Posts by Sam Hall15

A quick question for our dear expert, though I won't say who... 😁 how many hospitals in the US actually have a PACU? Feel free to wing it if you don't have the exact numbers...

That's true, though side effects from succinylcholine aren't actually all that common. I don't see why they would use it more frequently in developed Western nations than we do here. For instance, we still rely heavily on thiopental quite often, whereas they seem to use propofol for everything, which is a bit frustrating...
It can't even be compared to halothane.... And while I personally prefer Esmeron, succinylcholine still has its place...

It’s still available and in use, though perhaps not frequently since we don't have many American anesthesiologists here, but it is there; succinylcholine is quite good, truly... 😁
but all jokes aside, it would be absolutely insane to think an anesthesiologist would cut corners on medication, especially when it comes to fentanyl, or really anything else at all.

😁 Aside from Pavulon and succinylcholine, there isn't much here to save on costs... 😁 😁 😁

You might be leaning toward the Republican Party, but it wouldn't hurt to run a test with the Independent Party

I agree, she definitely needs a more thorough evaluation. It would be wise to run some tests, get an EKG, check her hormone levels, and schedule consultations with a cardiologist and a neurologist—perhaps an ENT specialist wouldn't hurt either. We should also look into testing her vestibular system and checking the blood vessels in her neck, along with some neuroradiology imaging and an EEG, depending on what the neurologist suggests. A cardiac workup is also necessary to rule out any neurocardiogenic syncope...
Has anyone else in the family dealt with similar issues? And have you ever struggled with anemia?

What led you to conclude that a misdiagnosis was clearly made? And what makes you think a diagnosis is impossible without further parameters?

For that specific procedure, you don't need to see a pulmonologist; your primary care physician should be able to handle it.

Based on the clinical presentation, a doctor could have identified pyelonephritis—a kidney infection—without any testing at all. However, that isn't an excuse to skip the diagnostics. Even with a diagnosis, running tests is essential because this is a serious condition. While we can debate the specific pathogen since certain bacteria are more common in certain populations, performing a urinalysis is vital to truly gauge the severity of the illness. Additionally, a complete blood count, basic biochemistry, and a urine analysis should have been ordered. Once the inflammation subsides, an ultrasound is necessary, though it should be done sooner if there isn't an adequate response to treatment. It seems the situation was taken a bit too lightly, but ultimately, the patient has the best perspective on their own health. Regardless, I wish them the best...

Hmm, that’s certainly an unfortunate situation, especially since they wasted so much of your time on nothing...
By the way, what you were writing about with all those abbreviations is called an anesthesiologist 😁

I hope your next experience is much better, though there is a silver lining here. They didn't take unnecessary risks; rather, it seems the anesthesiologist assessed the situation and adjusted the medication to meet your body's new requirements during surgery

Best of luck

In our neck of the woods, an anesthesia technician—often just called an anesthetist—is essentially a medical technician working alongside the anesthesiologist, much like how a scrub nurse assists a surgeon. While seasoned technicians possess immense knowledge and are invaluable because they anticipate exactly what needs to happen during a crisis, they don't have the authority to make clinical decisions for the patient. Their role involves prepping medications, placing peripheral IV lines, monitoring vitals, and assisting with manual maneuvers. Generally speaking, they are highly skilled in resuscitation procedures.
Now, things work quite differently in the USA. They’ve developed this system involving CRNAs and AAs who can administer anesthesia either independently or under the supervision of a physician (in this context, the surgeon). It is worth noting that the surgeons there aren't necessarily more knowledgeable about anesthesia than we are; in fact, they often stumble and have to call an anesthesiologist to bail them out. This doesn't usually happen during low-risk cases where everything goes according to plan. Lately, however, anesthesiologists in the States are starting to realize the dangers of such practices and are attempting to bring them back within realistic boundaries.

The likelihood of intraoperative awareness occurring alongside paralysis without adequate analgesia is extremely low, not to mention the fact that physiological markers would reveal such distress almost immediately. These scenarios predominantly occur in the USA, though I wouldn't attribute it to superior clinical insight. Rather, it seems to be a byproduct of their healthcare system. In an effort to cut costs and extend anesthetic services to rural areas, there is a heavy reliance on mid-level providers, specifically CRNAs and AAs. These are advanced practice nurses who operate either under an anesthesiologist's supervision or independently. They are quite politically active in lobbying for more autonomy—driven by financial incentives, of course—which ultimately places patient safety at risk.

Why wouldn't they just stitch it up under local anesthesia? If there was any doubt regarding potential tendon damage, then sending you to a specialist makes sense, but in your specific case, I don't think that was such a major risk—though I can't say for certain without seeing it...
If that's the situation, they won't be stitching it now unless there's heavy bleeding, which doesn't seem to be happening here. Just make sure to dress the wound regularly and have them check for any signs of infection; hand wounds can be tricky. All in all, I don't think there's any reason to panic.

Is penicillin specifically problematic? Not to my knowledge, there aren't any long-term consequences if you're thinking about several years down the line... and what exactly constitutes an excessive dose?

Are you experiencing any other issues, such as a tingling sensation, or does your tongue feel swollen or numb? Any other symptoms at all?

If it starts working, there's no need for more. However, if you find you still need to go, you could take another dose—provided you haven't had issues with potassium levels or dehydration before... just make sure you're drinking plenty of fluids...

That rule generally applies to facilities lacking dedicated recovery rooms, where you might feel tempted to sleep whenever you please. It's essentially about airway protection; anesthesia suppresses your cough and swallow reflexes, potentially leaving your upper airway obstructed by your tongue or soft palate. That is why staying awake is recommended until the effects wear off... however, in specialized recovery units, anesthesiologists and CRNAs monitor your airway closely, which allows you to sleep safely

I don't believe anyone intended to belittle your post; the goal was simply to provide a corrected version so the general public isn't misled by inaccuracies 😁
Perhaps the reactions were a bit more intense because you wrote with such certainty on the subject, but judging by the post, there might be some room for further study... after all, there wouldn't be a five-year residency if everything could be mastered via a single website and then used to advise others...

Local anesthesia is an option, but given the reasons you mentioned, it isn't the standard approach. While the child needs to be calmed, that doesn't strictly require general anesthesia; effective sedation combined with local anesthesia can often achieve the desired outcome...