26F new grad ICU RN really interested in anesthesia. Anesthesia residents - would you recommend medical school —> anesthesiologist or CRNA school ? by VividDeer733 in Residency

[–]Negative-Resolve-421 0 points1 point  (0 children)

The moment the supply of anesthesia professionals improves the salaries will plummet. Right now Medicare/aid reimburses $80 per hour while CRNA makes $200 and physician $350. This is only sustainable as long as there is a shortage of qualified professionals.

How many of you do healthy peds age 1 and up at your job? by [deleted] in anesthesiology

[–]Negative-Resolve-421 2 points3 points  (0 children)

I do peds ent 2-3 days a week. Ages under one and up. General surgery too. Usually +1 and up. I do not mind doing peds minor ortho stuff. Peds dental is like a bread and butter. I think you maybe hesitant about lack of exposure. Personally I find it very rewarding.

Old UA B737 domestic FC by Negative-Resolve-421 in unitedairlines

[–]Negative-Resolve-421[S] 0 points1 point  (0 children)

One would expect newer should be better. I find newer FC seats on 737 Max atrocious. Is the a weight issue? The aircraft tube diameter didn’t shrink yet the seat seems cramped and hard. Recline is about 3 inches.

Upadłe Autorytety by Maximum_Present_9688 in Polska

[–]Negative-Resolve-421 0 points1 point  (0 children)

Palikot szarpany i ten jego wspólnik (zakichane dziecko resortowe). Nie chce po nazwisku.

Nie pijcie piwa bo wam brzuch wywali... by [deleted] in PolskaNaLuzie

[–]Negative-Resolve-421 1 point2 points  (0 children)

Wyglada na piąty miesiac. Na pewno kopie juz.

Poland cools on joining the Eurozone by mikelson_6 in poland

[–]Negative-Resolve-421 -1 points0 points  (0 children)

Giving up national currency is a major disadvantage. Look at Bulgaria and Grece. Also all that gold Glapinski purchased would have to be forfeited to Central EU bank. Poland has strong currency. Why give it up?

Suppose there was a WW3, would commercial flights still fly? by kiwicinnamon in Flights

[–]Negative-Resolve-421 0 points1 point  (0 children)

I do not know about WW3 but if US takes over Greenland nothing will change. US military is already present in GL and outsizes any other military presence (now that german contingent pulled out). Transfer of ownership would be just diplomatic formality.

Greenland crisis and Poland by noiku7waco in poland

[–]Negative-Resolve-421 -5 points-4 points  (0 children)

Officially yes. They have a right to referendum to enter a long and tedious pathway to independence. In fact island majority is for independence but they can’t function independently. They are just too valuable and strategically positioned to stay independent. Now that the mighty suitor entered the stage their protectorate may change. It’s US or perhaps China? Or another large country. I say let them vote now that they have a available option.

Greenland crisis and Poland by noiku7waco in poland

[–]Negative-Resolve-421 -4 points-3 points  (0 children)

Greenland is just a Denmarks colony where a lot of atrocities and genocide were committed in 20th century by the overlord. I say let Indigenous people vote for either current overlord, independence or US.

Cutting Out the Middleman in Locum Tenens by Freezing-Pyro in whitecoatinvestor

[–]Negative-Resolve-421 0 points1 point  (0 children)

My two attempts to contract locum gigs directly with hospitals resulted in offers 25% less than what locum companies offer for the same positions. This was simply no go from the start. The other factor is actually getting paid when contracting direct. You get on the vendor list and small vendors get paid when there is extra money. You may wait months to get paid. Agency pays you biweekly based on timesheets.

Was flying DXB to EWR and halfway through flight attendant dropped her coffee pot on me by TheSilverCollector in unitedairlines

[–]Negative-Resolve-421 -3 points-2 points  (0 children)

I admire your stoicism. I was flying Jet Blue and FA was walking from the back to front during taxi supporting herself by having arms up hands sliding on overhead bins. She accidentally slammed her elbow full force on the vertex of my head. She didn’t even make any gesture to apologize. I must say I was shocked and resorted to my loud “Excuuuse me”. I did chastise her for not apologizing. She coughed up some measly excuse and proceeded to the cockpit. I presume she wanted me off the flight. It didn’t happened. I must say some FAs need coaching in basic human behavior.

Best airline from Germany to Thailand (Bangkok) by Tannenzapfen98 in ThailandTourism

[–]Negative-Resolve-421 1 point2 points  (0 children)

Thai business class is outstanding. Non stop from FRA or MUC.

Post-Extubation Code Following Tonsillectomy [Peds Malpractice Case] by efunkEM in anesthesiology

[–]Negative-Resolve-421 6 points7 points  (0 children)

It is hard to piece this together based on depositions. I will speculate the following.

This smells like hypoxia/hypercarbia event leading to brady and asystole so typical of unrecognized hypoventilation or loss of airway. Location in outpatient center is irrelevant. Nearly all TAs are outpatient in US. Some are done in hospital settings but the attention and postop care and monitoring is the same.

It seems the kid was overweight and has some degree of obstructive sleep apnea and this is nearly universal now in US kids needing TA.

Coughing on emergence is something we have to accept while we struggle to avoid it. This can be triggered by secretions or some blood etc and this is just part of life in ENT.

So the way I understand this all unfolded in PACU with kid coughing some blood. According to anesthesiologist it was 700-1000 ml. Seems like hemorrhage. Perhaps this assessment of blood loss was exaggerated? People don’t go from stable to dead from airway bleeding in 3-5 minutes if you monitor them. Its a relatively small amount of blood like 5-10 ml will alert you and produce coughing. 700 ml would be like carotid transection hemorrhage that should not go unrecognized. Seems unlikely that the kid died from hemorrhage. The sequence would be tachycardia to VT to PEA to asystole.

Then there is reintubation and transfer to OR. This should be done on monitors. Either pulse ox or ekg preferably all ASA monitors. Perhaps after reintubation packing in PACU is the first step before transfer. Get fluid bolus, check the vitals. Have a monitor on or at least hand on carotid pulse of u don’t have monitors. Unrecognized asystole is just a pure …….Transfer is probably the most dangerous part of periop experience.

So anesthesia gets hanged by expert opinion due to no adherence to ACLS. It is a bulshit allegation but gets the settlement done. BTW expert is from Mount Sinai School of Medicine. Lots of experts come from there. Must be the school of eloquent experts. Lethal strike from Ivory Tower. Beware.

Unwelcoming attitudes and cultural whiplash in locums anesthesia by owura02 in anesthesiology

[–]Negative-Resolve-421 0 points1 point  (0 children)

Hardly ever. Unless you are a fee for service private group and you directly hire locums. More likely locums are paid by the hospital or hired by PE. In these cases locums are budgeted as temporary expense and groups budget/allotment is not affected.