AmiK25

I would think that someone who does it everyday would know that you should not give someone 3 mg/kg of Fentanyl. I have never heard of giving 10% of your Sux dose to defasciculate....only heard of giving 10% of the intubating dose of a non-depolarizing agent. Does the Succs actually work? Also, lidocaine is given for other reasons besides prevention of increased ICP with Succs (which really requires about 1.5 mg/kg). It also blunts the sympathetic nervous system response to laryngoscopy.

The University of Cincinnati has all clinicals in the Cincinnati area, with most being at University Hospital on campus. The farthest site away from downtown is 30 minutes.

I realize that at one point you were discussing pushing epi for anaphylactic shock. However, in your post, you did not say epi, you said neo and I don't think you were still discussing anaphylactic shock because obviously, you do push epi, regardless of whether the patient is tachycardic or not (which they should be if it is anaphylaxis). I think that instead of learning from this thread (which we all have), you just cannot admit that there might be something you don't know and you have an excuse for everything. We are all learning on a daily basis, whether it be in the OR, ER, or ICU and we should all be able to admit that there are things we don't know. I'm not trying to be rude but that is my honest opinion.

Post-operative nausea and vomiting

what if the pt iwas allergic to eggs and you didn't know that? do you have we have a kit too. and i have never seen a board certified er doc or an intensivist in 20 years put pressors before fluids. see my post above about tachyarrythmias etc. you would really do that? push neo directly for a sbp in the 60s and a heart rate of 122? do you worry about throwing the pt into svt of 160 or so? do you have adenosine ready in 3 syringes? 6/6/12? do you wonder about inducing v tach? do you compare the mean to your baseline?? now you've got bigger problems!!! Actually, Neosynephrine causes a decrease in heart rate, not an increase. Neo would be a great choice for a patient with a low blood pressure with a high heart rate, especially if it was due to the vasodilating affect of propofol. Neo, although it has other actions, works primarily by vasoconstriction. This vasoconstriction causes an increase in afterload and venous return, which results in reflex bradycardia. So yes, in anesthesia, we routinely push Neo 100-200 mcg at a time for hypotension that occurs after induction. And yes, we also give fluid, etc...

The actual course may not be $1000 but by the time you pay for hotel, food, and gas....it will be right around that amount for the weekend.

You need something like 1700 hours, which amounts to about 1 year of full-time work.

I'm with you here....our new class starts Tuesday and I feel like the second years knew so much when we started last year and now that I am a second year, I don't know anything!! Congrats to the graduates....I can't wait! Ami

I agree with midwestern....I just don't see a good reason to spend that much money to recert while in school. As a poor RNSA drowning in student loan debt, I let my CCRN lapse. Now, I do think it helped me get into school so for those not already accepted, I highly recommend getting your CCRN...and once accepted, don't worry about!!

Hope this helps!

Somehow this sentence didnt' end up in quotes but it is supposed to be "I never thought I would have the intelligence to do it, but I heard someone make the comment that CRNA schools basically take you if you have ICU experience and a pulse." Now, I'm not saying you don't have what it takes to get into an anesthesia program, but that statement is definitely not true!! There are many applicants for a very small number of positions in most anesthesia programs.

Well, I haven't done OB yet (September and October of this year) but I will give it a shot. I would do a spinal (as long as the patient does not have plates/rods/screws in the lumbar region...which is doesn't sound like she does). My concerns would be autonomic hyperreflexia (make sure she has an adequate block before proceeding....but I'm not really sure the best way to assess this given the fact that she has no sensory function below T6....do you just look at vital signs??) and hypoventilation if the spinal was too high becuase she may already have some respiratory insufficiency due to paralysis of abdominal accessory muscles. Obviously, avoid Sux if you have to do a general and I suppose I would choose Mivacron or try to do an awake fiberoptic intubation given the incidence of cannot intubate/cannot ventilate with pregnancy. Like I said, I haven't been to OB yet just wanted to venture a guess. I may be way off. How did you handle the case?

Yeah, you're right...six months is probably closer to being accurate! I definitely still have days when I am all thumbs and feel like I don't know what I am doing, but it is getting better each day. Of course, now I have my OB rotation coming up soon and it's right back to not having a clue what I'm doing Ami

Sigma, Just remember...you will feel like a total idiot and completely out of place for the first month or so. Even something as simple as starting an IV, which you may have done hundreds of times, feels totally foreign in anesthesia school. Eveyone else feels that way, too, but it will get better. Sometimes, I even feel like a know a little bit of what I'm doing these days (10 months into an integrated program). Just have a positive attitude (it's very hard sometimes) and remember that there are a hundred ways to do anesthesia so when someone tells you you are doing it wrong, just smile and say "Ok, thank you." Good luck, Ami

Brian, We have them furnished in all our rooms...whether or not they work or the batteries are current is another story I would definitely not buy one...wait until school starts and then ask a rep if you want your own. Ami