The Anesthesia Consultant

MARCH 31, 2015

An anesthesia emergency occurs without warning. Your patient’s vital signs are dropping. You need the ultimate anesthesia emergency guidebook. That ultimate guidebook is the S tanford Emergency Manual of Cognitive Aids for Perioperative Critical Events S , written by the Stanford Anesthesia Cognitive Aid Group.

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The Anesthesia Consultant

MARCH 4, 2022

How soon will we see robotic anesthesia in our hospitals and surgery centers? Most of these discoveries originated in Silicon Valley, just miles outside Stanford University Hospital where I’ve been working for the past 42 years. Our medical world inside the hospital has changed more slowly. Relatively little.

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The Anesthesia Consultant

JANUARY 30, 2024

Imagine you’re two months out of anesthesia training, working at a community hospital, and at 2 a.m. you need to induce emergency anesthesia for a 300-pound man who just ate a full meal of pizza and beer two hours earlier. You’re working alone without that anesthesia attending who stood next to you during residency training.

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The Anesthesia Consultant

DECEMBER 30, 2022

Neither ciprofol nor propofol caused statistically significant differences in vital signs. 2022) conducted a phase III study at ten teaching hospitals, comparing ciprofol and propofol for deep sedation for colonoscopy or gastroscopy. mg/kg for the induction of general anesthesia. Chen et al. Wang et al.

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The Anesthesia Consultant

JUNE 18, 2019

Data exists that intravenous caffeine may be effective in assisting the awakening of patients following general anesthesia. Will a shot of IV espresso be the stimulus for you to return to consciousness after your general anesthetic? I tried it on several of my patients who had prolonged awakening after general anesthesia.

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The Anesthesia Consultant

JUNE 6, 2025

One problem was that the obstetrician had never hired and had never paid the intern, who received a regular paycheck from the hospital. Many surgeons chose to lord over the anesthesia attendings with verbal abuse and a condescending attitude. Surgeons are experts in surgery and anesthesiology providers are experts in anesthesia care.

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The Anesthesia Consultant

MARCH 2, 2018

Prior to surgery your patient tells you, “I always get a hangover after general anesthesia. Hangover after general anesthesia (HAGA) describes a patient who has a safe general anesthetic, but who then feels hungover, sedated, and wasted for a time period exceeding two hours afterwards. The patient is always right.

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The Anesthesia Consultant

OCTOBER 8, 2019

The most invasive type of airway tube used in anesthesia is called an endotracheal tube, or ET tube. At the onset of general anesthesia anesthesiologists place an ET tube through the mouth, past the larynx (voice box), and into the trachea (windpipe). She walked out of the hospital two days later.

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The Anesthesia Consultant

JULY 12, 2021

Vigilance regarding a sleeping patient’s vital signs was always paramount, but the constant effort to be vigilant could be mind-numbing. Since the development of the internet, anesthesia practice has changed forever. Every hospital operating room is equipped with a computer connected to the internet.

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The Anesthesia Consultant

JUNE 23, 2016

GENERAL ANESTHESIA FOR DENTAL OFFICES CASE PRESENTATION: A 5-year-old developmentally delayed autistic boy has multiple dental cavities. The dentist consults you, a physician anesthesiologist, to do sedation or anesthesia for dental restoration. Potent inhalation anesthesia (sevoflurane). What do you do?

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The Anesthesia Consultant

NOVEMBER 15, 2017

Let’s look at a case study which highlights a specific risk of general anesthesia at a freestanding surgery center or a surgeon’s office operating room, when the anesthesiologist departs soon after the case is finished. This is every anesthesia provider’s nightmare. Four liters/min of oxygen are administered intranasally.

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The Anesthesia Consultant

OCTOBER 11, 2020

An anesthesia machine, with the vital signs monitor screen on the left, and the electronic medical records computer screen on the right. His vital signs are heart rate = 100, BP = 150/80, respiratory rate = 20 breaths/minute, oxygen saturation 95% on room air, and temperature 100.2 The BP is 100/50.

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The Anesthesia Consultant

NOVEMBER 4, 2021

On physical exam, her vital signs are normal, her lungs are clear, and her heart exam is positive for the clicking sound of a mechanical valve and a 2/6 systolic murmur. Vital signs remain normal with BP=110/70, P=80, and oxygen saturation=99%. She is obese, weighing 200 pounds, with a BMI=35. She is on no medications.

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The Anesthesia Consultant

NOVEMBER 28, 2017

Tell the surgeon that the patient needs to have cardiac clearance prior to any general anesthetic, and that the case needs to be done in a hospital setting rather than at a freestanding surgery center. Just do MAC (Monitored Anesthesia Care) anesthesia for this case, but make sure he’s asleep.

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The Anesthesia Consultant

JUNE 15, 2022

The first public demonstration of anesthesia, at the Ether Dome in Massachusetts General Hospital Important advances in the history of anesthesia changed medicine forever. Humans have inhabited the Earth for 200,000 years, yet the discovery of surgical anesthesia was a relatively recent development in the mid-1800s.

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The Anesthesia Consultant

MAY 2, 2023

The Barnes Jewish Hospital, Washington University, St. Louis Imagine this: You’re an anesthesiologist in the operating room at a busy hospital. Anesthesiologists at Barnes Jewish Hospital at Washington University in St. Louis, Missouri are studying a novel system they call the Anesthesia Control Tower (ACT).

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The Anesthesia Consultant

AUGUST 7, 2017

AI computers will be stocked with information from multiple sources, including all known medical knowledge published in textbooks and journals, as well as the electronic health records (EHR)/ clinical data from thousands of previous hospital and clinic patients. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

JUNE 12, 2023

INTRAOPERATIVE DECISION A 60-year-old man with a history of hypertension is having a knee arthroscopy surgery under general anesthesia. Current electronic medical records (EMR) systems exist in every hospital, and the EMRs are generating the sort of Big Data that algorithms will be built on.

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The Anesthesia Consultant

FEBRUARY 6, 2019

“Free-soloing” describes the most anxiety–producing event in every anesthesiologist’s life: the transition from anesthesia training when your faculty member is backing up your every move and every mistake, to the real world of anesthesia when you have to do scary cases alone without assistance. at a community hospital.

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The Anesthesia Consultant

APRIL 4, 2021

His hospital chart shows no past anesthetics, and he has no medical problems except hypertension which is treated with lisinopril. His vital signs are normal, and his oxygen saturation is 96% on room air.You are six months out of anesthesia training and new to this hospital. What went wrong here?

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The Anesthesia Consultant

FEBRUARY 23, 2018

In July 1984 during the first week of my Stanford anesthesia residency at the Santa Clara County Hospital, the entire medical center owned only three Nellcor pulse oximeters. The oxygen saturation became recognized as “the fifth vital sign,” joining heart rate, blood pressure, respiratory rate, and temperature.

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The Anesthesia Consultant

APRIL 26, 2018

Norman Shumway MD PhD, a Stanford surgical professor and legend, invented the heart transplantation procedure and performed the first heart transplant in the USA on January 6, 1968 in operating room 13 of Stanford University Hospital. Upon arrival at the airport in the donor city, an ambulance transported us to the hospital.

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The Anesthesia Consultant

JUNE 27, 2017

Maggie is paralyzed from the neck down— a ventilator-dependent quadriplegic—and is hospitalized in a private room. Then he injects her IV with a syringe of adrenaline, and leaves the vital signs monitor on. The vital signs monitor shows her heart rate suddenly change to zero as she dies. Remarkable! Coma (1978).

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The Anesthesia Consultant

MAY 23, 2023

An ICU physician will write an order for the dosing of intravenous fentanyl, and the ICU nurse will be in constant attendance to monitor the patient’s vital signs and level of sedation. After surgery, hospital inpatients who have postoperative pain are typically treated with longer acting narcotics such as morphine or Dilaudid.

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The Anesthesia Consultant

SEPTEMBER 1, 2017

Be wary when administering general anesthesia to any patient who cannot walk up two flights of stairs. This requires preoperative workup to determine the diagnosis and to apply treatment prior to general anesthesia. I refused to staff the case, and told him, “Cases like this—that’s why we have hospitals.”

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The Anesthesia Consultant

AUGUST 16, 2018

His preoperative vital signs were normal with an oxygen saturation of 98%. Anesthesia was induced with propofol 250 mg, fentanyl 100 micrograms, and rocuronium 50 mg IV. His preoperative vital signs were normal. He walked out the hospital alive and well. Will I Have a Breathing Tube During Anesthesia?

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The Anesthesia Consultant

FEBRUARY 19, 2016

The procedure does not require a breathing tube, so we’ll administer the sedation and be vigilant regarding what happens to the patient’s vital signs. The most popular posts for laypeople on The Anesthesia Consultant include: How Long Will It Take To Wake Up From General Anesthesia?

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The Anesthesia Consultant

JANUARY 6, 2025

In the 1990s we were documenting all anesthesia care with pen on paper. Today hospital anesthesia medical records are recorded into computer software. Another study published in JAMA found that private equity-backed hospitals may have worse quality of inpatient care. Hospital subsidies for anesthesia groups.

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The Anesthesia Consultant

JUNE 17, 2025

Anesthesiologists are the airway experts in every hospital. An additional prominent inaccuracy of the episode is that almost none of the mass casualty patients, who are lying center stage on multiple gurneys throughout the emergency room, are connected to any vital signs monitors whatsoever.

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The Anesthesia Consultant

APRIL 8, 2025

You learn to inject propofol and intubate a patient in the first few months, but its a lifetime journey to master the medical aspects of evaluating and treating the heart, lungs, brain, kidneys and vital signs during anesthesia care. The goal is to be a perioperative (around the time of operation) doctor, not a technician.

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The Anesthesia Consultant

MARCH 2, 2020

With influenza illness may range from mild to severe and even death, but hospitalization and death occur mainly among high risk groups such as elderly patients or those with preexisting chronic illnesses. That is the real scare of the coronavirus issue—the fear that our hospitals could not handle the volume of severe infections.

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The Anesthesia Consultant

FEBRUARY 3, 2022

All four reach the surface, alive and anesthetized, and are transported to a nearby hospital. Anesthetized patients have no muscle movement and are unable to generate any body heat in the cold water. No one monitored the vital signs of the boys during their 3-hour underwater general anesthetics.

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