Dr. Andy Roark dusts off this Corridor of Fame episode wherein he discusses the necessities of anesthesia crash carts with Veterinary Anesthesia Nerd, Tasha McNerney. Collectively they discuss what instruments must be in your anesthesia crash package and how much widespread pitfalls they’ve seen in follow.
You too can take heed to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!
LINKS
Veterinary Anesthesia Nerds: https://www.fb.com/teams/veterinaryanesthesianerds/
RECOVER Assets: https://recoverinitiative.org/class/resources-and-tools/
Upcoming Webinar (Free RACE CE): https://drandyroark.com/headcases
ABOUT OUR GUEST
Tasha McNerney is a Licensed Veterinary Technician from Pennsylvania the place she works as a instructional advisor and aid anesthesia technician. Tasha is the founding father of the Veterinary Anesthesia Nerds, whereas additionally a Licensed Veterinary Ache Practitioner and board member of the Worldwide Veterinary Academy of Ache Administration (IVAPM) to teach the general public about animal ache consciousness. In reality, Tasha was the thought chief behind the now celebrated “Animal Ache Consciousness Month” inside the veterinary business. Tasha grew to become a veterinary technician specialist in anesthesia in 2015. Tasha likes to lecture on numerous anesthesia and ache administration matters across the globe and was beforehand named VMX Speaker of the 12 months.
EPISODE TRANSCRIPT
Dr. Andy Roark:
Welcome all people to the Cone of Disgrace Veterinary podcast. I’m your host, Dr. Andy Roark. Guys, I’m pulling one out of the vault for you, simply blowing the mud off of it. This can be a Corridor of Fame episode with my good buddy, the one and solely Tasha McNerney, the unique anesthesia nerd. We’re doing the anesthesia crash cart crash course. It’s only a field of pearls. That’s what it’s. It’s simply data, pearls, and I simply put ’em all collectively on this field and right here you go. From me to you. Pleased holidays. It’s a nice episode. It’s considered one of our hottest episodes of the final yr, and also you’re going to see why while you test it out, even in case you heard it when it got here out, it’s time to brush it up once more. There’s so many thoughts gem stones right here that you just went by and you set some in your mind the primary time, and I promise you there’s much more room. You’re prepared for different ones. Now you’re prepared for the subsequent degree of thoughts stones that go in. I don’t know what this metaphor is, however I feel you’re simply going to take pleasure in this episode. Let’s simply do it.
Kelsey Beth Carpenter:
(singing) That is your present. We’re glad you’re right here. We need to enable you in your veterinary profession. Welcome to the Cone of Disgrace with Dr. Andy Roark.
Dr. Andy Roark:
Welcome to the podcast, Tasha McNerney. How are you?
Tasha McNerney:
I’m good. How are you?
Dr. Andy Roark:
I’m so good. It’s so good to see your face once more. You’re considered one of my favourite folks. You and me go means again. I’m like means again, means again. You had been right here visiting my home when the pandemic hit, and I’ll always remember you and I began the pandemic collectively.
Tasha McNerney:
Sure, sure. I’ve nice recollections of visiting 4 totally different shops, searching for canned items after which lastly shopping for all of the beans at a CVS in some random South South Carolina city. Nonetheless have these beans.
Dr. Andy Roark:
I nonetheless have these beans one hundred percent. I’m like, these are my survival beans.
Tasha McNerney:
Yeah, nicely you save them.
Dr. Andy Roark:
My spouse, she was like, “we’ll by no means eat these.” And I’m like, look, so long as they’re there, I’ll sleep nicely at evening, however as quickly as you throw away my emergency beans, I’m going to be like, what are we going to do if society ends? Yeah.
Tasha McNerney:
Yeah. It was a superb time.
Dr. Andy Roark:
I felt, you recognize what? When the world went sideways, you and I took motion. That’s all I’m going to say. And most of the people, one hundred percent didn’t, however we did.
Tasha McNerney:
No, folks had been like, is that this occurring? And we each checked out one another and be like, oh, we higher top off this pantry. Though it wasn’t my pantry. I used to be like, I’ll enable you top off this pantry. You had been with me. I had gotten a name from my husband at house saying, all the pieces is off the cabinets. It’s form of pandemonium right here. And at that very same CVS, I purchased two packing containers of pasta and took them again in my baggage with me as a result of I used to be so apprehensive that I wouldn’t have the ability to discover pasta after I went house. So yeah.
Dr. Andy Roark:
Oh man. That’s nice to be with an anesthesia specialist as a result of when the world goes haywire, they take motion and I felt like that was instinctual for you.
Tasha McNerney:
Oh, 100%. I feel I all the time joke with the anesthesia is that we’re very cool, widespread, collected. When all the pieces is crashing within the ER or within the OR wherever we’re, it’s very a lot, okay, right here’s the issue, the place will we go subsequent? Alright. And we begin this sort of guidelines. It’s very a lot cool, calm and picked up in anesthesia. And the joke is that we’re lifeless on the within. And generally I’d agree with that in that we’re not going to be the folks freaking out like, oh my God, all the pieces is crashing. Go get this for me. Actually that truly with me that issues are actual dangerous if I get very calm and monotone. And if I say, okay, what I want you to do subsequent is flip off that vaporizer and may you hand me the epinephrine? Okay. Issues are taking place. Issues are taking place.
Dr. Andy Roark:
Yeah. Oh man. Yeah, you’re a bit lifeless on the within although. That’s simply inside baseball from an previous buddy.
Tasha McNerney:
Yeah. And you recognize what? Hear, I obtained a therapist. We’re engaged on it. We’re good.
Dr. Andy Roark:
I feel lots of people may stand to be extra lifeless on the within. I feel it will most likely be, everyone knows a individuals who must be just a little bit much less alive inside. It could assist them.
Tasha McNerney:
Yeah. Simply settle down.
Dr. Andy Roark:
Completely. Alright, for many who don’t know you, you’re a veterinary technician, specialist in Anesthesia. You’re the founding father of the Veterinary Anesthesia Nerds Group. It’s a Fb group, it’s a web site, it’s a convention. This factor has grown to how many individuals are concerned engaged with the Anesthesia nerds group now?
Tasha McNerney:
Oh, we have now about 65,000 members world wide proper now. Yeah.
Dr. Andy Roark:
It’s superior. It’s tremendous superior. It’s tremendous bonkers. And I may sit right here and sing the praises of the anesthesia nerds. I’m all about sensible training. I actually prefer to be taught stuff that I’m like, I’m really going to make use of this. And that’s what you guys are all about. So I actually like it. I’m tremendous glad that you just’re right here. I considered you lately after I had a pet underneath anesthesia and I can’t keep in mind why. It was an emergency of some type. And I had this pet underneath anesthesia and it simply form of dipped there for a second. And so while you pause for a second and also you’re like, is that this going to be a difficulty? After which it form of stabilizes and comes again out and I believed I may use a refresher on the crash cart. That’s precisely what I took away from that particular occasion was it was an emergency that got here in. I can’t keep in mind what it was. It went underneath anesthesia to get mounted. And I believed, you recognize what? Let’s simply freshen these abilities again up. And so I needed to get you in and simply say, run by the crash cart with me actual fast. Let’s do one hundred percent refresher on what’s in my crash cart, what’s it do, what do I have to find out about it? And simply make me really feel just like the mud has been blown off my crashing affected person data. Is that okay?
Tasha McNerney:
Oh yeah, let’s do it. So, ooh, there’s most likely so much to cowl, however we’ll sort possibly put it into classes while you’re taking a look at your crash cart. And once more, simply need all people to know that I’m speaking about this within the context of an anesthetic crash cart, not essentially your ER crash cart, which might be going to be just a little bit totally different, however once we have a look at our anesthetic crash cart or what we need to have in that high drawer of our anesthesia machine or available throughout any anesthetic occasion, that’s what I’m going to speak about right here. That’s cool with you. All proper. So initially, any emergency, once more, after I say to you, Hey, issues aren’t wanting good, are you able to flip off that vaporizer? After which one of many first issues that I need you to do is pull out our actual emergency medicine.
And after I say emergency medicine with anesthesia in thoughts after I’m speaking about are our emergency issues like atropine and epi after which our anesthetic reversals. So these are actually the 2 large issues in our crash cart. We all know that we need to have atropine or anticholinergic that we’ll use in emergencies as a result of it has a really quick onset, shorter period of motion than glycoparalate. However once more, in an emergency, we would like that quick onset. Now there’s some stuff, and I’ll allow you to guys listening at house perform some research as a result of I feel that is very, very fascinating. Wanting on the newer analysis that has come out previously couple of years asking, particularly beginning in human medication, asking is there actually any profit to utilizing atropine throughout a code or a CPR occasion? And the human medication, human literature has really discovered that there isn’t, they usually really don’t actually use atropine anymore throughout emergencies.
And in case you have a look at the most recent restoration tips, they really state that atropine is just not essentially helpful, however they don’t know if it’s actually going to do any hurt both. So in case you really feel such as you nonetheless need to preserve that in your again pocket, you’re most likely not doing any hurt. Nevertheless it’s just a little totally different than we thought 10 years in the past that we don’t essentially know that it’s actually doing so much throughout our CPR occasions or our code occasions. However I nonetheless will get it out. And I’ll say that my anesthesiologist will nonetheless have us give it throughout an emergency. Our subsequent is epinephrine, proper? And that’s as a result of we would like that fundamental constriction. We need to guarantee that our blood strain stays tight. We need to guarantee that we’re delivering oxygen to the tissues to the place it must go. So once more, our emergency medicine, then we have to eliminate no matter anesthetic.
Once more, if this can be a true anesthetic emergency, we need to guarantee that we have now reversals in our crash cart to reverse each single drug that may be reversed. Now, more often than not with anesthesia, we’re administering opioids. In order that signifies that we want naloxone before everything in our crash cart. So if we have now an opioid on board, we need to guarantee that we reverse that opioid with naloxone. Second commonest drug class that’s used are benzodiazepines, issues like Midazolam or issues like valium, and we have now a reversal for these. Lots of clinics don’t even carry the reversal, however I’d say in case you’re using issues like medazolam or Valium in your clinic, it’s worthwhile to carry the reversal simply in case issues get loopy. And the reversal for these is a drug known as flumazenil. It’s just a little dearer than naloxone.
And once more, lots of people don’t preserve it often on their cabinets. However I’d say that if in case you have an emergency, you need to have at the least one bottle of flumazenil or at the least one in your, or if in case you have an anesthetic emergency, the subsequent reversal agent that is essential can be antisedan or anapamazol. So that is going to reverse your dexmedetomidine or in case you’re in a follow that’s nonetheless utilizing xylazine, you’ll need your reversal to be yohimbine, though you possibly can use anapamazol as nicely engaged on these receptors. So that you need to have antisedan in your dexmedetomidine, proper? So if we got here right into a pressing state of affairs, we need to be sure that we have now entry to atropine and epi and the reversals for all of our medicine. Now, in case you’re using ketamine in your protocol, you don’t have a reversal agent for ketamine.
So simply notice that if issues get loopy and also you begin reversing all the pieces, that Ketamine remains to be going to be on board. We don’t essentially have a reversal for that. Now, that is only for an emergency. I’ll say that there are a pair different medicine that I do consider as all the time having in my crash cart, one possibly for some anti-arrhythmogenic results, after which one for if we begin to see possibly some irritation or one thing like that underneath anesthesia. And considered one of these is lidocaine and the opposite one is diphenhydramine. I prefer to preserve these on board as a result of particularly with our sufferers that aren’t hemodynamically steady sure breeds, if we see a ventricular tachycardia underneath anesthesia, so once more, this can be a ventricular tachycardia, and after I say that, I imply a beat that’s larger than 160 beats per minute. So if we see one thing like this, once more, that’s going to be not nice for ahead motion of blood and cardiac output, which delivers oxygen.
So we all the time need to be sure that we have now lidocaine out there as nicely. Particularly in these extra essential sufferers, you may want to present like a two meg per kg lidocaine bolus in case you see that your affected person is in vtac. Now once more, the explanation I discussed the speed is as a result of generally I’ve gone into clinics the place they’ll see what they describe as a gradual vtac or a ventricular escape beat, or they’ll see it, however possibly the speed remains to be solely round 100 beats per minute or 110 beats per minute. We don’t deal with these with lidocaine. That would really make it worse. So lidocaine is for these ventricular tachycardic emergencies. After which diaphenhydramine, I often prefer to have it on board as a result of generally my surgeons will word, Hey, I see that this affected person has had a response to both possibly they’ve extreme clipper burn or they’ve had a response to the chlorhexer iodine that’s been used to wash their pores and skin and now they’ve hives.
So if we see one thing like that, we need to guarantee that we are able to administer some diaphenhydramine to them. Okay, that is sensible. These are some emergency medicine. And so what I prefer to have in my anesthesia crash cart, now, these are form of adjunct medicine that I’ll discuss actually shortly, and that is extra blood strain medicine as a result of we all know that inhaling anesthesia together with loads of the medicine that we’re going to administer like ace premises, like propofol, like afaxolone, these medicine are going to trigger a lower in cardiac output and vasodilation, which goes to decrease our blood strain. We all know that hypotension goes to occur, we need to be prepared for it. Now, more often than not you’ve gotten a traditional wholesome hemodynamically steady animal. One thing like decreasing your vaporizer setting or administering a fluid bolus. A 5 ml/kg goes to get you the place it’s worthwhile to go for some animals.
However for different animals, particularly if in case you have an extended process in thoughts, we need to guarantee that we’re not simply letting that blood strain and that imply arterial strain dip persistently beneath 60 as a result of then we all know that oxygen supply to essentially necessary tissues, it’s going to be compromised. And that’s why I all the time prefer to have some blood strain medicine prepared and out there. Now, I’m not saying that each clinic has to have all of those blood strain medicine, however the three that I carry on me always are going to be dopamine, dobutamine, and ephedrine. And dopamine is a combined alpha and beta, and that’s why I actually prefer it. You probably have a affected person that only a cat that’s underneath anesthesia for, and we all know that we’re going to do 12 extractions, it’s going to be a protracted process, however their blood strain is already not doing so nice and they’re additionally a elevated kidney worth affected person and I need to guarantee that they don’t get too hypotensive, then I’m going to begin dopamine on this affected person once more, we’re going to have alpha results and we’re going to have beta results, which implies the beta goes to assist to extend the center fee and the contractility and the alpha goes to present you just a little little bit of a squeeze on these vessels much like one other alpha energetic drug dexmedetomidine.
Now dobutamine, and the explanation I prefer to have dobutamine round is as a result of for some animals like your mitral valve illness sufferers like your continual coronary heart failure sufferers, these little shih tzus that are available in they usually have coronary heart illness, these guys, if we’re about to do a lung process on them they usually get hypotensive, they’re going to do higher with dobutamine. And that’s as a result of dobutamine primarily acts at illness, can’t deal with the vasoconstriction that comes together with alpha activation and dopamine. So we’ll go along with dobutamine for these guys as a result of it’s prefer it’s having a celebration on the beta receptor. It’s like all beta on a regular basis. And that’s why I need to have dobutamine for these particular coronary heart instances. After which I additionally prefer to have a ephedrine, and ephedrine is a kind of as a result of it is vitally, very versatile. You can provide ephedrine as a one-off and it’ll final for about half-hour.
So I discover a phedrine very useful. It’s an alpha and beta, similar to dopamine, however not like having to arrange a focus infusion such as you do with dopamine, you can provide a one-off of ephedrine. Now you need to dilute it out. So be sure that in case you’re getting a vial of ephedrine, you’re diluting this out. So you’ve gotten possibly a one meg per mil focus, however then you possibly can give a dose of it. And generally if I say to my clinician, nicely, I’ve already tried the vaporizer, I’ve possibly tried giving, I don’t assume the center fee is a matter, and also you’re telling me we nonetheless have 30 to 40 minutes left of this dentistry, however I have to do one thing concerning the blood strain. If I don’t have entry to dopamine or I don’t need to take the time to arrange a CRIsad, I can possibly simply do a one-off of ephedrine.
And that’s actually efficient as a result of once more, ephedrine like dopamine efficient on the alpha and beta receptors, and we get about half-hour of exercise. In order that’s what I preserve in my again pocket if I simply want a fast one thing that I don’t need to arrange or I don’t have entry to arrange a syringe pump and an infusion and et cetera. After which another issues, similar to gear that I prefer to preserve with me always is an additional endotracheal tube, an additional laryngoscope. And in case you are at a follow that has entry to it, definitely paddles for fibrillation. Now once more, keep in mind if we’re going to use paddles, this must be a rhythm that’s a shockable rhythm. So we’re not going to shock vtac, however in case you see it’s actually essential issues go south and loopy and your affected person is in v fib, then we are able to shock that rhythm.
However I will even inform you that I’ve labored in loads of locations that don’t have entry to paddles they usually’ve executed okay with that. However that is simply gear. And the explanation I’ll return to the laryngoscope within the tube actually fast is on the off likelihood your affected person throughout motion from induction into the theater will get extubated through the off likelihood that transferring the affected person round on the desk, they get by chance extubated. I need to guarantee that I can shortly re-intubate that affected person. And once more, a laryngoscope goes to be the easiest way to try this as a result of it’s going to present me visualization of the place I’m going with the tube. If there are any issues, et cetera, I need to be prepared for these issues. And that turns into particularly, particularly particularly necessary in case you’re coping with brachycephalic sufferers, you all the time have an additional tube and laryngoscope able to go.
Dr. Andy Roark:
Yeah, that absolutely is sensible. That is wonderful. I didn’t have this as clearly damaged down for me in vet faculty as you simply did. This might’ve been so useful 15, 20 years in the past. That is wonderful.
Hey guys, I simply need to leap in right here actual fast and allow you to find out about an superior free one hour of RACE ce webinar that I’ve obtained coming at you actual, actual quickly on December the thirteenth at 1 p.m Japanese Time. I’m working with my buddy, Dr. Simon Platt, who’s a neurologist and a very fascinating particular person. I simply had him on the podcast. In the event you didn’t hear his episode on Spectrum of Care neurology, test it out. It’s an awesome episode. It’ll provide you with some concept of what we’re going to be speaking about. However man, he’s tremendous enjoyable and interesting, fascinating, and I can not wait to get in and host this webinar for him.
Anyway, it’s known as Head Instances, A Spectrum of Care Method to neurology usually follow. It’s made potential generously by Nationwide. There’s no payment to you. It does have RACE CE goes to be an awesome presentation about neurology usually follow and preserving neurology accessible to folks in instances when possibly folks don’t have as a lot cash as they want or they don’t have the power to only throw down and do probably the most aggressive therapy choices potential. So anyway, it’s going to be incredible. I’d like to see you there. I’ll put a hyperlink to register in present notes. Let’s get again into this episode.
Alright, fantastic. Speak to me about some dosages. So are there dosage calculators that you just actually like as a result of there you’re and also you’re doing the process and this can be a tense time and issues begin to go off the rails. What do you do to maintain these issues high of thoughts for you in a helpful means the place you say, okay, that is what we want. It’s not simply epinephrine to impact, however though that works, however how do you observe that info? How do you retain that in a really helpful format? Or do you simply realize it, you’re similar to, I do know you recognize it, however is that the easiest way to strategy this?
Tasha McNerney:
It’s most likely not the easiest way to strategy it as a result of once more, except you’re actually lifeless on the within and you’ll block all the pieces out and simply go to your rolodex of drug dosages, nevermind the issues beeping and other people yelling once more, I can do it, however I feel that’s simply because I don’t know, my mind features just a little bit otherwise, however
Dr. Andy Roark:
I’ve had folks say, how a lot? And I present ’em with my fingers like this a lot, they usually’re like, that’s not science.
Tasha McNerney:
Nope. Yeah, don’t do that you just guys at house. However definitely I’d say for anyone who’s , have a look at the vex web site. They’ve loads of actually nice issues. Take a look at the RECOVER initiative that’s going to present you a very nice dosing chart. And I do know that in case you go to RECOVER and have a look at the RECOVER initiative and their web site, in addition they have posters that loads of clinics will use that provide the dosages of primarily based on weight. They’ve a fast wait chart. So loads of ERs and emergencies could have this simply hanging of their follow the place they’ve a very nice weight chart that’s busted down between atropine, epinephrine reversal medicine, issues like, once more, in case you’re in an ER setting and issues get actually loopy, you need to bust out the vasopressin, issues like that. So I actually would advocate recuperate as a result of that’s most likely probably the most up-to-date tips so far as what the analysis is saying, new up to date dosages and having it simple and accessible.
One other factor that I do advocate that each follow does is take these dosages and make an excel spreadsheet or an emergency drug calculator, print that out primarily based on the affected person’s present weight and have that able to go. The time to print it out and put it into the excel spreadsheet is just not when all people’s screaming and the canine’s shedding loads of blood. We need to guarantee that we try this beforehand. And once more, as a result of it’s a very tense time, it’s good to have this printed out and checked beforehand as a result of once more, when issues are actually loopy and also you’re actually wired and your clinician says to you, okay, I want you to present a sure mg/kg dose, after which your mind is like, wait, how a lot does this affected person weigh? What’s the focus? And also you’re attempting to do that fast math doesn’t often work out nicely. These valuable seconds that you just’re taking to calculate out this drug could make an enormous distinction.
Dr. Andy Roark:
Yeah, yeah, that’s incredible. I’ll put a hyperlink to the RECOVER initiative drug doses in present notes, so folks may verify that out. I don’t assume I want a hyperlink to Microsoft excel, however um
Tasha McNerney:
I often say as a result of folks could make their very own excel, once more primarily based on what they’ve of their clinic, as a result of I don’t assume that each clinic possibly has vasopressin able to go for his or her sufferers.
Dr. Andy Roark:
Yeah, no, no, I like that. I feel that makes a ton, a ton of sense. What are the most typical pitfalls that you just see? What are the issues that folks both placing collectively a crash cart or utilizing what’s on their crash cart?
Tasha McNerney:
I feel that the majority widespread pitfalls, at the least from an anesthetic perspective that I see, is that there’s not an everyday checking of the crash cart and whether or not or not the medicine are expired or whether or not or not we have now sufficient quantity of the drug able to go. So as an example, I’d provide you with, yeah, to truly do what we have to do. Sure, I’ll have a bottle of atropine in there, but when there’s solely 0.4 mls, that may not get me the place I have to go. So having any individual verify that earlier than the process, and I’m an enormous fan of checklists, and also you guys know me. I like checklists. I like anesthesia checklists. In the event you haven’t learn the Guidelines Manifesto, please do your self a favor and browse this. It’ll change the best way you follow. However definitely having checklists in anesthesia and having any individual to go in earlier than the anesthetic occasion even occurs, verify that anesthesia machine, verify that cart, be sure that the lidocaine is in date. Just be sure you have a bottle of glycopyrrolate prepared and out there. Make it possible for in case you’re going to make use of dopamine, once more, you’ve gotten sufficient quantity to make up your cri as a result of I’ll simply provide you with an instance. I used to be serving to out anesthesia on a 62 kg
Dr. Andy Roark:
Wow.
Tasha McNerney:
Nice. Dane. Yeah,
Dr. Andy Roark:
That’s 140 pound
Tasha McNerney:
Nice Dane in for a CT process. And I went to have a look at the crash cart and our anesthesia machine in Ct and I taking a look at it, and I used to be like, yeah, we solely have 1 ml of atropine on this bottle. So yeah, I’ve atropine and it’s in days, however once more
Dr. Andy Roark:
That’s not going to make one aspect of his mouth dry.
Tasha McNerney:
One thing goes loopy with this affected person. Now I’ve to run to a complete different aspect of the hospital to get extra atropine as a result of that one ML is just not going to be sufficient for that dane.
Dr. Andy Roark:
Yeah. Yeah, that absolutely is sensible. Superior. Tasha McNerney, thanks a lot for being right here. The place can folks discover you on-line? The place can they be taught extra about anesthesia nerds?
Tasha McNerney:
Yeah, so the Veterinarian Season Nerds is at the moment a Fb group, and that’s the place we do loads of our dialogue and case-based stuff. However you too can discover us on the web site. And on the web site we have now hyperlinks to the Veterinary Anesthesia Nerds podcast in addition to a calendar of occasions. So you possibly can see the place all of us are talking. And after I say all of us, I don’t simply run anesthesia nerds on my own. I’m joined by Darcy Palmer, who’s a VTS in anesthesia, and she or he works out in Alabama. After which I’m additionally joined by Steven Sital, who’s a VTS in, once more, not solely a VTS in lab animal, but additionally a surgical analysis anesthetist and only a wealth of knowledge there. So we have now a calendar, so you possibly can see in case you needed to return hear us speak or lecture, we have now a calendar on there as nicely. After which we have now a contact type as nicely. So if in case you have one thing that you just needed to ask the anesthesia nerds otherwise you needed to request some assist for one thing, you will get us there.
Dr. Andy Roark:
That sounds incredible. Superior. Thanks a lot for being right here, guys. Thanks for tuning in. Care for yourselves. Have a beautiful remainder of your week.
Tasha McNerney:
Thanks for having me.
Dr. Andy Roark:
And that’s it. That’s the episode, guys. I hope you loved it. I hope you bought one thing out of it. I mentioned, you possibly can see now why that is the Corridor of Fame episode for us, and why so, so many individuals liked it when it first dropped. Guys, maintain yourselves, all people. I’ll speak to you in a while.
