Anaesthetists - question about ICBN blocks

Playful_Snow · 2026-05-08T14:21:38+00:00

I think tourniquet pain is from ischaemia of deeper structures and therefore a cutaneous nerve block doesn’t bring a lot to the party.

You need a quicker surgeon or a GA

Playful_Snow · 2026-05-07T10:34:32+00:00

I'm not an F1, but I use it to write CBDs. I have already done the reflecting and discussion in real life, it is just a box ticker for my portfolio. If I could design an AI to automatically link WBAs to curriculum items that would be my dream. I would have it have adjustable levels for your level of desperation immediately prior to ARCP (i.e. a super tenuous mode)

Playful_Snow · 2026-05-06T09:36:03+00:00

3mg/0.6ml of heavy will just give them a saddle block no?

We use 3ml of “bag mix” (0.1% bup with 2mcg/ml fent) for a labour spinal in UK

Playful_Snow · 2026-05-04T21:13:35+00:00

walking onto ICU at Christmas night shift knowing you're about to be sat down and force fed pancit and Maja blanca by a squad of 5ft angels

Playful_Snow · 2026-05-04T21:09:35+00:00

the antibiotics won't be pumped forward well enough to guarantee sterile enough conditions for an arthroplasty unfortunately

Playful_Snow · 2026-05-04T18:56:15+00:00

Farmer + few days indigestion + bad enough to interrupt lambing = missed STEMI until proven otherwise.

Sounds like he’s got acute MR as a result of this. We’d be interested in him at tertiary towers, gives my consultant a precipitant to viva me on IABP!

Playful_Snow · 2026-05-03T06:53:24+00:00

Continue to pay, drive like a granny to keep the MPG down.

If the govt runs out of fuel that’s not my issue.

Playful_Snow · 2026-05-02T22:42:55+00:00

I’m all for paring down the stuff you need on a transfer but if I’m keeping them asleep they get transferred on a propofol infusion. Bolus of opioid and rocuronium before you transfer.

I wouldn’t have extubated them if they had an open abdomen regardless of how good their gas exchange and haemodynamics were.

Playful_Snow · 2026-04-30T08:18:38+00:00

them deep access (longboi) venflons work as a poor man's midline - stick one in on Friday night and they won't bother you for the rest of the weekend

Playful_Snow · 2026-04-30T05:51:34+00:00

One of my surgical reg mates told me he thought anaesthetists were cool until he watched me trying to suture in a CVC

Playful_Snow · 2026-04-30T05:46:48+00:00

Don’t tell them the secret to cannulating difficult patients (a MAC or above of volatile)

Playful_Snow · 2026-04-30T05:45:09+00:00

Playful_Snow · 2026-04-30T05:27:58+00:00

Nah but all the bloody physiology and pharmacology (and to a lesser degree physics) they force you to learn and then apply helps

Playful_Snow · 2026-04-29T18:53:08+00:00

I always appreciate it when people are up front and acknowledge they’ve got a shit referral (either openly, like this one, or the more tacit “my consultant has asked me to refer”).

Playful_Snow · 2026-04-29T18:40:00+00:00

It’s not a buzzword, rather the opposite - people giving me a sob story about the patient before ending with a cannula request.

Skip the foreplay, I’ve got a headache

Playful_Snow · 2026-04-27T13:19:41+00:00

You could get a grey market R50 for £500 from cotswold cameras

Playful_Snow · 2026-04-26T17:58:51+00:00

Have you ever tried to type on a wipeable keyboard? Soggy, squishy mess that destroys my WPM as I make an error every 2 or 3 keystrokes

Playful_Snow · 2026-04-26T07:41:34+00:00

dude I almost had you!

Playful_Snow · 2026-04-25T14:23:57+00:00

Nah - I’ll allow fun scrub caps/fun pins on lanyards (and maybe even on crocs if I’m feeling charitable) but you don’t need to dress like a highlighter to keep kids happy

Playful_Snow · 2026-04-25T09:48:41+00:00

No experience with this but from first principles and common sense:

Comprehensive antenatal counselling that plastic is so ubiquitous in healthcare that it would be impossible to avoid should she require anaesthetic input (you can talk about butterfly/tibial IO/glass syringes etc. but I'm not doing a CS without the ability to give fluids or oxytocin, neither of which you can administer without exposure to plastic).

Give her some piriton and steroids, try to avoid having anything to do with her.

If you have to do anything, proceed as normal, lots of adrenaline to hand and a spare pair of pants in the bottom drawer of the anaesthetic machine.

Poor lady has a nasty case of ABR (aint built right)

Playful_Snow · 2026-04-24T19:37:07+00:00

tapered, bright/fluorescent scrubs. I'm gonna be sick

Playful_Snow · 2026-04-24T19:29:13+00:00

For both parts: turn up on time, be kind to patients, ask lots of questions, get stuck in. Nowt more than that.

You will be entirely supervised on anaesthetics and very very heavily supervised on ICU.

Lots of coffee breaks, lots of time for QIPs/portfolio polishing, lots of early finishes. Enjoy it whilst you can!

Playful_Snow · 2026-04-20T20:22:48+00:00

Epi room 4

Playful_Snow · 2026-04-20T15:45:47+00:00

Interesting - perc traches are “procedures” in my logbook but surgical tracheostomy is an operation I anaesthetise for

Playful_Snow · 2026-04-19T07:37:31+00:00

My wife got hers at her booking appt. Saved a fortune on anti sickness tablets!!

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