Keep in mind- if she showed up in the ER with a dislocated joint… they wont even care if she at that nugget a few hours ago and will slam her with deep sedation to pop her joint back in…

So, I prefer two weeks no injections but our facility policy is only one. So that is my first question. She hasn’t been recently placed on the drug so she is not at the highest risk. I don’t do gastric ultrasound, so that wouldnt be a factor in my decision making. I would proceed with SAB. I will say that I think we are all losing the forest for the trees on the issue of the empty stomach. If you have a diabetic, on insulin, who has relatively poor glucose control, and NOT on a GLP-1.. Why dont we make those patients do a 24 hour clear liquid diet pre operatively to reduce their aspiration risk??? I worry far more about that patient population that everyone just says, ‘oh , yes, higher risk” and proceeds.

GA- Aline, levophed, … have had pulm htn patients with spinals code on me. Not going there. Maintaining good mean pressures, precedex if tolerated, pain blocks can lead to good post op care in the elderly.

Since I trained with nerve stimulation that is no issue for me. How about… would you rather have No Tech to do a block or just put everyone to sleep”( ie… you have gone on a mission trip and there is no ultrasound available in the first place… what’s your plan?

I will take the 60 minute set up. I am all about making the patient experience the best. Rather put them to sleep and wake with a great conscious pain relief than just get through the procedure. That’s what drugs are for.

Give me the patients family every time. Surgeons can get on my last nerve some days. I have endless compassion and reserve for the folks I care for.

Give me perfect with a five second wait per minute.

Curvilinear

While I love having every tool in the tool box… the week limitation means I have to take the Five!

I am a half and half girl….

@kylenabecker are intermittently on back order. SO, under a hood in the hospital pharmacy, likely they are dividing the 30 ml vial into 5 cc syringes for the spinals ( 6 per vial). Someone grabbed KCL, thinking was mepivicaine,and divided into syringes and labeled as mepiv.

@kylenabecker The Nashville situation is truly tragic. In your article you asked a question about how something could happen 4 times. Mepivicaine comes in a 30 cc vial. We can only use one vial per patient. We only need 3-4 cc. We waste the rest. Local anesthetics are

Fight this nonsense. As a woman, it offends me when a women pulls this card thus devaluing the claims of others that are actually victims of abuse. If we do not stand for our principles, then it appears we never had them in the first place.

My little heart is beating so happy! Long time proponent of GI tract immunity and its effect on our overall heath, chronic disease, food allergies. Let kids eat dirt, early exposure now shown to reduce food allergies. Stop giving antibiotics for every runny nose ( and NO BENADRYL

Its 3 years post college. Wouldn’t put that in the ‘a lot ‘ category.

Have a great meeting- I will be with you all in spirit. My heart especially goes out to all of you who have lost a guiding light of your state organization.

Have a great time! Wish I could be there with you again, will see you in October!

“Ennui,is the most dangerous poison of life.” According to Jefferson, the antidote is “developing daily those principles of virtue and goodness which will make you valuable to others and happy in yourselves”

(Jefferson’s) His earlier writings use the term eudaimonia instead of the pursuit of happiness. Eudaimonia perfectly describes what it means to be an American. It’s not pursuit of happiness.. it’s the pursuit of each individual becoming the best version of themselves!