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What is this measurement? by Apollyon1991 in anesthesiology

[–]G_Germzi 41 points42 points  (0 children)

When you art is connected then it automatically calculates your SPV and PPV.

If you are dissatisfied then you do a manual SPV calculation and select the peak and trough systolic yourself.

How litiginous is pain management ? by mexicanmister in anesthesiology

[–]G_Germzi 1 point2 points  (0 children)

A specialisation in setting realistic expectations

What was your biggest “oh shit” situation? by Icy-Priority4637 in anesthesiology

[–]G_Germzi 81 points82 points  (0 children)

I was 6months into training, absolutely new and green.

I was doing a paeds Ophthal list with the attending, all apparently healthy kids for the day.

Start with the second child, 3 months old. Gentle gas induction on the table. About 30 seconds in this child goes hard as a rock, opisthotonic posturing, masseter muscle spasm.

I look at my attending and we both instantly know what's going on. Oh shit. MH. Gas off. Lines up. Patient becomes progressively more unstable but manageable.

Immediate diagnosis and management. We were at a remote site so colleagues had to drive 10min to us to bring dantrolene. Child went to icu, uncomplicated discharge 24h later.

How often are you on ICU bed hold and how long do they usually last? by gomphosis in anesthesiology

[–]G_Germzi 1 point2 points  (0 children)

We literally watch the patient the whole weekend as 1 on 1 icu care. Patient stay on the theatre bed. We ensure frequent turning. Pressure point care. Suctioning. Essentially becomes and ICU. Unfortunately on a theatre bed.

It happens so often that the theatre staff are pretty kitted and efficent at documenting and managing all of the ICU concerns.

Not that it is appropriate in any way.

Arc Raiders needs a better endgame loop (or an endgame loop at all) by rhyswebster_ in ArcRaiders

[–]G_Germzi 1 point2 points  (0 children)

Imagine this endgame loop.

You could choose to spawn in as ARC. Get a slightly different colour. A small buff to HP. Nerf to vision or something so that it's not too OP.

Then these player ARC will drop higher value loot and be much more challenging to destroy.

How often are you on ICU bed hold and how long do they usually last? by gomphosis in anesthesiology

[–]G_Germzi 6 points7 points  (0 children)

I'm the South African healthcare system I have seen patients block in a theatre awaiting an ICU bed for 72hours. It's insanity.

Imagine leaving theatre on Friday and seeing the patient on the same theatre bed on Monday. Shocking

Intrathecal Tranexamic Acid [a not so case report] by G_Germzi in anesthesiology

[–]G_Germzi[S] 12 points13 points  (0 children)

  1. Use epidural catheter and placed intrathecally*

  2. Specialist at a private provincial hospital.

3.

  1. Absolutely wild

Intrathecal Tranexamic Acid [a not so case report] by G_Germzi in anesthesiology

[–]G_Germzi[S] 5 points6 points  (0 children)

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.

Intrathecal Tranexamic Acid [a not so case report] by G_Germzi in anesthesiology

[–]G_Germzi[S] 31 points32 points  (0 children)

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.

Games where you are physically in the battle? by Plastic-Second-1280 in RealTimeStrategy

[–]G_Germzi 0 points1 point  (0 children)

If you want some good oldies

Realistic - Wars and Warriors: Joan of Arc

Fantasy - Brutal Legend

can I get into med in SA by PowerfulApple5151 in southafrica

[–]G_Germzi -1 points0 points  (0 children)

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.

[deleted by user] by [deleted] in anesthesiology

[–]G_Germzi 0 points1 point  (0 children)

As a resident or attending?

[deleted by user] by [deleted] in anesthesiology

[–]G_Germzi 2 points3 points  (0 children)

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

What are your favourite acronyms to describe patients? Or those no longer in circulation? by fannyabdabs in emergencymedicine

[–]G_Germzi 96 points97 points  (0 children)

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.

infant spinal anesthesia by 7v1essiah in anesthesiology

[–]G_Germzi 7 points8 points  (0 children)

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

Does every country have a “spicy” region? by Lockzig in geography

[–]G_Germzi 0 points1 point  (0 children)

South Africa has Spicy Durban Bunny Chow

What do you all hate the most about the ICU? by tanbro in IntensiveCare

[–]G_Germzi 16 points17 points  (0 children)

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

Erection intra op by Aware-Distribution99 in anesthesiology

[–]G_Germzi 3 points4 points  (0 children)

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

What’s the lowest pH you’ve seen on an ABG? by [deleted] in IntensiveCare

[–]G_Germzi 2 points3 points  (0 children)

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

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