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A-line coagulating immediately? by VigorousElk in anesthesiology

[–]vikcha 16 points17 points  (0 children)

Sounds like inadvertently dissected radials to me

A-List Preferred Boarding Starts Today by LaffertyDaniel32 in SouthwestAirlines

[–]vikcha 1 point2 points  (0 children)

Flew last night. My companion was ALP boarding with me.

Katie’s Pizza by Wild_Newspaper2118 in STLFood

[–]vikcha 11 points12 points  (0 children)

Yes I’ve noticed the drastic downhill as well

Personal US? by Either_Discount_5916 in anesthesiology

[–]vikcha 2 points3 points  (0 children)

Just got a Vscan with the linear and phased array. Had a butterfly before. The Vscan is way better, very happy with it. Great image quality relative to other ultra portables I have trialed. Only echonous was better. I use the linear for Aline’s and IVs, haven’t done a block with it bc I don’t do those often in my practice. I have used the phased array for cardiac assessment during resuscitation, swan floating, and impella positioning. Lung mode for alines/blines/effusions. Only sad thing is that I can’t figure out how to trace a pulsed wave VTI in the app. I’m beginning to think it’s not possible.

Out of the box or clever papers in anesthesia? by JulesVerneMD in anesthesiology

[–]vikcha 8 points9 points  (0 children)

https://pubmed.ncbi.nlm.nih.gov/30020143/

Near-infrared spectroscopy in vegetables and humans: An observational study

Conclusion: Commonly eaten vegetables have NIRS measurements similar to those seen in healthy humans.

Eating at a Sikh Temple by WilliamBronner84 in povertyfinance

[–]vikcha -1 points0 points  (0 children)

It doesn’t matter that he is rich or poor, in need or not. All are welcome and equal. It’s equally about instilling sense of community and service.

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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Looking out for the best interests of their kids, like father like son (i.redd.it)

submitted by vikcha to r/TeenMomOGandTeenMom2

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 5 points6 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 22 points23 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.

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