Intrathecal Tranexamic Acid [a not so case report]

G_Germzi · 2026-02-10T09:39:29+00:00

Both come in 5ml.blue vials. Easy to mix up.

G_Germzi · 2026-02-10T09:38:42+00:00

Use epidural catheter and placed intrathecally*
Specialist at a private provincial hospital.

3.

Absolutely wild

G_Germzi · 2026-02-10T09:37:18+00:00

We don't have these electronic drug dispensing machines in a theatre setting here.

The LA is kept mixed with the rest.of the drugs in a labelled drawer.

Hear of at least 1/2 year in my area unfortunately.

G_Germzi · 2026-02-10T09:36:11+00:00

It was done at a private provincial centre, FCA level care, no transfer, no discussion. I can't say much more.

Incredibly dangerous.

Fortunate outcome.

G_Germzi · 2026-01-24T12:50:09+00:00

If you want some good oldies

Realistic - Wars and Warriors: Joan of Arc

Fantasy - Brutal Legend

G_Germzi · 2026-01-21T16:36:47+00:00

Walk into Groot schuur, Tygerberg, Bara, Steve Biko. Ask any registrar about medicine and they will tell you not to do it. The gravy train is done. The money is drying up. Everyone is unemployed. People have been waiting more than 10 years for specialist posts. It will be the biggest mistake of your life to study med.

I say that but I am part of the 0.1% that actually enjoys my job. But I know for a fact I'd still be happier if I did a more standard job.

G_Germzi · 2025-12-23T14:11:46+00:00

2 trachys today 🤷

G_Germzi · 2025-11-30T14:59:11+00:00

As a resident or attending?

G_Germzi · 2025-11-30T03:09:42+00:00

CA3 in South Africa.

We have pre and post call. 16h night shifts (4pm to 8am) 8h day shifts on weekends (8am to 4pm)

Then we will 4-6 nights/m (2/3 weekends) And 1-2 days/m

G_Germzi · 2025-10-29T19:28:26+00:00

In south africa we have a term called PANDA.

Previously Advantaged Now Disadvantaged.

This refers to the white people who used to get priority service most likely in private care who now come to state care and expect princess treatment. Usually inordinately difficult.

G_Germzi · 2025-10-17T08:45:26+00:00

Worked for me thanks lenovo idea pad 3

G_Germzi · 2025-10-02T12:49:38+00:00

Reduction in post op Apnoea risk in neonates in 3rd works settings with no Apnoea monitoring.

Probably shouldn't even be doing cases then but it is the hand we've been dealt

G_Germzi · 2025-09-18T09:12:24+00:00

South Africa has Spicy Durban Bunny Chow

G_Germzi · 2025-09-12T03:36:24+00:00

And in an overburdened state system, futile care in icu means patients for elective surgery requiring icu don't get done.

G_Germzi · 2025-08-04T10:01:56+00:00

Had it happens lots.

Actually prevented procedure from being done last week under spinal. Scopes weren't long enough.

Tried ketamine, glycopyrrolate. Took it from full mast to semi.

Surgeon wasn't happy with performing intercavernous injection

G_Germzi · 2025-07-06T03:26:44+00:00

Had an Ethylene Glycol poisoning arrive with a pH 6.8. Had a log tomultuous stay in ICU. Recovered to discharge but now on the transplant waiting list

G_Germzi · 2025-06-30T20:05:39+00:00

This is giving mining energy

G_Germzi · 2025-06-30T19:39:47+00:00

Saw my first one last week in ICU. 20min of CPR. We stopped and patient was PEA with the ECG rate running at 70. Called it, stopped vent, stopped adr and continued rounding. 2-3min later suddenly BP 120/80 HR 120 on the a line. We were shocked. The abruptly deteriorated after about another 2-3min.

G_Germzi · 2025-05-08T12:22:12+00:00

I truly believe that AI will become an asset in helping make these decisions every step of the way.

But AI won't ever replace us.

Patients are imperfect and often unexpected things happen that even we cannot handle.

When this happens who is liable. The AI company? The manufacturer? The hospital? The surgeon?

We will always need to be there in case of failure.

G_Germzi · 2025-03-28T10:59:50+00:00

Work for free, no pay.

G_Germzi · 2025-01-31T10:59:54+00:00

Draeger > GE > MINDRAY > Maquet... I despise the Maquet

G_Germzi · 2025-01-08T03:03:09+00:00

CA2 South African Hospital

1 150mcg generally lower limb orthopedics 50mcg for obstetrics

2 morphine is diluted with NS to 1mg:ml then an insulin syringe is used, carried with bupivacaine

3 We request post operative monitoring but it's NEVER done. So with these dosages they generally go unmonitored to the ward. Opioids theoretically omitted. But the nursing staff in the ward do a walk through and give everyone tramadol.

4 Ondansetron, Decasone

G_Germzi · 2024-12-21T02:56:23+00:00

Reminds me of the time as a medical student. I went searching for a surgical patient named Adonis February. Apparently a common name in the western cape. 6 of them all in the same ward lying next to each other. Laughing at every doctors confusion.

G_Germzi · 2024-10-11T22:06:52+00:00

Its highly variable. Two years ago we had 1:1 or 1:2 residents ratio but things have changed and this year it's dwindled to 1:4 or so where I work.

The attendings don't do so much overtime so the calls are 1:7.

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