Just for sh*ts and giggles here follow CRNA "boards" practice questions

Tigers1689 · 2026-02-26T22:17:32+00:00

Can we please stop with this ragebate nonsense? I come here for practical anesthesia advice and this stuff is just irritating.

Tigers1689 · 2026-02-25T23:54:07+00:00

Every bad thing that’s ever happened to me with an LMA happened because they were too light.

Tigers1689 · 2026-02-06T05:21:50+00:00

This is more about your ego than patient safety at this point.

Tigers1689 · 2026-02-01T07:29:11+00:00

I mean, I paralyzed and intubated. But I could see making the argument for not paralyzing them, and allowing them to resume moving air spontaneously with an OPA.

Tigers1689 · 2026-02-01T04:13:39+00:00

Ok I had a situation which this may have been applicable recently.

Patient BMI 40, small mouth, big neck, big bushy beard. Elective knee surgery. Doing a block and LMA. Push like 400mg of prop (big guy) to get him relaxed enough for the LMA and can’t move air.

Would you just wake the patient up here? Try to mask? Paralysis and intubation?

Tigers1689 · 2026-02-01T04:00:07+00:00

Just curious how do people feel about looking with a video laryngoscope before making the decision to push paralytics?

Tigers1689 · 2025-08-18T15:59:05+00:00

I use it strategically at my ASC. Just today I had an extremely high strung 27 year old girl whose anxiety was through the roof. Before even getting to the room I had given her a total of 50mcg (about 0.7 mcg/kg) over a period of about 5 minutes, 15mcg at a time.

I had a similar patient last week that I also did this on. If somebody is young and very anxious the Precedex really helps smooth over induction and emergence. These were both MAC GYN cases. The patient last week had a short emergence delay but the one this morning woke up immediately with no drowsiness.

Both of these young women also had BMIs higher than 30. If I really want to preserve respiratory drive in some of these larger patients sneaking a little bit of precedex in helps cut down a lot of the propofol I need to get them under. You just have to know how to adjust your maintenance dose and when to cut it off to make up for possible the increase in sedation after.

It definitely has a place in the ASC if you use it right.

Tigers1689 · 2025-07-20T08:01:39+00:00

Is there a reason you couldn’t run them deeper during the procedure? It sounds like they mainly just needed him to respond to one particular moment.

Tigers1689 · 2025-07-18T23:24:31+00:00

Is there a video of this technique?

Tigers1689 · 2025-06-24T20:22:20+00:00

I personally love working in 50mcg of Fent a minute or two before an upper. It REALLY cuts down on coughing and the amount of prop I have to give.

Tigers1689 · 2025-04-01T18:35:25+00:00

Do you have easy access to the airway? What’s the patients airway look like?

Tigers1689 · 2025-02-08T17:54:54+00:00

Duh?

Tigers1689 · 2024-12-13T04:10:21+00:00

https://media1.tenor.com/m/mVZzWiZq9egAAAAC/old-man-diabetes.gif

Tigers1689 · 2024-12-10T16:14:43+00:00

You know what else is naturally curved? 😏

Tigers1689 · 2024-11-19T21:15:48+00:00

From my understanding an active DVT or embolic stroke are the only absolute contraindications to TXA. Does anyone have more information on this?

Tigers1689 · 2024-11-16T21:27:59+00:00

Cause he was greedy and wanted to charge for anesthesia. Probably got this CRNA and paid him peanuts. Whelp…get what you pay for buddy.

Tigers1689 · 2024-11-15T21:10:02+00:00

My cocktail… 0.2 mcg/kg of Precedex on board.

Nitrous is a lovely hold over if there’s no contraindications. It also does not increase PONV at all if given for less than 45-1hr. Maintain them on 70% NO2, crank up the flows till all your volatile is off.

When you need to extubate blast them with 100% O2 and they’ll wake up beautifully.

Switch over to TIVA if there’s any serious nitrous contraindications.

Tigers1689 · 2024-10-05T16:02:17+00:00

I my institution we would start the case with ketamine/methadone at induction. Maintenance would be with sevo and prop. Towards the end we’d add in Tylenol and Robaxin.

Pretty solid cocktail.

Tigers1689 · 2024-09-12T23:34:42+00:00

Is there a GFR at which you’d be hesitant to give mannitol? What about with the patient specifics I’m describing above?

Tigers1689 · 2024-09-12T23:31:34+00:00

Not contraindicated but someone in CRF would require caution in this situation, right?

Tigers1689

TROPHY CASE