pasgasser

Latest Activity

1. BIS Monitor

   pasgasser replied to sandman1914's topic in CRNA

   I agree completely. Multiple studies have shown that EEG is not a reliable method of determining sedation level. BIS only measures frontal lobe in some way that the company will not divulge then puts in a machine, generates a random number that has...

2. Pneumonic for GAS LAW

   pasgasser replied to CRNAMASTER's topic in CRNA

   pneumonics are ok, but Troy is correct. This is important and understanding the relationships is a must in practice. Few CRNA's or MDA's could quote these Laws but the magority should be able to derive them. After you understand them, they make se...

3. Beginner with OB epidurals

   pasgasser replied to SproutRN's topic in CRNA

   Sprout, your second catherter may have not been intrathecal. After placing the toughy needle the first time if you bolused the needle (like many including myself do) then that fluid plus the fluid from the first leak would be in the epidural space. ...

4. Why would an anesthesia provider do this?

   pasgasser replied to AmiK25's topic in CRNA

   The reason the provider changed the line is because at the onset of the case the pt descibed could easily need large bore access. A 4 lumen CVL is great for infusions but is a horrible volume line. If the 4 lumen line were new I would have likely l...

5. Side effects of spinal anesthesia

   pasgasser replied to Helori's topic in CRNA

   depending upon the pt's co-existing dzs it could (diabetes could cause the urinary retention to occur for several days). If the pt had not urinated after 72 hours I would investigate other causes. Also the type of local anesthetic is not mentioned ...

6. Side effects of spinal anesthesia

   pasgasser replied to Helori's topic in CRNA

   Urinary function is usually the last thing to return after SAB, this is lilkely the cause of your grandfather's issue. Nothing to worry about give it time. Because of this issue many providers including myself choose not to use SAB for out-pt proce...

7. Can someone explain this to me: Changing out various airway tubes.

   pasgasser replied to Diprivan/Vented's topic in CRNA

   The reason for such a large ordeal is that if it the original intubation resulted in the pt being intubated with a combitube it can be assumed all other avenues were tried unsuccessfully. Combitubes are a last resort measure. The normal INR is 1 in ...

8. Can someone explain this to me: Changing out various airway tubes.

   pasgasser replied to Diprivan/Vented's topic in CRNA

   The reason for such a large ordeal is that if it the original intubation resulted in the pt being intubated with a combitube it can be assumed all other avenues were tried unsuccessfully. Combitubes are a last resort measure. The normal INR is 1 in ...

9. CRNA working as PACU RN

   pasgasser replied to DKSH's topic in CRNA

   I'm curious. I am an anesthesiologist and at times I have sat with a pt in the PACU while waiting for the second on call RN to come in (I have also had the surgeon sit with the pt in the PACU while I have gone to the ER). Seriously is this a violat...

10. Woman Warns Against Anesthesia Awareness

    pasgasser replied to nursebedlam's topic in CRNA

    Awareness during anesthesia is terrible but the BIS monitor is likely not the answer. Many times a full EEG has been used to attempt to determine depth of sedation and many times it has been ineffective. It is nonsensicle to believe that the BIS wh...

11. Propofol question

    pasgasser replied to chris_at_lucas_RN's topic in CRNA

    This reply is to address pain on injection of propofol and not the original concern of chris. I have found two ways to help avoid pain on injection of propofol. 1)give 1 mg/kg of lidocaine 2 minutes proir to induction and stop the IV immediately afte...

12. dexmetatomadine

    pasgasser replied to jbro's topic in CRNA

    The surgeon injects the scalp with local/epi and no further analgesic is necessary. At times colleages have needed low dose remi or propofol to aid with the anesthetic but I have not needed these to date.

13. dexmetatomadine

    pasgasser replied to jbro's topic in CRNA

    The surgeon injects the scalp with local/epi and no further analgesic is necessary. At times colleages have needed low dose remi or propofol to aid with the anesthetic but I have not needed these to date.

14. dexmetatomadine

    pasgasser replied to jbro's topic in CRNA

    My precedex use hs been limited to awake craniotomies. It works well because the sedation is good but respiratory drive is not decreased so no increase in PaCO2 and a intra-op neuro exam is easy to obtain. I agree with the hypotension with the load...

15. dexmetatomadine

    pasgasser replied to jbro's topic in CRNA

    My precedex use hs been limited to awake craniotomies. It works well because the sedation is good but respiratory drive is not decreased so no increase in PaCO2 and a intra-op neuro exam is easy to obtain. I agree with the hypotension with the load...