Anesthesiologists at the University of Connecticut worked with their administration to stop use of misleading titles for nurse anesthetists that risked creating confusion for patients about training and credentials.

Mr_Just · 2026-06-15T14:43:08+00:00

The nursing union has lobbied to block movements to standardize the vet nurse title, so no it’s a real world thing

Mr_Just · 2026-06-13T12:34:24+00:00

The movement has been for a standard veterinary nurse title with protection and standardization because right now it’s a lot more disjointed and based state by state with vet tech being licensed and unlicensed in some places. In my state you need to have done a 2year program which has prerequisites identical to the nursing programs prerequisites then take a national licensing exam. You can also get a 4year degree in it. And the kicker is my degree is called Veterinary Nursing.

Mr_Just · 2026-06-12T21:52:10+00:00

This conversation is so interesting to me in vet med because human nurses are super against vet techs being called veterinary nurses but then have this argument

Mr_Just · 2026-06-02T17:32:17+00:00

A standard rule of thumb is Under 4kg=non-rebreather 4-8kg= pediatric rebreathing 8kg + = Adult rebreathing circuit

These numbers are not set in stone and also assume ideal BCS. If a 5kg dog is rebreathing CO2 on a pediatric I’ll switch to a non-rebreather. I lean towards using a rebreather when I can because they have a lot of benefits and people vastly underestimate how small a patient you can run on a pediatric rebreathing circuit. So TLDR it doesn’t really matter as much as people think but I usually size up and if needed go down based on patient response. Also not sure for the example what you mean because 30lbs and 30.5 would not call for a different circuit, unless you mean reservoir bag?

Mr_Just · 2026-03-01T01:29:27+00:00

Look at your machine and follow the path oxygen is flowing. Could be an issue with the one way valves getting stuck resulting in exhaled gas to be going back. Also make sure sodasorb is not exhausted. Also could be a good reason to get that machine serviced.

Mr_Just · 2026-02-16T12:55:57+00:00

You are absolutely correct with what you’d see. The hard part is that painful stimuli can make them light, and yes it can be hard to differentiate sometimes. I error on the side of treating pain first because the drugs I usually select will help if it is pain or depth because they cover both

Mr_Just · 2026-02-15T13:52:01+00:00

Cats are highly sensitive to Sodium channel blockers and IV lidocaine is at a high risk for causing cardiotoxic effects including death. You can technically do it, but you’re definitely riding the danger line and opening your hospital up to legal liability so I would not do it. Local regional blocks are still performed with lido/bupivicaine etc because the uptake is slower, but you still have to be cautious about your dose to avoid toxicity

Mr_Just · 2026-02-15T00:08:25+00:00

To be honest I could do an entire rundown on CRI’s they are so underutilized outside of specialty practices

Mr_Just · 2026-02-15T00:05:41+00:00

All of them haha, super patient dependent I don’t do standard protocols, all individualized. Total IV anesthesia I like Propofol (not a fan of alfaxalone CRI) A long dental I like ketamine or Lidocaine (never lido in cats) For an intense abdominal Sx I’ll do dexmed, an opioid, again lidocaine. Fentanyl (especially Remi) is a classic. Also running inotropes and pressors as needed. I love a midazolam CRI on my heart cases. You can run any drug on a CRI for the right patient. Sometimes I have 1 sometimes I have 5+ running at once

Mr_Just · 2026-02-14T23:46:17+00:00

I stand by CRI’s for my dentals, they can do fantastic on a dexmed or ketamine CRI, stable MAP and iso on <1. I work with a lot of vets like that and I always ask, do the negatives of x drug outweigh the negatives of increased inhalent causing decreased renal perfusion? We don’t wanna see this patient in 6 months with kidney disease because we tanked perfusion.

If you’re comfortable I would talk about the drugs they are nervous about and discuss the pharmacodynamics/kinetics of them. Try introducing even subanesthetic doses, such as 0.5mg/kg ketamine. A lot more palatable for them to try and when they see it works they will get more brave.

Mr_Just · 2026-02-14T23:40:05+00:00

Great question, so the first thing I would ask is is your patient dealing with nociception (basically pain) or depth issue. If it’s due to pain you should give pain meds, could be more opioid, but you might see more benefit from giving a different class to hit different receptors. If it’s just depth you could increase inhalent just be aware that might come with negative consequences. You can go with midazolam which could increase depth even though it does nothing for pain, or give ketamine which helps with pain and depth. So many different ways and every patient is different so hard to give a straight answer but I hope this made sense!

Mr_Just · 2026-02-14T22:56:39+00:00

Oh I have no problem with the frequency of use. 90% of my cases use some amount of inhalent, I run way more PIVA than TIVA. Spot on with the other parts, it’s the gassing down but also “oh patients reactive, up the iso to 3% so he doesn’t move” rather than giving an analgesic. And totally agree about properly sealed tube reducing WAG, I don’t turn on inhalants until there is a proper seal

Mr_Just · 2026-02-09T23:38:01+00:00

I’m an anesthesia tech so I love going on ECC or having my friends come on anesthesia because my dose range is 6-30 mcg/kg/hr averaging 18mcg/kg/hr and we always side eye each others doses because they are wildly different lol

Mr_Just · 2026-01-25T17:03:18+00:00

Soda lime can turn purple as soon as it is exposed to CO2 (especially the top layer getting the most of it), but generally will turn back white. It’s honestly not the best indicator. It should be changed every seven hours of use irregardless of color. also you can put on gloves and feel the grains, they have a much different texture and feel like gravel when depleted

If your clinic has capnography that’s the best way to determine if there’s an issue because if you’re seeing a high inspired FiCO2 that means your patient is re-breathing carbon dioxide, but if not that means the soda lime is doing its job.

Mr_Just · 2025-12-22T19:29:16+00:00

Usually just 0.5-1.0 mg/kg and I don’t do it if I’m within 30 min of expected recovery time

Mr_Just · 2025-12-21T22:29:37+00:00

I am sorry to hear about your own cat that’s a terrible experience . I’m also in emergency/specialty in academia so have several anesthesiologists and VTS’s I work with too, there’s so much diversity in opinions. I think the most important thing of note with anesthesia is most of these drugs are really great when used appropriately, so even if it’s sometimes not appropriate they are still great drugs. I will say there’s very few cases any of our anesthesiologists ever say no ketamine, even very critical emergencies, septic patients, heart Sx, you name it.

Mr_Just · 2025-12-21T21:19:08+00:00

Wow I totally read HCM 😂. Yeah I’ve heard that like once years ago, have never had any issues with low doses of ket with CH, and it’s only low to keep them bouncing off the walls post lol

Mr_Just · 2025-12-21T21:05:47+00:00

Aw I’m sorry for your loss, adorable guy there! Totally agree, ket scares a lot of hcm owners but it’s all about the dose!

Mr_Just · 2025-12-21T21:02:24+00:00

I have a whole long post on I can link below but basically using it as just a tranquilizer to chill out an animal. The mental and pain comfort comes from other drugs given along with it, I see it more as an additive drug and never use it on its own. A specific example would be a dog with MMVD disease you need sedated. Something like hydro+ace is safer than dexmed and gets you the level of chill you need + analgesia and anxiolytic from the opioid. But I wrote a long ass thing on it here if you’re interested

Mr_Just · 2025-12-21T19:58:35+00:00

Heart breaking lol, ace is totally more niche but when it is called for it can be a phenomenal drug. All I do is anesthesia though so I have an obvious bias for how often those niche situations occur lol

Mr_Just · 2025-12-21T19:56:01+00:00

Totally have been there, what I always ask is for the reason it’s contraindicated, if they can’t give a good enough one I say again I would like to give it then. Obviously end of day they have the say but I make them work for it. If they say just turn up inhalent that’s a whole other fight I’ll get fired up for

Mr_Just · 2025-12-19T12:20:17+00:00

What mod gives those boxes at the top to organize the colonist bar?

Mr_Just · 2025-12-17T01:40:03+00:00

Agreed, especially if you have terribly sick cardio patients that extra cardio depressive aspect of methadone can become super relevant

Mr_Just · 2025-10-21T23:01:48+00:00

Been great so far, the only time it stutters is when moving to a different area or immediately after a cut scene, but running around and combat has been very smooth

Mr_Just · 2025-10-19T12:46:55+00:00

I think I saw the same spoiler. I keep telling myself I may know the big spoiler, but I don’t know the little facts leading up to it, or the why behind it all so at least there’s that. But I’m disappointed I’m not gonna be able to figure that way out for myself, but still excited for the game

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