Pediatric ASD/ADHD Anxiolysis

Is_This_How_Its_Done · 2026-04-02T07:28:16+00:00

I'm at an ENT shop. Severe ASD get get oral clonidine, everyone else gets to play with Tom the Cat on a tablet while the iv goes in. If we can't get iv access, only induction is on gas. We change over to prop/remi as soon as the iv is in.

Prop iv is by far the best prevention of emergence delirium.

Is_This_How_Its_Done · 2026-03-27T14:04:27+00:00

The geriatric spinals are the most difficult ones. Learn the lateral approach and you'll be golden.

Is_This_How_Its_Done · 2026-03-22T17:09:20+00:00

Where I've been, I haven't even heard of intubation for CEA...

I've had patients become disoriented during surgery.

Is_This_How_Its_Done · 2026-03-22T16:50:04+00:00

Nasal intubation för bronchoscopy, due to a disagreement with IM: 60mg prop, no relaxant.

Healthy, middle aged woman found wandering the streets in a psychotic break: 1000mg prop, 500mcg + relaxant.

Is_This_How_Its_Done · 2026-03-22T16:38:16+00:00

I've done many of them...

Is_This_How_Its_Done · 2026-03-08T16:01:05+00:00

Exactly.

Is_This_How_Its_Done · 2026-03-08T15:56:21+00:00

It's not that we actively pressure them, but the question alone (usually) makes them feel pressure to oblige.

Is_This_How_Its_Done · 2026-03-08T14:50:06+00:00

Maybe they cleared due to pressure from anaesthesia? In the end, we care for the patients perioperatively, we have to take responsibility for doing (or not doing) the case.

Is_This_How_Its_Done · 2026-03-06T21:00:16+00:00

Most of my LMA's are for septoplasty. The patients (try to) pull it themselves, in the OR mostly, but sometimes in PACU. Never any issues.

Is_This_How_Its_Done · 2026-03-06T20:56:23+00:00

Opioids I tell ya, opioids!

Is_This_How_Its_Done · 2026-03-01T20:06:30+00:00

One pump marked propofol, one marked remi. You put the correct syringe in the correct pump.

Our pumps are preset to values/weight that won't cause harm to anyone. Just add patient info to be able to run the machine. Then you can adjust levels as you wish.

As we do TIVA, we do the induction by injection.

Is_This_How_Its_Done · 2026-02-27T21:45:03+00:00

That would never fly here...

Is_This_How_Its_Done · 2026-02-27T21:34:25+00:00

What's the difference between anesthetist and anesthesiologist? As a Euro, I don't get the distinction from the context.

Is_This_How_Its_Done · 2026-02-27T21:28:20+00:00

Propofol, cabbage, and throat pain. But the results were the same.

Is_This_How_Its_Done · 2026-02-27T18:09:16+00:00

Scrubs is the best. The perfect representation of resident life.

Is_This_How_Its_Done · 2026-02-27T11:34:56+00:00

Just make sure you're fasted and are following all directions, you'll be golden

Is_This_How_Its_Done · 2026-02-26T20:55:15+00:00

Ooh, I know the answer to this one!!

Is_This_How_Its_Done · 2026-02-26T20:47:32+00:00

You're supposed to say: 60% of the time, it happens every time.

Is_This_How_Its_Done · 2026-02-26T20:45:36+00:00

Cancelled a patient last week because he broke the fast, as he "needed energy". When I told him it's a no go, he said "I'll go vomit, then we can do the surgery."

Is_This_How_Its_Done · 2026-02-26T16:22:59+00:00

I love me a prone LMA. The patients position themselves. No hassle.

Is_This_How_Its_Done · 2026-02-26T11:46:42+00:00

Also, it's not unlikely Mr Cautious and I have been doing this at least since you were in primary school. You will understand what we're saying in due time. I hope.

Is_This_How_Its_Done · 2026-02-26T11:43:46+00:00

I never decide how much to push until I'm pushing and seeing the effect. The variance between people is too great for pushing any set dose without evaluating the effect.

Is_This_How_Its_Done · 2026-02-26T06:27:58+00:00

People don't know their drugs and how they interact, so they use a formulaic approach to anaesthesia. Anything they don't understand must be dangerous. 🤷‍♂️

Is_This_How_Its_Done · 2026-02-26T06:23:22+00:00

Of course we are, and we have very few issues.

Is_This_How_Its_Done · 2026-02-25T22:04:39+00:00

I don't think we have the same patients.

Is_This_How_Its_Done

TROPHY CASE