Hollywood movie called "awake"

oneillk1 · Mar 5, 2006

Like people need more to fear before surgery.:angryfire

Hey if it made just one person scared enough not to do the stupid thing that sees them in my OR (putting hand through glass window, driving drunk, overeating, drinking and smoking) I'm all for it.

Yes I am slightly cynical but that's the nature of the game here really.

INTEVA · Mar 5, 2006

Thank goodness for the use of BIS monitors during anesthesia;they just need to do an article or TV special so people can understand that things like this should not happen.

jewelcutt · Mar 5, 2006

People are already skeptical about medical professionals. I find a common attitude amongst a certain subset of the population that believes we don't care and that we're only in it for the money. I am constantly arguing with both my brother and father about the morals of most HCPs. I believe that those of us in the medical field are actually above the rest relating to morals and ethics, we actually care about what happens to others and have a wish to help. In a society that is skeptical about when they recieve pain meds in an ER and how long it takes them to see their doctor at an office visit, I can't help but think that this movie will only worsen their views of us. Society thinks we stand around or go on lunch when there are appointments to be seen. Pain is a very personal experience, and very emotional. How can this movie be a good thing for the anesthesia profession? Society doesn't care why anesthesia awareness happens, only that it they are caused pain and we didn't stop it. We will be seen as uncaring individuals who don't know what we're doing or how to correct anesthesia awareness. They're going to show some crass doctor denying the patient had it, and saying that it's not a big deal. The recall is going to be with doctors an nurses laughing in the background and talking about their golf games with music playing, then there's going to be some talk about getting this surgery done quick so they can get out of there, he'll ask for the scalpel, and then you'll hear a saw or something. You know they're not going to spin the movie with caring anesthesia providers who have support groups for individuals with awareness.The anesthesia provider is going to get shunned in the end by the almighty pt who was right all along (even if it is Hayden Chistensen, i love him!).

jwk · Mar 5, 2006

Thank goodness for the use of BIS monitors during anesthesia;they just need to do an article or TV special so people can understand that things like this should not happen.

BIS doesn't work. There are numerous threads on here about it.

Nitecap · Mar 5, 2006

BIS doesn't work. There are numerous threads on here about it.

I think to say BIS totally doesnt work may be a little drastic. I find it can work sometimes but freqly is inacqurate d/t other devices, poor pad contact ect. I do believe that it is the first of its kind and they will try to master developement of a new and one day standard monitor. No its not perfect but hopefully in 5 or so years they will have a monitor of that sort just as effective as say a ECG.

heartICU · Mar 5, 2006

I think to say BIS totally doesnt work may be a little drastic. I find it can work sometimes but freqly is inacqurate d/t other devices, poor pad contact ect. I do believe that it is the first of its kind and they will try to master developement of a new and one day standard monitor. No its not perfect but hopefully in 5 or so years they will have a monitor of that sort just as effective as say a ECG.

Not to incite an argument here, but how do you know it works? The problem I have with the BIS is that there is no second way to check its accuracy. For example, if I believe the EKG is reading an incorrect heart rate, I can feel the pulse. If I feel the ETCO2 is wrong, I can send an ABG. If I think the pulse ox is incorrect, I can check the ABG. There is no way to "check" to see if the BIS is working or not, other than asking the patient if they remember anything from surgery. And their memories are often jumbled from the miscellaneous drugs we administer (benzos, narcs, volatile agents, antiemetics, psychotropics, etc) not to mention their preexisting conditions.

Nitecap · Mar 5, 2006

Not to incite an argument here, but how do you know it works? The problem I have with the BIS is that there is no second way to check its accuracy. For example, if I believe the EKG is reading an incorrect heart rate, I can feel the pulse. If I feel the ETCO2 is wrong, I can send an ABG. If I think the pulse ox is incorrect, I can check the ABG. There is no way to "check" to see if the BIS is working or not, other than asking the patient if they remember anything from surgery. And their memories are often jumbled from the miscellaneous drugs we administer (benzos, narcs, volatile agents, antiemetics, psychotropics, etc) not to mention their preexisting conditions.

I get your point on the double checking issue no doubt. Here is how I think it works. I have cared for several BIS pts in the ICU and this is the place where I could really see it work b/c I may be with this particular real sick pt for 3 or more 12 hr shifts constantly staring at the BIS.

Many times say it the pt was on propofol infusion, nimbex maybe, fent we would use BIS. Pt riding along fine, BIS say 40-50. Then I go to turn him. After the turn and maybe suction stimulating the pt he is aggitated, tachy, hypertensive BIS around 75-80. SO I bolus 10ml or so of propofol or some ativan or versed, bam BIS back down to 40 or lower, HR down, BP back down. If I had a good connection to the pt with no other motion, electrical or any other interference you could really watch the trends. Pts family at bedside and stimulating him, talk to him in his ear crying hold his hand and what not BIS back at 75, family leaves, give a little propofol bolus BIS back down. This is my rationale for saying that I think at times it does work. I understand the whole not being able to verify it aurgument but then at the same time Im not gonna make a descision soley based on a BIS monitor value. Really I think of the BIS as just an adjunct to your pt assessment, intution, understanding of the drugs that you have given ect. Its just their to give me an extra piece of data to ponder during the desicion making process.

anilina · Mar 6, 2006

This is just another way for hollywood to make a montain out of a mole hill and scare the genral public. I know this has happened but I do belive we have advanced in our knowled of this problem. This movie 'Awake' people awake during surgery,will stir up fear where there should not be any.

SRNA1 · Mar 6, 2006

Hello to all.

Am a SRNA in South Carolina and our program was made "aware" of this upcoming Hollywood film. What a nightmare. This is going to have the community up in arms, no doubt. I will say that I have been working on a research project so far this year regarding BIS monitor usage. The reseach states that awareness is 0.1-0.2% for general surgery case but up to 1.5% for Cardiac cases. Trauma can be as high as 11-40%. By the way did the pharmacy check with the CRNA as to the wastage? Doesn't Fentanyl come in glass vials and wouldn't the CRNA know if the tech was scamming the drugs?

And is JWK a CRNA of SRNA? Let me know. The BIS does work although it has not been aprroved a Standard of Care for Anesthesia. It is used in conjunction with critical thinking as the patient ANS response. Further research is being conducted.

SRNA1

TheLemur · Mar 7, 2006

JWK is an Anesthesiologist Assistant who is well-respected around here for his clinical knowledge and opinions on all things anesthesia-related, despite the differences the two professions may have. At least, I think so.

SFCardiacRN · Mar 7, 2006

Doesn't Fentanyl come in glass vials and wouldn't the CRNA know if the tech was scamming the drugs?

I was at a hospital that had pharmacy pre-fill syringes and put them into fishing style tackle boxes for each case. This practice was discontinued after the tech got caught stealing.

steelcityrn, RN · Mar 7, 2006

this story is not that far fetched. too bad i didn't get my rough draft in first, i could possibly retire to hawaii...

[color=yellow]steelers are the super bowl champs!!