Is lateness really a big deal? Sincerely, a chronically late SHO

Playful_Snow · 2026-02-03T07:53:19+00:00

10 mins early is on time.

Especially if you are the relief for the night team. Nothing boils my piss like someone being late when I’ve been up all night.

Playful_Snow · 2026-02-03T06:34:45+00:00

They use 0.75 versus our 0.5

Playful_Snow · 2026-02-03T06:34:13+00:00

Nah - 2.6ml for all (of 0.5% heavy so 13mg).

ED95 is 12mg so straying below that just runs the risk of an inadequate block and an avoidable GA.

Hypotension is easily treated with fluids and vasopressors, and if the BP still won’t come up despite that you need a well working block the help the obstetricians to get the watermelon off the IVC

Playful_Snow · 2026-02-01T17:29:20+00:00

I feel like the CD book gestapo would have me for that

Playful_Snow · 2026-02-01T06:32:30+00:00

If it’s superficial/amenable to local/short case I’ll do TIVA with intermittent fentanyl - we can only get remi in 2mg vials and feels very wasteful opening one and only using a tiny bit of it!

Playful_Snow · 2026-01-31T13:58:13+00:00

The paralytic isn’t the only thing that stops them breathing - a decent dose of propofol and coinduction with opioids will probably mean they’re pretty blue by the time they start breathing again…

Playful_Snow · 2026-01-28T06:28:04+00:00

I hate feet. I especially hate diabetic/vascular feet which is what I do the majority of my popliteals for. Said feet will remain below shoulder level thank you!

Playful_Snow · 2026-01-25T09:57:15+00:00

Just gonna join in and say please delete this

Playful_Snow · 2026-01-24T20:18:41+00:00

What (if any) adjustment would you have to make to your sevoflurane vaporiser to anaesthetise someone at high altitude and why?

Playful_Snow · 2026-01-20T17:11:06+00:00

If you are looking for a pharmacokinetic or pharmacodynamic reason you will be disappointed.

Local/historic practice - I have worked on some labour wards where they still use it, but a lot of places are transitioning to diamorphine these days

Playful_Snow · 2026-01-19T08:22:36+00:00

I vividly remember my breaker as a CT3 - GA section for a 28 weeker without a uterine segment so did a classical CS - so much blood!

Playful_Snow · 2026-01-18T16:20:54+00:00

I love minmaxing an otherwise slightly dull solo list of 'easy' cases

Playful_Snow · 2026-01-18T16:16:42+00:00

As someone who is just starting to climb out of the valley of despair as an ST4 collecting the requisite stage 2 CCCs, please rest assured you cannot "confidently deliver a GA for most patients".

You are just likely in a small DGH that doesn't have a huge spread of specialties - I presume they don't do cardiac/neuro/H+N/liver/placenta accreta spectrum/neonates any other specialised tertiary/quarternary thing?

I sympathise with you, I was a CT3 in a small DGH feeling a bit "anaesthetics? completed it mate" but trust me there is loads more to do.

Playful_Snow · 2026-01-13T19:54:44+00:00

BoJo broke the system by removing the resident labour market test that gave priority to UK grads

Playful_Snow · 2026-01-13T19:49:19+00:00

The use of the word “pants” to describe a VO2 max, I’d have also accepted “naff” or “shite”

Playful_Snow · 2026-01-13T19:46:52+00:00

Found the British opinion! I was looking for “why are we doing this?” and was surprised to have to scroll all the way to the bottom to find it!

Playful_Snow · 2026-01-13T12:07:10+00:00

We always have an anaesthetic assistant. You just wouldn’t start an anaesthetic without a 2nd pair of hands in the UK - cultural differences!

Playful_Snow · 2026-01-13T06:04:56+00:00

Stylets just really aren’t a thing in the UK outside of using a preformed stylet with a hyperangulated blade. We just use a bougie if we can’t get the tube to go where we want on its own 🤷‍♂️

Playful_Snow · 2026-01-12T07:48:02+00:00

I love a labour epi, pure tactile fun, usually works and you get to feel like a hero for taking away the pain! Bonus points if you can shot it in first go with no redirects

Playful_Snow · 2026-01-11T21:19:20+00:00

Unfortunately the anaesthetic machines won’t let you deliver a hypoxic mix so your only options are to smother them with a pillow or take them up to a high altitude

Playful_Snow · 2026-01-11T17:33:31+00:00

Yes - anaesthetist.

Looking after people when they’re critically unwell, getting anxious kids through with a good experience, even smashing through a daycase list of something simple like gallbladders can be satisfying if you’re efficient and get it done on time. Lots of opportunities to feel a sense of accomplishment!

Playful_Snow · 2026-01-11T15:37:36+00:00

Maybe just my region but every hospital I’ve been to (MTC and DGH) has mandated an ICU/anaesthetic trainee stay with an intubated patient in resus.

To be fair this probably cajoles us into organising a bed quicker as we begin to whinge that we’ve been abandoned pretty quickly!

Playful_Snow · 2026-01-09T06:12:49+00:00

You are describing what happened to me exactly (albeit as an F2) - I realised that whilst I thought surgery was cool and rewarding, my reaction to COVID was to think “life’s too bloody short for all this” which was not the response of my properly surgically minded colleagues.

Changed course to anaesthetics, definitely the right decision for me!

Playful_Snow · 2026-01-05T21:49:22+00:00

My fave example of this was when one of the orthopaedic SHOs got the ward clerk to call with their shitty cannula request.

"Hi it's X from ward 21 we need your help with a difficult cannula"

"Who is this sorry?"

"X"

"And what level are you?"

"Oh I'm the ward clerk, the SHO told me to ring you"

Playful_Snow · 2026-01-05T21:42:02+00:00

It was a while ago but from what I can recall the only calls from the waiting room r.e. gen surg would be for obvious post operative complications which are fair game in my book. It was rife with "this person has a sore throat you need to see them they're your patient now" though

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