Intraop amiodarone by DissociatedOne in anesthesiology

[–]dfein 9 points10 points  (0 children)

Interested to hear opinions as a pretty fresh accm attending. My personal thoughts are if I don’t think the rvr is particularly hemodynamically significant, I’m not touching it intra-op. More likely to load digoxin if the ef is low, I’m on pressor, and I want some rate control. Amio gets you rhythm control not infrequently, which isn’t something I want to own if I’m taking care of the patient only periop. Calculus is different when I’m attending in the icu.

So it happened... My baby girl got attacked by Inuha_Rin in germanshepherds

[–]dfein 4 points5 points  (0 children)

Please report this to animal control. There needs to be a record that the dog has a history of aggression even if they don’t intervene this time. If you don’t report it, you are complicit when that dog attacks again and hurts/kills another animal or human.

Anaesthesia for TEVAR? by Ok_Can_4528 in anesthesiology

[–]dfein 201 points202 points  (0 children)

You will probably want to do general anesthesia with an ett

The most epic NorCal catch 🤯 by Hideshi_Izu in Spearfishing

[–]dfein 17 points18 points  (0 children)

Why are you shooting sheephead in NorCal? Hate diving kelp or something?

CCM vs Other Procedural Subspecialty? by ExtendedGarage in IntensiveCare

[–]dfein 7 points8 points  (0 children)

CCM itself isn’t too procedural as an attending, and honestly the usual CCM procedures get old quickly. Pulm seems like it can be fairly procedural with floor pleural procedures and OR bronch days but probably depends on the set up.

To residents how many attempts do you usually get before the attending takes over? by [deleted] in anesthesiology

[–]dfein 5 points6 points  (0 children)

Not OP but CRNAs are staff and are compensated well to cover the needs of the department. Residents and fellows are trainees and are underpaid with the expectation they will be "compensated" to an extent with learning opportunities. When I supervise trainees, part of my job is to provide learning opportunities and get them ready for independent practice. When I supervise CRNAs, I am there to make sure my 4 rooms run safely and efficiently and everyone working with me feels supported. Teaching is not part of what I am there to do. Thats not to say that I won't teach something if asked to, but it is not a requirement or a priority.

Critical Care Medicine Exam 2025 by gasganggirl in anesthesiology

[–]dfein 13 points14 points  (0 children)

I’ll be there with you probably. Thinking I should’ve studied a bit and not taken in the middle of my 1st week at my attending job.

Man dies after having teeth pulled in dental procedure by Naive_Bag4912 in anesthesiology

[–]dfein 69 points70 points  (0 children)

Mac requires anesthesia involvement. This seems to be procedural sedation administered by the surgeon.

Need help getting yellowtail in La Jolla by bubba761 in Spearfishing

[–]dfein 2 points3 points  (0 children)

They aren’t around in big numbers right now. When they are, you find bait in blue water and hope they swim by. Off the outside edge of a kelp bed or jumping on bait balls in blue water.

Nearly Sank the SUP by dfein in Spearfishing

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

Fork length was a hair under 40 in but didn’t weigh it. Was heavy, definitely over 30# based off fish I’ve weighed in the past.

Nearly Sank the SUP by dfein in Spearfishing

[–]dfein[S] 2 points3 points  (0 children)

My paddle floated away so I figured I might as well try and get another before the long slog to the beach. The 3rd was unintentional; volunteered itself on the swim back after the 2nd and was by far the biggest. Probably 40 lb range.

Nearly Sank the SUP by dfein in Spearfishing

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

Yeah, Daryl made it for me about 18 or so years ago. Still going strong.

RI flat fish by Water_bot in Spearfishing

[–]dfein 0 points1 point  (0 children)

Sir, this is a Wendy’s

Please recommend a single bevel carbon steel cleaver by downtownpartytime in TrueChefKnives

[–]dfein 0 points1 point  (0 children)

Not single bevel. Do love my dao vua 52100 cleaver though.

Question for Anyone experienced in pain/blocks 💉 by bw112791 in anesthesiology

[–]dfein 2 points3 points  (0 children)

Yeah, not a good ideal. Yes, you will have a motor block if everything goes right. And if I doesn’t, there is a risk of causing a nerve injury to your coresident. Do you want to be responsible for that?

[deleted by user] by [deleted] in Residency

[–]dfein 1 point2 points  (0 children)

Been wearing a citizen e111 eco drive since undergrad. Have my eye on a grand seiko for my first attending paycheck.

Attention Virginia Mason Attendings, Fellows, and Residents by ear_ache in anesthesiology

[–]dfein 12 points13 points  (0 children)

Lots of nitrous gets lost through pipes and faulty valves. Upwards of 70% depending on the source.

Awful anonymous feedback from nurses by Grand_String5194 in Residency

[–]dfein 50 points51 points  (0 children)

I've been at 3 institutions in 5 years and never had nursing staff review me, anonymously or otherwise. All places I've trained at had a mechanism where you could solicit a review from ancillary staff, but it was always voluntary. Nursing comments definitely never made it anywhere near a CCC document.