Congrats, you've made the front page of the newspaper...

[CodeBlu]

So, I was in the OR recently and the attending let me run a few cases with little to no input whatsoever (Unless I was obviously making an egregious error!)

Things went smoothly. They were easy and short cases. But, during the last case he started firing off different scenarios/questions at me. Honestly, I can't even remember the specific details of this one question. But, my assessment/management was completely off and he said "congrats, you've made the front page!"

Apparently there's only a few kinds of mistakes you can make in anesthesiology

i) Mistakes that you notice and correct before anything gets out of control.
ii) Mistakes that your peers and colleagues notice and berate you for.
iii) Mistakes that land you on the front page of the newspaper because you killed someone.


I've been browsing this forum for quite some time now, and I was curious to hear about some of your mistakes/errors in judgment. Sort of like M&M rounds so that myself and other med students might benefit from hearing them.

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[secants]

You were basically flying solo as a med student? Extremely jealous if true!

 

[CodeBlu]

You were basically flying solo as a med student? Extremely jealous if true!

I mean, as solo as one can fly without having a residency under the belt. But, I was freaking about everything and trying to micromanage everything. The heart rate jumped up from 70 to 85 and I started thinking about all the things that could make that happen etc etc.

Giving an anesthetic is NOT as easy as I thought it was when I started. Plus, I spent like 3 minutes trying to intubate one of the patients. I picked up a Mac 4 instead of the Mac 3, and only realized it as I was inserting the blade. Felt like a huge tool.

 

[kazuma]

It's probably more common if you rotate with a private group. By the end of my first rotation as an MS3 I ran basic ortho cases virtually on my own (drug selection, dosages, administration, tube/LMA, vent, etc) while my attending surfed hunting forums on the circulator's computer across the room or while he ate carrots and tuna in the core. Definitively some of my most memorable and intense memories of third year. If you prepare for your rotation you'll ace the pimping sessions and your attendings will be more likely to give you autonomy if they feel they can trust you.


Medication errors are mistakes you never want to make. Get in a habit of labeling and reading every syringe and double or even triple checking before you push them. I know someone who thought he was giving famotidine to a scheduled C-section patient in pre-op. Turns out it was 10mg of phenylephrine (roughly 100 times the dose you'd give to treat hypotension). Patient said she felt weird, it was then that he looked in his hand and discovered what he had given. The baby ended up being ok from what they see, but 18 years is a long time to wait.

 

[WholeLottaGame7]

So, I was in the OR recently and the attending let me run a few cases with little to no input whatsoever (Unless I was obviously making an egregious error!)

Things went smoothly. They were easy and short cases. But, during the last case he started firing off different scenarios/questions at me. Honestly, I can't even remember the specific details of this one question. But, my assessment/management was completely off and he said "congrats, you've made the front page!"

Apparently there's only a few kinds of mistakes you can make in anesthesiology

i) Mistakes that you notice and correct before anything gets out of control.
ii) Mistakes that your peers and colleagues notice and berate you for.
iii) Mistakes that land you on the front page of the newspaper because you killed someone.


I've been browsing this forum for quite some time now, and I was curious to hear about some of your mistakes/errors in judgment. Sort of like M&M rounds so that myself and other med students might benefit from hearing them.

Giving protamine on pump is the one that immediately comes to mind.

 

[deleted171991]

I was taught to check the label first when I take the drug out of the cart, the second time while I draw it up, and the third time when I give the medication.

For me, the highest risk of mistake is with look-alike medications and those in high/unusual concentrations. Also it's easy to mistakenly administer a usual drug the patient is allergic to (e.g. lidocaine), especially if the patient has many allergies.

 

[caligas]

Muscle relaxants have been given many times by accident. I know 2 people that have done it.

 

[Planktonmd]

So you think people are going to confess their mistakes and sins on the internet?

 

[Consigliere]

My biggest mistake and error in judgement was choosing anesthesiology as a career.

 

[deleted171991]

Same here. I still love it, though (that's the second biggest mistake).

 

[Planktonmd]

Same here. I still love it, though (that's the second biggest mistake).

Agree with you ... I still love it too ... And I cant imagine doing anything else
Why are we so bitter someone might ask...
The answer is simple... This specialty has been victimized and sabotaged by our elders, our leaders and our politicians...
It has been reduced into a nursing domain for political and financial reasons.
We are now fighting an uphill battle to reclaim what has been forfeited by the same people who claim to represent us now... This is the irony... The same people who sold us out are now running the ASA and want to take credit for any achievement we are unlikely to reach.

 

[CodeBlu]

Agree with you ... I still love it too ... And I cant imagine doing anything else
Why are we so bitter someone might ask...
The answer is simple... This specialty has been victimized and sabotaged by our elders, our leaders and our politicians...
It has been reduced into a nursing domain for political and financial reasons.
We are now fighting an uphill battle to reclaim what has been forfeited by the same people who claim to represent us now... This is the irony... The same people who sold us out are now running the ASA and want to take credit for any achievement we are unlikely to reach.

Well, isn't part of the issue that anesthesiologists have worked diligently to make the perioperative experience a MUCH safer one than it was 20-30-40 years ago?

 

[Planktonmd]

Well, isn't part of the issue that anesthesiologists have worked diligently to make the perioperative experience a MUCH safer one than it was 20-30-40 years ago?

True!
But the old generation anesthesiolgists thought that it is a good idea to let nurses sit in the OR and "provide anesthesia" so they "the old fat cats" could sit in the lounge and keep an eye on the stock market... these same idiots are now running the ASA and want to take credit for any achievement the new guys could attain.
This is the tragedy!

 

[deleted171991]

If what you say is true, it takes a special kind of psychopath to cash in both on the destruction and reconstruction.

 

[Planktonmd]

If what you say is true, it takes a special kind of psychopath to cash in both on the destruction and reconstruction.

My friend... If you lived in Florida you would know how many psychopaths there is in this business!

 

[CodeBlu]

My friend... If you lived in Florida you would know how many psychopaths there is in this business!

Please, do elaborate?

 

[D P356]

.

 

[Spinach Dip]

it takes a special kind of psychopath to cash in both on the destruction and reconstruction.

But, given what you know about human nature, does any of it strike you as surprising?

 

[DermViser]

So, I was in the OR recently and the attending let me run a few cases with little to no input whatsoever (Unless I was obviously making an egregious error!)

Things went smoothly. They were easy and short cases. But, during the last case he started firing off different scenarios/questions at me. Honestly, I can't even remember the specific details of this one question. But, my assessment/management was completely off and he said "congrats, you've made the front page!"

Apparently there's only a few kinds of mistakes you can make in anesthesiology

i) Mistakes that you notice and correct before anything gets out of control.
ii) Mistakes that your peers and colleagues notice and berate you for.
iii) Mistakes that land you on the front page of the newspaper because you killed someone.


I've been browsing this forum for quite some time now, and I was curious to hear about some of your mistakes/errors in judgment. Sort of like M&M rounds so that myself and other med students might benefit from hearing them.

And peoply say Anesthesiology is a "ROAD" specialty. It should be "ROD", but I guess to avoid all the double entendres.

 

[steven.a.smith]

I've been browsing this forum for quite some time now, and I was curious to hear about some of your mistakes/errors in judgment. Sort of like M&M rounds so that myself and other med students might benefit from hearing them.

What are you a nurse?
You want this place to do your homework for you..
AMAZON is your friend..
http://www.amazon.com/Complications-Anesthesia-John-L-Atlee-ebook/dp/B005VP5UJA/ref=sr_1_1?ie=UTF8&qid=1392560437&sr=8-1&keywords=complications in anesthesia
its 1000 pages. read it and come back and tell us what you learned

 

[epidural man]

So, I was in the OR recently and the attending let me run a few cases with little to no input whatsoever (Unless I was obviously making an egregious error!)

Things went smoothly. They were easy and short cases. But, during the last case he started firing off different scenarios/questions at me. Honestly, I can't even remember the specific details of this one question. But, my assessment/management was completely off and he said "congrats, you've made the front page!"

Apparently there's only a few kinds of mistakes you can make in anesthesiology

i) Mistakes that you notice and correct before anything gets out of control.
ii) Mistakes that your peers and colleagues notice and berate you for.
iii) Mistakes that land you on the front page of the newspaper because you killed someone.


I've been browsing this forum for quite some time now, and I was curious to hear about some of your mistakes/errors in judgment. Sort of like M&M rounds so that myself and other med students might benefit from hearing them.

Paralyzing someone without turning on the gas comes to mind.

I have never done this (that I know of)....

A first year rookie mistake is - after intubating, taping the tube, sticking the temp probe in - placing the bear hugger, charting...etc - then alarms start screaming at you all at the same time. Eventually...you realize you need to turn the vent on. Probably this has never caused harm to the patient...but it does make you look and feel very foolish. This I HAVE done...several times.

 

[norwood]

Anyone remember the valve problem on the Aisys machines, the one that would mimic severe bronchospasm if the tiniest bit of water condensed in the inspiratory flow valve? Ugh.

I was helping another guy start a case when we encountered it. Thankfully it was a pt who'd come over from ICU on an Ambu bag without any issues, so we went back on the Ambu and stat paged the tech, but without that key piece of information it would have been a real headache to solve the "bronchospasm."