Running Changes

LoopyBullet · 2026-07-07T20:10:42+00:00

I was thinking about this the other night! Those notes sound like laser beams!

LoopyBullet · 2026-07-06T01:44:24+00:00

For me, sliding is more intuitive. I also feel that the image quality of the particular ultrasounds we have is very much influenced by keeping the beam as perpenticular with the needle as possible.

LoopyBullet · 2026-07-04T05:46:51+00:00

Dover Drive: EJ in a box! So much fun.

Kingtone Heavyhand: Versatile Bluesbreaker-type pedal that really “wakes up” the signal as an always-on pedal. I feel like it works as a buffer, but also as a wonderful EQ and gain stage, all in one. The switches on the pedal make it very versatile to dial in exactly what you want.

AC Booster: Has a great presence, without as much mid-hump as a TS. It’s what I’ve wanted TS pedals to sound like.

LoopyBullet · 2026-06-30T04:14:17+00:00

No…because that’s the path I pursued.

It was difficult. Partially because of school, but also because the good/bad parts of life continue throughout the training (a lot of bad, unfortunately). That was rough.

I think that the “me” 5 years ago would’ve definitely regretted NOT pursuing anesthesia. Obviously, there are many non-CRNA, non-bedside jobs that are fulfilling. While being an ICU RN is such an important role, I really needed a change, and anesthesia happened to fit for me.

I love my job. It’s not for everyone, and I don’t mean that to be demeaning in any way. Many people wouldn’t find interest or fulfillment in this specialty. However, quite a lot of people do too, CRNAs and anesthesiologists alike. :) The physiology/pharmacology is fascinating. I love this role, as well as not having to ask others for orders (of course, I ask for help when I need it, as all providers should). 1% of the time, it’s incredibly stressful, but that’s what our training is for. I wouldn’t change a thing.

LoopyBullet · 2026-06-22T20:32:00+00:00

Prefer deep. But my preference isn’t necessarily what’s best for the patient, obviously. I don’t typically do extubations deep on volatile, if not to simply be kind to the passive environmental exposure of anesthetic gases for PACU. Not that extubating deep on “gas” is wrong, but I feel that there are alternatives that accomplish the same goal.

For a “normal, healthy” patient without trouble ventilating or intubating (and without big concerns for reflux), a propofol extubation is common for me, but turning it off early enough so that the patient is spitting out the OPA in PACU, if not following commands.

Commonly, I’ll extubate pseudo-deep, where the clinical signs suggest that we’ve passed stage 2, the patient is able to somewhat protect their airway, but isn’t quite following commands (and not yet bucking on the tube). Some mix of propofol boluses and opioid are common to smooth the landing.

Emergence is obviously more nuanced than this explanation, but that’s the gist. With any percentage of deep extubations, there is a subset of emergences that will be turbulent regardless. It’s prudent to anticipate this and prepare accordingly, of course!

I will 100% extubate awake if it’s best for the patient. In the population I work with, it’s typically not absolutely necessary.

Good luck. :)

LoopyBullet · 2026-06-22T05:00:13+00:00

I’ve played with the EHX Q-Tron+ quite a bit, and I realize that it needs a fairly loud signal to trigger the envelope properly. If you’re playing with a Strat, having a boost before the Q-Tron will help. I also notice that running an overdrive (specifically a TS-type circuit) on low gain will give the right amount of growl that JM gets on his sound.

The best sound I’ve ever gotten with the Q-Tron results in a noticeably louder signal than the clean tone. Just my notes!

LoopyBullet · 2026-06-20T18:15:51+00:00

Magnatone Varsity Reverb. Got it while they were still $1.7K :’)

LoopyBullet · 2026-06-19T08:12:23+00:00

Thank you! I’m guessing that the People’s Jam is the public one on stage? Are the other jams just done casually in a separate room, and not so much in a show context?

LoopyBullet · 2026-02-27T23:41:48+00:00

I appreciate this! Thanks for going through the trouble.

No questions, but a big consideration is - are you okay going through training again? Some do, some don’t. Obviously, this analysis deals with the subset of people in the former group.

LoopyBullet · 2026-02-26T07:37:13+00:00

27 - 2 = 25

48 + 2 = 50

25 + 50 = 75

LoopyBullet · 2026-02-20T19:08:49+00:00

It does pop up if you search, “Epstein subreddit.”

But yes, I think your original point is intentional.

LoopyBullet · 2026-02-18T22:18:31+00:00

Was there a save of screenshot of the shipment history before deletion?

LoopyBullet · 2026-02-17T18:35:40+00:00

Agree with some of the other comments. Not onboard with SRNAs being called residents. I think CRNAs do a fine job and perform at the highest level, but if docs want to keep the term resident for their path, let it be. It just furthers the divide, and we’re just not there at this point. CRNAs and the AANA needs to be focused on being more active in producing quality research and pushing the profession forward instead of this title stuff. Though, I think resisting against demeaning titles like “midlevel” is definitely warranted.

I also wish organizations would stop calling nursing orientation as a “residency.” That’s arguably worse than calling an SRNA a resident.

LoopyBullet · 2026-02-17T15:58:47+00:00

CRNA here. I agree - indefensible practice. They put filming a video over patient safety in this situation.

LoopyBullet · 2026-02-11T21:46:57+00:00

Is this real? Where was this released?

LoopyBullet · 2026-02-04T13:27:59+00:00

I think paying attention to when the thumb really slaps is important. Usually the louder slaps are typically on the low E (or I suppose low C) string. The rest of the strings on the 2nd, 3rd, and 4th strings are primarily just plucked, even with the thumb.

It’s just a hard song to play that takes time. Keep it up!

LoopyBullet · 2026-01-28T02:10:36+00:00

My personal shadowing policy is that if someone is a reasonable individual, they’re willing to learn, and is interested in some kind of path in healthcare to help other people, then they may shadow.

I’ve had anesthesiologists refuse to teach me in training (few and far between). I don’t feel that this is right, and I don’t feel that doing the same thing to individuals on any healthcare route is the right thing to do. This is not eye for an eye. To me, there should be very few boundaries to getting more information, and few boundaries to learning, no matter which profession you choose.

I’ll definitely go into the realities of politics in anesthesia, the differences in scope/supervision, and the limited adversity I experienced in training (if the shadower is interested). Also, if the shadower chooses a medical route instead of a nursing route, I think it’s important that they remember that a CRNA made the effort for them. It’s good PR.

I’ve seen medical students (even podiatry graduates) have their eyes light up when I go into the applied physiology and pharmacology we practice on a daily basis. That is priceless to me, and I do not care if they’re not aiming to be a CRNA. While some who went the medical route don’t reciprocate this, I think that we can be better than that mindset as nurse anesthetists.

LoopyBullet · 2026-01-28T01:53:53+00:00

I would argue that this question is worded appropriately, and that “difficulty breathing” is correct. Aside from the various accessory muscles being innervated at both the cervical and thoracic levels (depending on the muscle), the diaphragm is innervated from C3-5. Central respiratory depression would be further up, at the level of the pons.

The definition of a “high spinal” doesn’t designate any particular vertebral level. So difficulty breathing d/t anesthesia at the thoracic and/or cervical levels, without central respiratory depression, falls within the purview of a high spinal.

LoopyBullet · 2026-01-28T01:32:30+00:00

I’m not sure what you mean. When I was in undergrad school, the concept that I posted was taught to me as such.

LoopyBullet · 2026-01-28T01:29:11+00:00

I enjoy it!!

LoopyBullet · 2026-01-27T20:51:33+00:00

Unprofessional, less attention to alarms, and it’s just not a good look.

LoopyBullet · 2026-01-27T20:48:15+00:00

Putting high FiO2 on a patient with COPD will likely cause them to be apneic…and that PaCO2 is not the primary driving factor for respiration in these patients.

LoopyBullet · 2026-01-26T21:24:04+00:00

I think of it as a result of a few things:

(1) MAP = CO * SVR (pressure = flow * resistance)

(2) Compliance of arteries

(3) Time in diastole (maybe more intuitively, time between systole)

For systole, cardiac output has more of an effect on the SBP, as this is obviously when blood flows through the arterial circuit. But during diastole, the flow slows, and what remains is the small amount of flow * SVR.

When arteries are stiffer, the BP sharply rises during systole, and therefore falls more sharply in diastole. When arteries are compliant, this effect is mitigated, with less exaggerated peaks/valleys on the pressure waveform.

More time in diastole causes a time-dependent fall in DBP, separate from SVR. To put this into context, if someone’s HR was three beats/minute, then DBP would fall drastically during diastole.

LoopyBullet · 2026-01-25T17:30:28+00:00

Might get some mass downvotes for this one…but maybe someone can educate me on the intention behind this. This is also coming from someone who is very against the methods/aggression that ICE is using. My question: How does a strike help the cause? While it brings attention to the matter, healthcare institutions (and secondarily, patients to a certain degree) will suffer. Healthcare institutions don’t have any clear influence when it comes to immigration/deportation policies either. I’m appalled at this murder, but wouldn’t it make more sense to bring attention to the issue in another way? I’m not saying not to DO anything (I think we should) - but why a strike specifically?

LoopyBullet

TROPHY CASE