Nermana's Anesthesia Minute

Our understanding of fluid management, like many topics in healthcare, seems to be ever-changing.  An entire course could be dedicated to addressing the topic of fluid replacement, so this is a brief introduction.  In today's episode, I discuss the NICOM, their reliability, and how they are used in fluid management.  I also discuss what current literature recommends regarding fluid management (goal-directed fluid therapy, ERAS protocols, and general fluid management). 

Inducing general anesthesia is quite overwhelming to the new learner.  With time it becomes second nature.  However, the purposes of the medications that we use are frequently forgotten in the vast amount of data that is being assimilated.  In this episode, the common induction drugs are reviewed along with the reasoning for their use.

Pre-oxygenation seems like an easy step in preparing for anesthesia induction.  For the newer students, they have not likely had enough experience to appreciate the importance.  For the seasoned practitioner, they are skilled enough, that the importance can sometimes be forgotten.  In this episode, you will find a brief discussion of the importance and the math behind why it works.  

The Bispectral Index (BIS) monitor can be a great tool in anesthesia, especially with the use of total intravenous anesthesia (TIVA).  However, to use it correctly you must interpret all of the output data, not just look for a BIS value of 40 to 60.  This episode is a brief discussion of the basics of using a BIS monitor.

FiO2 selection in anesthesia often doesn't get a much thought as it probably deserves.  Here I will discuss the shortcomings of the WHO recommendations, some of the drawbacks to high FiO2, and what you can do.

This is the continuation of the basic ventilator discussion.  Here I discuss basic ventilator modes and some of the rationale for using each.

Starting out in the OR can be overwhelming for the SRNA.  Setting the ventilator is not as easy or intuitive as one might hope.  In this episode, I discuss basic ventilator parameters and my own preferences and reasoning for my decisions.

Lactated Ringers seems to be an often forgotten IV fluid outside of the OR.  Perioperatively, healthcare providers have some misconceptions based on limited knowledge of the fluid and hearsay.  In this episode, I discuss the truths and dispel the myths of the forgotten and seeming misunderstood fluid.  

ACE-I and ARBs are great at controlling blood pressure.  However, under general anesthesia, they can become the bain of your existence.  Here I discuss why and some possible solutions.

When your patient is taking a beta-blocker, why don't they tend to have reflex bradycardia with receiving phenylephrine?  The answer is not quite straightforward.