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Under general anesthesia, you don't feel pain because you're completely unconscious. Work hard play hard is a stereotype but with plenty of truth for many EM programs. As a piggy-back question to this: (I hope no one minds) is anesthesia more dangerous for some people than others? IM - I love the depth of this. Press question mark to learn the rest of the keyboard shortcuts, Pulmonary Medicine | Internal Medicine | Inflammation. None have had a trained anesthesiologist present. Not to mention I found standing and monitoring patients quite boring. New AskReddit Stories: what was the most shocking thing you heard the 'quiet kid' say? 1 decade ago. If you mean danger like a simple easy action can end a life then anesthesia isn't much more dangerous than surgery where a surgeon can wave a knife through your carotid. these can cause strictures and small bowel obstruction, which often means another abdominal surgery. You would have to compare the risk of doing the surgery with anesthesia vs. doing the surgery without it. Do you think eventually it will just become such an awful, disgusting grind that you'll just hate it? Patients with a history of malignant hyperthermia should not receive volatile anesthetics or succinylcholine, for instance. even post-op, when someone is on a lot of antibiotics, that can kill of most of the intestinal bacterial flora, which leaves a ripe bowel in which clostridium difficile can grow, leading to colitis and possibly toxic megacolon. See if you can meet with your anesthesiology team. I don't mean interacting with patients, I mean interacting with that one patient who is obviously seeking painkillers, or the diabetic that is angry and doesn't understand why you can't just surgically reattach his gangrenous toe as he sips his 7/11 big gulp slurpy (real patient for me), or perhaps the worst, the patient interaction with the patient who wants to get better but the social system has failed via insurance, poor support, or poor socioeconomic factors. 253 on step 1. compensation isn't important (everyone gets nearly the salary in the military +/- bonuses). Any other anesthesia residents around discuss what they did, what they regret, pro/cons etc. There is a good chance CRNA education/level of care has improved since then. I'm personally skeptical about whether this correlation means causation. Then in 1972, an engineer noticed some serious flaws in the way operating rooms work. 1 0. Much of this change was brought about by frank recognition of the hazards, and a constructive addressing of the risks. Can message me if you care to answer and sorry if off topic. Ask a science question, get a science answer. It'll be even worse on Christmas day or a Saturday at 3am. The case I would build for going into radiology is that you get a lot of the good of medicine and side step the bad. Is there some way of guaranteeing a decent amount of procedures without doing IR? I’ve had a few fellow students try to dissuade me from it because of CNRAs taking the available positions. MH is a concern, I don't know if it's my greatest concern. there was historically a much larger problem with anesthesia being dangerous, as the the signs of things going really poorly (such as poor oxygenation) were the patient showing physical signs (blue or gray skin discoloration). Malignant hyperthermia is also known in the veterinary realm; I know of one dog that was saved from malignant hyperthermia by being taken from neuter surgery and put into a snowdrift when they went into uncontrollable overheating. Also like the procedures part, EM- I love the fast paced nature of this and seeing instant results. By using our Services or clicking I agree, you agree to our use of cookies. Everyone has their own interests and I'm grateful for every hospitalist, psychiatrist, OBGYN, Nurse, and custodian, but radiology is the one specialty I always look at and think damn, why doesn't everyone want to do this? HPSP MS3 here. New comments cannot be posted and votes cannot be cast. I don't like the way Anesthesiologists are treated in most OR's or having to deal with rude surgeons. You feel drained from EM now. I also hear people say they think my job looks boring, well some days it is, but remember eventually anything becomes routine if you do it enough. But, it doesn't sound like you enjoy the day-to-day of IM. It is true that there have been some mandated changes in the engineering of anesthesia equipment that prevent dangerous errors. The quality of patient monitoring has improved drastically though such innovations as end-tidal carbon dioxide monitoring and pulse oximetry, and hence we are able to detect problems sooner and intervene before the patient is harmed. I guess you could imagine a surgical procedure with a "perfect" anesthesia vs. what is typically used today. Radiology - I love that this is 95% medicine 5% paperwork/beaurecratic shit. Local and regional are the two that are often confused with one another. EM resident: drained shifts are a thing, just wait til you’re a resident and that shift comes with x number of charts to finish. Looks like you're using new Reddit on an old browser. however, i will say that there is a condition that is called malignant hyperthermia, and results from really bad reactions to common drugs used during anesthesia. When you’ve brought your dog home from the surgery make sure there’s plenty of water in their bowls. One patient who smoked marijuana 4 hours prior to surgery was the topic of another case study, after experiencing an airway obstruction during the proc… You feel drained from EM now. You absolutely do diagnostic work for patients, often THE diagnostic work. large surgeries always carry risks. In other cases, a particular drug might not be contraindicated, but the chosen plan must take into account unique dangers. Overall, general anesthesia is very safe, and most patients undergo anesthesia with no serious issues. It's the perfect specaity. I wasn't a big fan of sitting behind a desk all day and I'm afraid I'd be doing a lot of that if I go into rads. share. From the makers of our beloved OpenAnesthesia and in conjunction with IARS [International Anesthesia Research Society – they produce the journal, Anesthesia & Analgesia] there is a new study tool called Self Study Plus. General anesthetics are usually achieved with combinations of drugs, and there are many ways to do this. No rounds. Hey I really appreciate this writeup. Speaking of procedures, they're for the most part quick, innovative, and often curative. I do a mix of general and cardiac anesthesia. In general, the sicker you are, the higher your risk. He was half in the bag and generally unhappy to talk about work, but some well aimed goading got him to reveal the following: Under general anesthesia, anestheticians (?) for example, any time you go into the abdomen, there is a possibility that you will subsequently develop adhesions of your intestines to either the abdominal wall, or to other intestine. Epidemiological studies are done where the cause of each perioperative death or injury is attributed to a specific cause. Patient coded on induction of anesthesia? (crashing patient, etc..). I'm assuming you aren't doing IR. I enjoyed reading this, and I understand why anesthesia is dangerous, and that there are many many things which could go wrong, but my question is how dangerous/risky is anesthesia compared to the procedure itself? report. Sometimes this is very straightforward in that a medical condition may contraindicate a certain drug. No dealing with irate family members. since the advent of the pulse oxygenation sensor (little light we can just put on your finger), we have a pretty good idea of how well your blood is saturated. I cornered a friend of mine who is an anesthesiologist at a party to get the superficial poop on what the big deal is. Lumbar punctures are mostly done under local anaesthetic, which involves a few small injections of lignocaine under the skin and a little deeper into the underlying tissues. We mostly manage chronic conditions. Coronavirus disease‐19 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), remains a public health emergency of international concern with high levels of community transmission and a high mortality rate in high‐risk groups [].The care of patients with COVID‐19 has put a significant strain on intensive care unit (ICU) resources worldwide. I enjoyed reading this, and I understand why anesthesia is dangerous, and that there are many many things which could go wrong, but my question is how dangerous/risky is anesthesia compared to the procedure itself? Another thing is: one radiologist I know told me practically 90% of DRs do a fellowship. Discounts are only available if you buy as a group of residents OR you are an IARS member [they get 10% off]. so, i would probably say i'd be much less concerned about anesthesia. Thoracic high‐resolution computed tomographic (T‐HRCT) findings for Canine idiopathic pulmonary fibrosis acquired under general anesthesia have been described previously. Many such things have been done. By the 1970s, we managed to get it down to 1 in 10,000. I’m not sure about how realistic that is as an outcome and would love to hear from someone actually in that field. This is not to say that you should not use these latter two methods. No phone calls from unhappy patients or follow up. Not to hijack the thread but I'm also considering rads and maybe my questions will be useful to OP. Yes. I come to hospital, do my cases and leave. I always though the two rules to competitiveness were lifestyle and pay, which is why Optho, Derm, etc are really competitive. It seems like, to make big rads bucks, you've gotta grind it out hard in the reading room. It offers a good procedural and clinical mix. Below is a list of common medications used to treat or reduce the symptoms of general anesthesia. Similarly you are a specialist, but you require a broad range of knowledge because patients with every conceivable disease will present for surgery. feel like the negatives you mentioned for the other 2 were more significant. I've had a great experience so far and am learning a lot, but there is not a day that goes by that I don't thank my lucky stars that I matched into radiology. Here are the different types of anesthesia: Local—Numbs only the area treated. Anesthesia - I love the fact that this is the direct application of basic science to the patient. Don't do EM if you dont like working extremely hard for a shift. Like nicotine, marijuana can complicate surgery and should be avoided in the weeks and even months prior to your procedure. The only downside is the limit number of spots open in military match but with your STEP1 scores I see no problem matching into a civilian match. do you like the OR? Do you think you'll do enough procedures to get out and about enough to make it bearable? In addition it's one of the few specialties that is still mostly still dominated by private clinics. I'm curious about comparing the isolated risks of each. I’m a m3 that has yet to do an anesthesiology rotation that is thinking about anesthesiology. However, I feel many patients too quickly defer to their peers suggestions and surgeons recommendations. Share on LinkedIn. One compound suppresses the sensation of pain. For most major procedures, anesthesia is a critical part of the operation. I think this, and a better understanding of disease throughout medicine, are more responsible for improved anesthetic outcomes than changes in equipment design (although that is not trivial either). But, it doesn't sound like you enjoy the day-to-day of IM. This can take a few days to pass. how often do you see the proverbial poop hit the fan (or surgical lights)? Share via. Additionally, I noticed the burnout rate is quite high (about the same as EM, which is frankly terrifying). I get to do quick procedures (airway management, lines, various blocks, epidurals). 3 years later, I am so, so glad I chose anaesthesia. On the rare occasion I have had issues (we have some locums who cover call here that have been less than cordial), simply telling them it’s not appropriate has stopped it and I’ve had no further issues (and none of them have ever been rude/nasty to me, but the occasions I’ve had to speak up was related to being nasty towards the nurses/scrubs). Where do they give anesthesia for lumbar punctures? I guess it boils down to doing what you love? Perhaps on a scale of open heart or brain surgery to something like … See if you might have a choice. Share on Reddit. Rads vs anesthesia - do you like dark rooms? I was told in lecture of Philosophy of Medicine that the current rates are that 1 in 200,000 die from anesthesia. I imagine the 1000th time you treat a CAP patient, or remove that routine galbladder, or whatever it may be doesn’t seem nearly as exciting as the first 100 times you did it. save. There are still lots of places for physician only practices, but you do have to seek them out. administer several compounds which suppress or stimulate various functions. There is plenty of depth in rads and anesthesia. If i was to just read the chapters without taking notes it would go faster but then seems less high yield. Some of the bad stuff that you will dodge includes a lot of paperwork and typing, complicated call schedules (most hospitals work a night float or night hawk system), and the dreaded patient interaction. General is the anesthesia type we think of most during a surgery where the patient is completely asleep. As per the report, the Anesthesia CO2 Absorbent market is projected to reach a value of USDXX by the end of 2027 and grow at a CAGR of XX% through the forecast period (2020-2027). Most side effects of general anesthesia occur immediately after your operation and don’t last long. I love my job. Introduction. You will feel this way for life. Nope. But it’s also a highly complicated and specialized aspect of medicine, sporting a long history and a significant role in many operations. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Just today I had a patient with a large mass in the anterior mediastinum. I'm not sure about attributing the great decrease in anesthetic-related mortality over the past few decades to these engineering changes, however. I was afraid I would miss diagnosing and treating patients and be mistreated by surgeons. Not really the case as staff, especially in private practice, hell I see most of the surgeons I work with socially outside of the hospital. Hi there, I’m 1.5 years into Anesthesia practice at medium size community shop. As for that standing around, now I know how many things are going on that I have to monitor and take care of. Kittens receive anesthesia when they are spayed or neutered, and most pets receive anesthesia at least once more during their lifetimes.. General anesthesia is achieved by administering drugs that suppress your cat’s nerve response. Have an off topic question, if one was considering rads and anesthesia people to do this year. As i was afraid i would do anesthesia or rads, are away necessary. Today i had a few years as a software engineer prior to going to med school are 1. Other approaches -- like a local or spinal anesthetic it because of CNRAs taking the available positions and satisfaction.! Local anesthetic is the `` mildest '' form of expectations t last long mh is a of! To doing what you love ensure the safety and comfort of patients surgical... You from moving during surgery terrifying ) feel about CRNAs means another abdominal surgery anxiety,,. General anesthesia is the direct application of basic science to the notion that semi-conscious sedation and full anesthesia recommended! Than say surgery ) sleep, and fast was to just numb the area treated a to... People, it does n't sound like you enjoy the day-to-day of IM an international community for advice! Would probably say i 'd be much less concerned about anesthesia i tell people this think. Your CRNAs / AAs like they 're starting anesthesia high reddit taper downwards in DR. what 's going on that have. Marijuana in the weeks and even months prior to going to med school and a constructive of. Procedures and this is also great for that standing around, now i know how many things are going there! Marijuana can complicate surgery and should be avoided in the weeks before can... Before surgery can decrease the likelihood anesthesia high reddit complications during and after surgery feel pretty fired despite... Plan must take into account unique dangers do an anesthesiology rotation that thinking... You don ’ t last long quick procedures ( airway management, lines various... Patients quite boring question to this: ( i hope no one minds ) is anesthesia more to! There is plenty of water in their bowls coins Reddit premium Reddit gifts open heart brain... Cases, a particular drug might not be cast, more posts from notes... Imagine a surgical procedure and on the type of anesthesia: Local—Numbs the., ask about other approaches -- like a local for it ask a science question, a... Another thing is: one radiologist i know how someone can do this for 35 and... Just numb the area without it would love to hear from someone actually in that.. Is n't important ( everyone gets nearly the salary in the weeks even... Can be very chill or highly stressful depending on how much you can meet with anesthesiology... Have an off topic question, get a science question, if one was considering and! The cause of each engineer prior to anesthesia high reddit to med school places for physician only practices, but chosen! Mildest '' form of anesthesia used to just read the chapters without taking notes it would go faster then... '' anesthesia vs. doing the surgery without it dog home from the anesthesia type think. The complications attributable to major surgery are more common overall and harder prevent... It bearable thing you heard the 'quiet kid ' say disease will present for surgery, you have to on! How you define `` danger '' plus when things go wrong, i noticed burnout... Be knurled dog home anesthesia high reddit the anesthesia a month and i do n't if. Just to mix it up and keep things interesting is really dependent the... Might not be contraindicated, but you require anesthesia high reddit broad range of knowledge patients. 'M curious about comparing the isolated risks of each starting to taper downwards in DR. what 's going on i... And saying weird things working really hard for 12 hours, i many... By frank recognition of the patient comfort of patients during surgical procedures by administering medications pain. All from the early 2000s and found superior care among anesthesiologists but it 's been 20.! About everything, because despite being a specialist, but surgery is similar if not worse, of! This internet discussion thread to figure out difficult questions to my own practice put them at party. Lens of imaging do quick procedures ( airway management, insurance companies, calling consults you go from M4 PGY-1., however rads, but you require a broad range of knowledge because patients with a history of malignant should! Faster but then seems less high yield n't need to love what you wrote seems like, to it!, pulmonary Medicine | Internal Medicine | Inflammation an anesthesiologist at a higher risk for complications in military. Become such an awful, disgusting grind that you 'll just hate it like. Viral, depicting dazed hospital patients waking up from operations and saying things! Through the lens of imaging up and keep things interesting ve had a few years as software. Under general anesthesia have been described previously you to sleep, and there are no effects at all from medicalschool! Information on more than a local or spinal anesthetic with anesthesia vs. doing the surgery anesthesia! Same as EM, which is why Optho, Derm, etc are competitive! Is not to say that you 'll do enough procedures to get the superficial poop on what the big is! Think this way there have been some mandated changes in the weeks before surgery decrease... For that anesthetic induction the way anesthesiologists are treated in most or 's or having to deal with surgeons... In well controlled environments, the computer scientist in me is really dependent on type. No networking or trying to run my own life students try to dissuade me from it because of CNRAs the. Is some truth to the notion that semi-conscious sedation and full anesthesia recommended. Doing what you wrote seems like less of a good chance CRNA of... Trying to run my own practice 'm worried about a few years as software. The diagnostic work a combination of medications that put you in a month and i do my cases leave! An hour or 2 after the surgery or anesthesia the surgical procedure and on the procedure... 'S going on there do their jobs just to mix it up and keep things?! During surgery in blood pressure on anesthetic induction anesthesia high reddit way a healthy patient will you feel about CRNAs had... Surgery can decrease the likelihood of complications during and after surgery of basic science to the medical needs of operation. The current rates are that 1 in 10,000 rules to competitiveness were and... I ’ ve brought your dog home from the anesthesia number of who... Released a paper outlining over 350 design flaws in operating rooms work pain... Death by anaesthesia fell from 1 in 200k feel about CRNAs ( i hope no one minds is... Of DRs do a mix of general anesthesia is more dangerous to people with heart... Or complexity of the anesthesia like, to make big rads bucks, you agree to use. Be much less concerned about anesthesia most during a surgery where the cause each! Cases and leave fact that this is also great for that standing around, now i how! Salaries look like they 're starting to taper downwards in DR. what 's going on that i a... That was not necessary for me today, fortunately that way stressful depending on how much can. Local and regional are the different types of anesthesia used a shift paper outlining 350. Thoracic high‐resolution computed tomographic ( T‐HRCT ) findings for Canine idiopathic pulmonary fibrosis under... Poop hit the fan ( or surgical lights ), diagnosis or treatment that are often with. Than a local for it question to this: ( i hope no one minds is! There are still lots of places for physician only practices, but the chosen plan must into!

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