Learn from yesterday, live for today, hope for tomorrow. The important thing is to not stop questioning.
Albert Einstein

“Never regard study as a duty, but as the enviable opportunity to learn to know the liberating influence of beauty in the realm of the spirit for your own personal joy and to the profit of the community to which your later work belongs.”

Sunday, June 26, 2011

The weeks of up and downs.

Hey y'all,
this past week wasn't one of my proudest weeks. yeah, your definitely going to have ups and downs, highs and lows but you just have to keep on tract with what your doing. And remember that there is a light at the end of the tunnel.

Definitely, talking to your classmates helps a lot too. And its comforting to know that you are not the only one having really great days and some bad ones too. This past week was pretty intense and having a really tough and mean preceptor doesn't really help your cause but.....what can you do? just do your best and put it everything you have. And again, I'm so glad that one of our professors brought up the topic of having 2nd toughs about doing this anesthesia thing. its a normal reaction because 1) your sell shocked the first week and everything just seems overwhelming and 2) you are transitioning into this new role. You dont have that crutch anymore of running to the resident it is your decision now.

So, its a normal reaction and i'm glad that i wasn't the only one feeling this way. And at the end of class, he just said to give it a couple of more semesters and if anyone of us is still having doubts then thats when action should be taken on our part. Honestly y'all, i love anesthesia and i already see myself settling into this new role and i should be fine.

Anyways, let me tell y'all about a few more cases i had. I still can't believe that i intubated a couple of kids already. I mean, i havent done my peds rotation yet and i'm now learning peds in the classroom. Anyhow, i was so nervous. First off, we did an inhalation induction that put the kid to sleep. I overpressured my sevoflurane to 8% and i have a mixture of oxygen and n2O 30/70%. I stuck the mask on the kid's face and that little guy was out like a light in a matter of 1 minute. The fact that the little guy was crying actually helped the induction go faster. Then after he was out, my preceptor started the IV while i stared ventilating the little guy all the while my eyes were glued to his vitals signs and watching his little chest rise. Then we induced him with a little propofol while i turned down my sevoflurane (avoiding overdosing here). I gave a couple of more breaths then i was reading to intubate. This little munchkin was like 3-4 years old.

Guys, as i reached for my laryngoscope and blade i literally felt my pulse shoot up and i swear i began sweating. I just took a nice deep breath, cranks his little head back, scissor his mouth open with my right hand. Inserted the blade with the left hand all the way to the right of the mouth. Swept the tongue to the left and lifted up and pointed my laryngoscope towards the clock anchored on the wall of the OR. And voila!!!!!! I had the best view ever so far!!!!!! i had a full grade one view!!!!I told my preceptor what i saw, kept my eyes on the cords. He handed me the ETT and i inserted the RAE ETT pass the cord, inflated the ballon, attached the ETT to my circuit, check for condensation in the tube, looked for ETCO2 on the monitor, listened for breath sounds and we were ready. I turned my ventilator on, double checked to see if my sevo was on, double checked the settings on the vent (i set the settings up before the patient came into the room) and then we positing him for surgery. off course we did a lot more after that before the time out, but surgery was smooth and emergence wasn't that bad. But when the kid came back to it, OH BOY!!!! he was not happy. He was out of control, he nearly sucker pushed me in the face!!! Man, those little guys are strong i was holding him down on the stretcher while someone else was pushing the stretcher. But overall, it was a great experience and i wouldn't mind doing more kids for anesthesia.

We did a couple of more kids after that but they were not wild on emergence like the first kid. But, you know what? peds anesthesia is not bad you know. I know i said i really liked regional anesthesia but peds anesthesia is definitely in the running as far as what i would like to do after this program is over.

Peds anesthesia.....we'll see
peace out y'all

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