VIV TMVR with Sapien 3
80 y/o s/p cabg 20 years ago. Redo sternotomy for severe Mitral regurgitaiton 15 years ago.
Other hx: Bil Fem-pop bypass, h/o stroke, severe COPD and severe pulm htn on ATC O2.
Chronic pain, CKD, etc.
Presented at valve conference for failure of mitral bpv. Mean gradient of 15 mmHg.
It was decided that we would proceed with VIV TMVR with a Sapien 3.
On paper, it sounded like a bad idea. Once I met the patient, it was clear to me she wanted this done as her severe MS was going to...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - March 12, 2024 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Source Type: forums
Generic Sevoflurane
Anyone have bad experiences with generic sevoflurane? Or with their supplier (or Piramal)? I can't speak to the service and haven't switched yet, but cost savings are substantial and worth investigating. Thanks in advance. (Source: Student Doctor Network)
Source: Student Doctor Network - July 12, 2023 Category: Universities & Medical Training Authors: BobLoblaw78 Tags: Anesthesiology Source Type: forums
NC Supreme Court rules CRNA can be held responsible for case outcome
N.C. Supreme Court overrules 90-year-old precedent protecting nurses from legal liability
This is an interesting development. The case at the center of this argument is whether a CRNA can be held liable for poor outcomes, even while under the supervision of an attending physician.
Description of case
A 3-year-old had a mask induction with sevoflurane and suffered a cardiac arrest leading to hypoxic brain injury. If the plan was generated by the anesthesia attending, is the...
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Source: Student Doctor Network - August 26, 2022 Category: Universities & Medical Training Authors: Agast Tags: Anesthesiology Source Type: forums
Nv.
gaswork post going up shortly (Source: Student Doctor Network)
Source: Student Doctor Network - March 31, 2022 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Positions Source Type: forums
PP in Reno, NV.
Reno, Nevada
500K on average. More if you like to work harder.
9 weeks vacation on average.
MD ONLY group currently. Zero plans for ACT model.
Private practice.
Very fair and equitable group.
No buy-in. Immediate financial equality and access to scheduled cases.
Voted in at 6mo to 12 mo to become a shareholder.
All subspecialties represented except for transplants.
Level 2 trauma center.
Largest OB volume in Northern Nevada
Pediatrics
Regional
Cardiac including...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - March 22, 2022 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Positions Source Type: forums
#Case_11 How to improve my next post-thyroidectomy stridor if any?
Hi SDN Anesthesiologists,
I hope you are doing well. Last week, we had a total thyroidectomy case for a female - young.
Her thyroid was a bit moderate in size, she was Mallampati class 2/3 almost 3, upper left shift of larynx. It was not that difficult to Intubate.
I had used Ketamine + Thiopental + Atracurium and sevoflurane then Isoflurane for maintenance, beside multimodal analgesia during the case. She was also some sort of retrosternal extension.
At the time of extubation, Surgeons...
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Source: Student Doctor Network - September 18, 2021 Category: Universities & Medical Training Authors: DrAmir0078 Tags: Anesthesiology Source Type: forums
CRNA shortage?
We don’t employ them but I hear rumors they are also hard to find despite the CRNA mills that are oh so common.
Curious if those on here that use the ACT model are also having issues finding CRNA’s to fill their practices. (Source: Student Doctor Network)
Source: Student Doctor Network - September 17, 2021 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Source Type: forums
Ugh ….
(Source: Student Doctor Network)
Source: Student Doctor Network - July 15, 2021 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Source Type: forums
Another AW case
It’s Friday, you are not on call and just finished an of EF 15% AVR/cabg x3. You have one foot out the door when all of a sudden you get called for a trach (fauk).
65 y/o morbidly obese patient with a pharyngeal mass. Smoked her whole life, can’t lie flat, can hardly talk. Below is her CT scan.
Plan? (Source: Student Doctor Network)
Source: Student Doctor Network - February 5, 2021 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Source Type: forums
Let's do some echo:
Let's do some basic Echo:
This comes from my personal data base, so I hope you guys dig it. Med studs and residents first.
Name 1-7 (Source: Student Doctor Network)
Source: Student Doctor Network - January 5, 2021 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Source Type: forums
Lead extraction and goobers case.
35 y/o male with history of SVT as a kid. Device has been in for 20 years and is now eroding through the skin.
Presents to hybrid OR for lead extraction. As per usual, I drop a probe and get the following images.
Comments, concern, plan? (Source: Student Doctor Network)
Source: Student Doctor Network - November 14, 2020 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Source Type: forums
NC Appeals Court Rules that CRNAs cannot be sued for malpractice
Nearly a century ago, our Supreme Court rejected the notion that nurses can be liable for medical malpractice based on their diagnosis and treatment of patients. The Court reasoned that nurses “are not supposed to be experts in the technique of diagnosis or the mechanics of treatment.”
Soon after the anesthesia team administrated the sevoflurane, Amaya went into cardiac arrest. After about thirteen minutes, Amaya’s treatment team was able
to revive her, but the oxygen deprivation left her...
NC Appeals Court Rules that CRNAs cannot be sued for malpractice (Source: Student Doctor Network)
Source: Student Doctor Network - July 8, 2020 Category: Universities & Medical Training Authors: jkdoctor Tags: Anesthesiology Source Type: forums
V shaped recovery
Nothing like 2008. I have personally never seen a market carve it’s way down and rebound so quickly.
Covid market has been the single best market I have ever seen in such short time. If you had the guts to invest heavily you accelerated your retirement.
Not out of the woods, but the market wants to move up and we are approaching an election year with a president whose main focus is the market highs.
Airlines and oil jumping. Still some value out there but drying up.
Those who...
V shaped recovery (Source: Student Doctor Network)
Source: Student Doctor Network - June 5, 2020 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Source Type: forums
Pediatric dosing
I am in PP and most of my colleagues use only sevoflurane for bmt & adenoids - very rarely use propofol or fentanyl. I normally induce with gas, use 2mg/kg propofol to intubate and titrate in 1mcg/kg fentanyl before case in done. Sometimes I even use up to 4mg/kg in older kiddos if they’re light when I go to put the tube in. I’ve been told by multiple more senior colleagues that might be too much. What do other folks do?
Also, full disclosure these cases are 15-20 minutes at most.
Thanks. (Source: Student Doctor Network)
Source: Student Doctor Network - May 31, 2020 Category: Universities & Medical Training Authors: pinkMD12 Tags: Anesthesiology Source Type: forums
Soleimani Death
Seems pretty serious and will definitely escalate tensions in the region.
Wars often start with assassinations like these, but tensions already escalating by what some call orchestration of Iranian leaders. Either way, this will be seen as an act of war.
Now we are sending more troops in.
Curious as to what you all think on this topic. (Source: Student Doctor Network)
Source: Student Doctor Network - January 5, 2020 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Source Type: forums
