Be-littling CRNA's

TraumaNurse · Jan 1, 2005

"Red Man's Syndrome" is caused by histamine release from Vancomycin administration. The histamine causes intense erythema to the face and chest and may or may not be accompanied by hypotension.

Profound hypotension from Vanco is usually caused by rapid administration (

Appropriate dilution of the drug and slow administration will decrease incidence of side effects.

And it is described in several of my anesthesia textbooks (We use Stoelting's Pharmacology and Physiology in Anesthesia Practice). It has also been called "red-neck syndrome" But I think that is a different condition causing one to wear plad lumber jackets, lose teeth and carry a shotgun! :)

stevierae · Jan 1, 2005

Could be because "Red Man's Syndrome" is just a slang term someone has come up with. I doubt you'll find it in a medical dictionary or textbook.

Huh--that's all I've ever called it, or heard it called-- I've heard it called that for the past 25 years; both clear back to nursing school and by anesthesia professionals, nurses and surgeons--just one more thing that makes me feel old, I guess (and I am just 50!) if there are people professing to have never heard of the syndrome.

I've seen it occur probably twice in my life--once when an anesthesiologist was sort of showing off to a nursing student, saying "I give EVERYTHING IV push; watch--" (when he heard me telling her about profound hypotension secondary to giving it too rapidly, as we were mixing it and preparing to IVPB it over an hour--the recommended infusion time.) He grabbed the syringe and did just that before we could object or even say "WTF?" BP plumetted; face and neck of patient turned brick red. Benadryl IV will counteract it. I seem to recall that he also gave some Epi or Ephedrine, as well. Pt. was already intubated.

He was an awesome anesthesiologist, too--we teased him

about it off and on over the subsequent years, too...

forane2001 · Jan 2, 2005

To the contrary: Red Man's Syndrome IS MENTIONED IN THE PDR

Could be because "Red Man's Syndrome" is just a slang term someone has come up with. I doubt you'll find it in a medical dictionary or textbook.

kids · Jan 2, 2005

To the contrary: Red Man's Syndrome IS MENTIONED IN THE PDR

While I can't attest to Red Man's syndrome being listed in the PDR I can say that an internet search of the specif term yeilded several referrences to it in connection to Vanco. Many from reliable sources,

http://www.anesth.org/contents/40/40_149-151.pdf

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=1694421

http://www.ijpc.com/_pdf/vancom2.pdf

http://www.surgicalinfectionprevention.org/FastFactsPreoperativeAntibioticSet.pdf

http://www2.bmtinfonet.org/drug/index.cfm?fuseaction=drugResult&drugId=376&origId=374&drugType=T&searchType=s&searchText=

http://www.jcaai.org/Param/Drugs/Commentary.htm

jwk · Jan 4, 2005

Ah, stevierae, we're both getting old.

I still think Red Man's Syndrome is slang, but obviously it's mentioned in several different print sources, so I stand corrected.

I only heard about it in the last 10 years or so. In my previous practice, it was rarely used. Now I see it grossly overused, particularly by paranoid orthopods, who order vanco and still use "the hoods" during total joints while wearing the scrub clothes they came across the street with from the other hospital.

ldkrn · Jan 4, 2005

You should run for office one day. Your answers here and there (you know where...SDN) are always dead on.

You know, I thought things were bad between the ICU and PACU nurses, or the med/surg units...but apparently they've got nothing on the OR staff. This type of petty behavior, folks, is why nursing is destined to be a second-tier profession, no matter what the job responsibilities are or how many degrees we have behind our names. Makes me sick to hear about this stuff.

RE Agent · Jan 5, 2005

Just wondering how many CRNA's feel put down in their job-especially by ancillary staff (scrub tecks,(lol) circulators, and PACU RNS
I love being a CRNA and like all of you I worked extremely hard under difficult cirumstances to achieve this goal. I have been in practice 3 yrs now and I really hate where I work because of the above. I really dont know what to do about it. Most of the ologists that I work for are tolerable. I have more harsh feelings toward the staff that anything and I really cant pinpoint what I ever did to any of them. All they see is the authority of the ologist.
An example of the BS I put up with: The other day I rolled into PACU with a 15 yr pt s/p ingunial hernia repair. The kid was completely stable, just sleepy and the nurse that was taking the him motioned for me to come to her light. I locked the stretcher and gave a verbal report like always and stepped to the end of the stretcher to finish my chart. She began applying the monitors and grumbled at me that I should have helped her hook him up. Now, if she had been busy or the pt unstable, I would have as I always do. She walked around me to hook up the BP cuff and then came up to me and sarcastically patted me on the back and said we really appreciate all of your hard work. you are so appreciated!!. Now wait a minute! Where did that come from. This woman has attitude anyway but I have never done or said anything out of the way to her and she gives me crap. Other CRNA's have problems with her. It is such a negative environment to work in.
We get crap from scrub techs, and circulators to. Those circulators really think they run the OR and anesthesia.
I guess I am just tired of the disrespect and I dont understand where it comes from. Why does she think she can talk to me that way or anyone for that matter. I dont command respect but when I am respectful I believe it should be given in a professional manner whether you like the person or not. I know that if an MD was at the foot of the bed she would kiss their butt. So I dont think I should have to tolerate this but I am not sure how to approach it. I have the paperwork to write her up (not that it will do any good, but at least someone will know that CRNA's are tired of their crap.) Any helpful hints would be apprecitated.
thanks
bill

Sounds like you work with some real unhappy people. It's not your fault, and they have to live with themselves. Don't tolerate it. If someone says something mean to you, tell them it's not nice to say things like that, and look them in the eye, and wait for a response. There are books on dealing with difficult people, and they are helpful. When someone is nice give them a good word, right there on the spot. Your the CRNA, your the one in charge of your patient. Your the one leading nursing with higher education, and professional practice. I wish you all the best!!!