Monday, December 28, 2009

Plight of the proseal plier!

let me buzz...

Proseal LMA is an improved supraglottic device with a drain port and a dorsal cuff incorporated for better seal and prevention of aspiration… the multitude of adjectives and traits kept ogling out from the vociferous tone of my well read superior. As a fresher, u just can’t imagine that this floppy thing with 2 tubes and a hood of a spitting cobra is going to be ever so vital in the anesthesia scheme of things!
The first week went with poignant accounts of peruse checks, looking for cuff leaks and insertion techniques. You stand beside your superior watching them shovel the 2 tubed snake into a zonked out patient all in the name of maintenance of airway. Well ,wait the fun doesn’t end there, does it! You pump in some air into the cuff and volla!! Positive pressure ventilation seems a piece of cake! It couldn’t get more easier than this… just hold the reservoir bag and SQUEEZE!
But you couldn’t get away with scant solace when surrounded by airway addicts now, could you? Zipping back rewind mode to shoveling down the snake moment… bespectacled pair of observant eyes glaring through, the consultant says “..Hmm.. Judging by the way the bite block got nudged out with inflation, placement tho theek lag rahi hai. Connect the circuit and check for ventilation”, she says. Taking my role of a 1st year with a sense of pride, I obediently yank at the flinty circuit to connect it to the snake dude in the zonked out dude’s mouth. “Hmm…”,says my consultant, “jelly and ryle’s tube..”. my superior snatches the moment to drill some gyan into my ever fresh from MCQs mode cerebral cortex. “how do you check for correct placement?”, he asks. Now, as a first year, I need not be right with answers given the notion “ ye tho first year hai!’. I rant out calculated guesstimates of plausible methods from my vague memory. The fun thing about anesthesia is that all questions will be repeated. If you ask me,if you learn about 1 entity once, u can survive upto 3 weeks of drillbit questioning going by the number of repetitions of the questionnaire that all seniors tap from.
With the surgery resident onlooking with the praying mantis pose, all decked up in sterile disposable layers of paper, the patient is handed over to them. Brief interruptions of additional queries from the senior resident interrupt my tryst with the beeps, blips and bells that the monitor efficiently rants out. Reversal of anesthesia is the next moment of reckoning. Pump in some drugs IV and the dude starts breathing again. Adamant commands ensue to wake him up to get the snake out. “ Aankhen kholo,saans lo, gehri gehri saans lo”, goes my senior resident. Not to be left behind, I join the chanting for total vocal reversal of anesthesia! “ Suction!!”,commands my resident. The snake has to come out or the patient will chew on it to behead the slithering thing! Sounds like a harry potter tale of the weird kind!
The two tubed snake is out ,the patient wheeled out and the next patient walks in.Routine events with tubes cannot be more intriguing as this for a fresher now, wont u agree?
As a popular saying goes… for a fresher, anesthesia is TDBD..”Tube Daalo,Bag Dabaao!”

Monday, November 30, 2009

treading on new land..a blog debut

let me buzz...

Anaesthesia can be terribly simple or simply terrible goes a popular saying. Each day is spent providing anaesthesia care shovelling long hours into the quagmire of altered patient physiology. While we go about handling the patient’s vitals with the surgeon’s demands juxtaposed, current advances and practices remain elusive to the learning curve.


This blog is an earnest attempt, a tiny step none the less, to help keep ourselves abreast with the latest fads, nuances and gizmos that seem to gather more attention than the patient at times!

Having got a feeler of this medical specialty coined snooze science for over a year, the quintessence to our profession lies buried beneath tons of written text, ever evolving journal articles and clinical trials. The segment on journal entries shall give you a brief insight, be it a difficult case, recent technique, drug formulation or just an observation.

Minute details about Anaesthetic implications and management in various conditions can go amiss with our daily routine. E books in pdf and pdb formats can prove quite handy while on the go or in the operating room. The segment on eresources and books will give you a definite edge.

Current advances in anaesthetic techniques and paraphernalia prove to be to be quite cumbersome to master with forever evolving trends. A news segment focussing on recent advances will give u a brief synopsis of what the future holds in store.

Orthopaedic chaps cannot find ,let alone drill, the funny bone as often as we do, no matter how hard they try! A fun section will ease all those tense non paralysed muscles on your forehead a wee bit, I hope. Heck, we could have a TOF watch monitoring that because that’s what we do exclusively intraop!

Any input in the form of posts, comments and contributions would be deeply appreciated.

With hope that we make some ripples, here is me signing off with a borrowed quote from Edward Lorenz’s chaos theory, “something as small as the flutter of a butterfly’s wing can ultimately cause a typhoon halfway around the world”.

Cheers