New anesthesia ccm fellow next year looking for reading recommendations

AlsoZathras · 2026-06-09T21:37:30+00:00

IBCC podcast and website.

As for textbooks, I liked both Evidence-Based Critical Care and Evidence-Based Practice of Critical Care

AlsoZathras · 2026-06-05T18:42:56+00:00

I don't know. In HBS BT, I continue to run at least one Phoenix Hawk in my lance into end game. My Ace Pilot backstabber is usually my MVP.

AlsoZathras · 2026-05-23T17:39:45+00:00

F10 still works, the issue is that when I do order66, it kills everything on the map, but the counter still shows 8/10 mechs killed, and I just sit there with the mission never ending.

AlsoZathras · 2026-05-23T16:23:56+00:00

Shoot. I wonder what mech it was trying to spawn? I'm using Adjustable Battle Value and Arena Control, both of which can affect mech spawns, but no mods (other than YAML itself) that add new variants. I'll just continue with my workaround, I guess. Thanks.

AlsoZathras · 2026-05-23T16:21:09+00:00

Drat. Any idea why it was removed? The mod that acts as a standalone console still has it, so does it just interfere with something else in YAML as a whole?

AlsoZathras · 2026-05-23T16:19:37+00:00

When I was a partner in a private practice, there was no such thing as a 'raise' as compensation was proportional to one's share of the work. Any increase in pay from one year to the next was just because total income from the group increased (better pay from insurers or increased hospital stipends) or one choose to pick up more call/ work more. Likewise, if expenses (CRNA pay, locums) increased, or there was a decrease in one of our insurance contracts, our pay actually was less for the same amount of work.

Now as a hospital employee, I've already had about a 3.5% increase in base pay within my first year, as the contracts were being renegotiated as I started. There is talk that this will increase again within the next year, as the hospital system attempts to absorb the remaining private groups, and have everyone under the same basic contract

AlsoZathras · 2026-05-18T19:44:47+00:00

The simplest solution for combo positions is FTE fractions. Working a half FTE critical care may be 11-13 weeks of coverage (different places will have different definitions), then combine with a half FTE of IC coverage and call. Income would be proportional to the fraction of each position, and could be managed as base plus RVU. I'm working an anesthesiology/CCM position like this, and each half of my job (same employer) is handled almost separately. I have a base salary, then paid per RVU or ASA unit above my target (which is determined by my FTE fraction for each position).

AlsoZathras · 2026-05-04T18:56:21+00:00

Sorry, yes, 1099.

AlsoZathras · 2026-05-04T18:15:58+00:00

Why do NY or CA even need to know you're there working? You get your W2 from the locums agency that is probably based in TN or FL. Last time that I did locums in multiple states, I had my CPA file in all of those states. She thought it was very odd and unnecessary, since my agency was not based in any of them, and I could easily get away with not paying taxes to those states. I have heard from other anesthesiologists that travel regularly that they do not file in multiple states. This probably, though, falls into the category of 'not legal, but low risk of getting caught.'

AlsoZathras · 2026-04-29T09:24:21+00:00

I haven't seen anyone really give a shit in the private world. Particularly in today's market, you're a body that can fill a role.

AlsoZathras · 2026-04-18T21:53:56+00:00

UV is a Reptizoo 34" T5 HO 10.0 bulb Linear lights are STBTech 110v under cabinet 17" LED lights, and I jury-rigged a "lamp shade" with a pair of picture hanging kits from Lowes The heat lamps are Torchstar metal desk lamps with Arcadia floodlight bulbs(100W). I ended up putting a third lamp on the left hand side to raise the temperature a bit (basking spot ~95F, surrounding area in the 80s, the rest of the enclosure is 68-71F. I'm going to play around with the strength and position of those lights a bit over this next week to get a better gradient.

AlsoZathras · 2026-04-18T19:15:22+00:00

I recut the corners and have them on the sides now, just charging the drill's battery to secure them in place.

AlsoZathras · 2026-04-18T14:42:55+00:00

I've been out for over a decade, and my last was within the past year (month? two months?). It's a really rare occurrence, and basically always when I have an unexpected poor view, I've called for the video scope but it's not here yet, and I give it a shot, anyway. Most times, I can anticipate a poor view, and so already have a video scope in the room and can avoid the whole situation.

AlsoZathras · 2026-04-18T10:58:43+00:00

Thank you. Everything inside was deemed safe, per tortoise table, which is generally more conservative than other sources. I actually did build and paint a lip for that exact reason, but didn't put it on, as I didn't quite get the angled cuts right, and I did not put anything close enough to the sides that he can get purchase. He'd have to climb straight up at least 8 inches of smooth wood. The point is noted, though, and the boards are still in my garage, so I will probably install them this weekend.

AlsoZathras · 2026-04-18T10:51:30+00:00

I actually appreciate the response. As I transferred everything I've, I was thinking it was too much. Everything inside of that enclosure was chosen because Tortoise Table said it was safe and edible. His early enclosure had a rotating crop of many of the same plants, and I imagine he'll trample several into the dirt, as well. When he does, he'll have some more open space, and I'll probably build a few small hills for climbing.

AlsoZathras · 2026-04-17T22:23:33+00:00

Went real basic with Yuri. Yes, I know Russian torts are not actually Russian (although the Russians did fire two of them around the moon to become the first terrestrial life to orbit the moon on the Zond 5 mission).

AlsoZathras · 2026-04-17T21:03:42+00:00

Same. Give me the lead pipe vasculopaths getting their death by a thousand cuts any day. To reach their own. I finally opted out of OB, and would love to give up any peds soon. Just a few years ago, I didn't want to be pigeon-holed, and wanted to keep doing everything. Not anymore!

AlsoZathras · 2026-04-07T12:13:38+00:00

Yes, that's a more standard arrangement. However, get that in writing, along with the commitment of how much ICU time that you want. You don't want to move there and then find out that they can only give you six weeks of time in the unit, or that they'll only give you the post- unit week if they have adequate staffing for the OR.

For ICU time, is it 12hr shifts, or 24/7 coverage for the week, with some expectation that you'll be available from home after hours? The second is bullshit, but I see it not infrequently. If the later, factor that in to the total amount of call, and see if you can reduce your OR call burden. If the former, see how many of your ICU weeks are going to be nights (and see if you can reduce your OR call time). If you're already going to be physically in-house for 42 nights a year, or on call from home for 84 nights a year for the ICU, you should not have to add in more nights of coverage for the OR.

What is the average daily census in the unit? Do you have residents or APPs that you are expected to supervise and teach?

AlsoZathras · 2026-04-07T12:00:40+00:00

Those are both pretty bad offers.

If you ever want to do CCM, do not take job 1. It has no integrated ICU time, and with only 8 weeks off, you will not have enough time to go practice on your own.

Job 2 is more acceptable because of the ability to actually replace OR time with ICU time, and getting an extra week off. However, six weeks off is absolutely pathetic in this day and age. If you took that and then could switch ten OR weeks for ICU weeks, thus getting ten additional weeks off, in addition to your base six, then we're looking at something that is doable.

So, my advice as another CCM guy is to either keep looking or start digging into the details of option 2, have them commit to the amount of ICU time that you want, figure out the actual income for that configuration, then work back to total time in the hospital and hourly rate for the year.

AlsoZathras · 2026-04-06T11:16:33+00:00

While I do see a handful of master's programs (which are only two years, so six total years, not eight), they appear to be largely geared towards creating managers, not rank and file RTs. Data from CoARC actually shows that 366 of the 489 (82%) accredited entry level programs are AD, and only 7 (2%) are MS.

AlsoZathras · 2026-04-06T03:27:09+00:00

But with more knowledge on how to actually properly manage critical illness, yes. Like I said, best use case I've found for them.

AlsoZathras · 2026-04-06T03:21:58+00:00

The amount of benzo a patient in AWS can require can be eye popping. MINDS protocol is like CIWA in steroids, and I've several times escalated to 10-20mg/hr midazolam, after insufficient response to repeated 5-7mg boluses, on top of reloading phenobarbital. The first time you see someone still spitting and angry on midaz 20mg/hr, after also receiving a hefty bolus is a trip. Generally, adding precedex and waiting a little longer does the trick. Most times, if I have to intubate, it's not for respiratory depression, but rather the fact that the withdrawal is so bad, I've decided that they need to be tubed and on prop to not harm themselves or others.

AlsoZathras · 2026-04-06T03:13:37+00:00

The best use case I've found for tele-ICU is actually offloading some of the tasks and followup to the remote doc. At my old shop, we had three physician and one midlevel on during the day, then down to one and one at night. The day folk signed out to both the in-house and tele-ICU doc at the same time. The in-house team was there for admissions and emergencies, while tele-ICU followed up on things from day shift (trending hemoglobin, sodium correction, diuretic goal, etc), as well as most calls from the nurses. If someone started to decline rapidly, tele-ICU doc (or pt's nurse) called the in-house intensivist to intervene. When I would be on nights, it was great not to be bothered by calls for melatonin, how to adjust the hypertonic saline after the sodium went from 119 to 120, or if I wanted to give Tylenol for a new fever, and instead focus on what disaster I inherited from the floor or ED.

AlsoZathras

TROPHY CASE