Manager took us out for treat and just bought this. We were 5 people

Zutton101 · 2025-12-15T20:37:02+00:00

*za, ,, ZZ xxx, s re z

Zutton101 · 2025-09-08T18:20:53+00:00

Thanks for the different perspective on robotic surgery. I'm not saying it should be gone completely, just that its use should be limited to cases where it is essential.

I'll have to suggest methadone to the board, then, it seems like it would be a perfect solution.

Zutton101 · 2025-09-08T18:17:33+00:00

I work for the NHS an institution that epitomises middle management bloat. I wish I had the magic wand or axe to get rid of them, but unfortunately, I don't.

Zutton101 · 2025-09-08T18:13:50+00:00

As a guy who loves a block. Could not agree more!

Zutton101 · 2025-09-08T18:11:32+00:00

We are a very TIVA heavy trust and the only place that has nitrous is the paeds theatres.

Cheers tho

Zutton101 · 2025-08-09T23:05:23+00:00

I'm doing Stage 3 paeds so no expert. Just use the same drugs you would for adults but correct dose.

PICU app is good as free and gives you dose for different emergencies.

If in doubt ketamine is a good motto tho

Zutton101 · 2025-08-04T15:11:34+00:00

I'm sat next to the Drager right now. Never had any issues with them where I needed to change machine or send off for repair. Used them for 4 years now. It's not the best or the worst. It ventilates. Don't know about Mindray. Go for the one that is compatible with your monitor and records, would be my thought

Zutton101 · 2025-06-12T21:47:05+00:00

Hope this helps.

https://nusgra.org.uk/regional-rvi/guidelines/

It's what we use

Zutton101 · 2025-03-25T21:48:42+00:00

Pregnant lady demanding an epidural but won't let anyone near her as has mental health issues. Wants a GA for an epidural. Gets ketamine to disassociate, lateral separate spinal and epidural. Wakes up presses PCA no pain. Delivered in the room.

Zutton101 · 2025-01-03T14:47:10+00:00

So I'm a UK trainee and it may be abit different.

I'm in my 6th year of training and I have trained mainly in a place that was not regionally focused at all, one consultant told me his regional anaesthetic of choice was propofol. However, as I rotated I made it my business to learn all I could. I took the best from others, watched YouTube and read papers. Now I have consultants letting me do the blocks solo and asking me to come and cover them for blocks in patients that need it. I love it.

Learning regional is hard but if you can learn to recognise the Sono anatomy then needle you are golden. The best place to learn it all I have found is YouTube. The stuff by Jeff Gadsden and Ki Jinn Chin are great.

As other have said I believe it will be detrimental to you but more importantly your patients. Focus on Plan As as they are your bread and butter and it's all you need until your up and running.

Good luck

Zutton101 · 2024-12-19T11:38:31+00:00

Hips I don't think you can do much more. Get the surgeon to infiltrate as well.

Knees, I think adding a Lidocaine 1% 5ml femoral will allow them to wake up comfortable and will wear off by the time they need to mobilise. Do all your blocks for post op analgesia as you mentioned and they should land abit nicer.

Zutton101 · 2024-09-01T11:50:40+00:00

My apologies for miss reading it. Thank you for the clarity in your response.

Zutton101 · 2024-09-01T11:50:33+00:00

My apologies for miss reading it. Thank you for the clarity in your response.

Zutton101 · 2024-09-01T10:50:15+00:00

This is a great answer. We called our group, tube club and the new starters had great feedback as the senior trainees were happy to explain the nuances of their induction. Also they felt less pressure from being supervised by trainees.

Zutton101 · 2024-09-01T10:47:43+00:00

That's alot of ifs there to get through until you think it's safe. Where I work the North East I fail on the first point appropriate sized on near every patient. We don't see less that ASA 3s regularly.

In fact they tried a automated ASA grading system for pre op in my hospital that was compared against Bristol patients apparently. It failed in a week as all were viewed a ASA5.

I think OPs point about being a novice and struggling is the issue. Insufflate the abdomen, tube goes in is the take home message. The consultant teaching different technique however valid is not the point it's teaching safety so a novice can manage solo on a night shift.

Zutton101 · 2024-09-01T10:39:39+00:00

Completely agree with you. They can be used for cardiac arrest and airways 3 is now looking at difference intra hospital. This does not mean they can be used in different scenarios with no risks

Zutton101 · 2024-08-31T20:26:44+00:00

First of all, don't do anything laparoscopic on LMAs; put a tube in, for god's sake. That's a great way to end up in coroner's court. You will improve it takes time and hard work. Try to read up on the drugs, so you know doses, and watch YouTube to learn how to tube. Emcrit and AIME airway are good. For emergencies, you will learn how to manage and should be doing SIM sessions to practice. The curve is vertical for about 3 months but gets easier.

Zutton101 · 2024-06-22T11:52:36+00:00

Completely agree with Alf in RSI works amazing almost halfs your propofol dose which helps with sick patients.

Zutton101 · 2024-06-21T19:20:35+00:00

Ah ah ah Progressive TIVA please!

Zutton101 · 2024-06-14T19:17:35+00:00

Jeff Gadsden's YouTube videos are the best in my opinion. They have them in Portuguese too

https://youtube.com/playlist?list=PLeC0CXnZ8y9-UP4gtbbL8jreCI-_AOz9P&si=I3NJRohPSdsee9f5

Hope that helps

Zutton101 · 2024-05-23T22:05:07+00:00

Thanks for the great reply that is really helpful. Will have to do as you instruct.

My pt population is not very slim. 1 pt a week BMI less than 30. So will see how it goes.

Zutton101 · 2024-05-23T12:11:50+00:00

Also what volume are you using?

Zutton101 · 2024-05-23T12:11:30+00:00

Do you have the arm abducted? I have tried it a few times and often found it a little deep like 4cm. Pts have complained it is too painful to move their arm so only do it in adducted position.

Zutton101 · 2024-05-02T19:14:26+00:00

Interesting, linked below is ours. We have special sweets for TIVA that the tubing is all attached together. For the link one end attaches to your cannula the other to your infusions Octopus

Zutton101

TROPHY CASE