I work in a procedure lab that does a lot of local anaesthesia with Lidocaine 2% and though not often, some patients are having very similar rx's to something in the procedure. At first I thought it was related to part of my moderate sedation meds but now I'm looking out farther and eyeballing Lidocaine 2% as a possible suspect.
What I would like is your personal experiences ie. signs, symptoms and treatment when you suspected a lidocain OD.
PLease refrain from too much quoting from a book. I am looking for personal accounts please.
This is the same insightful genius that continues to grossly overdose patients with lidocaine and causes toxicity S/S?
But you know, just my two cents.
You know, Joshua is right...this thread has gone off of its topic. You guys are too damn busy trying to prove your intellectuall superiority and brow beating this guy that you fail to even read the posts. The MD is given the lidocaine as part of a local. He felt that this may be causing the problems he was seeing and turned to the "experts" to see if they had seen it. HE WAS NOT GIVING THE LIDO! Really, you should all be ashamed of yourselves..no change from the history of nurses eating their young. You just went and got a grad degree and are now just eating more voraciously. I'm sorry I ever started looking at this BB. Some of you act just like the arrogant, sophomoric med students and residents on SDN.
You know, Joshua is right...this thread has gone off of its topic. You guys are too damn busy trying to prove your intellectuall superiority and brow beating this guy that you fail to even read the posts. The MD is given the lidocaine as part of a local. He felt that this may be causing the problems he was seeing and turned to the "experts" to see if they had seen it. HE WAS NOT GIVING THE LIDO! Really, you should all be ashamed of yourselves..no change from the history of nurses eating their young. You just went and got a grad degree and are now just eating more voraciously. I'm sorry I ever started looking at this BB. Some of you act just like the arrogant, sophomoric med students and residents on SDN.
speaking about jumping down throats... rn29306 wasn't referring to the poster as a genius but the DOCTOR administering the local... the part she was referring to is that why would anyone follow orders from a genius that is continually OD'ing patients... it isn't about browbeating anyone it is about common sense... and when you come to a forum where nurses have worked their orifices off to advance their practice and continue to fight for a profession which medicine stole... don't be surprised when it ticks them off that others are giving anesthetics just because a doc told em to... yoga is right on target.. any of those cases go to court and it still could be a problem for joshua even though he wasn't giving the lido... part of providing anesthesia is protecting the patient from the surgeons who are administering LOCAL ANESTHESIA.....key word...anesthesia... so i again propose.. know your institution's policies... (in this case country practice may also differ) these procedures that need anesthesia - need anesthesia providers...
i again will state - i think you would be just as adamant if a transport tech was practicing nursing... two different entities....
joshua, i think you will notice in my last post that you were commended for picking up on the problem and trying to protect your patients... my only point to you is be careful... docs will give orders to whomever will follow them - but the orders you are following may not fall within your practice guidelines...just make sure that way you are protected from his laziness.
joshua, i think you will notice in my last post that you were commended for picking up on the problem and trying to protect your patients... my only point to you is be careful... docs will give orders to whomever will follow them - but the orders you are following may not fall within your practice guidelines...just make sure that way you are protected from his laziness.
I usually do not get too involved in some of the BS on this BB. However maybe if you took the time to read the initial post, the vagueness of it makes it seem as if Joshua is administering the meds including the lido. Please do not begrudge us for our grad degrees because they are available for anyone to pursue. In the OR we usually nurture our young and not eat them that is usually a skill bedside nurses specialize in! That being said it is a sad day in healthcare when Joshua has to do the physicians homework for him and I would be skeptical about working for somebody of this nature. As far as the being ashamed comment, you need to reserve that for your kids! Many of us get sick and tired of the " you think you are better than us because you are a CRNA" mentality. I don't think any CRNA on this BB is going to aplogize to you for being a CRNA. At this point this has nothing to do with Joshua. Guaranteed whenever a discussion becomes heated between CRNAs and and a staff nurse the trump card is always about the CRNA feeling superior. Get over it because you will be waiting a long time for a CRNA to aplogize for being a CRNA. And as far as the graduate degree goes I display mine very proudly on my wall!
Unlike some I am refusing to air my dirty laundry in a public forum. We could nanny nanny boo boo this for eternity. Just check your facts. I read his post but you obviously didn't otherwise you would have seen where he followed with a clarification as he was being purposefully vague for what he thought was a good reason.
speaking about jumping down throats... rn29306 wasn't referring to the poster as a genius but the DOCTOR administering the local... the part she was referring to is that why would anyone follow orders from a genius that is continually OD'ing patients...
I was indeed speaking of the physician in this case, not the poster.
Nah. You now, I just started reading these things a few months ago. I was reading sdn but those med students and residents just want to flame everybody and it just got sickening. It just seems to be getting that way here. This guy was just trying to find out if anybody had any lido stories that might match his...he was obviously on to something. He wasn't looking to be lectured, beaten, scolded and called names...just thought he would turn to some experts. And now look at this poor soul from Slovenia asking about how anesthesia is delivered in the good ol USA. People are jumping on him light and right and making fun of him. He is from half way around the world for god's sake. He doesn't have any idea about here. There are just some guerilla tactics that would play better in Bahgdad than on here. I just came here looking for some insight, some knowledge, "pearls", and maybe some laughs. Right now it just saddens and disappoints me. Jumping on people, calling them names and being defensive will just not win to many fights at this level. We are professionals, right? I will use JWK for an example. He usually plays it pretty cool and is well organized in his thoughts. Jumping on him like a fifth grader is not going to help the crna cause. Makes crna's look bad and immature. Yes, I have heard about the wars: crna v. mda and crna v. aa. Acting like that will just not win many battles or influence people and make friends. I have many friends that are srna's and crna's....none act like some of the people have here. It's a public forum and opinions are like assholes...everyone has one and everyone has the right to it. I gave four years of my life serving our country and I respect that right. I just think it could be said better. That's all. I am proud to be starting crna school soon and I hope to serve the profession well and make all those before me and after me proud as well. I have much to learn about all facets, but at this point in my career I can learn just as much anesthesia from jwk as I can yoga. There have been a lot of great threads on here in the past...seems they have turned recently. Right now, I have a lot of rows to plow and hoops to jump. By the way, how are things out in SC these days? One of the greatest places to be!
.........Recently I've been exposed to 4 cases of an odd phenomenon that appears like acute seizures........
The procedure is implanting of Pacers and ICD's.
..........
Meds used by myself are usually
Diphenhydramine 50 mg iv once
Fentanyl 25-50 mg bumps
Midazolam 0.5-2mg bumps
.......
As this is a CRNA forum, please do not take offense when I suggest that these patients sound as if they would be best served by having an anesthesia provider giving them their MAC.
deepz
It sounds like this stuff is being done in the ep lab. Around here they use what "they" refer to as "deep cs" for these long ep procedures. They are usually done by RN's. Is it more like anesthesia than sedation? Does it sound like a duck and walk like a duck? Should an anesthesia pro be doing it...even with my minisucle knowledge, yep. but they don't, not around here anyway until something happens and they lose the airway.
I hope you rec'd my reply to your pm. You were doing okay until you started with the threats and as you can see I am not good at dealing with threats from others on BB or in person for that fact. Let us not send each other any more pms so we can exit our discussions with dignity no matter how we disagree on an issue. Peace for now until you make another threat!
It sounds like this stuff is being done in the ep lab. Around here they use what "they" refer to as "deep cs" for these long ep procedures. They are usually done by RN's. Is it more like anesthesia than sedation? Does it sound like a duck and walk like a duck? Should an anesthesia pro be doing it...even with my minisucle knowledge, yep. but they don't, not around here anyway until something happens and they lose the airway.
Part of the problem is that there is limited if any reimbursement for anesthesia professional services for pacemakers and AICD's, partcularly from Medicare. A similar problem is creeping in for anesthesia services for GI endoscopy, although we're still getting paid for most of those.
rayman
158 Posts
You know, Joshua is right...this thread has gone off of its topic. You guys are too damn busy trying to prove your intellectuall superiority and brow beating this guy that you fail to even read the posts.
The MD is given the lidocaine as part of a local. He felt that this may be causing the problems he was seeing and turned to the "experts" to see if they had seen it. HE WAS NOT GIVING THE LIDO! Really, you should all be ashamed of yourselves..no change from the history of nurses eating their young. You just went and got a grad degree and are now just eating more voraciously. I'm sorry I ever started looking at this BB. Some of you act just like the arrogant, sophomoric med students and residents on SDN.