Can We Use Peep with LMA?

Lately, I have seen some threads discussing whether it is safe to use LMA with Peep. I remember when I was in school, some of the preceptors would take out the PEEP after I inserted the LMA. The reasons they gave me were insufflations of stomach. But in the back of my mind, I wondered whether…

Fun Facts for Today

Just some fun facts to refresh our memory for NCE certification/recertification in case you need to take it soon. Morphine: 10mg IV = 1mg Epidural = 0.1mg Intrathecal (1/10 ratio; very hydrophilic) Hydromorphone: 1mg IV = 0.2mg Epidural = 0.04 Intrathecal (1/5 ratio; intermediate) Fentanyl: 100mcg IV = 33mcg Epidural = 6-10mcg Intrathecal (between 1/3…

Are We Afraid of General Anesthesia for Cesarean Section?

Are we afraid of general anesthesia for cesarean section? I remember when I was in school, I learned from the lecture that there are 3 reasons for avoiding GA besides decreased patient’s satisfaction and sleepy baby with GA. They are (1) difficult airway management (2) increased risk for aspiration (3) increased risk for uterine atony. I…

CRNA School and Kids

This is the topic that I haven’t tackled which I should have a while ago. I am sure you have wondered whether it is possible to get through the school when you have a family and small kids. Dealing with the demands of anesthesia school and parenthood simultaneously is by no means easy. But it is doable….

Should We Ausculatate After Intubation?

Since I graduated from anesthesia school, I have given up the time-honored habit of routine chest auscultation after passing the tracheal tube through the glottis. This is another practice that we have been taught in school as one of the best ways to confirm tube placement. I still remembered the first time I was asked…

When Can We Use Tranexamic Acid?

Lately, I have noticed some changes on the usage of tranexamic acid. In the past, it would be contraindicated to use on patients who had a history of stroke, DVT, A-fib, valvular disease, or SAH. Recent studies have shown that the use of TXA doesn’t significantly increase the embolic event in surgical patients. In our institution,…

Gifts For Anesthesia Folks on Valentine’s!

Happy Early Valentine’s! I figure I will post some ideas for the anesthesia folks today. First on my list is this coffee mug shown below. This phase is the one we often hear in our daily encounters with other departments or personnel. The second one on my list is this t-shirt which I find quit…

My First Spinal Placement

Hello SRNAs out there. I just realized haven’t posted much for SRNAs lately. So, this is a long overdue post for you who just started doing spinals in either OR or OB. It has been almost 3 years since I got in my first spinal as a student. I feel that it is time for…

Sugammadex is Coming !

Our hospital is finally getting Sugammadex. I am so thrilled that we have something else to use to quickly reverse patients other than neostigmine. I figure it it time to write a post about the medication to give you a quick summary of what the drug is, how it works, and the side effects etc….

Ditch the Needle, Teach the Knife Part II

Dr. Larson, a well-known anesthesiologist at Stanford once stated that an emergency cricothyrotomy is much quicker, easier, safer and more effective than any needle-based technique. I can state with confidence that there is no place in emergency airway management for needle-based attempts to establish ventilation. As you all can tell, I love airway topics as…