Anyone ever intubated a gorilla?

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Chip N Sawbones said:
A guy with a shotgun should be part of the routine staff in my hospital's ORs.
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And ERs. Although, when I think about it, the odds of hitting the animal without also sacrificing the physician seem.....low.
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OTCAwesome said:
Alright, so this is how it went down.

Arrive at the zoo around 7:30. The head zookeeper gives us a long safety talk, basically saying stay away from anywhere where the gorilla could grab you and rip your arms off. All the while there's a guy, we'll call him Jeff, standing quietly in the corner with a big ass shot gun at the low ready position. Now Jeff's job, as I'm sure you can deduce, is to "eliminate the threat" in case anything goes fubar.

Of course at this point, I'm questioning why I decided to do this, and how much trouble I'm going to get into with my wife if I happen to get my face eaten off. So, we go down through an OR suite and another procedure room to where all the cages are. The thing it kept reminding me of was the Velociraptor pen in Jurassic Park, and what do the Velociraptors in Jurassic Park always do? They get out and eat people.... Again, this instilled a lot of confidence in what was about to go down.
We got to the staging area, the first gorilla was chilling in her cage, rolling around, seeming like she was having a pretty good morning. This was until we busted out the blow dart gun (literally it's a blow dart gun, they said it's less traumatic than shooting it out of an actual gun, makes sense). At this point she, no pun intended, starts going ape ****. I mean, the females are probably around 40% smaller than the males, but I can totally see how if one of these wanted to stomp out your existence, there's not a whole lot that you could do about it.

So for blow dart induction it was:
0.1 mg/Kg midaz
0.5 mg/Kg Medetomidine
5mg/Kg Ketamine

When we blow dart her, she lets out this loud, deep, guttural yelp, staggers around for about two minutes until she decides to lay down for nap time. We wait another 10 minutes before approaching her, shes unresponsive, but breathing spontaneously. We move her to another cage where we're going to do the procedures. There's a cute little anesthesia machine about the size of a suitcase that i use to gas her down with iso (honestly it was nicer than the machines we use for mission work down in the Dominican). Now I'm sure we could have used a normal mask if they made a size 9 mask, but I don't think that exists, so we used a milk jug with the bottom cut out. Once I was confident that she was sufficiently deep, we opened her mouth with bungee cords. Now the key thing for intubating gorillas is to grab some4x4 and pull the hell out of their tongue, which I got from the vid @vector2 posted, thanks man! Once you do this, you can literally almost see epiglottis, so I just pooped a mac 5 in there and put an 8.5 in like normal business.

Once the tube was secured, I went to go pop in an IV. Great ape veins are definitely not like human veins, they actually have a pretty thick muscular walls, they feels more like arteries. We drew some blood and ran in LR, if for any reason she got light, we would have given propofol through the IV. They did their procedures, skin biopsies, echo, abd ultrasound etc, then it was time for wake up.

Now how do you wake up a gorilla you say? I would have thought deep, but no, no, no. So we turn off the gas and move her into the second cage that you can see in the second image, this is the gorilla PACU. Jeff is standing there just in case anything goes ****ey. The ETT is secured with plastic cord ties in a bow tie. Once she started to gag on the tube, I put my hand through the cage and quickly removed the ETT and bite block (the bite block being a door stopper wrapped in duct tape).

The second gorilla was way more relaxed, she actually let the vet tech inject her through the bars with the induction meds. This time I decided to use an LMA, a size 5 actually seated quite nicely, I'm sure for a larger male you'd need something bigger. At the end I exchanged the LMA for an ETT as the staff wasn't comfortable emerging with an LMA.

After emerging the second great ape, I went home, and my wife an I got ice cream and she told me how glad she was that my face didn't get eaten off.
View attachment 218491 View attachment 218492
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This has to be one of the best posts in quite some time on sdn. Absolutely hilarious. Well done, sir.

IMG_2560.GIF
 
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So for blow dart induction it was:
0.1 mg/Kg midaz
0.5 mg/Kg Medetomidine
5mg/Kg Ketamine

I am adding this to my repertoire for uncooperative autistic teenagers
 
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OTCAwesome said:
Alright, so this is how it went down.

Arrive at the zoo around 7:30. The head zookeeper gives us a long safety talk, basically saying stay away from anywhere where the gorilla could grab you and rip your arms off. All the while there's a guy, we'll call him Jeff, standing quietly in the corner with a big ass shot gun at the low ready position. Now Jeff's job, as I'm sure you can deduce, is to "eliminate the threat" in case anything goes fubar.

Of course at this point, I'm questioning why I decided to do this, and how much trouble I'm going to get into with my wife if I happen to get my face eaten off. So, we go down through an OR suite and another procedure room to where all the cages are. The thing it kept reminding me of was the Velociraptor pen in Jurassic Park, and what do the Velociraptors in Jurassic Park always do? They get out and eat people.... Again, this instilled a lot of confidence in what was about to go down.

We got to the staging area, the first gorilla was chilling in her cage, rolling around, seeming like she was having a pretty good morning. This was until we busted out the blow dart gun (literally it's a blow dart gun, they said it's less traumatic than shooting it out of an actual gun, makes sense). At this point she, no pun intended, starts going ape ****. I mean, the females are probably around 40% smaller than the males, but I can totally see how if one of these wanted to stomp out your existence, there's not a whole lot that you could do about it.

So for blow dart induction it was:
0.1 mg/Kg midaz
0.5 mg/Kg Medetomidine
5mg/Kg Ketamine

When we blow dart her, she lets out this loud, deep, guttural yelp, staggers around for about two minutes until she decides to lay down for nap time. We wait another 10 minutes before approaching her, shes unresponsive, but breathing spontaneously. We move her to another cage where we're going to do the procedures. There's a cute little anesthesia machine about the size of a suitcase that i use to gas her down with iso (honestly it was nicer than the machines we use for mission work down in the Dominican). Now I'm sure we could have used a normal mask if they made a size 9 mask, but I don't think that exists, so we used a milk jug with the bottom cut out. Once I was confident that she was sufficiently deep, we opened her mouth with bungee cords. Now the key thing for intubating gorillas is to grab some 4x4 and pull the hell out of their tongue, which I got from the vid @vector2 posted, thanks man! Once you do this, you can literally almost see epiglottis, so I just pooped a mac 5 in there and put an 8.5 in like normal business.

Once the tube was secured, I went to go pop in an IV. Great ape veins are definitely not like human veins, they actually have a pretty thick muscular walls, they feels more like arteries. We drew some blood and ran in LR, if for any reason she got light, we would have given propofol through the IV. They did their procedures, skin biopsies, echo, abd ultrasound etc, then it was time for wake up.

Now how do you wake up a gorilla you say? I would have thought deep, but no, no, no. So we turn off the gas and move her into the second cage that you can see in the second image, this is the gorilla PACU. Jeff is standing there just in case anything goes ****ey. The ETT is secured with plastic cord ties in a bow tie. Once she started to gag on the tube, I put my hand through the cage and quickly removed the ETT and bite block (the bite block being a door stopper wrapped in duct tape).

The second gorilla was way more relaxed, she actually let the vet tech inject her through the bars with the induction meds. This time I decided to use an LMA, a size 5 actually seated quite nicely, I'm sure for a larger male you'd need something bigger. At the end I exchanged the LMA for an ETT as the staff wasn't comfortable emerging with an LMA.

After emerging the second great ape, I went home, and my wife an I got ice cream and she told me how glad she was that my face didn't get eaten off.

View attachment 218491 View attachment 218492
Click to expand...

Awesome. Would make a great presentation at ASA, or maybe a Moth story if you like public speaking.
 
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Chetamine said:
Mark Greenberg at UCSD has a lot of experience at the San Diego Zoo.
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Ah yes, Greenberg. Excellent clinician albeit a little rough around the edges. A few of my favorite Greeny moments:

1) During first exposure to pediatric sedation as a CA-1
Me: So Greeny, how much propofol did you give that kid?
Greeny: About an inch.

2) During a case on a sick-ish preemie at the children's hospital that's gotten increasingly difficult to ventilate and concern has been raised for PTX.
Greeny (to x-ray tech): I need you to shoot an x-ray of this baby's chest right now.
X-ray tech: OK, first I'm gonna need the baby's name and medical record number.
Greeny: The name's dead f*cking baby if you don't take an x-ray right now.


As to Karen the orangutan. I legitimately think she ended up with a case of pump head after her ASD repair. She is one goofy monkey (and that's saying something 'cuz I'm literally comparing her to other monkeys).
 
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SaltyDog said:
Ah yes, Greenberg. Excellent clinician albeit a little rough around the edges. A few of my favorite Greeny moments:

1) During first exposure to pediatric sedation as a CA-1
Me: So Greeny, how much propofol did you give that kid?
Greeny: About an inch.

2) During a case on a sick-ish preemie at the children's hospital that's gotten increasingly difficult to ventilate and concern has been raised for PTX.
Greeny (to x-ray tech): I need you to shoot an x-ray of this baby's chest right now.
X-ray tech: OK, first I'm gonna need the baby's name and medical record number.
Greeny: The name's dead f*cking baby if you don't take an x-ray right now.


As to Karen the orangutan. I legitimately think she ended up with a case of pump head after her ASD repair. She is one goofy monkey (and that's saying something 'cuz I'm literally comparing her to other monkeys).
Click to expand...

They have a plaque about Karen by the Orangutan exhibit at the SD zoo. Cool stuff. I didn't realize physicians got so involved with animals.
 
caligas said:
Awesome. Would make a great presentation at ASA, or maybe a Moth story if you like public speaking.
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Yea, I've always wanted to do one of the Moth stories, I think I'd just need to get the zoo to sign off on it, which I'm not exactly sure they would do. We're definitely going to present it at the ASA though.
 
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OTCAwesome said:
Yea, I've always wanted to do one of the Moth stories, I think I'd just need to get the zoo to sign off on it, which I'm not exactly sure they would do. We're definitely going to present it at the ASA though.
Click to expand...

It's your story to tell. You earned it!
 
It's a boy! Vets, doctors help deliver baby gorilla at Philadelphia zoo
....Concerned about her and the baby's health, the zoo brought in a team of veterinarians and doctors who treat people. They included an ob-gyn, surgeons and anesthesiologists from hospitals affiliated with the University of Pennsylvania and Thomas Jefferson University, as well as University of Pennsylvania School of Veterinary Medicine.
It's a boy! Vets, doctors help deliver baby gorilla at Philadelphia zoo
Philly Gorilla.png
 
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CardioDad said:
It's a boy! Vets, doctors help deliver baby gorilla at Philadelphia zoo
....Concerned about her and the baby's health, the zoo brought in a team of veterinarians and doctors who treat people. They included an ob-gyn, surgeons and anesthesiologists from hospitals affiliated with the University of Pennsylvania and Thomas Jefferson University, as well as University of Pennsylvania School of Veterinary Medicine.
It's a boy! Vets, doctors help deliver baby gorilla at Philadelphia zoo
View attachment 219962
Click to expand...

I don't see "Jeff" in that picture. If you want me within arms reach of a gorilla, I want to see Jeff standing nearby at all times. Lol!


--
Il Destriero
 
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GravelRider said:
Bad airway...consider an awake fiberoptic.
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Now that's a funny response!

I will say this, however: gorillas are pretty f'n intelligent animals. Give one a circuit with nitrous and a little sevo running through it and he'll probably enjoy it and gladly keep inhaling.... just like we would.
 
damn lucky @#@!% i'd love to intubate a gorilla. what do you mean tasked?? surely you weren't coerced into an opportunity that i would have jumped at the chance for?
 
abolt18 said:
@nimbus got to thank you for linking to this thread. It was awesome.

@OTCAwesome holy crap dude this is so rad!
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If anyone @Arch Guillotti ever updates the forum thread stickies this one needs to be near the top. It was just as enjoyable reading OTC's trip report the second time around.
 
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vector2 said:
If anyone @Arch Guillotti ever updates the forum thread stickies this one needs to be near the top. It was just as enjoyable reading OTC's trip report the second time around.
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It's done although I am going to try and compile it with some of the others.
 
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Arch Guillotti said:
It's done although I am going to try and compile it with some of the others.
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The "last day of residency" one with the guy smoking a joint on the road trip was pretty good.
 
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"All the while there's a guy, we'll call him Jeff, standing quietly in the corner with a big ass shot gun at the low ready position. Now Jeff's job, as I'm sure you can deduce, is to "eliminate the threat" in case anything goes fubar."

Just to clarify. Was Jeff's job to eliminate the threat to the gorilla or to you?
 
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Outrigger said:
"All the while there's a guy, we'll call him Jeff, standing quietly in the corner with a big ass shot gun at the low ready position. Now Jeff's job, as I'm sure you can deduce, is to "eliminate the threat" in case anything goes fubar."

Just to clarify. Was Jeff's job to eliminate the threat to the gorilla or to you?
Click to expand...
I'm no weapons specialist, but in the picture it looks more like a rifle than a shotgun?
 
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I’m surprised about the emergence plan. I would have untied the ETT, left the bite block, and just let the gorilla pull the ETT out when they are awake. Or perhaps tie it to a string and pull it out from outside the cage.
 
Just gotta bump this for fun. Loved reading it again.
 
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deleted875186 said:
I’m surprised about the emergence plan. I would have untied the ETT, left the bite block, and just let the gorilla pull the ETT out when they are awake. Or perhaps tie it to a string and pull it out from outside the cage.
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What if the gorilla dislodged the ett during stage 2 and had laryngospasm?
 
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