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Per4mer8

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The media are complete *****s.

Anytime you read anything that is remotely science or medical based - they will **** it up.

Pretty much guaranteed.

So none of this means anything, but I read your post but all I noticed was you're from Canada, Borat, and your post count is 666........ :D
 

cincincyreds

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I don't think we will get paid in obamacare if there is a postop MI like with Mr. Clark.
 

Per4mer8

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An old dude with a bad heart. Why do you want to make a big stink about it?

"I" do not. My point was that I'm surprised more isn't being made of this seeing as how our media operates. We all know the risk of perioperative MI (assuredly, you and the other Attendings much more so than I), especially in an individual that is old, male, with a hx of CVA and DM.
 

Bertelman

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"I" do not. My point was that I'm surprised more isn't being made of this seeing as how our media operates. We all know the risk of perioperative MI (assuredly, you and the other Attendings much more so than I), especially in an individual that is old, male, with a hx of CVA and DM.

He has become irrelevant to most people. Once he had his stroke, he was no longer an entertainer.
 

Hockeyguy

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Not to be a d-bag but an interesting point to be made that that is history of cerebrovascular disease is one of five clinical risk factors that is often overlooked when evaluating a patient preoperatively. Case-and-point Dick Clark. The ASA/AHA included nit for a reason!
 

periopdoc

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Pre-CVA, what sort of gun do you think Dick Clark would have used? Post CVA? Post MI?


Yeah, I mean the way the media prejudges folks like Zimmerman, I am surprised they didn't work up at least one or two good protests insisting on the arrest of the anesthesiologist to hold him accountable for his actions.

- pod
 

aneftp

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Dick Clark was a minimum ASA 3 with his history. Complications will be more tolerated than an ASA 1 mother of 3 for "routine C section".....mishap happens during c section and everyone blames anesthesia.

Like my brother who's 10 years older than me told me before I started as an attending. The scariest patient isn't your aicd patient ef 10%, septic who's look like he's on his death bed.

It's the healthy young female with young kids to raise. Those are the most dangerous patients.

And my other sister who told me over the weekend patient coded on her in OR. Lady was septic, AICD, EF 10-15%, perforated appy. Emergency case. She put patient to sleep with only 80mg propofol and patient flat lines. Autopsy showed massive PE as cause of death. People aren't surprised.

But if it's healthy female patient who has code in OR after induction it's makes the news.

So Dick Clark dying isn't a great surprise even if it's a peri operative event.
 

Bertelman

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And my other sister who told me over the weekend patient coded on her in OR. Lady was septic, AICD, EF 10-15%, perforated appy. Emergency case. She put patient to sleep with only 80mg propofol and patient flat lines. Autopsy showed massive PE as cause of death. People aren't surprised.

I'm not second-guessing your sister's work. A PE is a PE.

But for the young people reading, that's quite a slug of propofol for this kind of patient. Probably could have put her to sleep with a little gas +/- N20 and 40 of propofol. Or etomidate, for that matter. I imagine this was an RSI, bit I think with some reassurance I would trade awareness for hemodynamic collapse on induction for this particular patient.
 

aneftp

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Etomidate not available. Crazy. She's at 37 OR facility and no etomidate.

I thought she was kidding. But it's true. No etomidate available or very limited a major level one trauma center. I just looked it up and as of April 3rd national bulletin on etomidate shortage.

You are damn if you do damn if u don't.

I've had a vascular patient code on me with 1mg versed and 50 mcg of fentanyl before declot.
 
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