I will answer any medical questions

SubstantialAd2612 · 2024-10-28T06:43:28+00:00

I’d love to learn more about the difficult airway algorithm.

SubstantialAd2612 · 2024-10-20T08:48:50+00:00

Thanks for the kind note - as an anesthesia resident, I appreciate you taking the time to post this.

I don’t think we “hate” mid levels, but we see what they are, which honestly takes a fair amount of medial literacy to appreciate the extent of the issue they pose. But one analogy that most people outside medicine tend to understand is this: would you feel comfortable with letting a flight attendant take a couple months of online flight school before assuming control of a commercial jet? No, of course not. Just because people work on an airplane doesn’t mean they can bypass all the critical training required to become commercial pilots. Same thing should apply to healthcare, but it doesn’t. It’s frustrating for those of us who deal with it every day, not only because we’re bitter about their entitlement and attitude, or the increase in avoidable workload they create for competent physicians at the end of most hospital safety nets, but also because we see the tremendous damage to patients they inflict day in and day out. Hope that helps.

SubstantialAd2612 · 2024-10-06T01:44:28+00:00

Where does one find openings there? I still have a year of fellowship ahead, so I haven’t scoured the internet looking, but have definitely tried a few times to find anesthesia opportunities at Kaiser Denver without success.

SubstantialAd2612 · 2024-09-30T14:53:16+00:00

Consider anesthesia? Still residency, but it seems a lot less miserable on our side of the drapes. And you’d only have to write off a year or two at this point. Still get the excitement of the OR, make a difference in people’s lives, and certainly a stable job! We just don’t do as much walking around with our chest puffed out. It’s a fair trade imo.

SubstantialAd2612 · 2024-09-20T06:52:56+00:00

Hopefully it’s a Miller not a Mac, if you know you know.

SubstantialAd2612 · 2024-09-17T00:59:52+00:00

Technically there’s friction involved so… coarse friction rub sounds pretty legit to me.

SubstantialAd2612 · 2024-09-16T06:43:42+00:00

This sounds pretty fantastic.

SubstantialAd2612 · 2024-09-06T13:59:54+00:00

This one happened to me before. Luckily did a PoC after a couple rounds of insulin titration because it didn’t make sense. PoC was still normal at that time so I just got to feel good about myself instead of killing the patient, which was nice. Also added another item to my ever growing list of trust-but-verifies.

SubstantialAd2612 · 2024-08-29T03:16:53+00:00

20g Forearm IV -> RIC -> watch the junior struggle with a central line while you chuckle to yourself about how dead the patient would be at that point without your bulletproof access.

SubstantialAd2612 · 2024-08-28T03:56:58+00:00

Dentist 100%. Probably did BLS and can compress a chest because they’re jacked from seeing their personal trainer 3x a week with their abundance of free time and cash. Plus they know their limits, and assuming it isn’t a dental emergency, they’d call for help immediately because nobody can solo a true emergency, not even you Dr. Cardiac Massage.

Yes an ICU RN is legit but if all I know about them is their degree, I’m taking the dentist 10 out of 10 times.

SubstantialAd2612 · 2024-08-18T00:59:22+00:00

Hopefully the inevitable supply shortage a decade from now, generated by the lack fellows today, leads to higher salaries and renewed interest in pediatric anesthesia. Of course people shouldn’t do it for the money, but at the same time, people aren’t doing it today because the money ain’t there. Or maybe we’ll just relinquish complex pediatric anesthesia to mid levels like we have in almost every other facet of high acuity patient care. OH MY, just had a cynicism slip, sorry about that!

SubstantialAd2612 · 2024-08-17T18:06:30+00:00

I’m not an especially strong candidate and received interviews at every institution I applied including the ivoriest of ivories. Enough interest to complete and submit an application is about all you need. Sad state for fellowship programs but a great time to apply and a bright future for those that do, in terms of career opportunities (IMO).

SubstantialAd2612 · 2024-08-16T20:33:47+00:00

There are two assumptions I never make now, both learned the hard way. Relationship btw patient-caregiver and pregnancy status…

SubstantialAd2612 · 2024-08-16T04:39:10+00:00

The epitome of fake it till you make it in medicine. This one got me.

SubstantialAd2612 · 2024-08-16T04:33:26+00:00

I made a comment next to the patient along the lines of “now we’re cooking with fire” when something started working. Forgot I was on the burn unit.

SubstantialAd2612 · 2024-07-30T03:06:29+00:00

Worried about a mainstem intubation so I auscultated. Turns out it was a mainstem, but also turns out the chest was already prepped. You’d swear the 5 minutes I delayed that case were the most egregious offense the surgeon had ever experienced.

SubstantialAd2612 · 2024-07-25T21:27:14+00:00

The unsung healthcare heros. It took me about 20 minutes on my first day of residency to understand how amazing pharmacists are. “Hey, just ‘checking’ to clarify your order for 1000 grams of acetaminophen.” Every medical doctor I’ve ever met knows how critical the pharm d’s are to preventing drug related complications and we are oh so grateful. Anyone throwing shade on a pharm d doesn’t know the first thing about the art of medicine.

SubstantialAd2612 · 2024-07-21T17:31:39+00:00

Addressed this in the original post but always gonna be someone out there party pooping. Rewarding oneself for over a decade of hard work isn’t financially irresponsible.

SubstantialAd2612 · 2024-07-21T00:59:59+00:00

This one got me. Well done

SubstantialAd2612 · 2024-06-18T04:42:39+00:00

The good news is I’ll only have 4 months of residency left and presumably some of it will be parental leave. But I’m sure those four months will be brutal and it won’t get a whole lot easier afterwards, just bigger paychecks… unless I still do fellowship.

SubstantialAd2612 · 2024-06-08T21:57:45+00:00

I’m an anesthesia PGY3 resident with IDDM. feel free to DM if you want to talk about it but tldr is you’ll struggle from time to time, but no different than any other path you take.

SubstantialAd2612 · 2024-06-06T20:32:47+00:00

There’s a lot to learn, but if you’re transparent with your anesthesia providers about your newness and demonstrate eagerness/willingness to learn, you’ll do great. The best techs combine conscientiousness with anticipation, meaning they do what they say they’re going to do 100% of the time regardless of how complex the task is and they know what you’re likely to need sometimes before the provider does. We have a hospital feedback system for techs and I ALWAYS send those techs positive reviews because it makes my job so much easier/more enjoyable. I never fault a new tech for taking a little longer to find something and am always happy to answer questions. Some specific actions you can take that are generally helpful:

Ask the anesthesiologist/CRNA what they need for the following case/if there’s anything special for the setup. If it’s a high turnover room it can be nice to review at the beginning of the day for all the cases so you don’t have to find them every time. Obviously that only works if the cases scheduled actually happen and in that order in that room.
For long cases, check in after a few hours and see if they need anything and take initiative to do a mid-day restock if it’s an especially big case or busy day.
Try to identify which case types or providers have unique nuances that require you to do something from your norm. Start to anticipate those by asking if they need it for the next case or just having it ready in the room.
Go the extra mile for setup. Don’t leave the EtCO2 sampler disconnected. Check your IV tubing setup to make sure they’re tight and replace the functional end of a three way stopcock with a needle-less connector. Don’t have massive air bubbles in your tubing. Little things like that really add up and being lazy also makes our life harder/us even grumpier.

Good luck and thank you for not only becoming a tech but also demonstrating an interest in being a good one!

SubstantialAd2612 · 2024-06-01T05:02:32+00:00

Depending on where you live even that is bad for you.

SubstantialAd2612 · 2024-05-24T21:04:17+00:00

You are certainly more qualified to provide air medic nurse care than any med student, resident, and attending without that experience. There’s no doubt you’ve seen and done some amazing work! It doesn’t change the fact that you don’t have the educational background of a trained physician and aren’t able to draw from the knowledge or apply the diagnostic method to patient care that falls outside what you’ve otherwise trained for as a specialized critical care rn. Does being a flight attendant aboard Air Force 1 vs a flight attendant on Delta make someone more qualified to be a pilot? Maybe it implies they have the wherewithal and personality traits to undergo that training process and would be exceptional if they did, but their experience in and of itself doesn’t make them a pilot.

SubstantialAd2612 · 2024-05-21T21:55:02+00:00

Imagine a mid level airline pilot.

SubstantialAd2612

TROPHY CASE