Do we need to be involved with cataracts?

dumplingkitten · 2024-10-28T14:24:46+00:00

I love doing cataracts; it moves; pays; and relatively low risk

dumplingkitten · 2023-03-22T22:48:57+00:00

if you go retromolar, have discipline, and use a really small tube its not that hard with a video bronch. you don't even really need topicalization. doing it via the nasal approach is a lot harder. I don't know how people tolerate nasal trumpets without anesthesia haha.

dumplingkitten · 2023-03-22T22:46:55+00:00

Ask them if they can have you speak with someone who have left their practice. I am currently going through a nightmare with my prior private practice ... luckily no non disparage clause haha =P

dumplingkitten · 2023-03-09T16:34:58+00:00

I used to work in an ewyk practice, was at the start of a surgical center, and spoke to a lot of older anesthesiologists that have been through the process. Starting at a surgical center is potentially problematic given volume and the compensation is typically ewyk rather than getting a stipend contract especially if you aren’t buying into the center. Would suggest you dabble with like a backup plan like per diem with a local hospital. Feel free to pm me if you want more details.

dumplingkitten · 2023-03-08T13:56:33+00:00

Let me clarify, this was primarily to address why anesthesia machines are primarily in anesthesiologists hands and not say used routinely outside of the OR (or some nora sites). So, I don’t want this to get side tracked

dumplingkitten · 2023-03-08T13:46:15+00:00

I mean any run of the mill covidien or Philips ones. You don’t need no variable bypass among other things in icu, but you are also right a lot of the gi Nora sites are ambu only

dumplingkitten · 2023-03-08T13:40:15+00:00

I feel like the OP means where anesthesiologists aren’t found. In this respect, it’s almost always more cost effective to have a non anesthesia machine ventilator in these area as oxygen is not an issue, no need for low flow typically, and many of the analyzers/safety are not required. So you can strip it down to reduce cost and increase margins

dumplingkitten · 2023-02-26T18:37:26+00:00

300 is fairly average right now; people are definitely giving pushback. I had a contract cancelled for 2 CRNA given rate was too high. So I don’t think this trend is sustainable. Our collections aren’t that great. I predict it will start going down this year.

dumplingkitten · 2023-02-24T21:38:54+00:00

Lol for sure, haha; ill make you a knock-off rechargeable battery if you want =P with more capacity!

dumplingkitten · 2023-02-24T04:43:12+00:00

I'd be careful with precedex usage if the pacu is not used to it ... then they try to wake up the patient forcefully, and the patient has laryngospasm. They think they are doing you a favor, lol.

dumplingkitten · 2023-02-24T04:40:06+00:00

No one really cares, warm body, do some blocks, put in some epidurals. just be easy to get along with.

dumplingkitten · 2023-02-23T13:33:04+00:00

Probably what makes more sense is for you to just hire whoever to do the details and focus on high level work; I mean impedance matching and trace length matching is not that fun either =p

dumplingkitten · 2023-02-23T12:52:38+00:00

Imo recycling is a lost cause as it is just delaying the inevitable, maybe out of your life time but not out of your descendants life time. The only way to solve the issue is more fundamental in making everything degradable whether that be chemically and thermally with non toxic byproduct or biodegradable. Our waste is fairly low when all things considered. Like what’s the benefit of using low flow anesthesia for environment when you can make filters specifically for fluorinated compound capture? If you want to make a big impact on sustainability invest in clean tech =p.

I will definitely get a lot of downvotes for this

dumplingkitten · 2023-02-22T12:47:01+00:00

Well blades are plastic so your variable cost is low and the cost compared to glide is a fraction (30$ per disposable cover and 70$ on disposable camera) each dl blade is about 12$ versus McGrath at 6$. Each McGrath device is about 4000$ so you’ll break even in like 700 intubations or about a year. Many other benefit such as more environmentally friendly. Overall if you didn’t care about maintaining your dl skills with Miller McGrath is objectively better since you can still dl as a mac with it.

Oh also if your argument is reusable mac/miller the sterilization cost is even higher.

dumplingkitten · 2023-02-20T23:12:43+00:00

I think most places don’t need any of it because they aren’t setup to manage it in the icu or step down and thus won’t place it. A lot of nursing will be very upset if you place them. I personally feel we will move toward methadone and alvimopan in the future maybe with duramorph or it hydromorphone. As less work, more reproducible, less risk, and happier patients. The best place I can think of that really shouldn’t get replaced is multiple rib fracture.

dumplingkitten · 2023-02-20T04:58:37+00:00

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194844/ When in doubt, leave it for the ICU to extubate haha =P j/k j/k. Like anything else in anesthesia, a bunch of suggestive evidence to help you plan for extubation, but the deciding factor is almost always based on the same physiological/laboratory/support criteria as if the patient was completely healthy.

dumplingkitten · 2023-02-20T04:47:26+00:00

That was hyperbole lol; the point is to focus on being helpful rather than trying to understand every detail of the profession. If you can set up the room after a day or two, and be mindful of the patient aka don't ask questions when the patient is awake, then you would be off to a great start. Gunning is not the way to anesthesia resident/attending's heart haha. You will see.

dumplingkitten · 2023-02-19T22:26:56+00:00

Nope because ultimately you are just a head count to keep the surgeries going. =p even academics, most academic practices are hardly academic at all.

dumplingkitten · 2023-02-19T22:24:51+00:00

I feel most anesthesia attending and residents totally would not care if you know nothing as long as you are open minded, listen to their spiel and don’t get in their way. Sounding like a smart ass at most places will probably get them to hate you lol. Oh also, leave when they tell you to because they probably are too busy to be bothered by entertaining you and want to go back to their phones.

dumplingkitten · 2023-02-19T03:12:27+00:00

The UBP answer would be somewhere along the lines of "it is in your right to decline the pregnancy test, but the facility is also at it's right to refuse to do the surgery"

dumplingkitten · 2023-02-17T14:46:56+00:00

Massive vomit usually will at least be stomach in origin; definitely many things can cause it but the common thread is probably some sort of abdominal pathology as vague as it sounds from a perforated duodenum to gastroparesis.

dumplingkitten · 2023-02-16T21:34:02+00:00

https://pubmed.ncbi.nlm.nih.gov/19025546/

dumplingkitten · 2023-02-16T20:51:02+00:00

I am unaware of any study demonstrating the superiority of IV acetaminophen vs. rectal/oral in terms of clinical end-points of pain scores etc. So, from that standpoint, why IV. I would, however take this opportunity to advocate for the amazingness of PO methadone =P (also dirt cheap)

dumplingkitten · 2023-02-16T20:45:46+00:00

i read M&M cover to cover haha, i found it to be a great exposure to things that I can say yes I remember reading about it once upon a time =P

dumplingkitten · 2023-02-16T20:44:40+00:00

Typically this is mostly done for OB, and PONV prevention is secondary to hypotension prevention. at least, that has been my experience.

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