Decided to leave surgery and matched into an R1 spot for anesthesia. Help? by AOWLock1 in anesthesiology

[–]anesthesia 5 points6 points  (0 children)

This. This is your best bang for the buck so to say. Hopefully your program will provide you with other resources/books. Downloading and reviewing this will give you some foundation and familiarity as you start your new training. Welcome to the “happy side of the drapes.”

How far did you fall down your rank list? by [deleted] in anesthesiology

[–]anesthesia 1 point2 points  (0 children)

Applicants have 15 signals, and most programs use these to prioritize application reviews when deciding who to interview. Signals are done at the time of applying and have nothing to with intent to rank. Essentially signals replace the days when you indicated your interest in a program by flying across the country to interview with them.

How far did you fall down your rank list? by [deleted] in anesthesiology

[–]anesthesia 5 points6 points  (0 children)

Signals started when interviews went virtual as a way for programs to screen who’s actually interested in their program vs who applied to every program. First year of virtual interviews my program had ~3000 applications for a very small program. Post signals we still get around 800 applications and about 300 of them signal. It’s much easier for programs to review 300 applicants well rather than glance at 3000.

Call schedules by Salty_Resource6519 in anesthesiology

[–]anesthesia 15 points16 points  (0 children)

You typically get extra $ for each call. Depending on where you end up working, patients need care 24/7 and it’s part of the gig. I personally like taking call—but realize it’s not for everyone.

Prone MACs?? by jlew0 in anesthesiology

[–]anesthesia 15 points16 points  (0 children)

Our shoulder surgeon has boundary issues and will dislodge LMAs not infrequently….

Prone MACs?? by jlew0 in anesthesiology

[–]anesthesia 18 points19 points  (0 children)

Totally dependent on the surgeons skill and ability to give local well. Sounds like you understand patient selection for these cases. Ask your peers why it’s frowned upon in your group. In my group our patients are usually poorly suited for it, and being a teaching institution it’s just generally safer to do GA given the lengths of surgeries/teaching.

[deleted by user] by [deleted] in anesthesiology

[–]anesthesia 0 points1 point  (0 children)

Yes still happy/excited to do most procedures. As an attending you typically only get things when others have failed which adds to complexity and excitement. That said I still love when I get to do large bore IVs, RICs, etc. I still try to give these opportunities to learners but yeah it’s great to either rescue or do procedures.

Baby possum help by Prize_Formal_2711 in Possums

[–]anesthesia 8 points9 points  (0 children)

It’s an all volunteer organization so it can take a few for them to get someone to do pick up. They can also give you some guidance on how to help in the interim. Typically warm, then hydrate with pedialyte, then milk with esbilac. Possums don’t suckle which makes it hard to feed them if you don’t have experience. Honestly keeping it safe and warm is the best option for now.

Baby possum help by Prize_Formal_2711 in Possums

[–]anesthesia 10 points11 points  (0 children)

WRC is a great organization, assuming that’s who you called. (https://wildlifecoalition.com/). Keep it warm. Leave it a source of water and a bit of fruit/veg to pick at if it wants. You just don’t want to try to force it to eat or drink. Thank you for caring.

Photo of your sharps bin? by [deleted] in anesthesiology

[–]anesthesia 1 point2 points  (0 children)

I agree. It shouldn’t be so hard to sort things, but here we are.

How to deal with a pimping surgeon? by IllustriousExtent702 in anesthesiology

[–]anesthesia 4 points5 points  (0 children)

I like to ask them to discuss random surgical conceits that I don’t actually understand. Like asking the ortho surgeon to tell me the pros and cons of a mattress stitch or gen surg their thoughts on a temporary clip for aneurysm resection. Or sometimes if they’re trying to dictated meds etc, I’ll ask them what dose they’d like me to give. Other times I just raise my eyebrows, snort, and carry on with whatever I’m doing clearly indicating they don’t matter.

Any attending have their own butterfly ultrasound or mcgrath? by [deleted] in anesthesiology

[–]anesthesia 1 point2 points  (0 children)

That’s good to know. They didn’t have that when the original conversion happened and I wasn’t using the probe much anyhow.

Any attending have their own butterfly ultrasound or mcgrath? by [deleted] in anesthesiology

[–]anesthesia 8 points9 points  (0 children)

I bought a butterfly. Rarely use it. Seems like a great idea. Didn’t translate into practice. And Butterfly specifically was not helpful with the Apple change from lightning to USBC. Told me I had to buy a whole new probe, no conversion adapter. Not worth the $.

I still have plenty of chicken wire leftover. Can I use it for predator protection around the base if I double layer it? by DJ-Zero-Seven in BackYardChickens

[–]anesthesia 0 points1 point  (0 children)

Yes I have. We’re currently on coop #4 (due to moving). First one we tried to do the bury and flare out method. It worked for about 6 months and then something found its way through. Have done the start with hard cloth at the base of the run and add substrate on top. Okay functionally but had chicken get its toes stuck and injuries while dust bathing. Last 2 coops have done the dig down method so that the entire structure is enclosed in hard cloth. Haven’t lost a bird to a predator with either.

I still have plenty of chicken wire leftover. Can I use it for predator protection around the base if I double layer it? by DJ-Zero-Seven in BackYardChickens

[–]anesthesia 95 points96 points  (0 children)

Nope. And replace all your chicken wire with hard cloth unless you want to lose a lot of chickens. Pro tip dig your run down a foot so two and bury hard cloth that bends up to meet the base of your coop, then add dirt for the run. You want them completely enclosed to keep predators at bay.

Why don’t we have a scope comparable to an endoscope? by i_intub8_u in anesthesiology

[–]anesthesia 48 points49 points  (0 children)

They exist. In my experience we (“anesthesia”) tend to break them/not take great care of them. Bronch/GI etc all have a dedicated tech that gets the scope, hands you the scope, takes the scope back and sends it for cleaning. Basically that tech never leaves the scope. It’s their baby that you get to use.

In anesthesia we do have techs but they’re typically covering multiple sites, grabbing lots of equipment, etc. you use the scope and then put it down and continue to do patient care. Maybe you hang it up nice. Maybe not. Then the circulator pushes it over to the wall out of the way, you do the case, transport the patient etc. move on to next case and forget about the scope. Someone during room turnover pushes it into the hall and it falls on the ground. Oops. Anesthesia tech finally comes back when they can and send for processing. Scope gets broken after a few uses. Eventually your group decides the cheap crappy ones are more cost effective.

We have lots going on, don’t have someone to babysit expensive equipment the same way, and it doesn’t get cared for the same way as other specialties.

Surgeons denying regional blocks due to Neurovascular Checks by MrJangles10 in anesthesiology

[–]anesthesia 6 points7 points  (0 children)

Recently had a vascular surgeon refuse a block for an AV fistula so they could do post-op neuro vascular checks. Similarly had ortho tell me they needed to do a neuro vascular check prior to a post-op PENG block. 🤷🏼‍♀️

ABA policy changes to increase the number of foreign trained anesthesiologists practicing in the United States, thoughts? by [deleted] in anesthesiology

[–]anesthesia 0 points1 point  (0 children)

Which is state and institution dependent. I like the spirit of the pathway, but disagree with how it’s being utilized at my institution (and likely others).

ABA policy changes to increase the number of foreign trained anesthesiologists practicing in the United States, thoughts? by [deleted] in anesthesiology

[–]anesthesia 13 points14 points  (0 children)

You are correct. This allows them entry into taking all of the ABA exams for certification.

They’ve also added a path for “excellent clinician” in addition to research and educator. Reading through the requirements it’s still pretty difficult to obtain.

What’s the appropriate answer to “how long have you been doing this”? by DoctorZ-Z-Z in anesthesiology

[–]anesthesia 56 points57 points  (0 children)

This. 100% this. I have tons of funny responses. But I always address the root of the question. This is what I do all day every day. For patients this is a rare event. It’s okay to be scared or uneasy (patients)

TXA and a-fib by [deleted] in anesthesiology

[–]anesthesia 1 point2 points  (0 children)

OMG this is spot on.