German anesthesiologists and anesthestic practice

[Gasboy07]

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I've been working in a small town in rural Australia and we've recently hired a new anaesthetist who was trained in Germany. Unfortunately we've had a lot of trouble with him as he didn't really get on with the other staff members and his skills and knowledge certainly did not reflect what was written on his CV.

My question (as a matter of curiosity), as I have kept quiet about this as work - do they do things differently in Germany? How could a consultant / attending supposedly perform worse than a 1st year registrar? Is this just him or is the system different and they have a different scope of practice?

 

[militarymd]

I'm pretty sure that in Germany they use GA for the majority of their elective C-Sections.....is that one of the things that does not jive with your practice in Australia?

 

[Gasboy07]

Here just about all elective c-sections are done regional anaesthesia unless there is a contraindication. Even for emergency ones - we generally try to identify the ones who may need an emergency (not crash sections) and put an epidural in early.

I was also interested in the role of AA / CRNAs or order members of the anaesthetic team there as well.

 

[zippy2u]

Well, I noticed that those sabbatical locum jobs over in Australia and New Zealand want you also to work in the ICUs as well as provide anesthesia. Maybe the Germans are like the Americans,... " O.K. guys, I kept him alive in the OR, now its your turn to keep him alive in the ICU" ( as the anesthesia dude hurriedly hightails it out of the ICU). It's a shame and I'm guilty of it and glad that the anesthesia big cats are now requiring 6 months in the ICU. I'd definitely need a year ICU fellowship before I would be comfortable managing pts in the ICU. My hats off to the Militarymen of the anesthesia world. Regards, ---Zip

 

[VolatileAgent]

currently working with two german anesthesiology attendings as visiting professors. both are excellent. you just might have drawn a short straw.

 

[cfdavid]

not to generalize, but what the hell...lol the germans usually have their sh.t together when it comes to things technical and scientific. remember organic chemistry??
so, yeah, perhaps you just got a bad one..

 

[UTSouthwestern]

I'd verify that CV if I were you.

 

[Noyac]

One of my best and favorite attendings in residency was German.

I'm thinking bad straw like the others here.

 

[Noyac]

I'm wondering how I would do there as well. Mostly b/c I don't know how to "get on".

 

[zippy2u]

Only German I ran across was in residency. Guy was a totally driven anesthesia phuckin' machine. His name was Niels and nickname was "Dr. Drager". He probably did more anesthesia in 3 years than I did in my whole career. He never took breaks, chief resident and spoke in a rapid staccato voice. Guy like that only comes around once in your lifetime. ---Zip

 

[Gasboy07]

I suspect we might have been shafted - oh well. such is life...

 

[Noyac]

Only German I ran across was in residency. Guy was a totally driven anesthesia phuckin' machine. His name was Niels and nickname was "Dr. Drager". He probably did more anesthesia in 3 years than I did in my whole career. He never took breaks, chief resident and spoke in a rapid staccato voice. Guy like that only comes around once in your lifetime. ---Zip

My attendings name was Neils. He sounds just like the guy you are describing. We called him Dr Drager as well. Was your guys last name Chapman?

 

[zippy2u]

Bingo, Noyac ----Zip

 

[Planktonmd]

I worked with many German residents when I was training in Europe, they were comparable to U.S. Graduates in many aspects,but what I liked the most about the female residents, was how open minded they were (sexually speaking ) 😀

 

[Noyac]

Zip, did you know his wife, Ruth? 😱

 

[zippy2u]

Sure didn't Noyac, but that dude reeked anesthesia BIGTIME ---Zip

 

[PainNGas]

I've been working in a small town in rural Australia and we've recently hired a new anaesthetist who was trained in Germany. Unfortunately we've had a lot of trouble with him as he didn't really get on with the other staff members and his skills and knowledge certainly did not reflect what was written on his CV.

My question (as a matter of curiosity), as I have kept quiet about this as work - do they do things differently in Germany? How could a consultant / attending supposedly perform worse than a 1st year registrar? Is this just him or is the system different and they have a different scope of practice?

Gasboy,

Mate you've been out there in the bush for too long...is that the new australian values/white australai II?

Germany has a very good medical system and training, ocmparable to the US.

Get a nice cool Vb and don't judge a whole system b/o one guy.

 

[Gasboy07]

Not being white myself I can't say that's White Australia 2.
I'm writing this as I personally have no idea and chose to be discrete and not ask around at work. I'm not making any judgements and I thought that they did have a very good system and being teutonically thorough people didn't slip through the cracks.

 

[PainNGas]

allright. maybe they shipped him out as he was socially challenged and even in germany where i grew up (as a foreigner) there is a limit to that.

no honestly, theoretical/nonclinical training might even better in germany. Clincial work is more in the US (with osme of the stuff med students have to wonder if it is"educational") but they are improving that. Postgraduate training is more "structured" in the US (as in a more "schoole-like" environment) but otherwise much the same.

 

[srik]

hi .its me i am doctoer and doing post graduate in anaesthesia . i had a question to any anesthetist consultant would you please answer my question please. i had a 29 yr old man was due for fistulectomoy under general anesthesia inj nalbuphine 4mg i/v was given .patient went into pulmnary arrest. ippv was done and patient was recovered and patient was recovered after 20 min .surgery was abundoned .in his past history he had a cardiac pulmonary arrest at aage of 5 years,when he was operated for tounge tie under general anesthesia what could be the possible cause and on what line we should investigate this patient.i m very thankful in advance of your time and answering my question in advance.

 

[Bougie]

Borat??? Is it really you?

 

[Planktonmd]

hi .its me i am doctoer and doing post graduate in anaesthesia . i had a question to any anesthetist consultant would you please answer my question please. i had a 29 yr old man was due for fistulectomoy under general anesthesia inj nalbuphine 4mg i/v was given .patient went into pulmnary arrest. ippv was done and patient was recovered and patient was recovered after 20 min .surgery was abundoned .in his past history he had a cardiac pulmonary arrest at aage of 5 years,when he was operated for tounge tie under general anesthesia what could be the possible cause and on what line we should investigate this patient.i m very thankful in advance of your time and answering my question in advance.

4 mg Nalbuphine is a very small dose.
So I have a few questions for you:

1- What other medications have you given with the Nalbuphine?
2- Were there any other symptoms with the apnea (the respiratory arrest), like wheezing, hypotension, rash....
3- Why would you use Nalbuphine for anesthesia? you are aware that it is an agonist/ antagonist aren't you?

The only logical explanation in the absence of other drugs, would be Anaphylactic Reaction.