Recent content by fakin' the funk

Would it matter if someone aspirated a sip of ginger ale? No, no it would not. Bombs away.

You see where she lives by getting a baseline room air ABG before you go to sleep. Her baseline pH is probably around 7.32-7.35 with a paCO2 around 50-55. The folks on here acting like a pH of 7.15 is no biggie kinda blow my mind. DLCO has nothing to do with ventilation impairment. Your very...

Thanks for the comment. Agree with others that churning is probably not for most folks - either the upside or the enjoyment. Contrast with, in most anesthesia practices you will make $1-2k for something like 2-8hrs of work.

The TJC standard that says this reads: "Peripheral nerve blocks (PNBs) can be used as the primary anesthetic for total knee replacement facilitating faster postoperative recovery than general anesthesia." and cites on this topic a single trial where they did lumbar plexus+ sciatic blocks with...

As pgg said - a purported BENEFIT of INTENTIONAL hypercapnia is definitely different than the known REDUCTION IN HARM associated with PERMISSIVE hypercapnia in severe respiratory failure states where minimizing all forms of VILI is a good.

No. CVC or IO or US peripheral.

The patients pull the catheters. We have a robust system where they call the pump mfr or the surgery dept before calling the anesthesia dept or on call anesthesiologist directly. (The most common question is "can I take my Percocet" YES OF COURSE) Thorough standardized discharge instructions and...

Looking at usually 20-30 charts per week, most of which are ASA2-4 cancer and spine and Ortho/Ortho trauma cases. Calling upcoming patients, coordinating with surgeons and hospitalists and medical consultants for same-day to weeks-ahead cases. Evaluating same-day, next-day upcoming inpatients...

I'm in a practice that is mixed MD/CRNA and we docs are essentially 1:3 when not in a room solo. My sense is that our CRNAs are quite good overall, and there is a high level of mutual respect and professionalism, generally. Typical for our CRNAs to do standard inductions solo. More complicated...

Given that our ERCPs are done nearly prone on septic patients and take 90-120 minutes: nah. Last gig, almost all done with a slight tilt and 20-30 minutes, sure MAC will prob be fine.

Please name one of the "dozens" of etiologies of AF that are you are concerned about in this situation, that would change your management, that are NOT 1) active myocardial ischemia, or 2) severe valvular (TV) disease, neither of which are present. You can't just wave your hands and do a "your...

The atrial rate is 220 and, who cares what the atrial rate is; it can be 500+ in afib. The ventricular rate is acceptable. You can't anesthetize a rumor, and you can't anesthetize a hypothetical scenario of a "2:1 block or worse". What exactly is asymptomatic, rate controlled AF the heralding...

I literally cannot believe how many people want to postpone this case in a CONTROLLED rate arrhythmia, in a patient with NO symptoms, who can easily do > 4 METs. Postpone for WHAT that would change YOUR management? Knowing an etiology wouldn't change your management, and pt being anticoagulated...

It's clears ad lib until 2 hours prior to anesthesia. Sips with meds after that, <30ml.

This is an excellent post.