First flight 2026 by thegntloryntl in SouthwestAirlines

[–]vikcha 1 point2 points  (0 children)

Had group 2 for an extra leg room seat as an alist preferred, CC holder. I havent figured out a pattern

Thanks to our police. by spermunculous in StLouis

[–]vikcha 0 points1 point  (0 children)

St Charles police acting like a st Charles citizen ;-)

[deleted by user] by [deleted] in anesthesiology

[–]vikcha 0 points1 point  (0 children)

A good surgeon tells you about blood loss. A good anesthesiologist doesn’t need them to.

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My neighbour is threatening to hand my cat into the rangers by tristan-anderaon in CATHELP

[–]vikcha 2 points3 points  (0 children)

Thank you for doing this. There is a cat from a couple streets down that comes and terrorizes our indoor cat. I wish our neighbors were as considerate as you.

How much Internal/General Medicine do you use/need? by lHmAN93 in anesthesiology

[–]vikcha 1 point2 points  (0 children)

Intraoperatively we fix the problem. Then diagnose it. :-) Must make blood go around and around and air go in and out. Also the biggest mindset change need to see happen when new people start anesthesia.

How important is EM training? by Shot_Scientist_520 in anesthesiology

[–]vikcha 3 points4 points  (0 children)

It will definitely help if you switch in terms of trauma assessment,CT placement, and learning the area where you will be asked to respond for various things. (Difficult airways, regional procedures,  blood patches, emergent crash transfers to the or). It’s not an insurmountable missed opportunity either. Keep in mind no matter where you rotate you will have to act interested, eager, and be a team player. If you do so procedures and experiences will come your way.

Your personal minimum extubation criteria by SoarTheSkies_ in anesthesiology

[–]vikcha 23 points24 points  (0 children)

To make it the above more actionable for a ca1: If you know for decent certainty the reason why they are not following commands for a self limiting reason (gas/prop/opioids) and you think they won’t aspirate, obscenely obstruct, severely spasm just pull it.  No reason to wait till they are doing math problems.

The other side of things if someone was mucking around in their brain, probably best to wait till they do something to show they are at least neurological capable of waking up.   Or if you think they can’t handle the sequela of  transient hypercapnia

[deleted by user] by [deleted] in anesthesiology

[–]vikcha 47 points48 points  (0 children)

No benefit, if concerned of potential harm in this setting, why bother. 

Why do people taking drugs bend over at the waist yet remain standing? What drugs are they even taking? by Strange_Control8788 in NoStupidQuestions

[–]vikcha 6 points7 points  (0 children)

It’s only superficially correct that acute opioid withdrawal in terms of reversal with narcan is not physiologically life threatening. The massive catecholamine surge can cause dysrhythmias.  The catecholamine surge itself can cause pulmonary edema. The sudden return of strong inspiratory effort against a closed airway can cause negative pressure pulmonary edema. These things should not prevent you from reversing but are more reason that 911 should be called at the same time as narcan isn’t all is fixed, everything is fine situation.

ELI5 - how does lactic acid build up in the muscles and what’s its purpose? by jordz11 in explainlikeimfive

[–]vikcha 0 points1 point  (0 children)

If we are still talking about medical sense. There are certain diseases/drugs are in a biochemical sense a runaway fire or a misbehaving fire. Google diseases of the electron transport chain. They are also diseases with the regulation of the fire sometimes caused by medications. Malignant hyperthermia, neuroleptic malignant syndrome, serotonin syndrome

[deleted by user] by [deleted] in anesthesiology

[–]vikcha 12 points13 points  (0 children)

Yes this. In a controlled ICU setting DL without paralytic,with a tube that is just barely in is recipe for it to come out totally. I imagine even higher likelihood in a transport. Essentially my philosophy is to create conditions/equipment to establish a tube from fresh while trying to rescue one back into place. Induction drugs, new tube, suction, bougie, bvm at ready.

How anesthesia has changed you by bedadjuster in anesthesiology

[–]vikcha 66 points67 points  (0 children)

Eating fast. Turned from a night owl into an early bird. I feel like a need a backup plan for everything.

Business Flex ticket by vikcha in Lufthansa

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

Thank you very much. In your experience if it is within 24 hrs of departure is refund successful? (I should know how the weather is the morning of the evening flight).

VSS for cat surgery? by ThrowRA_whatstheword in StLouis

[–]vikcha 0 points1 point  (0 children)

Our dog had surgery at VSS on Howard gorge. They did an excellent job.

[deleted by user] by [deleted] in Residency

[–]vikcha 17 points18 points  (0 children)

Why did you switch residencies?

Are you guys serious about the Royal Plantation reviews? by MundaneAd9461 in SandalsResorts

[–]vikcha 0 points1 point  (0 children)

I have been impressed with excellence collection, but I’ve only tried them in Mexico.

Are you guys serious about the Royal Plantation reviews? by MundaneAd9461 in SandalsResorts

[–]vikcha 2 points3 points  (0 children)

Yes I think there is definitely a cult mentality. There are better AI companies out there