Intense vagal episode with induction
Healthy mid aged woman, premeditated with versed, fentanyl, lidocaine, then after propofol was pushed gasped a bit, to bradycardia and then went asystolic for 12 seconds. Recovered spontaneously while we were scrambling for epi, atropine and preparing to perform chest compressions. We subsequentlg gave 0.4 mg glycopyrrolate and 15 mg ephedrine. Remained stable after, we continued with induction and did the case.
Anyone have similar experiences with propofol? (Source: Student Doctor Network)
Source: Student Doctor Network - June 28, 2019 Category: Universities & Medical Training Authors: eikenhein Tags: Anesthesiology Source Type: forums
http://radio.wosu.org/post/mount-carmel-fires-doctor-accused-giving-woman-lethal-dose-fentanyl#strea
Mount Carmel Fires Doctor Accused Of Giving Woman Lethal Dose Of Fentanyl (Source: Student Doctor Network)
Source: Student Doctor Network - June 8, 2019 Category: Universities & Medical Training Authors: Man o War Tags: Anesthesiology Source Type: forums
Best labor epidural mix
What do people think? I’ve used 1/18% bupi with 2 mcg/mL fentanyl and it seems to be inadequate for a significant number of people (as in they have a block but no sense enough). I like 1/8%bupi with fentanyl, slightly higher chance of getting a motor block but this has never been significant. Do people like ropivicaine ain’t better? (Source: Student Doctor Network)
Source: Student Doctor Network - May 28, 2019 Category: Universities & Medical Training Authors: dipriMAN Tags: Anesthesiology Source Type: forums
Drug company founder convicted of bribing doctors with money, strippers to sell more Fentanyl
https://www.cbc.ca/news/health/opioid-fentanyl-drug-company-conviction-insys-1.5121088
Seems like the culprit doctor is a pain anesthesiologist. How many of you getting these kind of bribes? Guess we shouldn't be surprised that there can be sleaziness everywhere. (Source: Student Doctor Network)
Source: Student Doctor Network - May 3, 2019 Category: Universities & Medical Training Authors: jope Tags: Anesthesiology Source Type: forums
Re: Fentanyl misuse in the UK: will we see a surge in deaths?
(Source: BMJ Comments)
Source: BMJ Comments - August 15, 2018 Category: General Medicine Source Type: forums
Re: Warshafsky did not intend to kill himself with fentanyl, coroner concludes
(Source: BMJ Comments)
Source: BMJ Comments - June 29, 2018 Category: General Medicine Source Type: forums
A celebrity overdose death that didn ’t get much attention
I came across this today by chance but Paton Oswalt’s wife died of an accidental overdose a few years back. She was 46 and the coroners report said she died of a combination of “Adderall, Xanax, and fentanyl.” This begs two questions, why was she on this ridiculous combination and who is the moron who was prescribing this?
https://www.google.com/amp/ew.com/news/2017/02/03/patton-oswalt-michelle-mcnamara-cause-of-death/amp/ (Source: Student Doctor Network)
Source: Student Doctor Network - April 26, 2018 Category: Universities & Medical Training Authors: PainDrain Source Type: forums
C-section meds choices with spotty epidural
Hey guys, CA1 here. I just wanted to get your thoughts on how you would approach a spotty epidural during C-section?
What I've been doing is obviously re-dose epidural with 2% lido + epi (+/- fentanyl) up to 20cc, then I would go to 3% chloro. From here, I've had attendings do many different things. Most of them start working in some ketamine (10mg a time), some give midaz, rarely give IV fentanyl (until the baby is out).
I was also wondering, is there any specific contraindication to...
C-section meds choices with spotty epidural (Source: Student Doctor Network)
Source: Student Doctor Network - April 26, 2018 Category: Universities & Medical Training Authors: whiteorgo Source Type: forums
Subsys Rx for Non-cancer Patients Is Considered a Criminal Act
It appears the prescribing of Subsys in non-cancer patients is now considered a crime by the federal government.
Las Vegas pain physician arrested for illegal fentanyl distribution: 5 things to know
Written by Brian Zimmerman | February 19, 2018 www.beckershospitalreview.com
Police arrested a Las Vegas pain management physician Feb. 13 for charges related to the unlawful distribution of fentanyl and healthcare fraud.
Here...
Subsys Rx for Non-cancer Patients Is Considered a Criminal Act (Source: Student Doctor Network)
Source: Student Doctor Network - April 22, 2018 Category: Universities & Medical Training Authors: algosdoc Source Type: forums
Opioid dosing under GA
This may seem a little basic, but I’m a resident and am curious how most people dose their opioids. I generally don’t give any long acting opioids for cases without significant post op pain. For cases where they’ll need post op analgesia, I usually dose some long acting opioids at the start of GA because I think it lets me use less fentanyl and smoothes out the hemodynamics. So long as it’s a modest dose, I haven’t had anyone yet that fails to breath by the end of the surgery. Do others do...
Opioid dosing under GA (Source: Student Doctor Network)
Source: Student Doctor Network - April 21, 2018 Category: Universities & Medical Training Authors: dipriMAN Source Type: forums
Re: Fentanyl misuse in the UK: will we see a surge in deaths?
(Source: BMJ Comments)
Source: BMJ Comments - April 9, 2018 Category: General Medicine Source Type: forums
Opioid Shortages
Opioid shortages leave US hospitals scrambling - CNN
Does anyone else's hospital have this problem? We've been out of dilaudid for over a month now and are critically low on fentanyl, morphine, and ketamine. Many of us are moving onto IV methadone, demerol, alfentanil... (Source: Student Doctor Network)
Source: Student Doctor Network - April 1, 2018 Category: Universities & Medical Training Authors: banister Source Type: forums
Prescription ODs level, illicit fentanyl skyrockets
Prescription ODs have leveled off, while illicit fentanyl ODs are skyrocketing, but the media is lumping them all in one big basket called the ‘opiate crisis,’ not making the important distinction. The illicit drug markets have nothing to do with doctors, pharmacies or pharmaceutical companies at all. I’m not saying that we in the medical community shouldn’t look for ways to improve things. We should. But we could prescribe zero opiates next year and the skyrocketing illicit fentanyl ODs...
Prescription ODs level, illicit fentanyl skyrockets (Source: Student Doctor Network)
Source: Student Doctor Network - March 22, 2018 Category: Universities & Medical Training Authors: emd123 Source Type: forums
NYT: 5 doctors charged in Subsys Kick-Back
5 Doctors Are Charged With Taking Kickbacks for Fentanyl Prescriptions
"One of the defendants, Dr. Goldstein, sometimes did not even stay for a meal at the programs where he was the featured speaker, instead ordering food from the restaurant and leaving with it, according to the indictment. Before one program in 2014, the indictment added, Dr. Goldstein wrote to an Insys sales representative,...
NYT: 5 doctors charged in Subsys Kick-Back (Source: Student Doctor Network)
Source: Student Doctor Network - March 18, 2018 Category: Universities & Medical Training Authors: drusso Source Type: forums
Shortages
Is anybody else as frustrated and concerned with the current shortages as I? We have recently run out of hydromorphone vials, are almost out of fentanyl, 0.5% bupivacaine, and prepackaged BD spinal trays.
I feel like we are MacGyvering stuff together on a daily basis. Anybody want to join me and import some goodies from across The Pond?
:/
Vent over.
PMMD (Source: Student Doctor Network)
Source: Student Doctor Network - March 14, 2018 Category: Universities & Medical Training Authors: pmichaelmd Source Type: forums
