Richard Doyle10 said:Who can I even talk to about this, where do people actually go for it, and what kind of damage am I looking at price-wise?
You should probably check out the main "Looking for a doctor" thread up above before starting a whole new discussion, just toss your question in there so we don't clutter things up with too many separate posts.🙂
Sam Hall15 said:.... and MH is malignant hyperthermia... My bad if my last post was a bit fuzzy, sorry about that
No worries on my end at all...😉...
As for the whole MH situation... I’ve actually got some firsthand experience with how scary this stuff gets, though indirectly—I once saw a case where an induction with succinylcholine went south fast because of malignant hyperthermia, and honestly, even tossing Dantrolene at it didn't help much since things moved way too quickly for anyone to react...😢....
Sam Hall15 said:Well yeah, for now, succinylcholine is pretty much the only short-acting relaxant that kicks in fast, and honestly, people blow the side effects way out of proportion. As long as you're keeping an eye on potassium levels and watching out for MH, most other stuff like intraocular pressure doesn't really move the needle that much. Esmeron isn't exactly your go-to if you need a quick RSI on a floor or in the ER where things could go south and you might have to scramble for a difficult airway protocol... though, then again, maybe you shouldn't be giving a relaxant at all in those spots, but that's a whole different conversation...
Regarding the PACU, Alexander Wright, do you and the anesthesiologists stay present there, or is there at least someone designated who's always nearby?
A little off-topic here... Man, Sam Hall15, chill out with the acronyms for a second... 😉...I know what PACU is, but I'm guessing "difficult airway conditions" is what you meant by the English bit, and I assume RSI on a ward means some kind of emergency before someone dies, but I'm still lost on what you mean by MH... 🤷...and look, if I don't get it even after bouncing around anesthesia and ICU for 15 years, I bet a lot of other people are struggling too... 😉...
Back to the topic... The PACU—which we’d just call the recovery room at my hospital—has to have an anesthesiologist present if it exists, and I’m pretty sure every major US hospital has one. If nothing else, how is a tech supposed to know when it's safe to send a patient back to their home unit once they wake up? 🙂
Alexander Wright said:Honestly, the real reason they're pushing sevoflurane everywhere is just because it costs a fortune compared to halothane. It's pretty obvious if you know anything about it.
Yeah, that’s definitely the big driver behind it all. Both Iso and Sevo are way more expensive to deal with.
Sam Hall15 said:We still have some in stock, and people use it—maybe not all the time since we don't really have American anesthesiologists here, but it's available, and Succamel is actually pretty solid. 😁 But honestly, jokes aside, it would be absolutely insane to think an anesthesiologist would cut corners on meds, especially when it comes to Fentanyl, though really, they wouldn't skimp on anything else either.
Yeah, totally... it's so effective that in malpractice suits, lawyers actually grill anesthesiologists about why they’d even bother using Lystenon/Lepotosukcin/Succamel when those drugs aren't even covered by Medicare because of those scary side effects. I mean, time has moved on, and other similar paralytics have basically overtaken it...🙂...just like Halothane was phased out about ten years ago...
I definitely agree that you generally don't see people pinching pennies on anesthesia drugs (though there's always that one outlier, right?). It's not even a choice, really; you just can't provide high-quality care without them.
Alexander Wright said:Man... a real old-school anesthesiologist just sticks to thiopental, succinylcholine, and pavulon, pulls the tube out with one smooth motion, and hoards fentanyl like a miser hoarding gold coins—honestly, they could probably pull off a whole liver transplant with just two shots of those orange Brownies. 🙂
I actually know a couple of those guys... the only thing that really gets under their skin is that nobody uses succinylcholine anymore and you can barely find it anywhere. 🙂
Honestly, stuff like Bivacyn or those other antibiotic powder sprays are a total waste of money—don't even bother picking them up. Now, Octenisept is a different story; that actually makes sense to use. If you've got a wound, just stick to cleaning it out with a solid disinfectant and throwing on a sterile bandage if you need to, and you can skip all that Bivacyn nonsense entirely.
It’s honestly pretty tough to give any solid advice based on just a few lines posted here on a forum. From a strictly medical standpoint, you really have to nail down what actually caused the heart to stop, because a heart doesn't just quit on its own without a reason. That said, if his EKG and stress test both came back totally clean—and I’m assuming he had an echocardiogram done too, which hopefully looked fine—then maybe there just isn't a clear enough indicator to justify heading into a Cath lab to start messing around with the coronary arteries.
But then again... let's be real for a second. You can definitely feel those little cliques of "medical geniuses" hanging around the cardiology world. They all seem to have their own specific way of doing things, and if a doctor doesn't follow their particular playbook... well, good luck to them, I guess. To make a long story short, if you feel like something is being missed or left out, go get a second opinion. Just try to stay level-headed about it. If you end up seeing someone at a high-end private clinic, you might find yourself stuck in an endless loop of expensive tests, new prescriptions, and constant follow-ups that never seems to end.
Look, if you're looking for alternative remedies or any of those pseudo-psychiatric homeopathy things, there's actually a specific sub-forum for all that stuff, so please just head over there for those kinds of questions... I’m pretty sensitive when it comes to those "alternative mantra" vibes, so let's just keep those comments out of this thread, okay?
stormymaker24 said:My surgeon actually prescribed it to me right after he performed a procedure to remove part of an ingrown nail... generally speaking, whenever I find myself dealing with a situation like that, I apply it just once and the results are nothing short of excellent.
It hadn't even crossed my mind, quite frankly; it seemed far more logical to assume it would be more effective if applied topically, directly onto the wound itself... but I suppose I was mistaken. 🤷
Just a quick heads-up, I think I might have gotten one little thing slightly off...
There’s actually one little exception when it comes to using local antibiotics—you might see someone prescribe mupirocin (Betrion) in specific situations. It’s really only meant for cases where they've isolated MRSA on the skin or if there's a pretty obvious, significant staph infection sitting right on the surface. Just a heads-up though, and I can't stress this enough: that's strictly for the skin, so you definitely shouldn't be putting it on any mucous membranes!
Honestly, don't even bother wasting your cash on Bivacyn spray, powder, or any other topical antibiotic—it’s basically throwing money down the drain. The only thing you're actually getting out of it is a placebo effect to make yourself feel better about treating a wound.
Even though you'll still see doctors at local clinics reaching for those antibiotic sprays like it's nothing... the medical consensus has shifted, and using antibiotics topically is pretty much considered outdated and wrong nowadays. You really should just skip it.
If you want to do it right, just focus on keeping the wound or the sting site clean and regular, maybe throw on a hydrocolloid bandage, and if the cut is deep or really dirty, just take an oral antibiotic instead. That's more than enough. Using them locally just risks creating cross-resistance in microbes and basically breeding tougher, hospital-grade bacteria.
So, yeah, even if some old-school surgeons or veteran medics try to argue with you about it... just forget about Bivacyn and all that stuff because there's just no real point or benefit to it.
It’s obviously going to pop up on the lab results right away. Plus, if something like that actually shows up, medical staff are basically required to call the FBI immediately so they can grab that smoker and haul them straight to the nearest precinct for questioning before they even get a chance to see a judge for sentencing!
You only get penicillin if your doctor actually writes you a prescription for it. I mean, what are you even going to do with that info? It’s not like you're just gonna be out here self-medicating and trying to figure out the right dosage on your own...
Honestly, this just feels like another total cash grab... I mean, claiming you can measure mineral content just by holding some metal in your hand? That sounds like pure pseudoscience to me. I'd definitely steer clear of that kind of "testing" and whatever fake results they're peddling...
I’m hoping the title makes sense to everyone... look, you don't have to agree with everything said here. If you feel differently, just say so. And honestly, if someone's posts are actually getting under your skin and raising your blood pressure, just hit that "ignore" button—it's a lifesaver because once you toggle that on for a user, their stuff just vanishes from your feed entirely.
So, bottom line: any more of those mindless, insulting comments where you're just being a jerk... and you're going to get a permanent ban from the board.
This thread deserves better than that kind of toxicity... and if this behavior keeps up, I won't hesitate to pull the plug on anyone acting out, regardless of what we're talking about.