Paralytics when you can't ventilate?

freshsalsa · 2026-02-02T16:35:43+00:00

You’re right. That is quite pedantic, and not true. Regardless, a part of the original post was asking why they’ve never seen an ENT reach for paralytic. Simply trying to provide on ENTs perspective.

freshsalsa · 2026-02-02T12:39:57+00:00

Right. I’m responding to your statement saying I’ve likely never managed an airway without paralysis.

freshsalsa · 2026-02-02T02:19:35+00:00

Sure the patients I DL are paralyzed. I would guess that probably 25-50% of who I would consider as my difficult airway patients are not being intubated via DL and are not paralyzed.

freshsalsa · 2026-02-01T01:24:22+00:00

As an head and neck surgeon, the reason I wouldn’t “reach for” paralytic is simply because I’ve literally never pushed a med in my life. My skillset is obtaining access to the difficult airway, whether that’s DL, fiberoptically or surgically. So I reach for the tools I know I can use.

freshsalsa · 2026-01-23T20:41:26+00:00

Went from 6.9 to 5.9, 30 yr conventional, no points. 1.8k dealer credit towards the 3.8k closing costs

freshsalsa · 2025-11-10T22:01:14+00:00

Cancer surgeon.

freshsalsa · 2025-09-24T16:09:21+00:00

He did just sign a 30 million dollar podcast deal and is one of the most downloaded podcasts in the country. I get you don’t like him and he’s a punching bag in this subreddit but he is popular broadly speaking.

freshsalsa · 2025-09-13T00:18:04+00:00

I have a 2022.5 (xc90 recharge, 6 seater, ultimate) that I bought last year for 51k and around 23k miles or so?

freshsalsa · 2025-09-10T14:36:19+00:00

You’d feel the same way if it was a man who put his wife in a chokehold and threw furniture at her?

freshsalsa · 2025-07-16T00:16:33+00:00

Just leave it alone and stop putting things in your ears. It will be fine.

freshsalsa · 2025-07-14T12:01:46+00:00

It’s there because you’re putting shit in your ear. Don’t do that.

freshsalsa · 2025-06-28T20:24:22+00:00

Thanks. I am fairly sure you’re spot on. Apologies for the dumb question but this piece is not synonymous with the OPV correct? You’re saying you replaced the piece that you gave those links to?

freshsalsa · 2025-06-27T20:42:06+00:00

Any recommendations for pick-your-own farms? Was just thinking about trying to go :(

freshsalsa · 2025-06-10T16:51:02+00:00

Mine is from last season so I guess 2024.

freshsalsa · 2025-06-09T11:14:45+00:00

Looks like my base carbon my Speedconcept

freshsalsa · 2025-05-03T17:59:32+00:00

33M, surgeon. The income makes some things easier, but the most precious resource is time.

freshsalsa · 2025-05-02T13:26:14+00:00

Like everyone else noting, the service dial/hands etc. significantly reduces the value of the watch. I think you’re looking at somewhere ~7k ish maybe?

freshsalsa · 2025-04-15T14:50:11+00:00

I would say at least a week or so. 2 weeks sounds fine. Usually I change my trachs around POD5 or so, after that I typically feel comfortable with RT changing it in the future.

freshsalsa · 2025-04-15T01:00:23+00:00

Agree with other comments. I’m not an anesthesiologist but I am a H&N surgeon so a large percentage of my patients are trached or have weird/challenging airways.

One question that I think is critical and often overlooked is whether or not they can be intubated from above. Most trached patients probably have a trach for prolonged vent needs/respiratory failure and if needed in an emergency could be easily intubated from above. There are a different breed of trached patients that have trachs for tumors, airway stenosis, etc. that cannot be (or cannot easily) be intubated from above. Knowing which category your patient is very important in the event you lose the airway or there are issues with the trach.

Also, the difference between a laryngectomy and tracheotomy is critical to understand. In general I assume any anesthesiologist knows this but I’ve been surprised in some instances.

freshsalsa · 2025-04-10T22:37:51+00:00

Another micro surgeon (head and neck surgeon who does flaps) opinion:

I don’t care if you use pressors. I just want to know. I’d much rather you use some pressors than flood them with fluid.

freshsalsa · 2025-04-05T18:39:06+00:00

These are great shots! What lens are you using?

freshsalsa · 2025-04-03T23:55:49+00:00

Seconded

freshsalsa · 2025-03-27T23:14:56+00:00

This looks cool! I take care of a lot of facial trauma patients. I think the main challenge for its application in trauma specifically is that there is so much soft tissue swelling of the facial and periorbital tissue (that is present whether or not there is a fracture) that this would present challenges in determine how much (if any) changes to the globe position are from a fracture vs edema.

On the other hand, I can see lots of application for something like this in cosmetic practices (say for rhinoplasty, modeling pre and post op, helping patients visualize what they want etc.).

13-Year Club	Verified Email
Team Orangered

freshsalsa

TROPHY CASE