The Anesthesia Consultant

OCTOBER 18, 2018

My name is Dr. Richard Novak, the author of About The Anesthesia Consultant. The Anesthesia Consultant exists to increase your knowledge about anesthesia and the practice of medicine before, during, and after surgery. This anesthesia blog contains more than 180 distinct pages and posts, all written by me.

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The Anesthesia Consultant

AUGUST 26, 2015

Anesthesiology is a wonderful profession, as I have described in many previous posts on theanesthesiaconsultant.com. But nothing is perfect, and anesthesia has one threat which could in time undermine the entire specialty. Anesthesia providers are at best consultants, and at worst, “worker bees” called upon to provide a service.

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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

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

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 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

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

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

MAY 6, 2017

A private practice single-specialty anesthesia group will usually provide anesthesia for similarly self-employed surgeons who are in private practice. For insured patients, the anesthesia group collects whatever the insurance company pays, along with the deductible or co-pay the patient owes through their insurance plan.

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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. In a perfect anesthesia world, patients will not move.

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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

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

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

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

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

APRIL 2, 2016

This technique induced vasoconstriction and resulted in decreased blood loss, and made transfusion and post-operative anemia rare. The procedures are done under general endotracheal anesthesia, and can last from 3 to 8 hours. A protocol for large-volume liposuction at our facility is as follows: General anesthesia is induced.

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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? Twenty-first century general anesthetics are nearly identical to the anesthetic techniques of the late 1990s. How can it be that general anesthesia has ceased to evolve?

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The Anesthesia Consultant

NOVEMBER 16, 2015

Particularly in acute care, the computer keyboard and screen have no place between an anesthesiologist and his patient, an emergency room physician and his patient, an ICU doctor and his patient, or an ICU nurse and her patient. Why Did Take Me So Long To Wake From General Anesthesia? What Are the Common Anesthesia Medications?

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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

MAY 10, 2016

Sugammadex reversal can make the duration of a rocuronium motor block almost as short acting as a succinylcholine motor block, and sugammadex can also eliminate complications in the Post Anesthesia Care Unit due to residual postoperative muscle paralysis. ANESTHESIA ELECTRONIC MEDICAL RECORDS (EMRs)– The idea is sound.

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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

DECEMBER 19, 2016

You’re are an experienced practitioner, but not a pediatric anesthesia specialist. One is how to safely perform the open-eye, full stomach anesthetic, and the other is the performance of pediatric anesthesia by non-pediatric anesthesia specialists. Why Did Take Me So Long To Wake From General Anesthesia?

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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

JULY 2, 2018

What should you do if your 2-year-old son or daughter requires surgery and anesthesia? Anesthesia for infants and children is most frequently initiated with an inhalation induction of sevoflurane vapor, because most infants and children do not have an IV line prior to induction. What are the anesthetic risks for children?

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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

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

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

MAY 2, 2023

Your patient is in mid-surgery, and you receive a call from the Anesthesia Control Tower that the patient’s blood pressure is too low, your blood transfusion replacement is inadequate, and that the patient is in danger. Louis, Missouri are studying a novel system they call the Anesthesia Control Tower (ACT). What do you do?

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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. Why are jobs posted on Internet sites usually inferior jobs? They are not guidance counselors.

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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

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

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

AUGUST 28, 2016

Let me begin by offering two anecdotes: I was an invited visiting anesthesia professor at a major university this year, and following one of my lectures an anesthesiology resident approached me for a discussion. The demand for anesthesia services will grow. How much money does an anesthesiologist earn? It depends.

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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. Anyone can put medical information on a Web server, and the information posted may be incorrect or outdated.

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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

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. Is CHATGPT as good as an MD? No, not really.

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