Manu B
@nitrousman75.bsky.social
Australian anesthesiologist of Indian origin living on Guringai land .
Refusal of an NG by someone who’s about to undergo a laparotomy for SBO is a difficult place to be in ,as an anesthetist ( & /or surgeon ) .
October 22, 2025 at 6:07 AM
Refusal of an NG by someone who’s about to undergo a laparotomy for SBO is a difficult place to be in ,as an anesthetist ( & /or surgeon ) .
used It when opioid free anesthesia was a fad for a while .Didnt continue with it . Some colleagues continued using it for abdominal surgeries but I don’t think anyone’s doing it any more ? Now use small lignocaine bolus before propofol . Also for minimizing coughing on extubation for c spines .
September 27, 2025 at 9:04 AM
used It when opioid free anesthesia was a fad for a while .Didnt continue with it . Some colleagues continued using it for abdominal surgeries but I don’t think anyone’s doing it any more ? Now use small lignocaine bolus before propofol . Also for minimizing coughing on extubation for c spines .
Ok that’s interesting .
September 9, 2025 at 8:10 AM
Ok that’s interesting .
Do you ever see muscle rigidity with such bolus doses of Remi & if so what do you do then ?
September 8, 2025 at 7:44 PM
Do you ever see muscle rigidity with such bolus doses of Remi & if so what do you do then ?
Pete , I don’t do IFT & don’t know anyone that does . Maybe I should .
September 6, 2025 at 7:59 AM
Pete , I don’t do IFT & don’t know anyone that does . Maybe I should .
I would add “ detect / prevent with IFT in paralyzed & look for response to commands in anesthetised patients who are not paralyzed ”.
September 5, 2025 at 10:45 PM
I would add “ detect / prevent with IFT in paralyzed & look for response to commands in anesthetised patients who are not paralyzed ”.
Infraclavicular Subclavian was my default before USG . I haven’t done any in 20 yrs but I don’t think I’ve lost that skill . IJ is easier with USG so have defaulted to that .
September 4, 2025 at 8:47 AM
Infraclavicular Subclavian was my default before USG . I haven’t done any in 20 yrs but I don’t think I’ve lost that skill . IJ is easier with USG so have defaulted to that .
IJ is my go to & USG the basic minimum std for a CVC .The exceptional circumstance you gave the only reason I mentioned landmark SCV as I feel based on my experience & skills ,I’d be losing precious time scouring for great veins with USG . Can’t comment on others opinion on this.
September 4, 2025 at 8:45 AM
IJ is my go to & USG the basic minimum std for a CVC .The exceptional circumstance you gave the only reason I mentioned landmark SCV as I feel based on my experience & skills ,I’d be losing precious time scouring for great veins with USG . Can’t comment on others opinion on this.
But I wouldn’t advise it to anyone who’s never done a subclavian using landmark technique .
September 3, 2025 at 10:25 PM
But I wouldn’t advise it to anyone who’s never done a subclavian using landmark technique .
If ever have to put a cvc in a rapidly exsanguinating haemorrhage ( never had to ) I would go for infraclavicular subclavian using landmark technique as it’s probably the only patent , easily accessible central venous access .
September 3, 2025 at 10:24 PM
If ever have to put a cvc in a rapidly exsanguinating haemorrhage ( never had to ) I would go for infraclavicular subclavian using landmark technique as it’s probably the only patent , easily accessible central venous access .
Never heard of cvc as an essential resus device .
September 3, 2025 at 10:25 AM
Never heard of cvc as an essential resus device .
Can I ask why the VL failed . Was it tube delivery where the problem was?
August 30, 2025 at 9:51 PM
Can I ask why the VL failed . Was it tube delivery where the problem was?
Reposted by Manu B
I still look at the ASA & DAS algorithms . Vortex model is a cognitive aid that tells you what the Goals are . It’s not telling you what to do .
August 30, 2025 at 6:59 AM
I still look at the ASA & DAS algorithms . Vortex model is a cognitive aid that tells you what the Goals are . It’s not telling you what to do .
hypothetical situation where I’m unable to intubate , bag & mask to maintain alveolar oxygenation but can achieve the same through a SGA ( reached green zone ) then I would delegate someone to look at ASA or DAS to tell me what to do next .
August 30, 2025 at 7:09 AM
hypothetical situation where I’m unable to intubate , bag & mask to maintain alveolar oxygenation but can achieve the same through a SGA ( reached green zone ) then I would delegate someone to look at ASA or DAS to tell me what to do next .
I still look at the ASA & DAS algorithms . Vortex model is a cognitive aid that tells you what the Goals are . It’s not telling you what to do .
August 30, 2025 at 6:59 AM
I still look at the ASA & DAS algorithms . Vortex model is a cognitive aid that tells you what the Goals are . It’s not telling you what to do .
That’s good . For me it was post vortex & what changed ( for me ) was being able to avoid fixation errors
( eg go back to bag & mask / getting to green zone ) and priming for CICO rescue . Avoids the E Bromley type situation outcome .
( eg go back to bag & mask / getting to green zone ) and priming for CICO rescue . Avoids the E Bromley type situation outcome .
August 30, 2025 at 6:29 AM
That’s good . For me it was post vortex & what changed ( for me ) was being able to avoid fixation errors
( eg go back to bag & mask / getting to green zone ) and priming for CICO rescue . Avoids the E Bromley type situation outcome .
( eg go back to bag & mask / getting to green zone ) and priming for CICO rescue . Avoids the E Bromley type situation outcome .
* Rapidly escalating high pressure situation .
August 30, 2025 at 3:43 AM
* Rapidly escalating high pressure situation .
Also Anes nurses find it a lot easier
( to help us ) than DAS algorithms .
( to help us ) than DAS algorithms .
August 30, 2025 at 2:41 AM
Also Anes nurses find it a lot easier
( to help us ) than DAS algorithms .
( to help us ) than DAS algorithms .
Its is a cognitive aid & that’s what’s needed in an airway crises to avoid fixation errors . Don’t ever recollect anyone reading out a DAS algorithm in my 23 yrs in anesthesia during a dynamic , rapidly evolving situation such as an airway crises .
August 30, 2025 at 2:39 AM
Its is a cognitive aid & that’s what’s needed in an airway crises to avoid fixation errors . Don’t ever recollect anyone reading out a DAS algorithm in my 23 yrs in anesthesia during a dynamic , rapidly evolving situation such as an airway crises .
Good Topic for research .
August 23, 2025 at 12:32 PM
Good Topic for research .
Postop pain is so dynamic .
Are there studies looking at acute immediate postop pain , pain after days , weeks , months in patients that had regional Vs those that didn’t?
Perhaps that would give better information ?
Are there studies looking at acute immediate postop pain , pain after days , weeks , months in patients that had regional Vs those that didn’t?
Perhaps that would give better information ?
August 23, 2025 at 12:18 PM
Postop pain is so dynamic .
Are there studies looking at acute immediate postop pain , pain after days , weeks , months in patients that had regional Vs those that didn’t?
Perhaps that would give better information ?
Are there studies looking at acute immediate postop pain , pain after days , weeks , months in patients that had regional Vs those that didn’t?
Perhaps that would give better information ?