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13 MAJOR CHANGES IN ANESTHESIOLOGY IN THE LAST TEN YEARS

The Anesthesia Consultant

It’s not clear the idea has widespread traction as of yet, and the concept will always be at odds with the individual aspirations of internal medicine doctors, hospitalists, intensivists, surgeons, and certified nurse anesthetists, all who want to make their own management decisions, and all who desire to be paid for owning those decisions.

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THE TWO LAWS OF ANESTHESIA (ACCORDING TO SURGEONS)

The Anesthesia Consultant

Surgeons work with physician anesthesiologists, with certified nurse anesthetists (CRNAs), or with an anesthesia care team that includes both physician anesthesiologists and CRNAs. There are Two Laws of Anesthesia, according to surgeon lore. They are: The patient must not move. The patient must wake up (when the surgery is over).

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A DAY IN THE LIFE OF AN ANESTHESIOLOGIST

The Anesthesia Consultant

While the surgeon, the nurse, and the scrub tech prepare the patient for the surgical incisions, you administer the antibiotic Kefzol (cephazolin) into the IV. For anesthesiologists, the interval between surgeries is a time when the surgeons, nurses, and the empty operating room are waiting for you to get things going again.

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HANGOVER AFTER GENERAL ANESTHESIA

The Anesthesia Consultant

Sessler’s unpublished data gleaned from electronic medical records on thousands of patients, one-third of intraoperative hypotension occurs during the time period between the induction of anesthesia and the surgical incision. Decrease the amount of anesthesia you administer between the induction of anesthesia and surgical incision.

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ANESTHESIOLOGISTS, DON’T BE AFRAID TO CUT INTO A PATIENT’S NECK

The Anesthesia Consultant

In a cricothyroidotomy, the cricothyroid membrane is divided by a surgical incision made with a wide scalpel (#10 scalpel). a cricothyrotomy is inserted in the cricothyroid space, cephalic to the trachea Using the scalpel, bougie, tube (SBT) technique, a bougie is inserted into the trachea through the incision. A lubricated 6.0

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LEARJET ANESTHESIA – THE EARLY DAYS OF HEART TRANSPLANTATION

The Anesthesia Consultant

The scrub tech, nurse, and the two surgeons prepped and draped the patient for surgery, and the initial incision was made over the sternum. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door.

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SERIALIZATION OF THE DOCTOR AND MR. DYLAN… CHAPTER TWO

The Anesthesia Consultant

It had been five hours since the initial skin incision. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door. Everything was stable, and I was pleased. Dr. Chang pushed the microscope away and said, “We’re done.