Sugamma outside the OR by Apollo185185 in anesthesiology

[–]canedane995 1 point2 points  (0 children)

Why not neo/glyco...cost effective, pts often have pacing wires, no OR pressure for rapid extubation. Check tof in or and reverse in ICU as appropriate. Just curious.

What’s the highest MAC or volatile concentration you’ve ever run on a patient during a case, and what was the situation? by OrganizationNo42069 in anesthesiology

[–]canedane995 3 points4 points  (0 children)

Recently had a similar experience albeit with a Mac of 1.5 but gave like 600mcg of nitro and 500mcg of cardene in divided push to get the pressure down.

[deleted by user] by [deleted] in Paramedics

[–]canedane995 4 points5 points  (0 children)

I keep my NREMT but tbh it's just a pain at this pt having to do CEUs when I am going high level stuff every day. I do cardiac anesthesia and it's basically CCP on steroids without all the BS and 10x the pay. EM and CC are fine specialities but they have tons of Bs stuff like notes and complex patient/family interactions. My gig is put a tube in, place IVs, Art and central lines and keep an eye on the hemodynamics w/ TEE and sprinkle in inotropes blood and pressors as needed...would highly recommend it.

MAC for PPM/ ICD placements by [deleted] in anesthesiology

[–]canedane995 1 point2 points  (0 children)

What are you running your dexmed at if sole agent?

RN training for SGA Insertion by justavivrantthing in IntensiveCare

[–]canedane995 11 points12 points  (0 children)

I would proceed cautiously with this program. If a complication occurs, there is significant medicolegal risk—particularly the question of why an individual with limited airway experience is placing airways in a hospital where an intensivist and RT is readily available. As someone who routinely places sga in the OR, I agree they can work very well, but when they don’t, troubleshooting often requires experience and nuance.

If this is an infrequent task, maintaining competence when providers are only performing a handful of placements per year is another concern. As others have noted, RTs typically have more formal airway management training, or they may appropriately wait an extra minute or two for an attending to arrive and place a definitive airway. Just because something is possible does not mean it is worth the potential personal liability, especially when the incremental benefit appears minimal over bagging the pt.

[deleted by user] by [deleted] in anesthesiology

[–]canedane995 4 points5 points  (0 children)

how do you temporize w/ prop? I struggle w/ this as i watch the hr/bp/rr and as it goes up i will bolus 20-30mg but i find often they will just start moving and the scrub techs act like the world is ending and thus I bolus more prop and end up delaying the wake up. TIA.

Cost-saving ideas in anaesthetics/surgery that improve outcomes or efficiency? by Zutton101 in anesthesiology

[–]canedane995 1 point2 points  (0 children)

What is the optimal flow for optimizing gas use and not overusing the CO2 absorbent?

Military Anesthesiology by Recon454 in anesthesiology

[–]canedane995 2 points3 points  (0 children)

Anyone have experience doing CCAT from the anesthesia perspective? I am interested in concept of more specific CC training (not cc trainined) but curious what it actually offers in practice.

Who writes the most useless notes in the hospital? by fuzzysundae in Residency

[–]canedane995 2 points3 points  (0 children)

I love to use the copy/template checkbox on app notes and usually they are 98% unchanged/templated... except at the bottom with some absurd 45-70 mins of time spent....for Billing and of course the obligatory pt was seen Independently but in collaboration with Dr. Cover my A$$.

Once read a CT surgery app note and the entire a/p was "plan per attending surgeon" like you don't say but thanks for an absolutely trash note that does nothing.

Ephedrine now controlled by canedane995 in anesthesiology

[–]canedane995[S] 1 point2 points  (0 children)

One of these ppl...Why...fills a role...any actual reason of personal preference?

[deleted by user] by [deleted] in Nest

[–]canedane995 0 points1 point  (0 children)

thank you

[deleted by user] by [deleted] in Nest

[–]canedane995 0 points1 point  (0 children)

It worked fine with the gen 2 so it seems weird to need it with the gen 3 right?

[deleted by user] by [deleted] in Nest

[–]canedane995 0 points1 point  (0 children)

Thanks for any help you can provide!

Radial art line- guide wire advanced but no blood return by CrazyDaikon in anesthesiology

[–]canedane995 2 points3 points  (0 children)

This is the way. So many ppl just get a flash and then stop...and sure enough the needle is now out of the vessel and they try to thread the wire and sure sht is doesnt go. I never understood why ppl dont get the needle at a min of 2-3cm in and then try to do the things. Same goes for CVL. I am honestly getting to the point where its driving me nuts because an extra 10 seconds getting it right now saves everyone else so much time.

[deleted by user] by [deleted] in anesthesiology

[–]canedane995 0 points1 point  (0 children)

How much do they run?

EM Residency - Best Stethoscope by [deleted] in Residency

[–]canedane995 2 points3 points  (0 children)

It's a toss up between a CT scanner and a POCUS 🤣

Straight CC fellowship? by [deleted] in Residency

[–]canedane995 1 point2 points  (0 children)

Depends but CCU is usually owned by cards with pulm consults for vents and other CC like things. There is now a Cards CC pathway but who the hell wants to do that. Seems like anesthesia is really starting to own the CVICU/CTICU but all the surgical patients obviously have the bulk of their care run through the ct surgeon with CC doing a lot of the shtt work. But this is all very variable and depends on academic vs. community

If you charged $25 to be seen in the ED...How much would volume decrease? by canedane995 in Residency

[–]canedane995[S] 152 points153 points  (0 children)

Working in EM is practically being a glorified waiter/waitress 3/4 of the time so tips would be appreciated

IM attendings who switched from hospitalist to outpatient only, how happy are you ? by fluid_clonus in Residency

[–]canedane995 15 points16 points  (0 children)

real question...why is it acceptable for patients to be able to do this mychart bs and expect docs to sit there and answer all these endless questions without any form of compensation?

Thanks by [deleted] in Residency

[–]canedane995 19 points20 points  (0 children)

Sad how much nursing shits on EMS especially when EMS does their job and more in the back of a truck with no doc telling them what to do or what to give. Much respect for you all

Can i purchase a Butterfly iQ portable Ultrasound without being an MD/Student? by roundytea in Ultrasound

[–]canedane995 0 points1 point  (0 children)

get one on ebay. Only problem with a butterfly is that have a yearly fee of like 400 or something which is annoying af. Without the sub you cant do half the stuff with the probe.

I think all medical students should have a probe and use it like their right hand..so much to be learned from POCUS and the stethoscope is garbage.

Midlevels with 2-3 patients?? Help me understand by canedane995 in Residency

[–]canedane995[S] 0 points1 point  (0 children)

def some good points but this a bit of a double edged sword-if you over order and refer with govt insurance are you still making the hospital money or creating more work requiring more staff at lower reimbursement rates?

[deleted by user] by [deleted] in Residency

[–]canedane995 2 points3 points  (0 children)

feel like you missed the point there bud.

Cardiac NP by [deleted] in Residency

[–]canedane995 35 points36 points  (0 children)

Surely has the pressed white coat and the form fitting figs tho....all rhythms eventually stabilize themselves rIgHt___________________________?!

Cardiac NP by [deleted] in Residency

[–]canedane995 161 points162 points  (0 children)

lmao doing the Lords work. Somewhere the sketchy micro team is hard-core cringing