Least Useful Rotation

[BadVB750]

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So, I'm on anesthesia right now and I started thinking about the least useful rotations as a resident. The rotation is nice cause I can get a lot of reading done but I haven't had a lot of opportunity to intubate. Many of the attendings have avoided me or not allowed me to attempt the tube. Usually the reason is "This is going to be a hard airway" as if EM only intubates easy airways in controlled settings. Also, I don't just pop into a room and ask to intubate, I introduce myself to the patient and ask the attending if I can manage the airway. Hopefully, next week when I'm at childrens I will get more opportunities to intubate. I have tubed more patients in the ED then I have in the OR.

I'm actually starting to look forward to OB next month where I will have responsibility and will be treated like a resident again.

 

[WallowaWanderer]

Dude, that sucks. I'm sorry you're having to go through that. Have other residents faced the same problem? Do you think there's someone you can talk to? Doesn't seem like there's much value in an observational anesthesia experience.

 

[ditch doctor]

Dude that totaly sucks for you, sorry that happened. It's unfortunate that happened. You should talk to your PD about this, this is a problem. First, as a medical student I did 2 rotations and I got about 30 tubes on the first rotation and about 70-80 tubes next. This year, I got 117 tubes and 37 LMA's on my month of anesthesia. And I actually did just walk around and go room to room say hi, tube and leave.

As far as not letting you handle the hard cases, I specifically asked to be paged for "hard" cases (short, fat people with crappy malimpati scores) and asked for pointers. We worked out that as long as we could bag, I got 2 looks, if we had difficulty bagging, I got one quick look.

Seriously, as an EM resident, why would you need to sit in on a 5 hour breast flap or watch some Attending/Nurse Anesthatist intubate someone over and over?

Honestly, I would have your people talk to their people, you should be getting at least 5 tubes a day, depending on how the surgical census is.

 

[EM_Rebuilder]

I did about 40ish tubes in my anes month... I could have probably done more, but I was always out of there most days well before noon...did a few LMAs also and watched about 3 or 4 fiberoptics..


Now, what bothered me was being in L&D the month after, and trying to be a tube hound for crashing moms going to the OR....five different times I was all over anes hey I did anes last month, got 50 tubes, can I tube this one for you. Same response everytime, no, this is an urgent case and you need to practice in a more controlled setting.

Now, what I dont get is that at this point in residency, I *probably* will not do another intubation until my next ED month (next July) at which time, I will be the head/neck/airway guy on anything that rolls in...... so how does anes classify the low GCS trauma/meds as less urgent than a stable mother with a crashing baby? I finally decided that it must have just been the anes residents enjoying the urgent cases since they dont come near the ED for them...

*shurgs*