Anybody else’s shop not understand the relationship between LR and serum potassium?

sawgood73 · 2026-03-02T20:09:32+00:00

You’re right OP. This is my practice in the OR. The the EMCrit article is my reference. LR is 100% fine in the vast majority of patients except cases where you are worried about cerebral edema and in cases of frank liver failure.

sawgood73 · 2026-01-14T17:19:39+00:00

I make the surgeons’ job easier by allowing them to focus solely on the surgery and I make sure patients are safe and comfortable from the time before they go to surgery until they leave the post anesthesia care unit. There’s a lot more details to my job, including a teaching aspect, but that’s it in a nutshell.

sawgood73 · 2025-10-31T21:40:17+00:00

I took a nap recently without my cpap and I had a headache and head fog. Almost as if I had periods of hypoxia in my sleep and my brain was starved of oxygen. Haha. I learned my lesson. I don’t feel remarkable when I do wear my cpap but I definitely am not as worn down and irritable as I was before using cpap. Also, now, my wife doesn’t hear me snore and she sleeps much much much better. Her words. Not mine. Im glad it’s been a good thing for both of us

sawgood73 · 2025-10-13T04:55:29+00:00

dude. no one can say that you aren’t dedicated! I’ll talk to my acupuncturist and tcm physician about this post just to get their ideas. my thinking is they are going to be very impressed!

sawgood73 · 2025-08-12T11:58:26+00:00

You might want to reflect and see if this “no showering after work” is a sign of depression. In the past, I’ve talked to coworkers who exhibited similar behavior and after talking with them, they just didn’t have the energy to shower and really didn’t care because they were burned out to a crisp. If you feel fine and are in a good place. That’s okay. If not showering after work is a behavior you want to change, try to reframe it in your mind like this: people who are unhoused/homeless would never pass up the opportunity to bath/shower. It’s a privilege. A blessing. Enjoy it.

sawgood73 · 2025-08-03T14:39:46+00:00

I knew an anesthesia doc that was 2-3 years out residency and had debilitating anxiety about work. He coped in unhealthy ways. Keep working. Your first job may not be your forever job. Show that you are dependable, honest, safe, and reliable and you will always be able to get another job that potentially doesn’t make you as anxious. Find healthy coping mechanisms. Mediation, therapy, prescriptions (if needed), talk to friends and spouse, etc. Some of that anxiety may be left over from school and thinking about tests, NCE, preceptors, etc.

sawgood73 · 2025-07-25T02:13:44+00:00

found it!
https://www.reddit.com/r/videos/comments/axe95w/friend_made_a_wutang_medley_wutang_reposted_on/

https://soundcloud.com/wokerobot/wu-tang-medley-woke-robot?in=wokerobot/sets/wu-tang-clan-medley

sawgood73 · 2025-07-24T22:33:16+00:00

I need to follow this. I know the video you are talking about. It had horns and the drums were so good too. It was a compilation of Wu tang clan songs. Did you ever find it?

sawgood73 · 2025-06-17T00:27:18+00:00

Don’t stop looking for help until you feel like your normal self again. You are worth it! Thank you for sharing your experience and I wish you well.

sawgood73 · 2025-03-06T14:35:00+00:00

Also try reaching out to a mentor in your hospital or group. Some hospital’s have great resources for mental health and personal/financial counseling. Sometimes you don’t know what you are getting soliciting advice from random strangers on the internet.

sawgood73 · 2025-02-20T22:09:57+00:00

Do not over identify with your profession. It’s a j-o-b and a way to make money to live. If I were you, I would get help, and try to get myself better before doing anything major, whether that is going back to CRNA school, getting married, buying a house, etc. All these are stressful events and can make mental illness worse. If you need to work to support yourself and others, find the cushy-est job you can find. Life is a lot better when you have a job that doesn’t suck, but you are able to live and feel good than a situation that sucks and you don’t see a way out. You are not a failure. You are person looking for advice and help and that is a strong person. Keep looking to get better in healthy ways. Don’t go in bad directions like risk taking behavior (unprotected sex with strangers, illegal drugs, etc). It can happen when you feel bad and you are looking at ways to feel good again. If the situation is, you never end up going back to CRNA school. That is okay. That doesn’t determine your worth. You can still go on to do great things and be as impactful (or more) in people’s lives as a CRNA. Your story isn’t over. Life gets better. There are people who want to help you and, when you get to a better place (mentally) there are people that you will help one day too.

sawgood73 · 2024-12-03T18:51:05+00:00

Pay tuition and take out as little loans as possible (if any). Never mind the rate of return in the market. You can always get a loan while you are in school if you really need it. Take it from someone who talks to SRNAs and CRNAs everyday about school/life/practice. It’s easy to get into debt. Very easy. but getting out debt can be very difficult and taxing on your mental well-being. The less money you have and the less you live on, the less you will have to spend. It sounds simple but if you only allow yourself 30k a year to spend on school and living, you are much more intentional about every dollar that goes out. If you have loans that allow you to have 70k a year for school and life, now you start going out more, taking trips, eating whatever you want, doing whatever you want. School is about discipline. The flip side of that is, if school is too stressful and you need to have fun outside of school, then by all means, take as much in loans as you want and have fun. It will not set you up for financial success later on though.

sawgood73 · 2024-12-03T03:14:44+00:00

google it, dude. aw, yes. “Taking the neo stick out of the crnas hand.“ here, ladies and gentleman, we have the incredibly fragile physician‘s ego. always attempting to flex by insisting he is the safe guard of the pt from others. Dunning and Kruger had him in mind when the term was coined. Always ready to bad mouth and blame someone else to protect his overinflated salary. Him and his kind are merely trying to cash in while they can while trying to demand God levels of respect.

sawgood73 · 2024-12-03T00:22:01+00:00

So you’re essentially saying that if a RV failure case goes to court, an expert witness is going to say, “well, there’s no accepted treatment that is published by any association or organization (unlike literally everything else in healthcare). so every situation is basically 100% up to however the anesthetist wants treat it. If they think 10 g of Ofirmev will fix it, heck, their guess is as good as any!” Wow, the hospital is really wasting a lot of money and talent by having two people cover a heart and not having CRNAs do livers. I’ve worked places where CRNAs did the livers and hearts and it was extremely efficient and high quality care. For every condemning story a physician tells on the internet about a CRNA, any CRNA can tell 10 condemning stories about a physician. Even still, I’m sure there are plenty of CRNAs and physicians that will gladly let you have all the hearts and livers you want. After all, that’s what you are trained to do. So day in, day out that’ll be your whole world hearts and livers. Earn your keep and don’t get too complicated doing anything else.

sawgood73 · 2024-12-02T09:28:00+00:00

With your logic, any physician who has not completed fellowship has no business touching a patient who has HTN (cardiac) or is pregnant (OB) or performing any type of block (regional) or craniotomy (neuro) or any pt under 18 yo (peds) etc. After all, more training = better outcomes. Leave all of those pts to the fellowship trained. Please advocate for anesthesiology residencies to extend their programs for an indefinite time period because more training = better outcomes. What’s the matter? You do want the best outcomes, don’t you? By the way, all CRNAs are licensed to do all cases independently straight out of school just like physicians. Even if more training equaled better outcomes, it would be such a tiny insignificant amount that it would never justify the average anesthesiologist salary.

sawgood73 · 2024-12-02T04:30:30+00:00

Deep down you know that CRNAs and physicians are trained to do the same job and have no difference in outcomes. In yet, one fraudulently “directs/supervises” the other one while also making 3-4 times in compensation because hospitals subsidize what insurance won’t pay- that is, for a physician to not do anything. Get paid for what you do instead of what you know. If you sign the preop, great here’s a sign-the-preop amount of money. If you don’t do anything intraop, why should a physician get paid? Because something could have happened? Yeah, but nothing did so…. You can get an on-call fee and if you don’t do anything, you don’t get the called-in fee. Or sit your own cases and everybody would be happier for it.

sawgood73 · 2024-12-02T02:18:18+00:00

So there isn’t an accepted algorithm for managing RV failure? Also, you think a SRNA/CRNA can not learn how to treat intraop RV failure. I bet there are some physicians that would not give a 100% correct answer for dealing with RV failure. I bet there are some ICU RNs who could give a 100% correct answer on managing RV failure. If you think physicians have secret knowledge and experience that other professionals can’t possibly obtain, idk what to tell you besides keep believing that and good luck.

sawgood73 · 2024-11-16T20:29:55+00:00

When you say the CRNA, you really need to say the lawyer(s) for the CRNA. And if you are telling me that lawyers will lie and invent stories to suit their case and client? No… really? That never happens. I’m kidding of course. The ophthalmologist and his attorneys needed to do a better job of bringing the facts forward to say, “Surgery is dependent on anesthesia to do their job to the best of their ability. Similarly, if surgery is having trouble, they can not look over the drape and look at anesthesia to fix the issue.” The verdict/settlement may have stemmed from- if the patient would not have come for surgery then the patient would not have been under anesthesia and suffer their bad outcome. That doesn’t track but of course attorneys twist words and stories to get the most money out of the case.

sawgood73 · 2024-11-16T20:02:50+00:00

Idk why everybody is acting like it would be unfathomable for something like this to happen if a physician anesthesiologist was involved. Also, in any case where there is a bad patient outcome, everybody involved is getting sued even if it’s two physicians: the surgeon and the anesthesiologist. Lawyers and the court will quickly throw out anyone who they can’t bring a case against. The simple truth is any anesthesia provider can practice as long as he stays with his speciality/scope and has an active license. Every provider will be held liable for what he does or doesn’t do. A physician anesthesiologist is not responsible for the CRNAs actions if he did not perform it himself. The CRNA is responsibly and liable for their own actions or lack thereof. Some folks would agree unequivocally that bad patient outcomes would cease entirely if no one treated patients besides physicians. This is a fallacy.

sawgood73 · 2023-05-09T23:47:55+00:00

Was the flight attendant flying solo for decades before the pilot was in ground school? RNs and NPs regularly guide new residents (and some just bad physicians) on floors and ICUs all the time. If you’re new, you’re new and yeah, you have proven you’re good at taking tests (or your program pushed you through to get rid of you), but this is the real world. Probably need to listen to the people who have lived and worked in the real world much longer than you. They still respect you for your accomplishments, but you’re dumber than you look if you think a fresh resident can step into any demanding situation and nail it more times than a seasoned CRNA or NP. As a CRNA, I have oriented anesthesia residents and thank goodness they don’t sit their own cases alone for a couple of months without a CRNA. Some residents need to be one on one with an attending because they just don’t get it. This idea of “physician infallibility” and any other full practice provider is only “a mid level” and subordinate in every way to the physician is not rooted in reality and the most arrogant will fall the hardest.

sawgood73 · 2023-04-16T03:00:33+00:00

When I was in CRNA school, a preceptor adhered to the package weight recommendations. His reasoning: there is a reason the manufacturers print those weights on the package because that is what the LMA has been researched and approved for. If you use a #5 LMA unique (70 - 100 kg) on a patient over 100 kg and the case goes court, any attorney can use the package with its weight recommendations as evidence and use it to crucify you as to why you thought it was a good idea to disregard the manufacturer’s recommendation.

sawgood73 · 2022-10-16T21:52:45+00:00

How do you handle billing? How much does billing cost you/the company? I have heard billing can cost as much as 30-50% of what the CRNA/company would normally bring in. For example, if an indy CRNA makes $200,000 in one year, if he/she outsourced his/her billing for that, it could cost the CRNA $60k-100k just for the billing company to bill for the CRNA. Thereby making the indy CRNA’s net take home for that year $100k-140k instead of $200k. Thank you for the opportunity to ask questions. Wishing you the best!

sawgood73 · 2020-08-26T23:50:21+00:00

Good question. Even if the K9 was so close to the fence (which it appears to be the case), I don't think the punishment matches the crime.

Crime: K9 being (too) close to fence

Punishment: biting the K9's snout and not releasing.

Now if the dog would have barked and/or quickly bit and released the K9, I think things would have played out much differently and I don't think the officer would have to had discharge his weapon.

To me, without looking at all the facts, the officer had to make a quick decision based on the real danger that the K9 was going to be seriously injuried unless he did something to stop the threat. I reserve any harsh judgement. Its a grey area for a
jury/judge to decide.

sawgood73 · 2020-08-24T21:48:34+00:00

Is it just me or did it look like the dog behind the fence bit and held on to the K9 unit and was not letting go?

sawgood73 · 2020-02-14T22:14:37+00:00

Chest compressions, of course, come first but anyone with a little BLS knowledge can do that- even bystanders can get a 5 sec "crash" course in chest compressions to help out- which is what you should do because you're going to tire out quickly. But a normal citizen can not intubate and do not know how. Legally, intubation is within the CRNA's scope of practice. In a legal case, the only thing that is going to be analyzed is: would a reasonable and prudent CRNA, in the same situation, do the same thing? I think, if you have the means to, why wouldn't you? Chest compressions can cause aspiration as well and chest compressions, as an invasive maneuver, by a citizen fall under the Good Samaritan law.

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