended on, but we’re back and trying to get back in the groove.

This episode is specific to a student question, but as always there’s a few clinical pearls for the clinician as well.

What is the difference between upper extremity and lower extremity exercise in regards to hemodynamic response?

Tune in to find out…

In this episode:

Identify “rhythmic” exercise
Difference between upper extremity and lower extremity rhythmic exercise response
What to consider clinically?

Jane Webinar:
The New Year, New Practice Software Webinar will be held on Tuesday, January 16 at 10 am PST.

Register here: https://janeapp.zoom.us/webinar/register/WN_KeeZDLp5RFGBJKmYY2Ptlg

Interested in joining the Jane community or want to trial a 1:1 demo? Go to Jane.app/payments and don’t forget to use code: CARDIOPULM1MO to get 1-month free grace period at sign-up.

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IG: @all_things_cardiopulm

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Linked-In: Rachele Burriesci

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Episode 41: You can be the Ferrari or you can be the Pinto. What it Means to Practice at the top of your license

Wed, 27 Dec 2023 06:00:00 -0600

If you love your job, you won’t work a day in your life. We’ve all heard the quote, but sometimes work is work and your co-workers and your supervisor make (or break) the environment. Employees enjoy being acknowledged for the “small things”, they would like support for their team and be valued for what they bring to the table. These are all things employees desire and Dr. Tina Fields strives to deliver for her unit.

In this episode, Dr. Burriesci chats with Dr. Tina Fields, the Supervisor and Director of Residency at University of Michigan Health. They burrow in deep on leadership and what that looks like on the “Cards” unit, how she facilitates her staff recognizing one another and empowers them with knowledge from within and adjacent to their scope of practice.

She ventures from her desirable leadership practices to the treatment of Left Ventricular Assistive Device (LVAD) patients and how that can be an incredibly complex dance. She explains that she wants her team to feel confident in the treatment of these patients (and all others), but that she also wants them to practice at the top of their scope. Her team knows what they’re doing, and they should advocate for themselves and their patients. She rounds out the episode by talking about what the University of Michigan’s Cardiovascular and Pulmonary residency looks like and how they set their residents up for success, even if their route ventures from their facility.

Join us for a conversation that not only educates but also ignites a passion for pushing the boundaries of physical therapy.

In This Episode:
- How to create great culture in a department
- How to create good PT culture hospital-wide
- What it means to practice at the top of your license
- Competencies and orientation
- LVAD training

Interested in Jane?
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 41: You can be the Ferrari or you can be the Pinto. What it Means to Practice at the top of your license

Wed, 27 Dec 2023 06:00:00 -0600

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 40: Rules for Sublingual Nitro

Thu, 21 Dec 2023 07:00:00 -0600

In this episode, Dr. Burriesci breaks down sublingual nitroglycerin. She gives the need-to-know facts, safety considerations and important education tips for your patients.

A perfect snippet for NPTE study prep and need-to-know rules for the treating PT.

In This Episode

MOA of Sublingual Nitro
Indications of Nitro
Side effects of Nitro
How to take Nitro
3 Rules of Nitro
Safety Considerations

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 39: Overlooking PT needs in the younger acute patient: A case of cardiac arrest

Wed, 13 Dec 2023 08:00:00 -0600

In this episode, Rachele gives some life updates and tells the tale of DIY, Thanksgiving, and hosting her 9 family members.

Gratitude all around for this episode for both family and you. Rachele has reached her 1 year anniversary of Talking All Things Cardiopulm and she is grateful to all of you who have listened, supported, and reached out.

This episode is a case review of a recent patient that spurred a thought and common trend in the acute care setting. Are younger patients overlooked? Independent a few days prior, they shouldn’t have any PT needs, right? Rachele thinks false and she gives her perspective on why and how we can help this patient population. She also gives clinical tools and insights to help the next patient who comes across your caseload.

In this episode:

Risk of VTE in orthopedic surgery
Bilateral PE
Cardiac Arrest
ROSC
Survival post-PE vs. survival post-PE / cardiac arrest
Younger age patients in acute care
Intubation affects on the lungs
Cough Assessment / Chest wall mobility
Splinting with Huff’ing/functional cough
How to improve a cough
Interval training
The benefits of the Trifecta
Inspiratory holds - benefits and use in this patient
Precursors to PE
Importance of assessing vitals even in the outpatient setting

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 38: Contraindication Study Guide - There are More Yellow Lights than Red - Part 2 of 2

Thu, 16 Nov 2023 05:00:00 -0600

In this episode, Dr. Burriesci breaks down her recently released Contraindication study guide for students prepping for the NPTE. In an attempt to make a clear-cut, hard stop, red light, contraindication guide, but she was quickly reminded that there is much more yellow/caution/“it depends” than hard stops. Unfortunately, “It depends” is not an answer you can pick on the NPTE.

This episode is part 2 of 2, so if you missed Part 1, Hard stop, Red Light and Grab Part 1 first.

Part 2 wraps up possible red lights in the ICU setting, including specific lines and tubes, specific diagnoses and high levels meds.

Join me to break down what is definitely a "Red Light" and what truly "depends."

If you are a student studying for the NPTE, listen for the black and white, and if you are a clinician, listen to all the gray.

Haven't grabbed your Contraindication study guide? Click the link below:
https://allthingscardiopulm.ck.page/683e1f6f42

Want to join the Cardiopulm Check Point Webinar? Nov 28th 5pm CST
https://allthingscardiopulm.ck.page/products/cardiopulmcheckpointnpte

Interested in Jane?
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

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Linked-In: Rachele Burriesci

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Episode 37: Contraindication Study Guide - There are More Yellow Lights than Red - Part 1 of 2

Thu, 09 Nov 2023 08:00:00 -0600

This podcast is an attempt to read between the lines, give rationale and thought process behind the clinical decisions you may be faced with day to day in your setting while giving guidance to the student sitting for the NPTE trying to navigate safety questions or the new grad getting their footing in a complex environment.

She attempts to pull out the hard stops (red light), but explains the rationale behind most of the yellow lights and when to proceed with caution as clinical judgments will play a pivotal role in most of the decisions you are faced with.

In this episode:
- Contraindications to exercise (Red light)
- Precautions to exercise (Yellow light)
- Guidelines on BP, HR, spO2, lab values, VTE
- Role of clinical decision-making and making decisions based on your patient
- Student vs. Clinician
- Acute Care Section CPG: Lab Values & Vital Signs
- Cardiopulmonary Section: VTE CPG & Oxygen Supplementation

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Did you grab your FREE Cardiopulm NPTE Contraindication Study Guide?
https://allthingscardiopulm.ck.page/683e1f6f42

Podcast episode: When is a PVC NOT just a PVC
https://podcasts.apple.com/us/podcast/episode-21-when-is-a-pvc-not-just-a-pvc/id1658078171?i=1000614336763

Sponsor Information:
Jane, an all-in-one practice management software with helpful features to power your practice.
Head to jane.app/guide to book a personalized demo.
Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 36: Breaking Down the Complexities of CRPS w Justine Feitelson

Tue, 31 Oct 2023 15:00:00 -0500

In this episode, Dr. Burriesci chats with Justine Feitelson about Dysautonomia and Chronic Regional Pain Syndrome (CPRS). Justine is a business owner, health coach, podcast host, and a CRPS warrior.

Justine takes us on her journey of being diagnosed with CRPS, dysautonomia and likely (h)EDS. She describes the difficulty in the unknown, the rarity of the disease and the long 8-month process of getting a diagnosis. Justine describes her battle of overcoming the pain of her limb and the resilience to return to her life. Justine is passionate and living proof. She has dedicated her life to doing better for people with CRPS.

Rachele and Justine pull together the similarities in the unknown, the rarity, the frustration and even the loneliness of dysautonima, POTS and CRPS. Join us just in time to close out Dysautonomia month.

In this episode:

CRPS
EDS/hEDS
Dysautonomia
Parasympathetic/Sympathetic Nervous System
Breathing - physiologic benefits
Benefits of exercise w CRPS/POTS

More on Justine:
Justine is a movement professional and health coach who works specifically with Complex Regional Pain Syndrome patients.

Once she was diagnosed with CRPS in 2019, she set forth on learning everything she could about pain and human movement so she’d have more tools to expose, desensitize and change the way her nervous system had become with CRPS - and help others do the same.

She realized our own bodies are the greatest tool to create change, yet as patients we often miss taking advantage of our most powerful asset - ourselves. Justine helps chronic pain patients optimize variables that effectively decrease pain through conservative pain management strategies even in the most complex cases using her signature MARSMethod.

You can check out her programs and work with the Empower You Chronic Pain Foundation, as well as the It's Not in Your Head podcast coming soon below.

Websites: www.resilientwarriorcoachingllc.com

Email: justine@resilientwarriorcoachingllc.com

IG: @resilientwarriorcoaching

Facebook: facebook.com/justine.feitelson

LinkedIn: LinkedIn.com/justine-feitelson

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

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Linked-In: Rachele Burriesci

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Episode 35: When did 8min become the goal? Practicing at the top of scope OR living up to the stereotype?

Sun, 22 Oct 2023 22:00:00 -0500

In this episode, Rachele gets real and straight to the point. (as if she has ever beaten around the bush in her lifetime). However, some recent student experiences brought this podcast to the forefront.

Dr. Burriesci has been in the Acute Care Setting for 14 years, she believes in the work that she does and she loves the setting. She believes PTs have a vital role in the acute care setting and can make a difference in a patient's recovery, length of stay, return to independence and education. She has been hearing and fighting against the stereotype for years and even had many students excited for their upcoming clinicals.

But what happens when the stereotypes exist and even worse what happens when they are pushed onto students as the standard of care?

TUNE IN for more, I promise this one is a bit spicy....

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 34: Unmasking POTS: My Journey and Inside Look at Managing Dysautonomia

Mon, 16 Oct 2023 16:00:00 -0500

In most episodes we hear how Dr. Burriesci treats patients and her vast knowledge of Cardiopulmonary care. Today is different! We have the pleasure of getting to hear about Postural Orthostatic Tachycardia syndrome (POTS), but in a different light than we are used to.

In this episode, Dr. Burriesci shares her story of being diagnosed with POTS. She starts at the beginning of her journey and explains what those beginning moments felt like when she was in the emergency room with minimal answers. She takes us with her on journey of what she did to get a diagnosis and how she best manages her symptoms in her daily life. Along the way, she sprinkles in little nuggets of knowledge and glimmers of hope for others who battle the same diagnosis.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 33: How ‘Bout That Cough?

Fri, 29 Sep 2023 18:00:00 -0500

In this episode, Dr. Burriesci describes the 4 phases of a cough, ways to assess cough sequencing, and how to implement proper cough techniques into our physical therapy practice to improve overall aerobic conditioning.

She guides us through different diagnoses which may impact cough mechanics and how to tailor it for the patient’s needs. These clinical pearls will have your patients implementing good strong effective coughs. 💪🏻

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 32: Building Resilience in our Nervous System through Breath Control

Thu, 21 Sep 2023 12:00:00 -0500

You could brush your teeth for 28 minutes every Sunday, but would you? It may be more efficient to perform this task in one sitting, but rather we do it every day to continue the cycle of taking care of ourselves. It’s a daily task that has compounding benefits to our overall well-being and health.

This same ideology can be applied to nervous system hygiene, keeping our nervous system healthy on a daily basis, so we can manage the highs and lows of our day-to-day lives.

In this episode, Dr. Burriesci welcomes Jessica Patching-Bunch, JPB, to discuss a missing piece in regulating the autonomic nervous system: nervous system hygiene. JPB explains what nervous system hygiene means, what that can look like, how much time it actually takes out of our daily lives to perform, and the importance of this topic. Dr. Burriesci links how this can impact physical therapy students, clinicians, and our patients when we begin to incorporate the daily task of nervous system hygiene.

In this Episode:

Breakdown of the autonomic nervous system (ANS)
The power of breath to tap into ANS control
Defining nervous system hygiene
Utilizing nervous system hygiene to regulate the ANS
The importance of small compounding efforts in our daily practice
The simple yet complex benefits of breath control

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 31: Stack-Stack-Stack Breathing

Thu, 07 Sep 2023 06:00:00 -0500

Come in!! Rachele is taking us behind the scenes of what it’s like to set-up for sauce (marinara) day. She tells us the adventures of finding a tomato vendor, long hours and walls covered in sauce to make her family’s recipe. She explains the importance of digging through the rotten tomatoes to find the best ones. When you want an outcome, you have to lean into the process.

In this episode, Dr. Burriesci defines what stacked breathing is and how to fit it into clinical practice. Just like making sauce, we get to break our current tomatoes down to redefine them. In physical therapy terms, with our patients who have impaired inspiration, we get to break down their current pattern to rebuild something better. She explains how to group exercises with stacked breathing so you get the perfect recipe and best bang for your buck.

In this episode:
- Discus family tradition
- The process of sauce day
- Stacked breathing
- When and how to incorporate stacked breathing into your practice

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 30: Set the Diaphragm up for Success

Wed, 30 Aug 2023 06:00:00 -0500

The world around us never settles down and while we understand it to be commonplace, our bodies can sense the rising stress. This impacts our breathing and is known to increase respiratory rate. This increase with rate can also increase the upper chest breathing, making us (and our patients!) be less efficient breathers. So what can we as physical therapists do? Teach our patients how to adequately diaphragmatic breath.

In this episode, Dr. Burriesci breaks down the do’s and don’ts of diaphragmatic breathing with patients. She teaches applicable ways to set our patients up for success, long-term, when it comes to properly engaging the diaphragm. She tweaks the usual cues and explains that our words do matter. These simple changes to our language and understanding the “why” behind the various breathing sequences will impact our patients in a multitude of different ways.

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 29: The ABC's of ABG's

Wed, 16 Aug 2023 06:00:00 -0500

A, B, C, oh wait, ABG?

In this episode, Dr. Burriesci hosts Briana Drapp of PT Elevation and teaches the ABC’s of Arterial Blood Gases (ABG’s). Dr. Burriesci explains what PaO2, PaCO2, HCO3 and SaO2 means, why we should care and how to extrapolate the information of each of these numbers into real world, clinical information to benefit our patients. She breaks down the numbers into metabolic vs pulmonary and alkalosis vs acidosis by finding who the “problem child” is.

By the end of this episode, you’ll have interpreted multiple examples and have a better understanding of why this matters to you as a clinician. She gives you information in small bites rather than getting lost in the whole alphabet soup.

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

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IG: @all_things_cardiopulm

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Linked-In: Rachele Burriesci

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Episode 28: Prevention, Progression & Pathophys of PAD

Tue, 08 Aug 2023 10:00:00 -0500

Peripheral Artery Disease (PAD) is a diagnosis that very much resembles coronary artery disease, except the pain occurs in the legs instead of the chest. Treating these patients can be tricky due to the activity limitations they experience. So how can we make a difference in clinic?

In this episode, Dr.Burriesci breaks down what PAD is. She explains the risk factors, pathophysiology and how physical therapists can best treat this disease. Traditionally, “no pain, no gain” are words that you will never here out of a PTs mouth, but what if this time is different? She explains the why behind the treatment interventions and the potential results our patients will experience.

In This Episode:

Break down the pathophysiology of PAD
Risk factors of PAD
Diagnostic Testing
Education
Treatment interventions for this patient population
Progression of disease
Prevention of progression

Jane Promo Code: CARDIOPULM1MO
Jane is an all-in-one practice management software with features to run your entire practice, including online booking, scheduling, charting, and billing. 👋 And our PCI-compliant payment solution, Jane Payments, has all of your payment needs covered.

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 27: Can you take the heat? Compensation, Adaptations & Safety Considerations

Wed, 02 Aug 2023 06:00:00 -0500

Have you ever wondered why exercising in the heat feels so much harder? This week on Talking All Things Cardiopulm, we're going to tackle this burning question.

With rising temperatures and high humidity, it’s important to understand the body’s response, in order to make informed decisions about our time outdoors and more importantly, exercising in the heat of the day.

In this episode, Dr. Burriesci breaks down the body's physiological response to high heat and some important environmental considerations. She describes the response of the cardiovascular and pulmonary systems to the body's compensations and what this looks like compounded with comorbidities, such as COPD and heart failure. She also navigates through the signs of heat-related illnesses such as heat exhaustion, heat injury, and heat stroke, you'll learn how to recognize these conditions and what to do if you or someone else experiences them. Lastly, she gives tips and tricks for mitigating the overwhelming heat, while maintaining safety with exercise.

In This Episode:

Break down of thermoregulation
Body’s Compensation to High Heat
Cardiovascular & pulmonary response
Ability to acclimate to high temps
Tips for exercising outdoors in the summer months
Considerations with patients with comorbidities

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 26: The Human Touch: Redefining Communication in Healthcare

Wed, 26 Jul 2023 08:00:00 -0500

If you’re in healthcare, you understand the range of healthcare literacy among our patients. However, healthcare literacy is not the entire story. The experience of actually being in a healthcare facility accounts for a large portion of a person’s healthcare perspective.

Could you imagine entering a facility expecting to discuss your concerns and be heard? But instead, you are met with an impersonal environment where your worries are downplayed. Or if no one took the time to explain what procedures you would be undergoing that day? It’s a truly terrifying experience, yet many people have these exact interactions.

In this episode, Dr. Burriesci recounts her personal experience with an appointment and describes what it felt like being on the other side of the table. She explains the importance of basic communication and its impact on patient care. Our words can enhance the patient experience, calm the nervous system, and improves patient outcomes. Healthcare can be a fast-paced, scary experience, but we can help guide the process and take the fear out of the experience. We can either add to the ever-surmounting anxiety or we can change the entire trajectory for the better by taking an extra moment to lessen the anxiety for our patients and bring the human aspect back into our approach.

In this episode:

Discuss a current personal experience in healthcare
The basics of communication
Importance of identifying yourself
Help calm the nervous system with an explanation of the plan
Build trust and rapport.
Tips to prep for your next appt.

If anyone is looking for an EMR system for their business, I highly recommend Jane. It is super easy to use, highly customizable and has great integrations for easy payment.

Go to: jane.app/payments

Use code: CARDIOPULM1MO for a 1-month grace period for your new Jane subscription!

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 25: Students are NOT free Labor!

Tue, 18 Jul 2023 17:00:00 -0500

In this episode, Dr. Burriesci discusses the frustrations with student affiliations. With the help of Webster and the Oxford Dictionary, she breaks down the definition of a student and an intern. She dives into the purpose of clinical affiliations and what they should represent. She explains why facilities should prioritize a systematic approach to student experiences and perhaps even form a dedicated committee to prevent reinventing the wheel each and every time and to make a purposeful learning experience for the student.

In this episode:

- Discuss the role of a CI

- Levels of supervision for students on clinical affiliations

- The over-emphasis of “caseload”

- Arbitrary differences between “full caseload” between facilities & potentially employees

- Mentoring students to make good clinical decisions

- Teaching efficiency by observation and sharing skills

- Importance of constructive feedback

- Importance of receiving feedback and being willing to learn

Sponsor Info:
jane.app/payments

Use code: CARDIOPULM1MO for a 1 month grace period!

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 24: Documenting the Cardiopulm Exam

Wed, 12 Jul 2023 12:00:00 -0500

In this Episode:
- Benefits of Jane
- How I use Jane
- How to show skill in your documentation
- Documenting exam findings
- Articulating your assessment

Interested in Jane?
Jane, is an all-in-one practice management software with helpful features to power your practice. Head to jane.app/burriesci to book a personalized demo. Don't forget, you can use the code CARDIOPULM1MO at the time of sign-up for a 1-month grace period applied to your new account

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 23: Assessing and Managing Orthostatic Hypotension

Wed, 05 Jul 2023 06:00:00 -0500

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Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

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Episode 22: Gardening the Parallels to Goals and Life

Wed, 14 Jun 2023 06:00:00 -0500

A garden produces vegetables and fruit all summer long and while that feels like it happens overnight, that’s not true. Gardens take time, nutrients, sunlight and the proper environment to grow and flourish in the best way each individual plant can.

In this episode, Dr. Burriesci plants the idea that personal growth is a game of patience, hard work behind the scenes, and some dropped leaves before we flower. There’s no overnight success. When growing our own gardens we need to learn how to adapt, face challenges and setbacks and give ourselves the tools to make adjustments when needed. Remember there are many weeks prior to picking fruit where it’s just dirt in a cup (or a box).

Listen for a lighthearted episode on how to dig deep, persevere when the winter months come and bloom where you are planted.

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IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

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Linked-In: Rachele Burriesci

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Episode 21: When is a PVC NOT just a PVC

Wed, 24 May 2023 12:00:00 -0500

Do you know that flutter in your heart or when your heart skips a beat because you have had too much caffeine for the day? That’s called a premature ventricular contraction (PVC) and most of the time, it is benign. But when does that change?

In this episode, Dr. Burriesci unravels the mystery behind PVC’s as they appear on an electrocardiogram (EKG) and dlve into how physical therapists can play a pivotal role in managing PVC’s. She explains how PT’s can identify, address and what can exacerbate PVC symptoms. She educates on how to address this during a session and when to terminate a session because it can become more than just a benign PVC.

Now grab a coffee, or watch your caffeine intake, and listen now!

In this Episode:

Definition of a Premature Ventricular Contraction (PVC)
ECG descriptors for PVCs
Common causes of PVCs
What 3 PVCs in a row actually mean
Common PVC patterns on ECG

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Episode 20: What is the pulse-ox trying to tell you?

Wed, 17 May 2023 06:00:00 -0500

If you only had access to one PT tool or device for your eval and/or treatment session what would it be?

In this episode, Dr. Burriesci delves into the item she’d (likely) bring to a desert island, a pulse oximeter. She explains the invaluable information that can come from this device and it’s not specifically O2 related. Yes a pulse ox will give you a quick read on oxygen and heart rate, and yes there are common causes for inaccuracies, but what else is it inadvertently telling you? Listen in for a few clinical tips that you likely won’t find in any textbook.

And after this episode, you’ll have to let her know if you too will take the pulse ox with you on your deserted island.

In this episode:

- Normal values of spO2

- Common causes of inaccurate readings via pulse-ox

- Atrial fibrillation

- Premature Ventricular Contractions (PVCs)

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Episode 19: Wear the damn stethoscope

Wed, 26 Apr 2023 09:00:00 -0500

In this episode, Dr. Burriesci chats about how necessary it is to advocate for our own profession and sometimes that can be as simple as wearing your damn stethoscope. Although this episode is not specifically promoting wearing your stethoscope and it’s definitely not about shaming you for not wearing one, it’s actually about recognizing our role in supporting each other.

It’s all about elevating our profession while also educating other professionals and patients about what we are capable of doing. With such a wide scope of practice in our field, we have to remember that even if something is not in our comfort zone or even a skill we don’t personally enjoy, that does not give us permission to down our own profession. We need to do better and support one another, so we can continue to elevate our profession.

But if auscultation is a skill you want to become more comfortable with, start by wearing your stethoscope and finding a mentor that can help you master this skill. Like any area of your life, in order to improve your skills it starts with practice. And if you’re looking for a mentor, book yourself a mentor session with Dr. Burriesci.

In this episode:

Importance of elevating our colleagues
Promote your skills
Supporting our wide scope of practice
Learning a new skill requires practice

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

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IG: @all_things_cardiopulm

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Episode 18: Pericarditis to Tamponade

Wed, 19 Apr 2023 06:00:00 -0500

As part of the healthcare team, Physical Therapists help investigate what symptoms our patients may be experiencing and help facilitate better motion and positioning to help them find relief from their symptoms.

In this episode, Dr. Burriesci reviews a recent patient case of pericarditis and the possible manifestations of this diagnosis. She explains what symptoms and presentations we may see from this patient population so we can be prepared when we assess our patients. She educates the patient on positioning to help relieve symptoms, breathing strategies, and exercises that can give us the most bang for our buck. She also walks us through what medical interventions are utilized while inpatient and when we should (and shouldn’t!) see these patients from a readiness perspective.

In this episode:

Pericarditis
Pericardial Effusion
Cardiac Tamponade
Pericardial drain
Differential diagnosis (angina vs. non-ischemic chest pain)
Breathing strategies, positioning and interval training
Importance of vital sign assessment

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IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 17: A different viewpoint: Cardiomyopathy w. Dr. Brunelle

Wed, 05 Apr 2023 06:00:00 -0500

When we think of a cardiac patient, who’s had heart surgery, we think of an older adult. They could be anywhere from slightly deconditioned to very deconditioned, which means it could impact how much physical activity they can handle. But, what if that’s just a stereotype?

In this episode, Dr. Burriesci starts by introducing Dr. Kyle Brunelle and his passion for lifting, hiking, jujitsu and breathwork. In 2020, he started a physical therapy business, Renegade Performance, with his wife. He is the optime of an athlete; yet there’s an invisible illness he’s been dealing with since 2015. He was diagnosed with Hypertrophic Cardiomyopathy and had an Implanted Cardiac Defibrillator in 2016 but has continued to maintain his high level of physical activity throughout his journey. Dr. Kyle brings a unique viewpoint of the healthcare field because of his clinical background and his venture as a patient. He also has a fun fact about an external defibrillator he carried around for months and a fascinating ICD placement that I can bet you’ve never seen before.

Find out more about his diagnosis, symptoms, and exercise routine now in this episode!

In This Episode:
- Dr. Kyle Brunelle's background as a PT and business owner
- Hypertrophic Cardiomyopathy
- Diagnostic findings and symptoms
- Symptom mgmt & treatment of HCM
- S-ICD and Kyle's unique placement
- AED / BLS

Find Dr. Kyle Brunnelle at:
IG: @renegademvmt
website: https://www.renegademovementandperformance.com/

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 16: 3 Roads to Specialty Certification

Wed, 29 Mar 2023 22:00:00 -0500

Have you been a clinician for a few years and wonder what’s next in your career? Do you think about what more you could be doing or do you have a special interest in a specific population, but you’re unclear what it takes to work with them? A residency is maybe the next step. However, it can feel overwhelming to think about uprooting your life to move, taking a pay cut or even finding the why behind the big life change.

In this episode, Dr Burriesci breaks down the three main roads to becoming a board-certified specialist: residency, mentorship, and self-study. As someone who utilized self-study for her first certification, residency for her second speciality and now mentors people who are sitting for their CCS exam, she explores the pros and cons of each road. She explains that while one lane may not work within your lifestyle, another may be the exact fit for you. She navigates through how to apply, what the interview process looks like (from resident and facility standpoints), what moving across country looks like, tuition vs pay in residency and so much more.

If you feel like there’s a missing piece in your practice or that you desire more mentorship in a specific topic, check this episode out!

In this episode:

How to tackle applying for specialty
Qualifications to sit for a specialty exam in cardiovascular & pulmonary
Finding a mentor
Pros and cons between self-study vs residency
Applying to a residency
Setting yourself up for success
Is it a good fit for you?

APTA specialist Certification:
https://specialization.apta.org/

American Board of Physical Therapy Residency & Fellowship Education:
https://abptrfe.apta.org/

Mentoring Sessions w Dr. Burriesci
https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

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Episode 15: Stop Blowing out the Candles

Wed, 22 Mar 2023 06:00:00 -0500

We hear that words matter, but could the words we say as clinicians be impacting our patient’s results?

It could be!

In this episode, Dr. Burriesci chats about Pursed Lip Breathing (PLB) as an intervention for patients with an Emphysema diagnosis, anxiety or post-exercise. This intervention is extremely popular and easy to perform, but the traditional cue of “blow out the candle” is often misused. We want to give our patients a different cue that is mindful of the 1 second inhale to 2 second exhale, to prevent air trapping, encourage air to move out of the lungs and pace breathing. But if we stop saying “blow out the candle”, then what do we say? Find out now what phrase we should use to maximize PLB and get the most bang for your buck.

In This Episode:

Mechanism of pursed lip breathing (PLB)
Pathophys of Emphysema
Importance of the words we choose in cueing
Visual feedback techniques of PLB

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 14: Did you do breathing exercises w your patients today?

Sun, 19 Mar 2023 12:00:00 -0500

You get a breathing exercise, you get a breathing exercise, everyone gets breathing exercises (even your orthopedic patients)!

In this episode, Dr. Burriesci educates on the importance of utilizing breathing exercises and how they can be incorporated into patient sessions, across the spectrum. She explains that almost every patient/client can benefit from breathing exercises and that there are specific breathing exercises that can be used to help each diagnosis. But the benefits of using breathing are endless, even if you are not treating patients with cardiac or pulmonary conditions. Incorporating breathing will help set your patient up for success, it will put them in the driver’s seat, give them control and give them the tools to manage a number of issues: SOA, pain, anxiety, atelectasis, pulmonary edema, mucus, diaphragm strength/endurance, gas exchange, the list goes on.

So, while this may not be your common practice (yet), we have to remember to use interventions that we know will make a difference and to treat the whole person. Let’s individualize care for our patients, maximize function and utilize breathing to do just that.

In this episode:

Discuss the benefits of breathing exercises
Discuss how to perform the following breathing exercises:
- Inspiratory holds
- Stacked breathing
- Paired breathing
- Incentive spirometer
Discuss which breathing exercises will benefit post-surgical patients
Post-surgical patient: median sternotomy, thoracotomy, clamshell incision
Define atelectasis
Discuss changes that occur in the lung post-general anesthesia

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Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

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Linked-In: Rachele Burriesci

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Episode 13: Heart Failure from a PT perspective, review of the CPG

Fri, 10 Mar 2023 23:00:00 -0600

We know Heart Failure (HF) is a diagnosis that does not occur overnight, rather it occurs due to years and years of stress placed on the heart. Resulting in years and years of management and likely hospital admissions and readmissions. As clinicians, we have to understand our patient’s diagnoses to help guide their therapy and give them the tools to set them up for success. We should implement strategies that can help manage the progression of the disease process and better yet let's start earlier to be preventative vs reactive and in time to actually make an impact.

In this episode, Dr. Burriesci walks us through the latest HF Clinical Practice Guidelines (CPG) along with the New York Heart Association classifications. The goal of the CPG is to establish an evidence-based approach for the optimal treatment of HF. Dr. Burriesci dives deep into how we can utilize these recommendations for our patients and explore the research behind the 2020 CPG. She reviews the daily activity, education, neuromuscular electrical stimulation, resistance breathing training and exercise recommendations set in the CPG. She goes on to explain how we can tailor these interventions to our own patients. This episode gives us, as clinicians, the knowledge of what the perfect numbers should look like, but the realistic insight that we must meet our patients where they’re at to reduce their overall risk.

In this episode:

Unpack the Heart Failure CPG
Describe ACC stages vs NYHA Classes of HF
Discuss 9 action statements aka recommendations for treating patient with heart failure
- Increase physical activity
- Educate!
- Aerobic training
- HIITs
- Strength training
- Inspiratory/respiratory muscle training
- NMES

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 12: Heart Failure it Doesn't Happen Overnight

Fri, 03 Mar 2023 22:00:00 -0600

What’s an illness that is diagnosed by a cluster of symptoms and can have pink frothy sputum? Heart Failure!

To say heart failure is a complicated diagnosis is an understatement. As clinicians, we have to think about the underlying pathophysiology to understand patient presentation, how to direct treatment (coming next week to your favorite pod) and how we can help our patients navigate this diagnosis that can feel overwhelming, even to us!

In this episode, Dr. Burriesci goes through the pathophys of heart failure and the subsequent signs and symptoms that result. She explains that the pressures exerted on the chamber, the afterload, cause the chamber to fail over time and cause a back-up. Follow the back-up and you will find the symptoms. We flow further into the information by looking into what other systems are impacted when the body begins to compensate for heart failure. This again impacts how we, as clinicians, will chart review, think about testing and how we treat our patients. All of these factors help set our patients up for success over the years.

In This Episode:

Difference between left and right heart failure
Difference between systolic and diastolic dysfunction
Structural difference between dilated and hypertrophic cardiomyopathy
Signs and symptoms common in both left and right heart failure
Discuss the systems compensations in response to failure

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 11: Are they cardiac risk factors or so much more?

Wed, 22 Feb 2023 06:00:00 -0600

As physical therapists, we are known to have catchy phrases like “movement is medicine”. We hear it all the time in school, we say it to our patients, but is it more than just a catchy phrase? Would it be the magic pill that solves so many disease management problems?

In this episode, Dr. Burriesci walks us through how lifestyle modifications may take us down a path of less disease. She reviews how chronic kidney disease, coronary artery disease and diabetes all have similar risk factors that link back to lifestyle modifications of, you guessed it, diet and exercise.

This episode puts in perspective the importance of educating patients on lifestyle modifications and utilizing adequate exercise prescription to make an impact in our patient’s daily lives and create longterm change . We empower patients with knowledge to increase their aerobic fitness while reducing their BMI, blood pressure, glucose levels and more. Each of these put our patients one step closer to living an overall healthier lifestyle and mitigating disease risk. Movement really is medicine.

In This Episode:
- Cardiac risk factor
- Diabetic risk factors
- Chronic kidney disease risk factors
- Metabolic syndrome
- Understanding the link between all four processes
- Identifying the importance of lifestyle modification

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Episode 10: Heart disease in Women its not just a male disease

Wed, 08 Feb 2023 06:00:00 -0600

In This Episode:
- Bring awareness of risk of heart disease in women
- Common misconceptions of heart disease based on gender
- Identify atypical signs of angina
- Cardiac Risk Factors
- Reasons for misdiagnosis of heart attack in women
- Obstructive disease vs. microvascular disease

Ezekowitz J et all. Is There a Sex Gap in Surviving an Acute Coronary Syndrome or Subsequent Development of Heart Failure? Circulation: 2020 (142)23.

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IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

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Episode 9: COVID-19, What you still need to know

Wed, 01 Feb 2023 06:00:00 -0600

How did a 2-week shutdown turn into a 3-year (and counting) battle of the same virus? The virus has taught us about what a spike protein looked like because we saw it everywhere. But yet, we aren’t sure why some people get GI symptoms and others end up in a critical condition in the hospital.

The novel virus, COVID-19, is unlike any other virus that we have had to deal with in the modern age. It quite literally hits both ends of the spectrum, causing issues with both clotting and bleeding. It hijacks a person’s system and creates chaos for an undetermined amount of time. However, Dr. Burriesci is here to give us a 40,000 feet view of what COVID looks like. She explains what symptoms looked like at the beginning of the pandemic and how that has shifted to what it is being seen today. She also chats about her journey through the start of the pandemic, including the loss of her mentor and coach Joe Lewinger, her wife treating on the front lines, and her family back in NY.

In This Episode:

Dr. Burriesci’s Journey through the start of the pandemic
Defining Acute COVID-19
Pathophysiology and signs and symptoms of COVID-19
Making sense of the moving target
Understanding the location of ACE 2 receptors systemically
Progression of signs and symptoms and change with more recent variants

Joe Lewinger's Story
https://nypost.com/2020/03/29/mary-louis-ad-joe-lewinger-leaves-behind-everlasting-legacy-through-hardship/
https://www.cnn.com/2020/05/18/us/student-grief-teachers-coronavirus/index.html

Want to learn more about COVID? Purchase my COVID workshop-replay:
https://www.allthingscardiopulm.com/covid-workshop-replay

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

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IG: @all_things_cardiopulm

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Linked-In: Rachele Burriesci

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Episode 8: Educate! Educate! Educate!

Wed, 25 Jan 2023 06:00:00 -0600

Healthcare can be overwhelming, especially if our patients aren’t given the tools to wade through all the medical information that they are given. We’ve all been in at an appointment where we forget to ask important questions or don’t have the words to ask insightful questions. As clinicians, we can set our patients up for success by educating them on the “why”.

This episode serves as a reminder to educate our patients so we can give them autonomy and the power to make safe decisions for themselves when it comes to their care. When we educate our patients, we also give them the words and empowerment to ask the right questions, advocate for themselves and understand their current situation.

In this episode, Dr. Burriesci explains that our patients aren’t as fragile as we may think. When we educate our patients, we get to link arms with them and partner in their care. We give them control of their body, help prevent re-admission, better their health outcomes and so much more!. No matter the setting we practice in, we are always in a spot to educate our patients. When we do better, our patients do better!

In This Episode:

Discuss the importance of educating our patients/client
Knowledge is power
Importance of describing disease process, assessment findings and interventions
Teach the medical jargon and break it down

Find me on:

IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

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Linked-In: Rachele Burriesci

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Episode 7: Episodic & Reversible - All Things Asthma

Wed, 18 Jan 2023 23:00:00 -0600

Asthma. What feels like an ordinary disease, can vary significantly in presentation ranging from mild to severe, and can even result in a medical emergency. Each person experiences a different journey with asthma. While they may be diagnosed with the same “type” of asthma, they can experience different triggers and severity of symptoms leading up to an asthma attack. These are very specific to you (and your patients). Identifying these triggers is key to control.

Dr. Burriesci gives us the good news that asthma is both reversible and episodic. She takes us through the pathophysiology, 6 types of asthma, diagnostic tools, signs, symptoms and medications that can help manage the disease. She also explains the best way to manage asthma symptoms is through prevention and education. As an asthmatic herself, she explains her story while also diving deep into the information that can assist others on their personal asthma journeys. Whether you’re an athlete who is triggered mid-workout or a middle-aged person experiencing symptoms later in life (hint, there’s a larger population than we realize!), there’s a solution for you!

In this Episode:

Pathophys of asthma
Types of asthma
Diagnostic testing for asthma
Symptoms of asthma
Common medications used to control asthma
Management of asthma

Links:
https://www.pnmedical.com/product/the-breather/

Note: No affiliation to the breather

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Episode 6: Surviving Cardiac Arrest it Takes a Village

Wed, 11 Jan 2023 22:00:00 -0600

This podcast’s mission is to bring cardiopulmonary topics to the forefront of conversation, but Dr. Burriesci did not need much help with this topic as people around the country have found themselves glued to the tv waiting for updates on Damar Hamlin, the Buffalo Bills player who went into sudden cardiac arrest. Everyone wants to know exactly what happened to send the 24-year-old into this scary moment. After staff performed CPR on the field in front of his family, fellow players and fans we were all shocked. There were words like “commotio cordis,” “myocardial infarction” and “cardiac arrest” being thrown around, but what does that mean and how can a bystander help in these sudden moments of panic?

Dr. Burriesci helps define the differences between cardiac arrest and myocardial infarction and brings to light the frequency of these episodes in the community. She describes how cardiac arrest occurs and potential causes of this type of event. She brings to light the things we can do in those moments to better our patient/family member/friend’s odds of survival, including the importance of BLS (basic life support) as a community member, activating emergency response system, locating AEDs in the community and apps that can help with CPR.

In This Episode:

Defining differences between myocardial infarction and cardiac arrest
Incidence and survival rate of outside-hospital cardiac arrest
Incidence and survival rate of in-hospital cardiac arrest
Heart conditions: Hypertrophic cardiomyopathy, heart failure, commotio cordis
Importance of timing in the initiation of high-quality CPR and emergency response systems
BLS
AED usage and location

Transcript: https://www.allthingscardiopulm.com/transcript-ep-6

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IG: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

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IG: @all_things_cardiopulm

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Episode 5: Putting the SMART back into SMART goals

Wed, 04 Jan 2023 14:00:00 -0600

The concept of “new year, new me” can be overwhelming when it seems like your goals are so far out of reach. Your goals seem too big, too unattainable and you aren’t sure how to even achieve the overarching goal you set. This can happen with patient goals too; you just don’t know where to start.

In this episode, Dr. Burriesci breaks down the SMART AF goals that help pare down goals to meet you (and your patient!) where you’re at. This takes those overwhelming, vague goals and turns them into actionable and achievable goals. With this concept of making each goal SMART AF, you take the overwhelming and time-consuming portion of writing goals and streamline it to find that Goldilocks “just right” for each individual person. This concept can be applied to each of your physical therapy patients or to your personal goals any day of the week, not just in this new year. This gives you actionable steps to Get After It!

In this episode:

Break down the concept and importance of incorporating SMART-AF goals into your patient care and personal life.
S- specific
M- measurable
A - attainable
R - relevant
T - timely
A - audience
F - functional

Transcript: https://www.allthingscardiopulm.com/transcript-ep-5

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Episode 4: All Things Cardiac Rehab

Wed, 14 Dec 2022 06:00:00 -0600

In this episode, I discuss both outpatient and home-based cardiac rehab and my experience running both programs. Both are considered class IA recommendations, yet remain underutilized. We will discuss the benefits and the barriers to this type of program.

In this episode:
- Benefits of cardiac rehab
- Structure of a cardiac rehab program
- Diagnoses approved for cardiac rehab
- Difference between outpatient and home-based cardiac rehab
- Barriers to participation
- Equal benefit of both programs
- Why home-based programs may yield better outcomes over the longterm

Transcript:
https://www.allthingscardiopulm.com/transcript-ep-4

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IG: @all_things_cardiopulm

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Episode 3: Predicating Patient Outcomes: The Crystal Ball

Thu, 01 Dec 2022 23:00:00 -0600

In today's episode we will be discussing the development of your crystal ball in clinical practice. How are clinicians able to predict the next steps? Is it magic or is it a compilation of your own experience, trends, looking at the whole picture and of course assessing vitals.

In this Episode:

What is the crystal ball?
How do you develop these skills?
Importance of vitals.
Understanding hemodynamic response
Importance of looking at the whole picture.

Transcript: http://www.allthingscardiopulm.com/transcript-ep-3

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Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

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IG: @all_things_cardiopulm

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Episode 2: The Trifecta

Thu, 01 Dec 2022 23:00:00 -0600

In this episode, I discuss the 3 main components that I believe should be included in each cardiopulmonary session. Discussing the benefits of each component and diving into the physiology of the why. It truly is tapping into the basics and meeting your patients where they are at.

Welcome to Talking All Things Cardiopulm. I am your host Dr. Rachele Burriesci, physical therapist and Board Certified Cardiopulmonary Clinical Specialist.

This podcast is designed to discuss heart and lung conditions, treatment interventions, research, current trends, expert opinions and patient experiences.

The goal is to learn, inspire and bring Cardiopulm to the forefront of conversation. Thanks for joining me today and let’s get after it!

In this episode:

Discuss the 3 main components that needed for any cardiopulmonary session
Benefits of breathing
Benefits of aerobic training
Unitizing interval training
Importance of vital sign response
Benefits of strengthening

Transcript:

www.allthingscardiopulm.com/transcript-ep-2

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

Text at 913-308-4494

Episode 1: Meet All Things Cardiopulm

Thu, 01 Dec 2022 23:00:00 -0600

In this episode meet Dr. Rachele Burriesci, PT, DPT, CCS, GCS, the host of Talking All Things Cardiopulm. She’ll give you a brief description of her journey from student-athlete to physical therapist and discuss major milestones across her 13-year career.

Welcome to Talking All Things Cardiopulm. I am your host Dr. Rachele Burriesci, physical therapist and Board Certified Cardiopulmonary Clinical Specialist. This podcast is designed to discuss heart and lung conditions, treatment interventions, research, current trends, expert opinions and patient experiences.The goal is to learn, inspire and bring Cardiopulm to the forefront of conversation. Thanks for joining me today and let’s get after it!

In this episode:

Background info about the host: Dr. Rachele Burriesci, PT, DPT, CCS, GCS
Reason for the “e” in Rachele
The parallel between sports and life/PT
Progression through her 13-year PT career
Falling in a love with acute care, cardiac and pulmonary population and being a lifelong learner

Transcript:
www.allthingscardiopulm.com/transcript-1

Join my main newsletter: https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

Text at 913-308-4494