Recent content by xjohns1

i think doing this adds some risk (how much, who knows) without a defensible benefit to the pt. i would argue a test dose of dilute la+epi is the standard of care for epidural catheterization. not only are you not doing a true test dose before dosing the epidural by touhy, you also are...

yes. i disagree that this would be a cogent argument. i don't mean to be antagonistic, but this is sloppy thinking. you may end up in court or "attacked" with a bad outcome on either the maternal or fetal end. the strategy here is not to throw up your hands and say, 'i'm going to court...

i think this is the most interesting and important question to arise from this discussion: where in the sequence do you require the iv? i think trying to reiterate fundamental guiding principles here is important because there will be great temptation in the moment to deviate from them...

i should clarify: there is a form of a checklist in our procedure note template. it has yes/no check boxes to indicate compliance with the elements of the common central line guidelines: chlorhexidine, hand hygiene, full drape, etc. since it's a procedure note, of course it's usually completed...

our anesthestic of course depends on the indication for the awake crani. for seizure focus excision we give no drugs that suppress seizure activity (no benzos, no propofol). the pt is normally not in pins. we run a dex (0.75 mcg/kg bolus over 10 min then 0.75 mcg/kg/h infusion) and...

you guys are killing me with this. miller, 7th edition, p. 1708: dose (meq)=weight x (140 - Na+) x 0.6 Hall, 3rd ed., p. 171, q. 402 dose of Na+ = body weight x 0.6 x (desired Na+ - current Na+) the 0.6 is fraction of body weight that is total body water, not ecv.

hey! it's nice to hear from a former ucsfer! b.d. was in my class and is now in private practice in the south bay. he's a great guy (we had a great class). i agree with you that icu organization is a very interesting topic. i think the feeling in the division regarding open vs. semi-open...

i'm currently a fellow in critical care through anesthesia in a unique icu setting at ucsf. it is a largely open unit (total over 70 beds) and is a combined medical-surgical unit along with a neurosurgical/neurovascular/neurology unit and a cardiac/cardiothoracic unit. the intensivits and...

the aba answer is wrong. your calculation is correct. the replies to your op that indicate calculation should be based on extracellular fluid are incorrect. the total body water must be used. i looked into this question and the reason one looks at the total body water is because the osmotic...

i think the field is rich with opportunity for research. and, like was mentioned, the best departments will foster broad research, not just the traditional how-do-volatile-agents-work sort of thing (though, this remains important work). some of our most prominent research faculty have major...

i can't quote you a percentage of female anesthesiologist-scientists but they are very much out there. jeanine wiener-kronish is a superb example. she is an anesthesiologist-intensivist, NIH funded, and has interests that are not directly related to or anesthesia. she is now the chairman at...

i think this is a reasonable approach to an airway where there is so much blood or secretions that management is impossible from the proximal airway, i.e., oropharynx, once other blind techniques (lma, combitube, blind oral or nasal intubation) have failed. however, in a case where there is...

my opinion as a ca-3 who has never had to personally resort to an emergency surgical/needle airway (but has heard reports of many attempts by colleagues at my institution during my training) is that what you describe is an important lesson: emergency surgical/needle airways are often highly...

i recently saw a small (could fit in a scrubs pocket) tee handbook that i'm trying to buy. i can't remember anything about the title or author and don't know who owned this one that i saw laying around. i haven't been able to find anything that resembles it with google searches and am...

i am a ca-3 at ucsf and will be doing my fellowship in critical care medicine here sarting in july. i'm expecting in by about 0700 out by about 1800-1830 m-f. call is in-house, taken 1 week at a time 1800-0700 daily. i would so boldly state here that we have the largest and most well-regarded...