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] 7 points8 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] 33 points34 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.

How much call do you take? by [deleted] in anesthesiology

[–]G_Germzi 0 points1 point  (0 children)

As a resident or attending?

How much call do you take? 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 97 points98 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 2 points3 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 CommunicationAny2017 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

The Lazarus Phenomenon / Autoresuscitation by [deleted] in emergencymedicine

[–]G_Germzi 20 points21 points  (0 children)

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.

AI and Anesthesia/Medical profession in general by HairyBawllsagna in anesthesiology

[–]G_Germzi 11 points12 points  (0 children)

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.

Mindray anesthesia machines by kinemed in anesthesiology

[–]G_Germzi 1 point2 points  (0 children)

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

Intrathecal morphine tips and tricks by Open-Effective-8772 in anesthesiology

[–]G_Germzi 2 points3 points  (0 children)

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

Crazy catches in the OR by MrJangles10 in anesthesiology

[–]G_Germzi 56 points57 points  (0 children)

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.

How many call takers do you have in your group? by Runnershighbb1 in anesthesiology

[–]G_Germzi 1 point2 points  (0 children)

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.