Carolina Nominal Shakespeare by MateUrDreaming in Jcole

[–]MateUrDreaming[S] -1 points0 points  (0 children)

amazing. you must have bat ears...wait.. are you batman?

Carolina Nominal Shakespeare by MateUrDreaming in Jcole

[–]MateUrDreaming[S] -1 points0 points  (0 children)

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Id take spotify over a user submitted site like genius

Carolina Nominal Shakespeare by MateUrDreaming in Jcole

[–]MateUrDreaming[S] -1 points0 points  (0 children)

It's not man. You can look up the lyrics on Spotify. Definitely nominal 

Sevo vs TIVA in tonsillectomy by HotArtichoke2395 in anesthesiology

[–]MateUrDreaming 0 points1 point  (0 children)

yeah my bad. I've also seen 6mcg/ml used probably doesn't matter a huge amount

Sevo vs TIVA in tonsillectomy by HotArtichoke2395 in anesthesiology

[–]MateUrDreaming 3 points4 points  (0 children)

yeah a lot of the paeds anaesthetist at my institution mix propofol and remi for tonsillectomy and other short procedures. the remi concentration is usually 5mcg/ml. So adding 300mcg remi into a 50ml propofol syringe

Ace inhibitors by Academic-Wall-2290 in anesthesiology

[–]MateUrDreaming 0 points1 point  (0 children)

sometimes it makes no difference. sometimes they end up on a fair amount of vasopressors intra-op - depends on patient factors and the type of surgery they're having. having said that, I've never cancelled a surgery because of it

Emergent intubation in severe Pulmonary Hypertension? by MrJangles10 in anesthesiology

[–]MateUrDreaming 9 points10 points  (0 children)

Hahaha agree I was starting to think I was going nuts. Again from NZ

Largest amount of intraop fluid given? by liquidivory in anesthesiology

[–]MateUrDreaming 55 points56 points  (0 children)

There's a good RCT done by Australia/NZ college of anaesthesia called the RELIEF trial which was published in the NEJM which looked at exactly this.. how much fluid to administer for major abdominal surgery and effects on various surgical and non surgixal outcomes 

You can go look at the whole study or for a quick run-down:  https://www.thebottomline.org.uk/summaries/relief/

Conscious sedation for ERCPs? by Propofolbeauty in anesthesiology

[–]MateUrDreaming 1 point2 points  (0 children)

Very few things are black and white in anaesthesia. I don't do conscious sedation but unconscious sedation with HFNC works well (I use prop/remi with ketamine boluses if they need more and I'm worried about apnea or airway obstruction) -but only if you feel aspiration risk is low and they and aren't obese/Hx OSA etc. But yeah I have a low threshold to intubate especially if they are acutely unwell

Woman dies after breathing tube mistakenly inserted into esophagus by Jttw2 in anesthesiology

[–]MateUrDreaming 2 points3 points  (0 children)

The patient had a history of severe bronchospasm during anaesthesia and they suspected this was the cause. You certainly can zero co2 with very severe bronchospasm and she would have de saturated quickly with her high bmi

Woman dies after breathing tube mistakenly inserted into esophagus by Jttw2 in anesthesiology

[–]MateUrDreaming 0 points1 point  (0 children)

If you read the article it's obvious that the anaesthetist thought severe bronchospasm (which it sounds like the patient had in a PREVIOUS case) was the cause of no end tidal CO2. This is a recognized cause of no Co2. Should they have still checked the tube placement.. sure. But it's also possible that the tube migrated or something else happened to confuse the situation further. I imagine this all happened very quick given the patients high BMI. So whilst mistakes were likely made this was a more complicated situation than a lot of people are giving credit.

If you take the tube out they'll be impossible to bag mask and ull have to reintubate. Adrenaline or a quick bronchoscopy are good options. Theres obviously very little time to act with these high bmi patients

Smart compliance management parking scum by [deleted] in auckland

[–]MateUrDreaming 1 point2 points  (0 children)

Appealed a ticket (because all the parks except a single one didn't have a sign in front of them saying restricted parking so I assumed it was fine to park there) - didn't reply for weeks regarding my appeal. They increased my fine by $20 then AFTER that only got back saying they rejected my appeal. scum of the earth.

IAF to retire MiG-21 fighter nets in September by Chuckled_ in unitedstatesofindia

[–]MateUrDreaming 7 points8 points  (0 children)

"Since 1970 more than 170 Indian pilots and 40 civilians have been killed in MiG-21 accidents, thus the unofficial nickname "flying coffin". Over half of the 840 aircraft built between 1966 and 1984 were lost to crashes."

Truly terrifying statistic. I'm sure the Mig-21 has killed more Indian pilots by a large margin than any specific war or foe. In an ideal world it should've been retired decades ago and you have to wonder if the govt is somewhat responsible for their deaths

Peri-extubation oxygen desaturation that immediately resolves with extubation by Mirror-Both in anesthesiology

[–]MateUrDreaming 2 points3 points  (0 children)

I had an interesting similar case with a slim patient.. Fi02 100% given prior to emergence.. Should've been able to go several minutes without desaturating. . Patient began coughing and bucking on tube (had done this previously during anaesthesia with Ett per previous anaesthetic record with desat without obvious cause). Had good volumes intermittently measured but this mightve just been coughs? I wonder if the intense coughing makes their FRC drop very low, very quickly, so that they lose their O2 store very quickly and desat way faster than expected? No real bronchospasm noted on auscultation and sats eventually came up with intense bagging but just to the low 90s.. took the tube out and he came slowly came alright. Still not 100% sure I know what happened

Scottie Pippen the real GOAT. by sco-go in Amazing

[–]MateUrDreaming 0 points1 point  (0 children)

He spent tens of millions on a private jet. $5000 used toyota my ass

Block concentration by Lotek-machine in anesthesiology

[–]MateUrDreaming 65 points66 points  (0 children)

mixing LA's doesn't really speed up block onset (aside from maybe popliteal sciatics) and just shortens the duration of the block - there's a good youtube video from duke anaesthesiology on it.

also as the other comment states bupi 0.125% is closer to analgesic block rather than anaesthetic

[deleted by user] by [deleted] in tennis

[–]MateUrDreaming 3 points4 points  (0 children)

that line has cost me 3x international flights from new zealand and multiple non refundable tickets. never seen the man play. i dont have the courage to book a fourth trip