pasgasser

pasgasser

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All Content by pasgasser

  1. BIS Monitor

    pasgasser replied to sandman1914's topic in Certified Registered Nurse Anesthetist, 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...

  2. Pneumonic for GAS LAW

    pasgasser replied to CRNAMASTER's topic in Certified Registered Nurse Anesthetist, 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...

  3. Beginner with OB epidurals

    pasgasser replied to SproutRN's topic in Certified Registered Nurse Anesthetist, 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...

  4. Why would an anesthesia provider do this?

    pasgasser replied to AmiK25's topic in Certified Registered Nurse Anesthetist, 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....

  5. Side effects of spinal anesthesia

    pasgasser replied to Helori's topic in Certified Registered Nurse Anesthetist, 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....

  6. Side effects of spinal anesthesia

    pasgasser replied to Helori's topic in Certified Registered Nurse Anesthetist, 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...

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

    pasgasser replied to Diprivan/Vented's topic in Certified Registered Nurse Anesthetist, 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...

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

    pasgasser replied to Diprivan/Vented's topic in Certified Registered Nurse Anesthetist, 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...

  9. CRNA working as PACU RN

    pasgasser replied to DKSH's topic in Certified Registered Nurse Anesthetist, 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...

  10. Woman Warns Against Anesthesia Awareness

    pasgasser replied to nursebedlam's topic in Certified Registered Nurse Anesthetist, 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...

  11. Propofol question

    pasgasser replied to chris_at_lucas_RN's topic in Certified Registered Nurse Anesthetist, 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...

  12. dexmetatomadine

    pasgasser replied to jbro's topic in Certified Registered Nurse Anesthetist, 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...

  13. dexmetatomadine

    pasgasser replied to jbro's topic in Certified Registered Nurse Anesthetist, 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...

  14. dexmetatomadine

    pasgasser replied to jbro's topic in Certified Registered Nurse Anesthetist, 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...

  15. dexmetatomadine

    pasgasser replied to jbro's topic in Certified Registered Nurse Anesthetist, 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...

  16. The most challenging anesthesia cases?

    pasgasser replied to UCDSICURN's topic in Certified Registered Nurse Anesthetist, CRNA

    Tenesma sounds like tough case. Regarding awake crani's try using dexmeditomidine. It provides exceptional sedation while not decreasing respiratory drive and increasing PaCO2 (important for awake...

  17. CRNA To MD

    pasgasser replied to rigor0313's topic in Certified Registered Nurse Anesthetist, CRNA

    I am familar with 2 CRNA's who then went to medical school and both went into anesthesia. They both stated that their motivation was a desire to have increased medical knowledge. (Some people enjoy...

  18. extubating deep

    pasgasser replied to athomas91's topic in Certified Registered Nurse Anesthetist, CRNA

    I extubate many pt's deep. In response to gaspassah, I would not extubate a neuro pt deep. By using IV lidocaine coughing on the ETT is avoidable, however, the volatile anesthetic depth needed to...

  19. Foreign MDs becoming US CRNAs

    pasgasser replied to calgal's topic in Certified Registered Nurse Anesthetist, CRNA

    As a physician I have come in contact with several foreign trained doctors the biggest issue is that often they cannot pass the USMLE and therefore cannot practice medicine in the US. For some the...

  20. Treatment for Pediatric bronchospasm

    pasgasser replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    Isoproterenol is a beta

  21. Treatment for Pediatric bronchospasm

    pasgasser replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    Acetylcholine is a bronchconstrictor so giving pre-op atropine or glycopyrolate decreases intra-op bronchospasm. These are effective IV, IM, or

  22. Treatment for Pediatric bronchospasm

    pasgasser replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    Tenesma is correct in that epinephrine is one of the most effective if not the most effective way to treat severe bronchospasm and is usually more readily available than isoproterenol. Ephedrine is a...

  23. Anti-dysrhythmic therapy for Malignant Hyperthermia

    pasgasser replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    Until the potasium is lowered the pt's arrhythmia will likely be resistant to all measures. After the potassium is lowered I would use the usual protocol (ACLS) to treat arrhythmias and would start...

  24. Anti-dysrhythmic therapy for Malignant Hyperthermia

    pasgasser replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    I have not posted on this board before so I will introduce myself. I follow this board and read primarily the posts regarding clinical questions and do not desire to be involed in politcal...