Gotosleepy

Latest Activity

1. Beginner with OB epidurals

   Gotosleepy replied to SproutRN's topic in Certified Registered Nurse Anesthetist, CRNA

   like said above.... the catheter issues are old... In fact, microcatheters are BIG in Europe now and are on their way through the FDA process - some of the microcatheters are 32 Gauge!!!! In fact most...

2. lets discuss extubation

   Gotosleepy replied to gaspassah's topic in Certified Registered Nurse Anesthetist, CRNA

   georgia ... agreed... i like adding vioxx 25mg po prior to induction... in my practice, i feel it has made a nice improvement on limiting narcotic

3. Is It Possible to Feel Surgical Procedure

   Gotosleepy replied to nightingale's topic in Certified Registered Nurse Anesthetist, CRNA

   interesting note: we used to do and interpret our own EEGs for SSEPs/MEPs and carotids while doing those cases.... now the neuro depts have a political stranglehold... the incidence of awareness used...

4. lets discuss extubation

   Gotosleepy replied to gaspassah's topic in Certified Registered Nurse Anesthetist, CRNA

   there is nothing wrong with high-dose narcotic techniques - especially in neonates or in cardiac or even in neuro patients.... but to use high dose fentanyl for other cases that are short (ie:...

5. lets discuss extubation

   Gotosleepy replied to gaspassah's topic in Certified Registered Nurse Anesthetist, CRNA

   while i like the idea of high-dose narcotics - giving a patient 700mcg of fentanyl for a 20 minute case? give me a break.... while i agree the less volatile you use, the better the wake up, I find...

6. lets discuss extubation

   Gotosleepy replied to gaspassah's topic in Certified Registered Nurse Anesthetist, CRNA

   10 to 15 ug/kg??? isn't that a bit high? unless the case is going to last 4 hours or

7. what would you consider GENERAL anesthesia

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

   i like the old definition of MAC... if there is a fire during a MAC, the patient should be able to get up off the OR table and run with you to the nearest exit... 3% DES??? masking them... with a...

8. opinion on clinical practice

   Gotosleepy replied to gaspassah's topic in Certified Registered Nurse Anesthetist, CRNA

   i don't think giving NDMB prior to establishing an airway is very smart at all... However, I frequently give NDMB prior to establishing an airway if I know that the patient has a recent history of...

9. opinion on clinical practice

   Gotosleepy replied to gaspassah's topic in Certified Registered Nurse Anesthetist, CRNA

   nobody can defend giving a paralytic without ventilating... however we do it all the time for RSI.... are all RSI patients easier to intubate? and what do you do for a patient that is MH-susceptible...

10. opinion on clinical practice

    Gotosleepy replied to gaspassah's topic in Certified Registered Nurse Anesthetist, CRNA

    so if you can ventilate .... does that mean that you can always intubate? and if you aren't 100% positive that you can intubate, why not do all of your inubations awake?.... food for

11. opinion on clinical practice

    Gotosleepy replied to gaspassah's topic in Certified Registered Nurse Anesthetist, CRNA

    okay.... so now you can't ventilate, patient is desaturating.... are you going to try to intubate? if so, what drugs will you give and

12. Is it possible to titrate paralytics?

    Gotosleepy replied to Diprivan/Vented's topic in Certified Registered Nurse Anesthetist, CRNA

    gaspassah.... i see your point, and I have become far more selective in which patients i use LMAs... And no, i don't advocate the use of LMAs for c/s as they do in England.... not because i don't...

13. Is it possible to titrate paralytics?

    Gotosleepy replied to Diprivan/Vented's topic in Certified Registered Nurse Anesthetist, CRNA

    athomas... what is the incidence of aspiration with general anesthesia, what is the incidence of aspiration for LMAs and for ETT.... you'd be surprised by what you

14. Is it possible to titrate paralytics?

    Gotosleepy replied to Diprivan/Vented's topic in Certified Registered Nurse Anesthetist, CRNA

    the reason i still use lmas despite my 2 silent aspirations is based on scientific grounds (ie: literature based).... just because i have 2 adverse reactions with a device doesn't mean i shouldn't...

15. Is it possible to titrate paralytics?

    Gotosleepy replied to Diprivan/Vented's topic in Certified Registered Nurse Anesthetist, CRNA

    i agree with you jwk... they should definitely not be used indisciminately... in fact, i had two silent aspirations in no-risk factor young patients (both were okay after all), but still LMA isn't...