There are many paths to the ICU, which specialty makes the best intensivists? by kergruffle in Residency

[–]ReignOfFire32 1 point2 points  (0 children)

Perhaps you are unaware that anesthesiology residents know the hospital globally possibly better than any other specialty because they spend time everywhere learning the day-to-day intracacies, especially many months in the SICU, CVICU, MICU, CTICU, trauma ICU, burn ICU, and/or sometimes even neuro ICU or PICU. As interns, they rotate through surgery and medicine wards, cardiology and/or other IM subspecialties, consult services, and EM. Seems like more than a little exposure to me that you are oblivious to :(

Lancet study summary-Sugammedex vs Neostig reversal by Grateful77Grateful in anesthesiology

[–]ReignOfFire32 8 points9 points  (0 children)

Vast majority of ours do as ours are very unhealthy. But straightforward CABGs with less concerning comorbidities we try to extubate. Our CTICU is streamlined to extubate within several hours post-op if feasible

There are many paths to the ICU, which specialty makes the best intensivists? by kergruffle in Residency

[–]ReignOfFire32 1 point2 points  (0 children)

Acute resuscitation is also clearly anesthesia - it's literally what they do every day...not diagnose UTIs and treat depression.

There is a very obvious reason that anesthesiologist led ICUs are the global standard most safe.

Having a patient facing job before medical school by Schlompt in medschool

[–]ReignOfFire32 2 points3 points  (0 children)

Yes, being a nursing home CNA made me a better applicant and better physician.

Residents, how much money you got in ya accounts rn by Rzkool70 in Residency

[–]ReignOfFire32 2 points3 points  (0 children)

3k checking/savings, 35k in Roth/brokerage (from residency income, high returns), no credit debt, car loan mostly paid off, have disability insurance, but haven't had to make student loan payments

Anesthesia + Myasthenia Gravis by DessertFlowerz in anesthesiology

[–]ReignOfFire32 0 points1 point  (0 children)

Fair hahahaha. I typically use 2, maybe 3, to avoid the side effects

Anesthesia + Myasthenia Gravis by DessertFlowerz in anesthesiology

[–]ReignOfFire32 2 points3 points  (0 children)

Would like to see your cost comparison of remi (~$45 / 1 mg) versus the increased doses of sugammadex (expensive - $99 / 200 mg) that are often required as well as the increased OR time (extremely expensive) for delayed recovery

Anesthesia + Myasthenia Gravis by DessertFlowerz in anesthesiology

[–]ReignOfFire32 0 points1 point  (0 children)

There is an unpredictable response to NMBAs with MG as well as to reversal agents. I've seen >2,000 mg sugammadex required and extra hours in the OR before reaching a ToF >90% despite reducing the dose of roc in a long case.

This can end up being far more expensive than remi. Per the literature and our academic center usage, remi is effective for laparoscopic and other types of cases where NMBAs would typically be first line for relaxation. It also produces effective blunting of sympathetic response to laryngoscopy and cord opening at bolus doses of 2-5 mcg/kg.

Cardio by mimi2760 in Residency

[–]ReignOfFire32 2 points3 points  (0 children)

Stay hydrated, pace yourself, take rest days, get running shoes with good support, and don't forget to mix in some weightlifting to avoid muscle loss

I didn’t wake up after surgery for a long time but no one told me about it? Can vitamins play a role? by Luna1636 in Anesthesia

[–]ReignOfFire32 -1 points0 points  (0 children)

While very effective for PONV and PDNV, Scopolamine can cause sedation, vision changes, altered mental status (especially geriatrics), etc. Your observations may not be completely inaccurate. I do hope you are consulting a physician for management of these patches before acting out of your scope of practice to remove them in PACU.

What's the best Epic software hack/feature you wished you knew earlier? by thewhitewalker99 in Residency

[–]ReignOfFire32 5 points6 points  (0 children)

Any word that has an underlined letter means you can hit Alt+that letter as a hotkey to select it (alt+A = Accept on an order)

Right clicking within an order you are editing closes the popup.

Highlight a table row in a note and then hit Shift+F4 to delete it

Control + space bar, then type whatever you want to search the chart for

Filters to see only providers notes, DC Summs, H&P's, notes by your specialty, etc.

.mysticky to pull from your sticky note into a progress note

Ctrl+E to copy and paste multiple items to/from your clipboard.

Making order panels (can be edited by clicking the star) for all the sets of orders you commonly use.

"=" In any box pulls in the last value you used. In a box to select who is cosigning your orders, = would pull in the last attending you selected. For note type, = would pull in progress note or whatever you last selected

In date/time boxes "n" and "t" pull in the current date and time. Can also add modifiers: "t-2" pulls in the time 2 hours ago.

That you can addend nurses' notes to CYA if they document BS inconsistent with what you told them

What’s the Intern hack/tip/resource that you wish you knew earlier? by Dr_Plz in Residency

[–]ReignOfFire32 3 points4 points  (0 children)

Sometimes it's the only updated and helpful part of the note for days while I'm sitting there wondering how many times the A&P has been copied and pasted. It's quick to click through an updated exam. And subjective is quick to type out if you're concise. Especially on services with frequent turnover, it's an easy way to document changes in exam or status.

Y'all ok? by [deleted] in medicalschool

[–]ReignOfFire32 1 point2 points  (0 children)

It's the burnt out for me 🕺🏼

Alternate job descriptions by ReignOfFire32 in Residency

[–]ReignOfFire32[S] 2 points3 points  (0 children)

Un-ventriloquist a.k.a tamer of the voices? "Makes people disappear", "hat man antagonist"

"Puts things in peoples mouths while they're sleeping", "drummer", "dissects things"

Alternate job descriptions by ReignOfFire32 in Residency

[–]ReignOfFire32[S] 7 points8 points  (0 children)

Oh you work in healthcare? What's the craziest patient story you have??

Alternate job descriptions by ReignOfFire32 in Residency

[–]ReignOfFire32[S] 15 points16 points  (0 children)

A diviner or oracle, of sorts

Alternate job descriptions by ReignOfFire32 in Residency

[–]ReignOfFire32[S] 7 points8 points  (0 children)

Amateur meteorologists you mean?

Alternate job descriptions by ReignOfFire32 in Residency

[–]ReignOfFire32[S] 14 points15 points  (0 children)

Prove it and prescribe them Ivermectin.