The Anesthesia Consultant

MARCH 31, 2015

An anesthesia emergency occurs without warning. You need the ultimate anesthesia emergency guidebook. That ultimate guidebook is the S tanford Emergency Manual of Cognitive Aids for Perioperative Critical Events S , written by the Stanford Anesthesia Cognitive Aid Group. Your patient’s vital signs are dropping.

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The Anesthesia Consultant

MAY 2, 2023

The Barnes Jewish Hospital, Washington University, St. Louis Imagine this: You’re an anesthesiologist in the operating room at a busy hospital. Anesthesiologists at Barnes Jewish Hospital at Washington University in St. Louis, Missouri are studying a novel system they call the Anesthesia Control Tower (ACT).

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The Anesthesia Consultant

JUNE 4, 2024

Ability can also be evidenced the quality of the anesthesia residency/fellowship training program you’ve completed, as well as the medical school you’ve graduated from. Do you think patients want a friendly anesthesiologist who is all thumbs in the operating room? No, they want a skilled practitioner.

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The Anesthesia Consultant

APRIL 26, 2018

Learjet anesthesia? Yes, anesthesia can be a glamorous specialty. Norman Shumway MD PhD, a Stanford surgical professor and legend, invented the heart transplantation procedure and performed the first heart transplant in the USA on January 6, 1968 in operating room 13 of Stanford University Hospital.

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Concordia Anesthesiology

AUGUST 30, 2021

Without a doubt, the operating room (OR) brings in the lion’s share of a hospital’s revenue, amounting to as much as 70% or more. So, why aren’t hospitals developing and expanding the OR? to improve the bottom line, changes to the existing anesthesia staffing model may help. improve efficiencies 2.

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The Anesthesia Consultant

OCTOBER 14, 2022

Imagine this scenario: You’ve just finished anesthetizing a patient in a hospital setting, and the patient now requires transport from the operating room (OR) to the post-anesthesia care unit (PACU). This is a reasonable policy, but what if anesthesia patient transport to the PACU lasts 4 minutes and 59 seconds (i.e.

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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

AUGUST 17, 2020

In 1999 the Institute of Medicine published the landmark “To Err is Human” report , which described that adverse events occurred in 3 – 4% of all hospital admissions, and that over 50% of the adverse events were due to preventable medical errors. Mistakes happen in medicine. We can’t fix problems we haven’t identified.

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The Anesthesia Consultant

NOVEMBER 18, 2017

America’s hospitals are in fiscal chaos. Anesthesiologists work in hospitals, and when a hospital closes, anesthesiologists lose their jobs. Hospitals are losing money, particularly when it comes to the treatment of Medicaid/Medicare patients. 2 An anesthesia group’s success is closely tied to the fate of their hospital.

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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. What do you do?

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Transforming Outcomes

JUNE 26, 2020

When you think of the operating room (OR), what comes to mind? At my first hospital, I visited the nursing director regularly to see if there were any openings. Managing the room, including supplies, equipment, lighting and documentation. An intense and stressful work environment? It’s certainly all of those, and more.

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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. Anesthesiologists typically spend 90+% of their working hours in the operating room.

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The Anesthesia Consultant

MARCH 2, 2024

If you wonder how much the anesthesia scene has changed significantly over the past four decades, check out this narrative: In 1986 I was in my second and final year of anesthesia residency training at Stanford, and I was looking for a job. I heard about an opening with a busy private practice anesthesia group in Southern California.

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The Anesthesia Consultant

MAY 6, 2017

The Merriam-Webster online dictionary defines private practice as: “a professional business (such as that of a lawyer or doctor) that is not controlled or paid for by the government or a larger company (such as a hospital).” A private practice anesthesia group needn’t be a physician-only group. Let’s look at the issues. It depends.

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The Anesthesia Consultant

JULY 28, 2022

There are hundreds of anesthesia textbooks, but which current books are the gold standards for anesthesia knowledge? Should you buy these books, or should you advocate that your hospital purchase them for the medical library? All anesthesia providers should have access to the current two-volume 3112-page edition.

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Surgical Directions

FEBRUARY 22, 2022

Pauses in elective cases, staff shortages, and supply chain woes brought on by the COVID-19 pandemic have put hospitals under severe financial duress across the country, spurring the need to look for any opportunity to reduce costs.

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The Anesthesia Consultant

AUGUST 15, 2024

It’s easier to train non-anesthesiologists (emergency room MDs, critical care internal medicine MDs, EMTs and helicopter trauma RNs) to use VL versus DL. For non-anesthesiologists, who will not undergo three years of anesthesia residency training to become DL experts, learning video laryngoscopy instead of direct laryngoscopy makes sense.

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Somnia

MAY 31, 2024

Anesthesia departments are crucial to the success of operating rooms (ORs). Ensuring your anesthesia team excels in both areas is vital. Here are five warning signs that your anesthesia team might be underperforming: 1. Here are five warning signs that your anesthesia team might be underperforming: 1.

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The Anesthesia Consultant

SEPTEMBER 1, 2017

One goal of theanesthesiaconsultant.com is to make the practice of anesthesia safer. The practice of anesthesia on healthy patients is quite safe, but we want to do everything we can to avoid preventable errors. The safety of anesthesia on ASA I and II patients has been compared to the safety record of commercial aviation.

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The Anesthesia Consultant

NOVEMBER 15, 2023

The capacity to deliver this much oxygen to a non-intubated patient is a marked advance in anesthesia care. One day after attending the ASA meeting in San Francisco, I heard an in-person lecture in Palo Alto, California by Professor Anil Patel from the Royal National Throat, Nose and Ear Hospital in London.

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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

JUNE 12, 2023

I entered three anesthesia consultations into CHATGPT, one preoperative, one intraoperative, and one postoperative. INTRAOPERATIVE DECISION A 60-year-old man with a history of hypertension is having a knee arthroscopy surgery under general anesthesia. This could indicate a cardiac event or a complication related to the anesthesia.

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The Anesthesia Consultant

JULY 12, 2021

Anesthesia is a hands-on specialty. Anesthesiologists could chat with the surgeons and/or nurses, make an occasional phone call, and at times read materials they brought with them into the operating room. Since the development of the internet, anesthesia practice has changed forever.

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The Anesthesia Consultant

JUNE 26, 2018

Point/Counterpoint: How new is modern anesthesia? Are modern anesthesia techniques radically different from the methods of twenty years ago? How can it be that general anesthesia has ceased to evolve? What about regional anesthesia? Anesthesia in 2018 is markedly different from anesthesia in the 1990s.

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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

JUNE 18, 2019

Data exists that intravenous caffeine may be effective in assisting the awakening of patients following general anesthesia. I tried it on several of my patients who had prolonged awakening after general anesthesia. Anesthesia was terminated 5 minutes later and the rats were placed on their backs on a table. It helps a lot!”

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The Anesthesia Consultant

FEBRUARY 16, 2021

To aid you in visualizing yourself in the hospital, I’m substituting the pronoun “you” instead of “I” in the narrative below. Anesthesia is not the career for you if you like to sleep late—surgery always begins at 0730 hours). You take the elevator to the third floor and proceed to the locker room.

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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. The patient consents.

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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. You’re on your at the hospital, sometimes on weekend nights, and sometimes at 3 a.m. Their role is to teach anesthesia, to take care of patients, and to do research.

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Ed Mariano

MAY 29, 2023

Annual meeting Vice-Chair Dr. Engy Said put together a fantastic point-of-care ultrasound and regional anesthesia workshop on Thursday. We had great talks on patient safety and communications, diversity and inclusion, pain management, and regional anesthesia. I think this meeting achieved all of these objectives! Michael Champeau!

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The Society of Thoracic Surgeons

MARCH 29, 2024

Ascension Saint Thomas Hospital Improves Performance through Better Medical Record Management KCummings Fri, 03/29/2024 - 08:54 Overview In the fast-paced environment of healthcare, hospitals face significant challenges related to medical records. A key obstacle was the time it took to address missing paperwork.

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The Anesthesia Consultant

MAY 4, 2016

If a patient suffers a bad outcome after anesthesia, did the anesthesiologist commit malpractice? If there was an anesthesia error, was it anesthesia malpractice? There are risks to every anesthetic and every surgery, and if a patient sustains a complication, it may or may not be secondary to substandard anesthesia care.

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The Anesthesia Consultant

MARCH 23, 2020

Today’s post demonstrates making a reusable N95 mask from common inexpensive operating room supplies. The required parts are an operating room anesthesia mask and a ventilator in-line bacterial/viral filter: The mask assembly is held over your face with elastic straps. The video is posted here.

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The Anesthesia Consultant

JUNE 15, 2022

The first public demonstration of anesthesia, at the Ether Dome in Massachusetts General Hospital Important advances in the history of anesthesia changed medicine forever. Humans have inhabited the Earth for 200,000 years, yet the discovery of surgical anesthesia was a relatively recent development in the mid-1800s.

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The Anesthesia Consultant

MAY 12, 2015

In the operating room, you induce anesthesia with your standard recipe of 2 mg of midazolam, 100 mcg of fentanyl, 200 mg of propofol, and 40 mg of rocuronium, and intubate the trachea. Let’s look at the anesthesia literature to learn what has been described about this problem. Her blood pressure is 150/90 on admission.

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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 8, 2019

The most invasive type of airway tube used in anesthesia is called an endotracheal tube, or ET tube. At the onset of general anesthesia anesthesiologists place an ET tube through the mouth, past the larynx (voice box), and into the trachea (windpipe). If the patient has an ET tube, it is usually removed.

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