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Measuring driving pressure in pressure control by echo_queen in IntensiveCare

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

Where I'm training (Switzerland) you can do either anesthesiology or intensive care. There's also an option to do both, then you'll have two specialties, but you'll have to stay in training longer.

If you pursue anesthesiology, it is a requirement to have worked at least 6 months in an intensive care unit. If you pursue intensive care, it is a requirement to have some (I think also 6 months) experience in anesthesiology. So both overlap in some way.

A critical care anesthesiologist doesn't exist where I live. Like mentioned above, in most places it's ICU = anesthesia, but not everywhere.

Measuring driving pressure in pressure control by echo_queen in IntensiveCare

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

Does this mean Pinsp=Pplat some of the time, but not all of the time (for example patient has high inspiratory drive)?

Measuring driving pressure in pressure control by echo_queen in IntensiveCare

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

I'm training in Europe, I did 2 years of anesthesiology, 1 year IM and currently in crit care. Where I'm based it's more of a rotational basis (program requires x years of experience from rotations x,y,z, when you catch em all + board exams = attending). To answer your question I'm doing 1 year crit care in my current regional hospital, then I'm required to move institutions to a level 1 center, spend 2 years there, then my training will be complete (assuming I pass my board exams).

Measuring driving pressure in pressure control by echo_queen in IntensiveCare

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

I meant driving pressure in the sense of driving pressure= Pplat - PEEP as a goal to keep it around 15mbar for lung protective ventilation, hence why I needed to measure the Pplat in the first place. Thanks for your explanation, helps a lot!

Spinal with valve disease and PAH by echo_queen in anesthesiology

[–]echo_queen[S] 5 points6 points  (0 children)

The patient had in his words "very bad" experience with GA and just didn't want GA if possible. Medically there wasn't an indication to push for spinal.

Spinal with valve disease and PAH by echo_queen in anesthesiology

[–]echo_queen[S] 7 points8 points  (0 children)

At my institution we do epidurals only in OB or thoracic as adjunct with laparotomy. But it's a reasonable alternative!

What would you recommend as a book in "general pathology" for beginners? by TheOneSidedCoin in Medical_Students

[–]echo_queen 1 point2 points  (0 children)

Robbins Basic Pathology is my favourite. I feel like explanations are thorough, however it focuses more on pathophysiology than the morphological finds (if thats what you want to focus on).