The Anesthesia Consultant

SEPTEMBER 15, 2020

There are Two Laws of Anesthesia, according to surgeon lore. Surgeons work with physician anesthesiologists, with certified nurse anesthetists (CRNAs), or with an anesthesia care team that includes both physician anesthesiologists and CRNAs. In a perfect anesthesia world, patients will not move.

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The Anesthesia Consultant

OCTOBER 28, 2018

The combination of autism and anesthesia requires careful planning. The parents/guardians and the anesthesia team need to be actively involved with forming the preoperative plan for uncooperative patients. It’s not infrequent that autistic patients need surgery and anesthesia. Anesthetizing uncooperative patients is difficult.

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The Anesthesia Consultant

FEBRUARY 22, 2018

THIS ORIGINAL ANESTHESIA CARTOON WAS PUBLISHED IN THE CALIFORNIA SOCIETY OF ANESTHESIOLOGISTS BULLETIN, VOLUME 52, NUMBER 2, APRIL-JUNE 2003. IS ANESTHESIA AN ART OR A SCIENCE? The most popular posts for laypeople on The Anesthesia Consultant include: How Long Will It Take To Wake Up From General Anesthesia?

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The Anesthesia Consultant

APRIL 25, 2021

On March 28, 2021 the anesthesia world in the United States was rocked by the headline: “ Wisconsin Hospital Replaces All Anesthesiologists With CRNAs. “ The medical center previously had an anesthesia staff that included both MDs and CRNAs (Certified Registered Nurse Anesthetists). Why did this change happen?

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The Anesthesia Consultant

SEPTEMBER 3, 2021

At times, physician anesthesiologists employ certified registered nurse anesthetists (CRNAs) to assist them in what is called the anesthesia care team (ACT) model. In a minority of states (19 of the 50 states) in America, governors made it legal for an unsupervised CRNA to provide anesthesia care. No, they are not.

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The Anesthesia Consultant

JANUARY 29, 2018

Most anesthesiology residents go on to do a one- to two-year fellowship program to learn a subspecialty, such as critical care or obstetric anesthesia. The job of a certified nurse anesthetist was listed as #11 on the Best Paying Jobs list. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

JUNE 20, 2017

We learn those skills, and then we pass the American Board of Anesthesia written and oral exams on these skills. Then for the rest of our careers we lose many anesthesia skills. Every year in June across the United States another class of anesthesia residents finishes training. In the 1990’s the rock group R.E.M. Very common.

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The Anesthesia Consultant

FEBRUARY 4, 2018

Recognizing frailty in anesthesia patients is critical. What if your patients, especially elderly patients, could enter their personal data and symptoms into an iPad app, and what if that information could help you determine if their risk for anesthesia was too great to risk having surgery? What Are the Common Anesthesia Medications?

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The Anesthesia Consultant

JULY 12, 2021

Anesthesia is a hands-on specialty. Anesthesia is said to be “99% boredom and 15 panic,” because 99% of the time patients are stable, yet 1% of the time, especially at the beginning and the end of anesthetics, urgent or emergency circumstances could threaten the life of the patient. Love it or hate it, the EMR is here to stay.

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The Anesthesia Consultant

DECEMBER 14, 2016

Patients wonder what the disease is, if it could possibly strike them during anesthesia, and how the disease would be treated. MH is rare, life threatening, and triggered by general anesthetic drugs. This biopsy of the anterior thigh muscle (quadriceps) is done under local anesthesia. What Are the Common Anesthesia Medications?

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The Anesthesia Consultant

OCTOBER 4, 2021

Anesthesia vital signs monitor display A second and more compelling use for smart glasses would be the display of a patient’s vital sign monitoring in real time on the smart glass screen, so that an anesthesiologist is in constant contact with the images of the vital sign electronic monitors. Let me give you a historical perspective.

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The Anesthesia Consultant

MARCH 24, 2022

The only way to end the sedative effects of propofol is for an anesthesia professional to support the airway, breathing, and circulation of the patient until the drug effects of propofol wear off in time. I’ve never administered a dose of flumazenil in my entire career, nor have most of my anesthesia colleagues.

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The Anesthesia Consultant

APRIL 26, 2018

Learjet anesthesia? Yes, anesthesia can be a glamorous specialty. Note that the anesthesia transport team member was only an anesthesia fellow or a resident. The eligible residents were second-year residents (anesthesia residency training was only two years in duration during the 1980’s).

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The Anesthesia Consultant

SEPTEMBER 19, 2018

. * * * * LEARN MORE ABOUT RICK NOVAK’S FICTION WRITING AT RICK NOVAK.COM BY CLICKING ON THE PICTURE BELOW: The most popular posts for laypeople on The Anesthesia Consultant include: How Long Will It Take To Wake Up From General Anesthesia? Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

FEBRUARY 13, 2018

Meanwhile, back at the metaphor, anesthesiologists practiced their essential healing profession, and hoped HMOs and hospital administrators would not decrease their anesthesia quantum wage any further. The most popular posts for laypeople on The Anesthesia Consultant include: How Long Will It Take To Wake Up From General Anesthesia?

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The Anesthesia Consultant

OCTOBER 21, 2015

The incidence of cardiac arrest totally attributable to anesthesia mismanagement was low (0.47 per 10,000 anesthetics), and anesthesia mismanagement was responsible for only 1.5% 2) From 2010 to 2013 the National Anesthesia Clinical Outcomes Registry reported the risk of intraoperative cardiac arrest as 5.6 of deaths. (1)

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The Anesthesia Consultant

OCTOBER 1, 2015

It’s vital that your stomach is empty prior to elective surgery and anesthesia. Under anesthesia these reflexes are absent. These fasting guidelines do not apply to surgical procedures under local anesthesia, or to those with no anesthesia. Once you’re anesthetized, your cough reflex and gag reflex are abolished.

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The Anesthesia Consultant

AUGUST 26, 2015

But nothing is perfect, and anesthesia has one threat which could in time undermine the entire specialty. No, it’s not the nurse anesthetists, nor the stress of covering surgeries in the middle of the night, nor the stress of saving patients who are trying to die in front of our eyes during acute care emergencies.

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The Anesthesia Consultant

FEBRUARY 8, 2016

The most difficult challenge for any anesthesiologist is the transition from the end of anesthesia residency into the beginning of your first job. Their role is to teach anesthesia, to take care of patients, and to do research. You’re on your at the hospital, sometimes on weekend nights, and sometimes at 3 a.m. See #4 below.

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The Anesthesia Consultant

NOVEMBER 15, 2017

Let’s look at a case study which highlights a specific risk of general anesthesia at a freestanding surgery center or a surgeon’s office operating room, when the anesthesiologist departs soon after the case is finished. The assessment is ASA II, and the plan is general endotracheal anesthesia. What went wrong?

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The Anesthesia Consultant

FEBRUARY 16, 2021

Anesthesia is not the career for you if you like to sleep late—surgery always begins at 0730 hours). Anesthesia Workstation You log into the EMR system, and then you log into your first patient’s chart. The lower drawers to the computerized pharmacy cart unlock, and you’re able to access the propofol you’ll use to induce anesthesia.

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The Anesthesia Consultant

DECEMBER 19, 2016

I ask this question when I’m teaching anesthesia residents and medical students. Control of the airway is the most important clinical priority in anesthesia care. The INTUBATION AFTER INDUCTION OF GENERAL ANESTHESIA section of the Difficult Airway Algorithm is bifurcated into two pathways. Their most frequent answer is.

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The Anesthesia Consultant

MAY 29, 2018

The most popular posts for laypeople on The Anesthesia Consultant include: How Long Will It Take To Wake Up From General Anesthesia? Why Did Take Me So Long To Wake From General Anesthesia? Will I Have a Breathing Tube During Anesthesia? What Are the Common Anesthesia Medications?

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The Anesthesia Consultant

FEBRUARY 6, 2019

Every anesthesia provider must learn to free-solo anesthesia early in his or her career. A typical hospital will have dozens of other anesthesia providers working in the same building. Commercial aviation is sometimes compared to anesthesia practice. In anesthesia there is no guaranteed second anesthesiologist.

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The Anesthesia Consultant

OCTOBER 26, 2016

I commonly hear two questions from my patients: “How does anesthesia work?” General anesthesia is the sum of hypnosis (sleep), amnesia, analgesia (pain relief), and the lack of any motion response to pain. Why Did Take Me So Long To Wake From General Anesthesia? Will I Have a Breathing Tube During Anesthesia?

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The Anesthesia Consultant

APRIL 2, 2016

The procedures are done under general endotracheal anesthesia, and can last from 3 to 8 hours. At times the second room is not occupied, and a solo anesthesiologist is the only anesthesia professional present on site and must be prepared to handle any and all emergencies. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

FEBRUARY 11, 2018

He writes, “Our specialty, anesthesia, has suffered an identity crisis for decades. Afterward the surgeon bellowed his disapproval regarding how the anesthesia team had failed to keep the patient alive after he had spent all day “curing” the patient. Maybe you’re worried that nurse anesthetists will take your job away.

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The Anesthesia Consultant

DECEMBER 29, 2015

How do you feel when you meet your anesthesia provider prior to a surgical procedure? In an abstract presented at the 2015 American Society of Anesthesiologists annual meeting, data from the 2014 National Anesthesia Clinical Outcomes Registry was compiled for every anesthesiologist of known age who performed at least 100 cases.

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The Anesthesia Consultant

DECEMBER 23, 2015

Regional anesthesia is a growing frontier in modern clinical anesthesia, in part because of the availability of ultrasonic imaging to help us direct needle placement. The subspecialty of regional anesthesia has blossomed. following general anesthesia in contrast to a peripheral nerve injury rate of 1.7%

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The Anesthesia Consultant

JANUARY 2, 2016

More care team anesthesia and more Certified Nurse Anesthetists (CRNAs). Rather than physician anesthesiologists personally performing anesthesia, expect to see CRNAs supervised by physician anesthesiologists in an anesthesia care team, or in some states, CRNAs working alone. Anesthesia has never been safer.

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The Anesthesia Consultant

OCTOBER 17, 2019

The study looked at malpractice closed claims and found: 1) Outcomes remained poor in malpractice closed claims related to difficult tracheal intubation; 2) The incidence of brain damage or death at induction of anesthesia was 5.5 This training needs to be a requirement for all anesthesia professionals.

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The Anesthesia Consultant

MARCH 20, 2016

Nowadays when patients arrive at the hospital for surgery, it’s not uncommon for them to be armed with abundant information on their disease, their pending operation, and even their anesthesia options. The most popular posts for laypeople on The Anesthesia Consultant include: How Long Will It Take To Wake Up From General Anesthesia?

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The Anesthesia Consultant

JUNE 27, 2017

The premise of Coma was that healthy young patients were developing brain death after general anesthesia, for no apparent reason. Each of these drugs is a liquid, which is then vaporized by special equipment to deliver inhaled anesthesia gas. These vaporizers are metal cylinders about the size of half-gallon milk carton.

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The Anesthesia Consultant

JANUARY 19, 2017

A bell-shaped curve exists for the abilities of anesthesia doctors as well. I’ve been practicing anesthesia since the mid 1980s. I’ve met and worked alongside hundreds of anesthesia colleagues from all corners of the globe. Planning anesthesia care, based on your training, experience, and knowledge, is critical.

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The Anesthesia Consultant

JUNE 23, 2016

GENERAL ANESTHESIA FOR DENTAL OFFICES CASE PRESENTATION: A 5-year-old developmentally delayed autistic boy has multiple dental cavities. The dentist consults you, a physician anesthesiologist, to do sedation or anesthesia for dental restoration. Options for anesthesia induction include: Intramuscular sedation.

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The Anesthesia Consultant

OCTOBER 4, 2016

After ten minutes, the TOF nerve stimulation of the facial nerve showed four equal twitches, and the sevoflurane anesthesia was discontinued. At the conclusion of surgery, electrical nerve stimulation of the facial nerve with a Life Tech Mini Stim showed four equal twitches in the TOF, and the sevoflurane anesthesia was discontinued.

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The Anesthesia Consultant

AUGUST 16, 2018

If something dire goes wrong during anesthesia and surgery and the flow of oxygen to the brain is cut off, an anesthesia practitioner has about five minutes to diagnose the cause of the problem and treat it. The good news is that catastrophic events causing sudden drops in oxygen levels are very rare during anesthesia.

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