Canadian lawsuit lol

[psycho-matic]

My question is what would you do for this patient for a lap chole if she also refuses volatile. Excluding the option to refuse to anaesthetise her... How would you maintain her?

Epidural?

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[coffeebythelake]

Epidural?

for a lap chole? no thanks.

 

[pgg]

Epidural?

Yeah sticking a needle in the spine of a lunatic and keeping her awake during surgery is gonna work out greeeaaaat ...




Midazolam is a great induction drug, if you don't mind admitting the patient overnight. Maybe remimazolam will show up someday.

 

[Ashers]

This is an allergy list from a patient in a case that I took over from a CRNA in residency CA1 year. It is one of the most ridiculous I've seen (not the longest or craziest, but ridiculous). I try to clean up allergy lists when I can, but sometimes, I don't feel like fighting. I had a patient swear she was allergic to epinephrine because her heart raced; she was very mad at me when I said that's not an allergy.

 

[psycho-matic]

My question is what would you do for this patient for a lap chole if she also refuses volatile. Excluding the option to refuse to anaesthetise her... How would you maintain her?

Epidural

Yeah sticking a needle in the spine of a lunatic and keeping her awake during surgery is gonna work out greeeaaaat ...




Midazolam is a great induction drug, if you don't mind admitting the patient overnight. Maybe remimazolam will show up someday.

I'm not anesthesia lol but thought I'd take a crack at it since I read these forums. I know neuraxil has been done for abdominal surgeries before.

 

[psycho-matic]

Yeah sticking a needle in the spine of a lunatic and keeping her awake during surgery is gonna work out greeeaaaat ...




Midazolam is a great induction drug, if you don't mind admitting the patient overnight. Maybe remimazolam will show up someday.

Given its short half life, why does one need to be kept overnight if getting a versed drip?

 

[pgg]

Epidural

I'm not anesthesia lol but thought I'd take a crack at it since I read these forums. I know neuraxil has been done for abdominal surgeries before.

Spinals are done routinely in many parts of the world for intra abdominal procedures because it's a $1 anesthetic and the patients are motivated/stoic. Not really a great patient experience in many cases though.

Given its short half life, why does one need to be kept overnight if getting a versed drip?

Dosing and context sensitive half life are the issue, as is the fact that patient response to benzos is quite variable. 2 mg of midazolam given for anxiolysis won't be an issue. 15 mg as an induction dose is going to zonk a lot of people for hours and hours. Some will have a full day memory hole. Can be hard to discharge those people.

High dose benzos are a wonderfully smooth inductions, but they come with some baggage.

 

[nimbus]

View attachment 380790View attachment 380791
This is an allergy list from a patient in a case that I took over from a CRNA in residency CA1 year. It is one of the most ridiculous I've seen (not the longest or craziest, but ridiculous). I try to clean up allergy lists when I can, but sometimes, I don't feel like fighting. I had a patient swear she was allergic to epinephrine because her heart raced; she was very mad at me when I said that's not an allergy.

I had a patient who brought a sheet like that. One of the entries was “all Eli Lilly drugs”.

 

[nimbus]

Given its short half life, why does one need to be kept overnight if getting a versed drip?

Half life is dose dependent and much longer after high doses.

 

[GassYous]

Spinals are done routinely in many parts of the world for intra abdominal procedures because it's a $1 anesthetic and the patients are motivated/stoic. Not really a great patient experience in many cases though.


Dosing and context sensitive half life are the issue, as is the fact that patient response to benzos is quite variable. 2 mg of midazolam given for anxiolysis won't be an issue. 15 mg as an induction dose is going to zonk a lot of people for hours and hours. Some will have a full day memory hole. Can be hard to discharge those people.

High dose benzos are a wonderfully smooth inductions, but they come with some baggage.

Bag o anesthesia
Bunch of midaz fent prop and roc and let it drip in

 

[abolt18]

I had a patient who brought a sheet like that. One of the entries was “all Eli Lilly drugs”.

Hilarious.

 

[Ashers]

I had a patient who brought a sheet like that. One of the entries was “all Eli Lilly drugs”.

what did they have against Eli Lilly?

 

[nimbus]

what did they have against Eli Lilly?

I dunno. Didn’t get into it with her. Maybe she didn’t like the letter L.

 

[norski]

Pacu nurses will hate you

Do just that every once in a month or so. Thing is, once we let the pacu nurses know "this may look a bit funky, but it's due to the drugs we had to use", they're pretty compliant. Patients, too, for that matter.I mean, for a normal ketamine induction, I rarely give more than 2.5 of midaz to smooth things over.

And it should've been what the idiots in Canada had done. Or even thio, which as far as I know is very much available in Canada, eh?