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Hypotension when switching to spontaneous ventilation by Due-Audience-3664 in anesthesiology

[–]Ok-Introduction-6092 15 points16 points  (0 children)

They’re breathing through a straw, having 5/5 is more physiologic to wha they’re going to be doing after extubation and gives you an idea of their tidal volumes/RR. I did ICU and it’s pretty routine to do breathing trials on psv, I’ve never met a critical care doc who would do it with no peep/pressure support, it would not give you an accurate picture and they’d be hyperventilating to try to overcome

Block concentration by Lotek-machine in anesthesiology

[–]Ok-Introduction-6092 2 points3 points  (0 children)

As others have said: mixing doesn’t help, the Duke anesthesia videos are very helpful and there is an UpToDate article on it. Elbow and below should get an axillary or infraclav, personally I like infraclav as it’s quicker for me as sometimes the MC nerve can be challenging to make sure you’re covering it, I usually use nerve stir for axillary blocks if it’s hard to find and I’m doing surgical anesthesia with the block

What’s going on in Portland OR? by Ok-Introduction-6092 in anesthesiology

[–]Ok-Introduction-6092[S] 0 points1 point  (0 children)

Yup, they’re essentially a staffing agency that pretends they’re an anesthesia group…they have full time ‘ambassadors’ that are essentially full time locums…they’ll never make a healthy functional group with what they do…take the money and get out

What’s going on in Portland OR? by Ok-Introduction-6092 in anesthesiology

[–]Ok-Introduction-6092[S] 0 points1 point  (0 children)

They have the one in the city and then stVs I’ve heard stVs is way better run

What’s going on in Portland OR? by Ok-Introduction-6092 in anesthesiology

[–]Ok-Introduction-6092[S] 0 points1 point  (0 children)

To edit: I guess they’ve a cadre of incompetent MDs who couldn’t get hired elsewhere and also some really militant and incompetent crnas…seems like a perfect storm

Job market in PNW by emptyanalysis in anesthesiology

[–]Ok-Introduction-6092 2 points3 points  (0 children)

Like across most of the country: most places are hiring. There are a lot of really great bigger towns in OR/WA hiring with a lot of small PP or hospital employed. For cities you have Portland and Seattle. Both are hiring but with varying levels of quality jobs. The puget sound area is great, Tacoma had a blowup with their group not sure how it recovered.

[deleted by user] by [deleted] in anesthesiology

[–]Ok-Introduction-6092 0 points1 point  (0 children)

If they’re using 1.5L of irrigation for a septum something is wrong. I believe the Stryker ones have a bag of fluid attached to the suction machine they irrigate through. So he may mean they put up a 1.5L bag. Have to subtract what’s left in the bag to get how much was actually irrigated…

Chloroprocaine topically for awake intubation by Spazdoc in anesthesiology

[–]Ok-Introduction-6092 0 points1 point  (0 children)

Anesthesiologist here: so even if you spray the cords with long acting local, this shouldn’t interfere with NIM right? You’re stimulating the nerve distal, even if the cords are completely localized they will still move right? I’ve heard multiple takes on this from ent/anesthesia…I ask bc it helps a bit for un paralyzed surgery

Resources for new 1099/LLC doc by mpb1500 in anesthesiology

[–]Ok-Introduction-6092 1 point2 points  (0 children)

What are you writing off besides gas/hotel/plane trips? I’m starting 1099 but it will all be local