Recent content by psychbender

As an aside regarding poorly functioning rocuronium, I am convinced that it is a function of how long its left out of the fridge here. From what I recall reading through the product insert many years ago during a long flap case as a resident, the effectiveness decreases measurably when left out...

Did it as a CA2 to a teen who was a heart transplant recipient, in for some minor-ish procedure. Went, "hey, the heart is chemically denervated, he won't get bradycardic..." *whistles innocently away from the PACU*

I vacationed in a very nice double-wide trailer at the lake last year. Aside from the ****ty water pressure, it was actual really fun, and cheaper than the larger houses we've rented there in the past. I vacationed in a very nice double-wide trailer at the lake last year. Aside from the ****ty...

My wife was reading over my shoulder, and just decided that you're my spirit animal, man.

I'll add that to the reasons I'm glad I gave up call.

Any start time before 7am is pure bull****. As for the actual question, I generally roll in 0630-0645ish for consistency (ICU handoff starts at 0645). OR starts are typically 0715 or 0730. I'll stroll in, leisurely set up, consent, line/block my patient, then bull**** with colleagues until the...

Yeah, no, we don't deal with that bull****. Speech and nursing tell me their recs or what they need, I say fine, they put the modified order in, and I sign it eventually. Restraint renewals are entered automatically, and I cosign. If RT cannot find the artery, I ask them to phone a friend (and...

I stand corrected. Looks more like an acute respiratory process, then. BMP doesn't jive with chronic CO2 retention. Odd that she would be as described, awake and breathing comfortably on the vent. Adjust PSV, treat possible COPD (albuterol, methylpred vs dexamethasone) trend gases. To ICU tubed...

Often, the greatest determinant is the nursing and intensivist. Some like to run out the clock and have a quiet shift, extubating right before 6hrs, regardless of the anesthetic. Without a concerted push to earlier extubations, how anesthetic choices affect this will be lost in the weeds.

Ok, I have to ask, why did you check a blood gas in a patient with good respiratory mechanics, who was awake and oxygenating well? They are awake... and showing that they can mechanically breath well enough through a tube. Take the damn tube. I may have missed it skimming through all the...

Just squirt it down the tube, enough will get down at usual flows, even without the nebulizer. Won't be too useful in awake patients without the nebulizer components, though.

Albuterol bullet for nebulizer. What's the issue?

My experience is quite a bit out of date by this point (close to a decade ago now), but I recall Vandy really beat the **** out of you with regards to work hours. I had the PD send me a schedule for the month I interviewed. Assuming 0 minutes for signout, fellows still were coming up against...

As an intensivist, that's quite frustrating. When I came to my current shop, I was quite aggressive, and able to get nursing buy-in (by being very involved in all aspects of care, and charming when doing what I wanted, rather than be an dingus). As a result, our average time to extubation was...

Ooooor, they could just get the patient breathing and extubated that much sooner. Often, if patients are getting a little fidgety, flipping them to PSV gets them to calm back down, so the nurse can finish the initial charting.