Tenesma

Tenesma

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All Content by Tenesma

  1. New CRNA vs. MDA and Patient outcome study

    Tenesma replied to gotosleep's topic in Certified Registered Nurse Anesthetist, CRNA

    I felt after hanging out on your boards for this period of time that most would recognize me as an MDA (and the reason i hang out here every once in a while is because i enjoy all forums where there...

  2. 'Shivers'/Uncontrollable Shaking after anesthesia?

    Tenesma replied to warzone's topic in Certified Registered Nurse Anesthetist, CRNA

    the cause is unknown but there are a lot of theories around... but the most important thing you should do is get control of that shivering... especially in people with compromised cardiac function......

  3. Related to shivering question

    Tenesma replied to lml33's topic in Certified Registered Nurse Anesthetist, CRNA

    there is no real answer regarding the shakes - but by most standards it is felt to be a hormonal response, and not related to sympathetic outflow. the reason why your BP dropped with both epidurals is...

  4. New CRNA vs. MDA and Patient outcome study

    Tenesma replied to gotosleep's topic in Certified Registered Nurse Anesthetist, CRNA

    flawed study for several reasons: 1) it is retrospective - we need a prospective well balanced study 2) it only looks at mortality rates on mainly benign procedures - in which morbidity/length of stay...

  5. inserting invasive lines in school

    Tenesma replied to MTM's topic in Certified Registered Nurse Anesthetist, CRNA

    hehe... by the way, tenesma is the plural of tenesmus - which means anal spasms... how is that for

  6. inserting invasive lines in school

    Tenesma replied to MTM's topic in Certified Registered Nurse Anesthetist, CRNA

    every MD should know how to insert a chest tube in case of an emergency (if a surgeon isn't around) - and definitely the first treatment for a pneumothorax isn't a chest tube but rather a needle...

  7. PA's doing Anesthesia??

    Tenesma replied to smogmatt's topic in Certified Registered Nurse Anesthetist, CRNA

    1) the ASA has no motivation to provide MDA care in rural areas as there aren't major tertiary medical centers in rural areas requiring a higher level of complexity in care 2) the army has 60 active...

  8. PA's doing Anesthesia??

    Tenesma replied to smogmatt's topic in Certified Registered Nurse Anesthetist, CRNA

    smiling-ru... i understand your point of view... i am sure at the bottom of everything we do there is always the intent for power and more money, i just don't think it is that obvious in this...

  9. PA's doing Anesthesia??

    Tenesma replied to smogmatt's topic in Certified Registered Nurse Anesthetist, CRNA

    smiling ru.... "This translates into a workhorse who can not practice without the anesthesiologist, which means an increase in work production and income for the anesthesiologist, without a perceived...

  10. PA's doing Anesthesia??

    Tenesma replied to smogmatt's topic in Certified Registered Nurse Anesthetist, CRNA

    i just read that article from the AMA... i don't think this has anything to do with being threatened in a financial way... i think the big issue in that article revolves around non-physicians assuming...

  11. PA's doing Anesthesia??

    Tenesma replied to smogmatt's topic in Certified Registered Nurse Anesthetist, CRNA

    i disagree about the money issue... if this was about money, then there would be no incentive to add providers (or provider assistants) to the market as this would lead to decreased reimbursement....

  12. PA's doing Anesthesia??

    Tenesma replied to smogmatt's topic in Certified Registered Nurse Anesthetist, CRNA

    i don't know what the ruckus is all about... it is clear that there is a shortage of anesthesia providers in this country... CRNAs and AAs are two different animals and aren't in conflict with each...

  13. Lidocaine question

    Tenesma replied to New CCU RN's topic in Certified Registered Nurse Anesthetist, CRNA

    hmmm.... now the story is coming together, and getting interesting.... did the patient get a sengstaken-blakemore tube??? is he on an octreotide drip? it sounds like he is way behind in fluids.... or...

  14. Lidocaine question

    Tenesma replied to New CCU RN's topic in Certified Registered Nurse Anesthetist, CRNA

    why was the patients pressure low? was it a real pressure? (proper reading?).... usually if the pressure is low prior to intubation, i address it after intubation - as intubation is extremely...

  15. Lidocaine question

    Tenesma replied to New CCU RN's topic in Certified Registered Nurse Anesthetist, CRNA

    lidocaine used to be pretty popular as part of the normal induction meds.... and some people are still in the habit of using it, even though there isn't much evidence for its usefulness... in fact,...

  16. Nitro vs Nipride

    Tenesma replied to braden74's topic in Certified Registered Nurse Anesthetist, CRNA

    brenna: svr is decreased because of dobutamines direct effect, but also at the same time remember that SVR is a purely calculated number (in which cardiac output plays a big role)... i am sorry i...

  17. Nitro vs Nipride

    Tenesma replied to braden74's topic in Certified Registered Nurse Anesthetist, CRNA

    brenna: you are on the ball when you say that decreased afterload is beneficial in the setting of pump failure.... however dobutamine is a poor choice for improving SVR. In fact, it works mainly...

  18. Nitro vs Nipride

    Tenesma replied to braden74's topic in Certified Registered Nurse Anesthetist, CRNA

    for Tia: dopamine and dobutamine are 2 very different drugs despite very similar names... and are therefore used for totally different situations. dopamine has dopaminergic, beta and alpha agonist...

  19. 24hr call shifts

    Tenesma replied to TexasCRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    well since my name was mentioned by roland.... i might as well throw in my 2 cents... 24 hour shifts... to be quite honest is a definite improvement over my old 36 to 40 hour shifts in the past... i...

  20. CRNA to MDA

    Tenesma replied to scurvy's topic in Certified Registered Nurse Anesthetist, CRNA

    never trust caribbean schools..... first of all, nobody ever becomes an anesthesia attending without passing anesthesia boards which REQUIRE 3 years of anesthesia residency, which in turn require 1...

  21. Becoming a CRNA - From One Who Did It

    Tenesma replied to kmchugh's topic in Certified Registered Nurse Anesthetist, CRNA

    there are no accelerated MDA programs... in order to become an MDA you still have to do 4 years of medschool and 4 years of residency - whether you have your CRNA or not. there are a few accelerated...

  22. malignant hyperthermia

    Tenesma replied to ICUBecky's topic in Certified Registered Nurse Anesthetist, CRNA

    ICUbecky... thanks for the extra info on your patient... the temperature in this case is most likely due to the systemic inflammatory response after a massive cardiac arrest - the body releases all...

  23. malignant hyperthermia

    Tenesma replied to ICUBecky's topic in Certified Registered Nurse Anesthetist, CRNA

    It is not unusual for anoxic injury to the brainstem to cause misregulation of the thermo-regulatory centers - kind of like the brain is getting the information that the body is hypothermic and then...

  24. MD vs CRNA

    Tenesma replied to New CCU RN's topic in Certified Registered Nurse Anesthetist, CRNA

    MDA isn't insulting/derogatory in any way....

  25. MD vs CRNA

    Tenesma replied to New CCU RN's topic in Certified Registered Nurse Anesthetist, CRNA

    i see where you are coming from but i still have one point of contention left over... i really, really hope that it isn't the policy of the AANA to follow surgeon's "orders" to provide anesthetic......