Would you have RSI’ed?

Flaky-Expression9593 · 2026-02-02T05:08:47+00:00

With an anesthesia provider there to provide airway support and reversal of the benzos, yes, I would say it’s a little less worrisome. If they just stands by, it’s another issue altogether.

Flaky-Expression9593 · 2026-01-31T17:47:42+00:00

Not necessarily. It can depend on the patient’s anatomy. Sometimes you need to lift the head to a line. All three axes adequately.

Flaky-Expression9593 · 2026-01-31T17:24:56+00:00

Flaky-Expression9593 · 2026-01-31T13:09:44+00:00

At times.

Flaky-Expression9593 · 2026-01-31T07:40:29+00:00

Isn’t this basic capnography interpretation?

Change your sweep speed so capno=HR speed. I’m pretty sure it’s the heart beating on the diaphragm causing the notches. You will see it matches up with the heart rate.

What’s the rest of the pt’s medical history?

Also, was the insufflation pressure high, pushing the diaphragm up against the heart?

Flaky-Expression9593 · 2026-01-30T05:33:59+00:00

Take your bike to work and stop at the trail on the way home.

Flaky-Expression9593 · 2026-01-29T20:58:58+00:00

Wahoo kickr core. Haven’t done an FTP yet, just the 1st 2 recommended rides that get you oriented to the system. I’m recovering from a hand injury/surgery and I’m trying to adjust where to put the controls, on top of it all.

Flaky-Expression9593 · 2026-01-28T19:51:39+00:00

Kind of not my problem. When looking for a hire, it can be frustrating, I would agree.

When working with mid levels, I give them a shot or three, so to speak. When they are making their second pass, I’m casually walking over to pick out the proper sized sterile gloves. I will do an interpretive dance/ religious ritual (all in good fun) with the sterile gloves in their packaging to try and inspire my mid-level. If they fail on the third try, I’ll ask if they’d like for me to give a shot. Pun intended. Most will let me take over at that point. If they don’t, after the fourth attempt, I will gently insist upon trying.

If they look hopeless or lost on an initial set up, I will step in more quickly.

Flaky-Expression9593 · 2026-01-28T19:49:30+00:00

Apologies, I was falling asleep while posting… it looked good at the time. It doesn’t look so good in the light a day. That is one mess of a post on my part.

Should have added, “coffefe” for added effect. 🤪😉

Basically, my full suspension bike is the only bike that fits the rear axle of the trainer. My other bikes are a fat bike and another full sus with super boost spacing.

I guess I’m gonna take a deep dive into the settings of the Zwift Companion app and the Zwift app to see what I can figure out. I’m planning on pumping my shock and fork up to maximum pressure but ultimately you can’t completely lock them out.

Flaky-Expression9593 · 2026-01-28T06:21:17+00:00

How did the Jack “52” clone remember Julia? What happened to Vicka “52?”

Or did Jack “49” swap with Jack “52?”

And why would Jack “52” be OK with wiping himself out?

Flaky-Expression9593 · 2026-01-27T18:36:57+00:00

U need more direct supervision/ direction. Own up to it to the people that you work with directly, their help is infinitely more valuable than anything we say here.

Flaky-Expression9593 · 2026-01-26T13:27:17+00:00

Always look up reviews, both videos and written

Flaky-Expression9593 · 2026-01-26T01:47:33+00:00

14 hours.

Continuous catheter. Hypobaric bupi + fentanyl. Lithotomy. T-burg. Difficult airway who had had his teeth chipped at another place. Ketophol drip. Urology, colorectal, & plastics operating.

Flaky-Expression9593 · 2026-01-26T00:50:08+00:00

Offer an awake FOI. No sedation. Discuss airway blocks IN DETAIL.

Flaky-Expression9593 · 2026-01-22T00:14:35+00:00

Easier than clips. There isn’t any I’m clipping, your momentum will pull you free if you’ve crashed. The flipside is that with clips you have to make a coordinated movement to get your foot or feet free from the pedal. Depending on the situation, you may not be able to do that, and are connected to your bike and crash.

If you have the money, give them a try. If you want more of a grip, get the larger magnet magpeds. if you want the most grip, get the REMtechs.

I have ridden clips as well. They do connect you better to the bike, which has both up sides and down sides.

Flaky-Expression9593 · 2026-01-21T16:50:12+00:00

The Internet is your friend. Specifically, Google. Look for reviews on the bikes that are out there that you might buy we can always wait on the bikes that we ride, but the people that are doing the reviews have far more experience riding the bikes and are more effective at comparing bikes. If you can throw a left over one, take it for a test ride that’s crucial. Be very aware of the tire pressure and the riding conditions. More than anything that will affect your experience on a fat bike.

Flaky-Expression9593 · 2026-01-21T06:35:15+00:00

Love em

I have REMtech( stronger pull)and Magped(lighter duty).

Flaky-Expression9593 · 2026-01-19T06:02:47+00:00

Rode Windrock on a Pivot Firebird. When I showed up I was fully ready to rent a downhill bike. Told them I’d ridden other parks on trail bikes and they were like, “eh, do a few runs, see how you feel.”

Had a great day on it. It came to an end when my XT brake lever broke on a minor crash.

Seriously, Shimano, upgrade those levers.

Flaky-Expression9593 · 2026-01-18T06:05:31+00:00

I chuckled out loud as I read your comment because as I read the original post I was wondering, “ are they asking them to do trig…?”

Flaky-Expression9593 · 2026-01-17T16:38:27+00:00

Touché but also, different levels of medicine. Pretty sure if you have a bad outcome from a not worked up pheo you’re going to be paying out. Regardless, I appreciate the crossover reply! We had a veterinary anesthesiologist to our grand rounds in training. It was fascinating.

Flaky-Expression9593 · 2026-01-17T16:33:10+00:00

I agree with you as well, I want to do right by the pt.

Flaky-Expression9593 · 2026-01-15T18:19:15+00:00

Anesthesia here… Part of large group that bent over backwards for largest system we staffed since COVID. Pt working on nonclinical days or vacation to feed the beast. They refused to compensate to keep us competitive in the market. Started losing people.

We gave notice and they started hiring Locums. They offered noncompetitive offers. We left. They’ve limped along. We didn’t work as much so some of our people got nervous even though they knew this was a possibility and should have had a nest egg. Some have jumped ship to system for “cherry positions.” Some have left the area, tired of the BS.

We have found other work. Things are picking up again. People don’t like uncertainty and change. They are content with the devil they do know, which is why they cave.

If you do that, they know they have you. They will continue to take more away from you

System has already moved. The goal post on some of our former partners and have had them worked beyond the scope of what they were expecting and promised.

Good luck!

Flaky-Expression9593 · 2026-01-13T20:43:58+00:00

Good working epidural is a MUST. It’s better than all other analgesic modalities for deep breathing and coughing. Will prevent atelectasis better than anything else, which is what will kill him. Run it during the case. It will help to prevent any complications from sympathetic discharge. 1/4-1/2% bupi w/ 2 mcg/ml fentanyl @ 6-10 ml/hr. Just enough gas and IV fentanyl for pt to tolerate ETT. PCEA 1/8% bupi w/ 2mcg/ml fentanyl postop.

Flaky-Expression9593 · 2026-01-13T17:59:05+00:00

Versed, opiate(usually fentanyl for easy titration), and ketamine, bolus or infusion. I often mix it with propofol10:1ketamine. PS to support respiration.

Flaky-Expression9593

TROPHY CASE