sproutsfriend

Agree completely, I loaded up my brain with so much info that it was clogged up and I had tremendous trouble critically thinking and that made it tough. The verdict is still out on my exam result.

Valley is INVALUABLE. I took the exam last week. Studying Valley for the past 3 months has made me much more knowledgeable about every aspect of physiology as well as anesthesia. Memory Master and Sweat book are excellent. However, now that I've taken the exam I would also recommend spending time in Stoelting's co-exisiting disease text.

Most do even if you don't witness it in public.

I agree, its the oxygen carrying capacity of the intravascular volume that we need to worry about. If we dilute the grams of hgb per deciliter down too much with excessive fluid administration our oxygen delivery will be insufficient to meet oxygen consumption by the tissues. The critical hgb where compensatory mechanisms are exhausted and metabolism switches from aerobic to anaerobic is typically between 3-4.5 g/dl This makes sense mathmatically because if you calculate the oxygen content based on a hgb of 3 g/dl and then multiply it by your cardiac output your delivery will be usually under typical oxygen consumption of 3 ml of oxygen per kg of body weight per minute and ischemic tissue will result.

The term resident was started back when young M.D.s actually lived in the hospitals (their residence) during their internships.

Neo could be a good choice but also look at the diastolic BP before giving an alpha 1 agonists such as neo because a beta blocked heart can go into failure if the SVR gets too high.

The vent delivers positive pressure ventilation so the negative pressure you describe would not be present. I'd let the CO2 creep up to stimulate catecholamine release which should raise HR and increase SVR.

Die thread die

Look in the Mass General book and it will confirm that 5 mg of phenylephrine is utilized. I've used it a number of times and it works very well.

I may be missing something here but the robotic prostatectomies I've done (as stated in an earlier reply) took only 2 hours and 15 minutes not 8 hours. 2:15 is shorter than 3-4 hours. Also, I'm not sure what if any advantages the robot has over the conventional laparoscopic approach. I will say this however, that there were no wasted movements (which could also occur with the conventional laparoscopic approach). One last advantage which doesn't deal with anesthesia charges but does save health care dollars in theory is that the robot is manipulated by ONE surgeon only which eliminates the 2nd surgeons charges which could or could not occur in a lap technique and an open technique.

It is well worth it. I was at an institution in Bham Al. which was one of the first doing the davinci robotic procedure. They've now done over 500 cases. The patient has less pain, the average blood loss is 50 cc's compared to 2500 cc's and the procedure is 2 hours 15 minutes typically. Recovery time is shortened and hospital discharge is sooner so lenght of stay is less so more DRG money for the hospital to retain. The surgeon (not surgeons) sits at his console in the corner and it looks as though he's playing a video game while the robotic arms are being manipulated. When I need my prostate taken out this is the way I'm having it done.

Unfortunately, it appears we'll need more than a few truthful threads to deflate his head. The greatest most respected leaders of all time lead by demonstrating servant leadership and respect for all those around them. The fact that the OR nurses expected him to wipe off the back is an indication that he has shown little respect for them in the past. Our nursing background is what profoundly differentiates our care from anesthesiologists. We have a caring component with our anesthesia delivery that physicians are often deficient in demonstrating. Our nursing background is also what distinguishes us from the AAs. (Oooops, did I open up a can with that comment?)

I can't help myself, I'm a chronic name caller. Just ask the moderators of this forum who have censored me repeatedly.

The MDAs on the Student Doctor Net are providing the e-mail addresses of the Florida legislators hoping that their faithful will pressure them into passing the bill. Those idiots don't realize that many of us monitor their threads and will use the e-mail addresses to defeat the bill. Invest a little time in a broadcast e-mail to those legislators. Here is the link http://forums.studentdoctor.net/showthread.php?t=197770

I completely agree.