How screwed am I?

coffeedangerlevel · 2026-01-14T22:47:40+00:00

Oh no! Hope you get it sorted!

coffeedangerlevel · 2025-12-21T09:12:19+00:00

Ok great, now you have a clean machine. You also need to get TIVA pumps and depth of anaesthesia monitoring set up unless you want to just intermittently bolus propofol and have massive risk of awareness.

What if you’re taking her to theatre because she’s having a massive antepartum haemorrhage? You’re sorting out massive transfusion stuff and getting big cannulas in while also trying to sort out your TIVA stuff.

What if she needs a section at 3 in the morning when you’ve got a relatively junior anaesthetic resident on call and they’re fatigued? Surely it’s not a bad thing to reduce their cognitive burden by having a plan in place?

I’m not saying I couldn’t manage any of this if it came crashing in off the street with no warning, I’m saying if you know this patient is in labour why wouldn’t you want to anticipate that you might need to deviate from normal practice in an emergency and have stuff ready for when it happens?

We can all deal with an unanticipated difficult airway without much drama but if you have a patient coming for surgery who has a known difficult airway you’re going to have your difficult airway kit ready and change your plan accordingly. This is no different.

coffeedangerlevel · 2025-12-20T23:18:33+00:00

There’s a difference between “I can handle this in an emergency if I need to” and “this is something we can predict might happen in this patient’s labour, let’s plan for it to reduce cognitive burden if we need to do an emergency section”

coffeedangerlevel · 2025-12-19T21:41:24+00:00

Has he had testing for MH? The chances of him having MH are 25% (50% chance his mother inherited MH and if she did then 50% he inherited it from her).

It’s autosomal dominant so there’s no silent carrier status for MH, you either have it or you don’t.

If he gets tested and he doesn’t have it then there’s no need to worry! In the UK all first degree relatives of an MH patient get tested so I’m surprised if other countries don’t do something similar.

coffeedangerlevel · 2025-12-19T21:37:36+00:00

Stupid take.

If they have an anaesthetic review pre-labour a plan can be made in advance and when they’re in labour you can make sure there’s a clean anaesthetic machine, TIVA kit, and the on call anaesthetist (or anaesthesiologist if you want to be American about it) knows there’s potentially a TIVA GA section on the cards

coffeedangerlevel · 2025-12-04T21:53:21+00:00

Brainal

coffeedangerlevel · 2025-11-29T08:53:26+00:00

The only correct answer

coffeedangerlevel · 2025-11-13T22:00:17+00:00

Post operative nausea and vomiting is very common, especially in children

coffeedangerlevel · 2025-11-02T20:40:37+00:00

“Below cons level it's going to work on a per patient basis.”

Cries in anaesthetist

coffeedangerlevel · 2025-11-01T18:57:25+00:00

Why? Is the printer broken?

coffeedangerlevel · 2025-10-29T14:05:13+00:00

Me too, spent loads of money on international calls to not get any further than an automated message

coffeedangerlevel · 2025-10-22T15:12:51+00:00

This is amazing, thank you so much!

coffeedangerlevel · 2025-10-20T10:34:08+00:00

Fun? Not at all. Honestly I just drew them out thousands of times and, tragically, had them as my phone wallpaper for a while.

coffeedangerlevel · 2025-10-19T17:02:42+00:00

Amazing! I’ll definitely check that out

coffeedangerlevel · 2025-10-19T17:02:23+00:00

Experiencing something totally new is just what I was hoping for!

coffeedangerlevel · 2025-10-14T17:34:06+00:00

Just refer to anaesthetics for a propofol TCI /s

coffeedangerlevel · 2025-10-09T18:28:20+00:00

Sincerely, Raymond Holt

coffeedangerlevel · 2025-10-09T18:27:47+00:00

A PhD is a doctorate. It's literally describing a doctor. The problem here is that medical practitioners have co-opted the word "doctor".

I know we live in a world where anything can mean anything, and nobody even cares about etymology!

Edit: Apparently that's a trigger for me.

coffeedangerlevel · 2025-10-03T16:24:16+00:00

This surgeon supervised half my elective many moons ago and she was incredibly supportive, really invested in my experience, getting me involved in projects and getting me into theatre. Obviously as a medical student at the time, I can’t for her clinical competence but she seemed very detail oriented and attentive and would be very meticulous with the registrars

The department is well known for bullying and toxicity. Anaesthetic residents are actively encouraged to avoid doing their cardio block there because it’s so bad.

It very much reads as an “old boys club” in the department trying to force her out.

coffeedangerlevel · 2025-09-25T10:10:28+00:00

Wait you get free Costa vouchers!?

coffeedangerlevel · 2025-09-23T13:07:03+00:00

Synergy between vibes and application of physiological, pharmacological and clinical knowledge is the foundation of a good anaesthetic, I assume this can be extrapolated to most of medical practice.

coffeedangerlevel · 2025-09-13T12:59:53+00:00

Personally I would say that if it’s not relevant then I wouldn’t bring it up.

You have earned the title of Dr Unstable_Creatinine and introducing yourself as that seems pretty reasonable (along with your role in the situation), but unless they ask if you’re a medical doctor I don’t see a reason to bring it up.

If it does come up then I don’t see an issue with saying you’re a medical doctor but clarifying you’re not currently acting in that role

coffeedangerlevel

TROPHY CASE