etherscreen

What I Was Not Necessarily Taught About Anesthesia is an excellent read!!! I can't recommend it highly enough for students as they progress through school. I think it's only available as an app???

I'm doing some research, and I'd like to ask a few questions. 1. What are your favorite review courses for the NCLEX? 2. What about each course make it stand out? 3. What didn't you like? 4. If you had to do it all over again, what would be the most important things you'd look for in a review course? Thanks so much!

This book is a must read by everyone before they enter school! It's very basic, but it will orient your mind to the essence of anesthesia practice and will help create a conceptual framework from which to build upon. How to Survive in Anaesthesia by N.Robinson Good luck in school!

Congratulations!!!

Hi CrnaRose. I didn't receive an email from you. Feel free to try again, PM me here, or send a message through Facebook. I'm happy to help you put a plan together. Since you didn't do very much of the course (and because I have very little data on you), you'll need to complete more content. I can look at your answers and compare them to the correct ones, and from there we can begin to formulate a solid plan for you.

Hi CrnaRose One common issue is that students often use too many review courses. It's quite easy to become paralyzed by having too much content at your fingertips, and often this means that students don't actually complete any of them. I can say that every student that's completed all of APEX has gone on to pass the National Certification Exam. What's most important to me is that you pass on your next attempt. The rate of failure increases as a function of number of attempts as well as the time that elapses since graduation. If you're previous plan didn't work, it may be time for a fresh one. What you need to do is contact APEX to create a customized plan to increase your odds of passing on your next attempt. Good luck!

First off, congratulations on getting into school. Getting in was the easy part At no other time in your professional career will you have the time to hone your craft that way that you will during your education. This means that you read before class, don't bolt out of the OR when the clock strikes a certain time, or skimp on your studies at home. Study habits are a personal thing. Learn the times of day when you're at your peak and maximize your learning during these times. For me, this is in the afternoon and after dinner well into the night. When things aren't clicking, put the books down for a few minutes and refresh. I recommend what I like to call "learning in layers." Learn the basic skeleton of the content you're trying to master. Then go back and fill in the gaps with key details, and after that go back and fill in the holes with minor details, and finally the minutia. Let's say your learning about local anesthetics. First, I would become familiar with the chapters a basic book such at Basics of Anesthesia or Morgan and Mikhail's Anesthesiology. After I've digested this content, I'd go another layer beyond these texts. I love Stoelting's Pharmacology and Physiology as well as Pharmacology and Physiology for Anesthesia by Hemmings, particularly for the molecular basis of action. If you start with one of these books, it's very likely that you'll miss the big picture. It's easy to get lost in the minutia. If you feel you're getting buried in the minutia, back up and re-orient yourself. Turn the content into a story. Learning the physiology of the neuromuscular junction isn't a collection of facts, but rather a fascinating story with some really cool characters. Find a study group. Take turns teaching each other. If you can't teach it to someone else, you don't know it! Learn to be an excellent test taker. There is an art form to this. To get better, you're going to need to practice with well-written practice questions backed by clear explanations. You have choices here. I'm clearly biased, but in the end, it's about picking something of high quality that meshes with your individual learning style. Don't be afraid to ask questions, but you shouldn't be asking questions about things that you should already know. There is a fine line here. You will be judged by the questions you ask, because they usually parallel your understanding. On the flip side, you can hurt someone if you don't ask. Your number one priority is your patient - not your pride. This is your job, your passion, and your life for the next several years. Make the most of it!

for those of you hesitant to add steroids to your local anesthetic mixture, there's also some interesting evidence that 10 mg dexamethasone IV also prolongs the duration of ISB. [h=1]Effect of dexamethasone on the duration of interscalene nerve blocks with ropivacaine or bupivacaine.[/h]Cummings KC 3rd1, Napierkowski DE, Parra-Sanchez I, Kurz A, Dalton JE, Brems JJ, Sessler DI. [h=3]Author information[/h] [h=3]Abstract[/h][h=4]BACKGROUND:[/h]Pain after shoulder surgery is often treated with interscalene nerve blocks. Single-injection blocks are effective, but time-limited. Adjuncts such as dexamethasone may help. We thus tested the hypothesis that adding dexamethasone significantly prolongs the duration of ropivacaine and bupivacaine analgesia and that the magnitude of the effect differs among the two local anaesthetics. [h=4]METHODS:[/h]In a double-blinded trial utilizing single-injection interscalene block, patients were randomized to one of four groups: (i) ropivacaine: 0.5% ropivacaine; (ii) bupivacaine: 0.5% bupivacaine; (iii) ropivacaine and steroid: 0.5% ropivacaine mixed with dexamethasone 8 mg; and (iv) bupivacaine and steroid: 0.5% bupivacaine mixed with dexamethasone 8 mg. The primary outcome was time to first analgesic request after post-anaesthesia care unit discharge. The Kaplan-Meier survival density estimation and stratified Cox's proportional hazard regression were used to compare groups. [h=4]RESULTS:[/h]Dexamethasone significantly prolonged the duration of analgesia of both ropivacaine [median (inter-quartile range) 11.8 (9.7, 13.8) vs 22.2 (18.0, 28.6) h, log-rank P [h=4]CONCLUSIONS:[/h]Dexamethasone prolongs analgesia from interscalene blocks using ropivacaine or bupivacaine, with the effect being stronger with ropivacaine. However, block duration was longer with plain bupivacaine than ropivacaine. Thus, although dexamethasone prolonged the action of ropivacaine more than that of bupivacaine, the combined effect of dexamethasone and either drug produced nearly the same 22 h of analgesia.

Surgeons do things the same way every case, those of us in anesthesia should be making decisions based on a particular patient for a particular case at a particular point in time. "Always" and "never" are dangerous words in our profession. And no, I do not place OGTs without a specific indication.