Sunday, July 3, 2011

Anesthesia 101

After introducing myself to the anesthesiologist I would be working with for the day he quipped, "I'm not an intubation monkey, you are going to learn something this month." With many years under his belt and all the students he has seen, I had a feeling he was speaking from experience. He taught and I learned from the best writing space available, his knee.

Moving Forward

Some have said that fourth year is the apology for the first three years of medical school. We get more freedom to explore our interests and roam about the country finding residency programs worth our time. At last we get a little autonomy and it was for this reason I chose to do anesthesia early in my fourth year. Since I plan to go into emergency medicine, it will help me with sedations, analgesia, medications and airway management via intubations. (Apparently, Dr. Anesthesiologist saw right through that one.) Fortunately, I had no problem with the first tube of the day and we were rather productive as far as teacher and student are concerned.

It seems that for the most part, anesthesia is a calm environment at the head of the table hidden behind the sterile drapes. It consists of mostly monitors, charting and pharmacologic management of the surgical patient. On rare occasions things get a little hairy and I was fortunate enough to experience one such event on the first day. Fortunate because it brings a new understanding to the profession. The patient was dying and the anxious surgeon was eager to start the case. But before anything could happen the patient needed to be resuscitated or the surgery would be futile. Tensions ran high for a short time, but through focused efforts the patient responded to treatment and the surgery was performed as planned with no complications.

Every rotation seems to have significant learning potential and I doubt this one will be any different. I look forward to a busy and productive fourth year. It also happens to be my last year as a tuition paying student which is quite a happy thought.

Question of the Week
A patient becomes cyanotic, has profuse sweating, an unstable blood pressure, and a temperature of 106°F two to three minutes after induction of general anesthesia with halothane. Appropriate intervention would consist of respiratory support and the administration of which of the following?

A. Succinylcholine
B. Dantrolene
C. Acetominophen
D. Hydrocortisone
E. Epinephrine

Answer & Explanation

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