Max, what I love about your videos is that they help me as an anesthesia tech learn more in depth what my providers mental checklists are & how I can always be one step ahead to assist them.
My sister is an anesthesiologist and your videos have really shown me just how complicated her job is. I myself have had over 50 surgeries and I appreciate this inside look at what really happens to me.
It's been said the anesthesiologist is the most qualified person in the room during sugery.. Fun fact; most hospitals before anaesthesia located operating theaters on the top floor so that the screaming wouldn't carry into the streets.
My answer before watching the video: They monitor the ever-living snot out of the patient and make subtle adjustments as needed in order to maintain that sweet spot where the patient is paralyzed and unfeeling but not starting to die.
You're hilarious. I can't beleive that i can spend hours watching your anesthesia videos. I am not in the medical field but just started watching your videos on a whim. Well, i can honestly say that I have learned so much (useless to my everyday exisitence) but very interesting. If i ever need surgery, I hope my anesthesia doctor is just like you, Max.
You and your colleagues do great work; and we patients appreciate these videos because none of you talk to us much while we're actually with you. So, thanks!
Dr. Max that is quite ingenous. While this may seem simple to some, your approach covers a great deal of important detail, that might otherwise get over looked! You need to recommend ALL doctors learn their ABCs! Great video!
I appreciate your videos. I'm not a student but I am a patient who has had 5 abdominal surgeries with my last one two weeks ago. I have always wanted to know exactly what happens when I am off in sleepy land. Thank you so much! ☺️🩺🥼👨⚕️
Never forget in nurses training in surgery (1965) seeing the anesthesiologist who was also editor of state medical journal sitting with legs crossed pumping a breathing bag with one hand while holding the medical journal on his lap with other hand reading it
I liked the way to remember those basics. I can't speak for anyone else, but for me I know that in your job you have a lot to consistently monitor. One of the first things I want to know when I have surgery is WHO IS MY ANESTHESIOLOGIST.
Another great reason for being diligent watching a patient's to temp if there's a personal history of malignant hyperthermia. When I worked in surgery, we always had an MH cart in the room just in case. Dantrolene is a wonderful thing if something happens...
Can I ask you a stupid question? Is it true that they often put in a rectal thermometer during surgery or do they place it elsewhere? Just morbidly curious.
Great video, and I really enjoy your videos. Sadly not all Anesthesiologists are like you. I have been awake unknown to the Anesthesiologists, even if I had told the Anesthesiologists that I had Anesthesia awareness, and what goes on post induction is grotesque and irresponsible.
I am like a horse, despite my 155cm. The meds take longer to kick in, or work less and i wake up in a blink. So, I ve :ben thru: intubations and extubations.... not nice.... very not nice grrr
these mnemonics are already in my muscle memory and im sure many seasoned anesthesiologists have done these without even thinking. im sure many would agree, that post induction is all about time control.working out phamacokinetics of TCIs and inhalationals and anticipating the next time reducing manoeuvres are the key to reducing cost and morbidity. trust me, if you just started anesthesia as your field of choice, your consultants always come at the right time.especially when we anticipate something to go wrong.
Thanks I work Doing OR nursing assistant and I’m learning about anesthesia tech at work this videos it helps me a lot greetings ,it helps me because I not need to bother no one
Your video really enlightened me what I went through under GA when I had to go through with two surgeries within a period of 6 weeks. Both time I was reminded to keep breathing after I woke up .
Hi Dr Max, hello from Brisbane Australia. I really enjoy your videos ! You seem really confident and l would feel very comfortable having you as my anaesthetist, as we refer to you here. Best wishes for your future career.! Barbara
I had major surgery done recently and wow the cost to pay the anesthesiologist is higher than the cost to the surgeon. I was so shocked, haha. The bear hugger is so nice. I got to use one in my recovery and for a few days. My surgery site has to be be kept warm. Thank you wonderful medical science and wonderful medical professionals!!! I am eternally grateful!!!
Thanks for explaining this. I recently had surgery at UCLA in Los Angeles and remembered to ask for bubble gum flavor for my pre oxygenation mask you mentioned in a previous video! It smelled so good as I drifted off to sleep! 💤.
Yeah, adults should also get something that doesnt taste like crazy glue.... in the Netherlands, my son got operated on in 2018; they explained to him that the "air" comming from the mask could taste strong... so in NL not even the kids get bubble gum? :(
Hey DOC, I JUST WANTED TO SAY THAT I LOVE YOUR VIDEOS AND BEING IN THE MEDICAL FIELD I STILL LEARN A LOT FROM YOU. I WAS A CORPSMAN IN THE MILITARY, WHICH IS A BATTLEFIELD MEDIC AND I ALWAYS LIKE TO LEARN MORE. THAT IS WHY THEY SAY THAT DOCTORS PRACTICE MEDICINE, BECAUSE THEY ARE ALWAYS LEARNING. THANK YOU FOR WHAT YOU DO
Really interesting!!! Thanks Dr F! I always enjoy your videos. Do you sometimes work with a respiratory tech? I ask as during one of my surgeries, there was one and we were chatting a bit. Again, so interesting! She was the one that put the mask over my nose and I "fell asleep." The anesthesiologist was also there.....he asked what music I'd like to drift off to!! Smooth jazz.... it really makes a huge difference when the medical team treats you as a person and not "just" the next surgery. Cheers from 🇨🇦👍😊
I think you should address the concerns about Crnas taking over anesthsia as it will help anesthsia aspirants get better clarity about what to expect in the near future
Wow no newspaper lol. Our town passes them out every weekend. No one ever reads them they eventually turn to pulp on the sidewalk 😂. My parents actually read them though. Great vids keep it up !
I know your videos aren't targeted at patients, but this level of detail is exactly the kind of thing I am seeking. I am scheduled for anterior/posterior lumbar fusion and a laminectomy in less than a month, and for some odd reason, I've been obsessed with knowing all the facts of the General anesthesia and the associated details. Great job on the video and the many others you've publish ed!
@@kendallevans4079 I definitely tried every other option. It's been 15 months since I had the surgery, and I am happy that I had it done. It is a painful recovery!
I continue to learn more from you than my brother Ron who is an anesthesiologist. Somehow in the future, you two have to get together and discuss what happens in a complicated case like a heart/lung transplant
I had emergency surgery once, and I was upset as I had just eaten a large meal. I kept telling everyone "I have a full stomach of food! I can't have surgery!" Well, they kept assuring me, the anesthesiologist would take care of it. Now I know how they took care of it!
If it was a emergency surgery you probably should remember getting the gastrical tube, because with a full stomach, you do this before inducing the anesthesia, not after.
@@lwolfstar7618 because it was a emergency cesarian. No time to loose. But a emergency surgery can be everything, you just can't wait 6hrs after the last meal :)
@@lemboshauser4700 to be fair they also didn't get a chance, between contractions I grabbed the mask and took the mother of all inhales and blacked out on the spot lmao
@@lwolfstar7618 because this is a real emergency. There a different levels of emergencies where your different amount of time To prepare the patient and make general anesthesia safer for him. There are basically not many ones where it is like in a emergency cesarian section.
Educational & fun. Well done. You should write a book too, Anaesthesia 😁 after all, you have the ideal sponsor. No but seriously you must have so many stories to share!!!
I always get Mt, Sinai and Cedar Sinai hospitals mixed up. I also have wondered for years what you do after the patient is asleep. The TV is always misleading. 😊 You certainly teach me a lot! I’m probably gonna be much more talkative to the next anesthesiologist and telling them about your TH-cam channel.😀
Ask fo propofol please milk looking at him right in the eye !? 99 per cent of aneasthetic is fine so don’t worry you’ll have a good Nap & wake up in recovery or not remember & then wake up back in youre Bed x
It’s A very rare thing for a patient to wake up especially in a big operation so don’t worry mention youre fears & hell he will listen & you are going to be Fine I promise you to wake up it’s very very rare in an Abdominal operation Cos you will be given relaxants which make sure you don’t wake up x
Hi Doc Max, love the new logo. Ha Ha needles ah terrified. Wish you were here in the UK. Would be happy to be put out if my anesthesiologist was as good looking and fun like you are. Phew you can breathe a sigh of relief I am a young oldie of 68 years on the mileage. Hoping all my bits and pieces keep in good working order for a good while yet.
An alternative post intubation checklist from Australia - also using ABCDE :) airway - confirm tube placement, depth, and secure circuit breathing - O2 sats, CO2, gas flows and ventilation parameters circulation - HR, BP stable and cycling regularly drugs (4 As) - anesthetic (have you turned it on?), antibiotics, antiemetics, analgesics. environment/everything else - temperature monitor, Bair hugger, blood sugar level/ABG, head to toe pressure care and DVT prophylaxis (stockings, calf compressors) If haven’t done it before induction, surgical safety checklist / time-out prior to skin prep
I was nasally intubated for my last surgery. That actually was worse than the surgery. Where my nasal septum joins my upper lip hurt for months afterward. Hope I never need nasal intubation again!
Very interesting. I found general anesthesia to be completely fine, but understand peoples concerns. Since switching to RSI protocols in EMS, I admit I’m not a technician that is ‘happy’ using RSI pre-hospital, but that’s the way EMS is moving. (Talk about being on top of ones game, least you all have a controlled setting, try it in a vehicle that is half way down an embankment or a moving ambulance hehe)
What types of changes in vitals would you expect to see if your patient goes into anaphylaxis? (Asking as someone with several medication allergies including some meds you might commonly administer.)
I’m a CRNA. Don’t believe we will be “taking over” . It is a team effort to ensure patients receive excellent care! We all have our strengths and weaknesses, and need to work together to keep patients safe.
It's good that you aren't trying to take over and just want to be an effective member of the team. There is a very vocal minority of CRNAs that will do anything to replace doctors and get rid of CAAs
Conner Broeker, yes it is unnecessary to act that way. We all have our part in the care of the patient. If we keep that in mind with the patient being the priority, all is well. Anesthesia really is an awesome job if we can all work together effectively, and push the political stuff aside.
dear Max my name is Amel Avdić, I am an anesthesiologist at the Clinical Center of the University of Sarajevo, Bosnia and Herzegovina. I am delighted with your videos. I am wondering if it is possible to visit your hospital in NY as a visiting doctor. Thank you in advance
When my son had to be put to sleep for a biopsy, I asked the anesthesiologist if he was going to stay in the room. He said yes and told me I watch too much tv. But at that time, there was a problem with them walking out of a room. Made me feel better to ask
Hey Doc, I love your channel! I am convinced if I would have had my first surgery at a young age and seen the awesome team work that goes on in the OR, I would have become an anesthesiologist. I just had my first surgery. The gasses made my throat and head burn before I went out. I wonder what they were.
I'm sure I don't have enough information to give for a good answer but I have a question. When I had a roux en y bypass in 2003 I woke up to the nurses saying I was super blue. I freaked out because my biggest fear was waking up on a vent. Turns out I was physically blue, I aspirated the dye the surgeon used to check for leaks in my new stomach. Did I probably just vomit at some point? It never came out of my hair and just grew out. that stuff doesn't mess around. Thanks!
Speaking on anaphylaxis during surgery, it happened to me. See, I'm allergic to latex. During the surgery, they changed my I.V. site, and placed a Band-Aid over the old site. I was 13, but I remember them telling me that almost instantly I broke out in hives and my oxygen dropped. I also went into anaphylaxis from Vancomycin (probably spelled that wrong) a few years ago. I was fully awake and remember it fully. Scary stuff!
I met the anesthesiologist but during the procedure he put a nurse anesthetist in charge who did a lousy job, me waking up in pain. The anesthesiologist was sitting in the office reading and I complained to him and he acted surprised I woke up in the procedure.
While that surgery table looks more narrow every time I see it and while I enjoy the sensation of I'm about to fall off this table, please make it more narrow so that I feel like I'm actually falling. LOL Enjoy your videos very much. I am learning a lot.
Well thank you , now I won’t roll my eyes when the doc asks me to go get a blanket for a sedated patient after the patient ( when still awake 😂) adamantly refused a blanket . I learn a lot from you Dr Max!!
My Anesthesiologist almost killed me during Ablation surgery. I had to be rushed to Cardiac ICU. I woke up Intubated, tied down and had a packing cloth up my nose because they cut my nasal passage inserting a trumpet to provide me with an additional air way. I was bleeding in my mask and into my lungs. They fucked up and admitted it. So instead of a one day turnaround I was a guest in the hospital for 6 days.
No we do not, although I've had anesthesia before and it was just like time traveling from the moment the meds went in until when I woke up in the recovery room.
Dr Feinstein I've just started to follow your channel and I've been a medical buff since I was a kid growing up because of the congenital birth defect required so much medical care. So the OR has been a room I've frequented over the years, from watching your videos I had no idea that Anesthesiology seems so complex and in a way simple as well. I have two specific questions for you and I hope to get some answers before my next procedure next week 1. is medication to help reduce/prevent vomiting always given during anesthesia or is that only given when the patient absolutely needs it? 2. Is it possible for a patient to have negative reactions to the anesthetic gasses and not have any negative reaction to IV anesthetic? (not necessarily an allergy reaction, maybe its a side effect?) and can general anesthesia be administered totally via IV without gasses or is gas still required?
1) Meds can be given to prior to surgery to reduce risk of aspiration; some meds are given to reduce the risk of nausea/vomiting after surgery. Elective surgeries call for an empty stomach because of the aspiration risk. 2) Yes it is possible for a patient to have negative side effects to anesthetic gases but not IV medications. And yes it is possible to go through general anesthesia with totally IV medications. If you have negative side effects to gas, this should be discussed with your provider so they can make the appropriate decision, in some cases they can still use anesthetic gas but give additional medications to counteract the negative side effect. Anesthetic gas and anesthetic IV medications are both helpful.
Hey Doctor I had a knee replacement and woke up during the surgery and was speaking to the doctor while the surgeon was sawing on the knee . But there was no pain why didn't she put me back under ? I remember everything after I heard that saw cutting away at my knee. Just wondering is this normal ? Loved the videos keep making them. There great.
Very nice guy he answered everyone of my questions and even when I repeated them still answered him he shrugged his shoulders and I said no offense if I knew that I was going to have a Breathing tube down my throat and literallouis be in a slight medical coma I'd be asking every question under the sun a 100 times more than youdown
What happens when a patient already has a tube going from their nose to their stomach? Do you leave that one in? I ask because I had one in my nose till surgery and when I woke up after surgery, it was gone
Hi Dr Feinstein! I’d like your view on whether becoming an anaesthesiologist in a few years will be worth it with the huge and ever increasing number of CRNAs these days. Is anaesthesiology a dying field?
Max, what I love about your videos is that they help me as an anesthesia tech learn more in depth what my providers mental checklists are & how I can always be one step ahead to assist them.
My sister is an anesthesiologist and your videos have really shown me just how complicated her job is. I myself have had over 50 surgeries and I appreciate this inside look at what really happens to me.
Over 50? How????
Why the hell has everyone had so many surgeries? I am 37 and I haven't had a single one.
@@looksirdroids9134 good for you that you're in peak physical health and an alpha individual
50 🤔
@@theprmstrful1 I have a lymph node disease and cancer plus the basics like appendix, gallbladder, c-sections and 5 eye surgeries. It adds up quick.
Its so obvious you love your profession. And we are lucky to have you
It's been said the anesthesiologist is the most qualified person in the room during sugery.. Fun fact; most hospitals before anaesthesia located operating theaters on the top floor so that the screaming wouldn't carry into the streets.
Either the top floor or a whole other builiding several meters away from the main one.
Or even possibly the basement.
@@Aawsomeguy lol….basement normally are for the dead😂😂….but i get what you men though
@@chakritsasorn yea we get what you men 😂😂🤣
@@Aawsomeguy 0 ko
I like how creative you are to keep the us entertained as we learn. Stay humble! Love your videos!
My answer before watching the video: They monitor the ever-living snot out of the patient and make subtle adjustments as needed in order to maintain that sweet spot where the patient is paralyzed and unfeeling but not starting to die.
pretty accurate
You're hilarious. I can't beleive that i can spend hours watching your anesthesia videos. I am not in the medical field but just started watching your videos on a whim. Well, i can honestly say that I have learned so much (useless to my everyday exisitence) but very interesting. If i ever need surgery, I hope my anesthesia doctor is just like you, Max.
You and your colleagues do great work; and we patients appreciate these videos because none of you talk to us much while we're actually with you. So, thanks!
Dr. Max that is quite ingenous. While this may seem simple to some, your approach covers a great deal of important detail, that might otherwise get over looked! You need to recommend ALL doctors learn their ABCs! Great video!
Air Book Chair
Door, Eyes, Flights
I appreciate your videos. I'm not a student but I am a patient who has had 5 abdominal surgeries with my last one two weeks ago. I have always wanted to know exactly what happens when I am off in sleepy land. Thank you so much! ☺️🩺🥼👨⚕️
It’s crazy how much I love these videos! I’m not even remotely in the medical field! They are so interesting!
Glad you found them so enjoyable!
Never forget in nurses training in surgery (1965) seeing the anesthesiologist who was also editor of state medical journal sitting with legs crossed pumping a breathing bag with one hand while holding the medical journal on his lap with other hand reading it
I watch every video hoping you were my next anesthesiologist! You are a consummate professional! Thank you for all the videos! Logo is great!
F could be Fever or Freezing?
I liked the way to remember those basics. I can't speak for anyone else, but for me I know that in your job you have a lot to consistently monitor. One of the first things I want to know when I have surgery is WHO IS MY ANESTHESIOLOGIST.
I never met mine. Damn it!😡😡😡😡😡
Another great reason for being diligent watching a patient's to temp if there's a personal history of malignant hyperthermia. When I worked in surgery, we always had an MH cart in the room just in case. Dantrolene is a wonderful thing if something happens...
isn't MH a rare condition? always having a MH is so unusual according to my textbooks!
Can I ask you a stupid question? Is it true that they often put in a rectal thermometer during surgery or do they place it elsewhere? Just morbidly curious.
@@intrepidtomato where you would like it?
Should have millions of subs...so humble...I wish he could induce me in a couple weeks
thank you Dr for these videos. You explain in a natural way that sticks to memory
I always wait for ur video.Hope next year I be able to pass anesthesiologist PG induction exam.cheers.
Best of luck!
Props on the logo - much better than the vanity license plate on a late model BMW reading “INTUBATR”
Great video, and I really enjoy your videos. Sadly not all Anesthesiologists are like you. I have been awake unknown to the Anesthesiologists, even if I had told the Anesthesiologists that I had Anesthesia awareness, and what goes on post induction is grotesque and irresponsible.
I am like a horse, despite my 155cm. The meds take longer to kick in, or work less and i wake up in a blink. So, I ve :ben thru: intubations and extubations.... not nice.... very not nice grrr
Love Dr. F's videos they are amazing.
Great video man! I love the new logo! I learned a lot!
Thanks Darrion, I appreciate it!
@@MaxFeinsteinMD you welcome
Woah, loving the new logo
Thanks Ryan!
these mnemonics are already in my muscle memory and im sure many seasoned anesthesiologists have done these without even thinking. im sure many would agree, that post induction is all about time control.working out phamacokinetics of TCIs and inhalationals and anticipating the next time reducing manoeuvres are the key to reducing cost and morbidity.
trust me, if you just started anesthesia as your field of choice, your consultants always come at the right time.especially when we anticipate something to go wrong.
Thanks I work Doing OR nursing assistant and I’m learning about anesthesia tech at work this videos it helps me a lot greetings ,it helps me because I not need to bother no one
Loving the new logo chief 👌🏻
Thanks Nick!
Your video really enlightened me what I went through under GA when I had to go through with two surgeries within a period of 6 weeks. Both time I was reminded to keep breathing after I woke up .
Hi Dr Max, hello from Brisbane Australia. I really enjoy your videos ! You seem really confident and l would feel very comfortable having you as my anaesthetist, as we refer to you here. Best wishes for your future career.! Barbara
I had major surgery done recently and wow the cost to pay the anesthesiologist is higher than the cost to the surgeon. I was so shocked, haha. The bear hugger is so nice. I got to use one in my recovery and for a few days. My surgery site has to be be kept warm. Thank you wonderful medical science and wonderful medical professionals!!! I am eternally grateful!!!
They deserve every penny, there smart and one mistake your dead
@@Ink30 Well yes I agree LOL.
Max, you are adorable. I am watching these videos after having had shoulder surgery a few weeks back. I am finding them very interesting!
Thanks for explaining this. I recently had surgery at UCLA in Los Angeles and remembered to ask for bubble gum flavor for my pre oxygenation mask you mentioned in a previous video! It smelled so good as I drifted off to sleep! 💤.
Yeah, adults should also get something that doesnt taste like crazy glue.... in the Netherlands, my son got operated on in 2018; they explained to him that the "air" comming from the mask could taste strong... so in NL not even the kids get bubble gum? :(
Hey DOC, I JUST WANTED TO SAY THAT I LOVE YOUR VIDEOS AND BEING IN THE MEDICAL FIELD I STILL LEARN A LOT FROM YOU. I WAS A CORPSMAN IN THE MILITARY, WHICH IS A BATTLEFIELD MEDIC AND I ALWAYS LIKE TO LEARN MORE. THAT IS WHY THEY SAY THAT DOCTORS PRACTICE MEDICINE, BECAUSE THEY ARE ALWAYS LEARNING. THANK YOU FOR WHAT YOU DO
Really interesting!!! Thanks Dr F! I always enjoy your videos.
Do you sometimes work with a respiratory tech? I ask as during one of my surgeries, there was one and we were chatting a bit. Again, so interesting! She was the one that put the mask over my nose and I "fell asleep." The anesthesiologist was also there.....he asked what music I'd like to drift off to!! Smooth jazz.... it really makes a huge difference when the medical team treats you as a person and not "just" the next surgery.
Cheers from 🇨🇦👍😊
THE doc F :) the original one!!
I love your videos!!! Keep up the awesome work Dr Feinstein!!👍😊
Your camera quality is EPIC
I think you should address the concerns about Crnas taking over anesthsia as it will help anesthsia aspirants get better clarity about what to expect in the near future
This would be an excellent topic!! Discussing what cases go to physicians vs CNRA’s
CRNA’s have been doing anesthesia since the 1950s. Shut up
@@tmercari8807 If only some CRNA's took more pride in their title instead of fighting to be called doctor.
Fast and interesting presentation of applying anesthesia
Wow no newspaper lol. Our town passes them out every weekend. No one ever reads them they eventually turn to pulp on the sidewalk 😂. My parents actually read them though. Great vids keep it up !
I know your videos aren't targeted at patients, but this level of detail is exactly the kind of thing I am seeking. I am scheduled for anterior/posterior lumbar fusion and a laminectomy in less than a month, and for some odd reason, I've been obsessed with knowing all the facts of the General anesthesia and the associated details.
Great job on the video and the many others you've publish ed!
The first time I read your comment, for some reason I thought it said "lumber fusion" which sounds like a terrible operation for someone to endure!
@@User0000000000000004 that IS what he said, and there is a painful recovery afterwards.
Me too
Lumbar fusion??!!.....Have you tried EVERY other option? Don't mean to scare you but that isn't for the faint of heart!
@@kendallevans4079 I definitely tried every other option. It's been 15 months since I had the surgery, and I am happy that I had it done.
It is a painful recovery!
In London we read Metro and Evening standard between Monday to Friday during our commute to and from work. Both are free....more than our NHS.
I continue to learn more from you than my brother Ron who is an anesthesiologist. Somehow in the future, you two have to get together and discuss what happens in a complicated case like a heart/lung transplant
I had a nice chat over email with him, thanks for connecting us!
I had emergency surgery once, and I was upset as I had just eaten a large meal. I kept telling everyone "I have a full stomach of food! I can't have surgery!" Well, they kept assuring me, the anesthesiologist would take care of it. Now I know how they took care of it!
If it was a emergency surgery you probably should remember getting the gastrical tube, because with a full stomach, you do this before inducing the anesthesia, not after.
@@lemboshauser4700 they didn't do that while I was awake before my emergency cesarian 🤷♀️
@@lwolfstar7618 because it was a emergency cesarian. No time to loose. But a emergency surgery can be everything, you just can't wait 6hrs after the last meal :)
@@lemboshauser4700 to be fair they also didn't get a chance, between contractions I grabbed the mask and took the mother of all inhales and blacked out on the spot lmao
@@lwolfstar7618 because this is a real emergency. There a different levels of emergencies where your different amount of time To prepare the patient and make general anesthesia safer for him. There are basically not many ones where it is like in a emergency cesarian section.
Educational & fun. Well done. You should write a book too, Anaesthesia 😁 after all, you have the ideal sponsor. No but seriously you must have so many stories to share!!!
I had to have eye surgery a while back and the anesthesiologist was wonderful. (They all were honestly.) We were all joking around until i passed out.
LOVE THE BEAR HUG. ive had a lot of surgeries and i love that thing
That was very entertaining & explaining to us reg folks & pre med idiots what needs to happen prior to surg....thank you.
I always get Mt, Sinai and Cedar Sinai hospitals mixed up. I also have wondered for years what you do after the patient is asleep. The TV is always misleading. 😊 You certainly teach me a lot! I’m probably gonna be much more talkative to the next anesthesiologist and telling them about your TH-cam channel.😀
B explains why I always feel so cold after surgery!
I always love when this one pops up :)
Sit and read the newspaper? Wow Dr Feinstein you look great for 84 years old!
I'm an anaesthetist and I agree with you!😄
Great Dr.........You are Light For The Future, thanks for that piece, educative and fun🙏🏻
Thank you so much , video very informative very educational.
I'm having abdominal surgery in August, and I am going to have to force myself to not grill the anesthesiologist on these 😂
Don’t worry about it ❤️when I had my operations I would ask so questions they don’t mind
My dad is a paramedic and he brought his CRNA a crossword puzzle book when he got his rotator cuff done.
Ask fo propofol please milk looking at him right in the eye !? 99 per cent of aneasthetic is fine so don’t worry you’ll have a good Nap & wake up in recovery or not remember & then wake up back in youre Bed x
It’s A very rare thing for a patient to wake up especially in a big operation so don’t worry mention youre fears & hell he will listen & you are going to be Fine I promise you to wake up it’s very very rare in an Abdominal operation Cos you will be given relaxants which make sure you don’t wake up x
I am so glad to know I have never been just laying there freezing
I come from a long line of doctors, and I've heard most of them tell me that "It's the anesthetist's surgery. They're the boss. What they say, goes."
Thanks for adding actual captions for the Deaf
Hi Doc Max, love the new logo. Ha Ha needles ah terrified. Wish you were here in the UK. Would be happy to be put out if my anesthesiologist was as good looking and fun like you are. Phew you can breathe a sigh of relief I am a young oldie of 68 years on the mileage. Hoping all my bits and pieces keep in good working order for a good while yet.
Thank you for your work on identifying sex-differences between men and women in presentation and outcomes in myocardial revascularization!
I didn’t know the alphabet posted ads on TH-cam! Keep up the great work! 😊
Just had anesthesia yesterday bro woke up ready to fight people. Terrible anxiety. First time that happened.
Happens relatively commonly, particularly in younger patients.
I always am violent when waking up, even at 37 years old.
Thank you for this video! I like your sense of humor!
An alternative post intubation checklist from Australia - also using ABCDE :)
airway - confirm tube placement, depth, and secure circuit
breathing - O2 sats, CO2, gas flows and ventilation parameters
circulation - HR, BP stable and cycling regularly
drugs (4 As) - anesthetic (have you turned it on?), antibiotics, antiemetics, analgesics.
environment/everything else - temperature monitor, Bair hugger, blood sugar level/ABG, head to toe pressure care and DVT prophylaxis (stockings, calf compressors)
If haven’t done it before induction, surgical safety checklist / time-out prior to skin prep
I love your explanations. Thank You.
I was nasally intubated for my last surgery. That actually was worse than the surgery. Where my nasal septum joins my upper lip hurt for months afterward. Hope I never need nasal intubation again!
Hello doctor can you please make a video about how we wake somebody up after anesthesia
Very interesting. I found general anesthesia to be completely fine, but understand peoples concerns. Since switching to RSI protocols in EMS, I admit I’m not a technician that is ‘happy’ using RSI pre-hospital, but that’s the way EMS is moving. (Talk about being on top of ones game, least you all have a controlled setting, try it in a vehicle that is half way down an embankment or a moving ambulance hehe)
I LOVE a bair hugger. When the patient’s unconscious I’m sure they’ll let me have a corner.
What types of changes in vitals would you expect to see if your patient goes into anaphylaxis?
(Asking as someone with several medication allergies including some meds you might commonly administer.)
Tachycardia, hypertension, hypercapnia, hyperthermia, increased airway pressures. And I’d also be looking for a rash on the patient’s skin.
...not HYPOtension...? When i get a reaction, i need to use epi, to raise mybp so i can get up...
I’m a CRNA. Don’t believe we will be “taking over” . It is a team effort to ensure patients receive excellent care! We all have our strengths and weaknesses, and need to work together to keep patients safe.
It's good that you aren't trying to take over and just want to be an effective member of the team. There is a very vocal minority of CRNAs that will do anything to replace doctors and get rid of CAAs
@@mustang8206 facts
Just fyi, if you are putting a phrase in quotations, the perils belongs BEFORE the final quotation mark, and not after it.
Thanks 😆 Didn’t proof read due to the fact that it’s TH-cam. Are you guys Anesthesiologists? If so, cheers! Thanks for all you do!
Conner Broeker, yes it is unnecessary to act that way. We all have our part in the care of the patient. If we keep that in mind with the patient being the priority, all is well. Anesthesia really is an awesome job if we can all work together effectively, and push the political stuff aside.
From Russia with respect. Make a video about the postoperative pain management.
first thing i do is turn on old yeller... (sevo)... then all the other stuff (vent settings, tape tube, yada yada)
lol old yeller, love this
Hi Dr. Feinstein,
Can you please do a video of post spinal/epidural headaches? Thanks!
dear Max
my name is Amel Avdić, I am an anesthesiologist at the Clinical Center of the University of Sarajevo, Bosnia and Herzegovina. I am delighted with your videos. I am wondering if it is possible to visit your hospital in NY as a visiting doctor. Thank you in advance
BEST AND EASY. Thank You Dr.
When my son had to be put to sleep for a biopsy, I asked the anesthesiologist if he was going to stay in the room. He said yes and told me I watch too much tv. But at that time, there was a problem with them walking out of a room. Made me feel better to ask
Hey Doc, I love your channel! I am convinced if I would have had my first surgery at a young age and seen the awesome team work that goes on in the OR, I would have become an anesthesiologist. I just had my first surgery. The gasses made my throat and head burn before I went out. I wonder what they were.
I'm sure I don't have enough information to give for a good answer but I have a question. When I had a roux en y bypass in 2003 I woke up to the nurses saying I was super blue. I freaked out because my biggest fear was waking up on a vent. Turns out I was physically blue, I aspirated the dye the surgeon used to check for leaks in my new stomach. Did I probably just vomit at some point? It never came out of my hair and just grew out. that stuff doesn't mess around. Thanks!
Speaking on anaphylaxis during surgery, it happened to me. See, I'm allergic to latex. During the surgery, they changed my I.V. site, and placed a Band-Aid over the old site. I was 13, but I remember them telling me that almost instantly I broke out in hives and my oxygen dropped.
I also went into anaphylaxis from Vancomycin (probably spelled that wrong) a few years ago. I was fully awake and remember it fully. Scary stuff!
You should do on about the steps of induction
Do you want to wake up an anesthesiologist
Say “closing” .😂😂😂😂😂
Hahaha that's pretty good
I met the anesthesiologist but during the procedure he put a nurse anesthetist in charge who did a lousy job, me waking up in pain. The anesthesiologist was sitting in the office reading and I complained to him and he acted surprised I woke up in the procedure.
While that surgery table looks more narrow every time I see it and while I enjoy the sensation of I'm about to fall off this table, please make it more narrow so that I feel like I'm actually falling. LOL Enjoy your videos very much. I am learning a lot.
F = for fever?
It could be a memory hook to place the pt on some type of thermometer plus it makes me think to look out for malignant hyperthermia.
Thought this exact same thing as soon as he got to it.
You can add centigrade to the C part of your mnumonic
Dr Max is the bomb!
Well thank you , now I won’t roll my eyes when the doc asks me to go get a blanket for a sedated patient after the patient ( when still awake 😂) adamantly refused a blanket . I learn a lot from you Dr Max!!
I owe this provider lunch
My Anesthesiologist almost killed me during Ablation surgery. I had to be rushed to Cardiac ICU. I woke up Intubated, tied down and had a packing cloth up my nose because they cut my nasal passage inserting a trumpet to provide me with an additional air way. I was bleeding in my mask and into my lungs. They fucked up and admitted it. So instead of a one day turnaround I was a guest in the hospital for 6 days.
Did you have to undergo anesthesia as part of your training? So you’d know what the patient is feeling throughout the process?
No we do not, although I've had anesthesia before and it was just like time traveling from the moment the meds went in until when I woke up in the recovery room.
Dr Feinstein I've just started to follow your channel and I've been a medical buff since I was a kid growing up because of the congenital birth defect required so much medical care. So the OR has been a room I've frequented over the years, from watching your videos I had no idea that Anesthesiology seems so complex and in a way simple as well.
I have two specific questions for you and I hope to get some answers before my next procedure next week
1. is medication to help reduce/prevent vomiting always given during anesthesia or is that only given when the patient absolutely needs it?
2. Is it possible for a patient to have negative reactions to the anesthetic gasses and not have any negative reaction to IV anesthetic? (not necessarily an allergy reaction, maybe its a side effect?) and can general anesthesia be administered totally via IV without gasses or is gas still required?
1) Meds can be given to prior to surgery to reduce risk of aspiration; some meds are given to reduce the risk of nausea/vomiting after surgery. Elective surgeries call for an empty stomach because of the aspiration risk.
2) Yes it is possible for a patient to have negative side effects to anesthetic gases but not IV medications. And yes it is possible to go through general anesthesia with totally IV medications. If you have negative side effects to gas, this should be discussed with your provider so they can make the appropriate decision, in some cases they can still use anesthetic gas but give additional medications to counteract the negative side effect. Anesthetic gas and anesthetic IV medications are both helpful.
Love the new logo Max!
Thanks Doctor for this another interesting video.
A question: why is it necessary to keep the patient warm? I was thinking the opposite...
I admire your intelligence ❤️
Hey Doctor I had a knee replacement and woke up during the surgery and was speaking to the doctor while the surgeon was sawing on the knee . But there was no pain why didn't she put me back under ? I remember everything after I heard that saw cutting away at my knee. Just wondering is this normal ? Loved the videos keep making them. There great.
Sounds like you got regional anesthesia and were under medications to make you comfortable but were not intubated.
I like your cap, it's so cute.
Very nice guy he answered everyone of my questions and even when I repeated them still answered him he shrugged his shoulders and I said no offense if I knew that I was going to have a Breathing tube down my throat and literallouis be in a slight medical coma I'd be asking every question under the sun a 100 times more than youdown
What happens when a patient already has a tube going from their nose to their stomach? Do you leave that one in? I ask because I had one in my nose till surgery and when I woke up after surgery, it was gone
Hi Dr Feinstein! I’d like your view on whether becoming an anaesthesiologist in a few years will be worth it with the huge and ever increasing number of CRNAs these days. Is anaesthesiology a dying field?