Made Tragic Mistake! I Want to rejoin the Air Force!

[MedicalCorpse]

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Members don't see this ad.

Nobody told me that today's Air Force anesthesiologists are allowed, nay, encouraged to use ether and sodium pentathol (sic!) in their daily practices!

http://www.airforce.com/careers/job.php?catg_id=3&sub_catg_id=1&af_job_id=63

Where do I go to sign up again???

A chastened and chagrined,

--
R

P.S. For you non-anesthesiologists, diethyl ether is no longer used anywhere in the First or Second Worlds on humans, due to its flammability and other adverse clinical characteristics (airway irritability, emetogenicity). Sodium thiopental is similarly almost never used in clinical anesthesia, except in places (such as military bases) where saving a few bucks makes the use of propofol for induction of general anesthesia undesirable. Oh, and it's sodium pentothal, not pentathol. Other than that, the web page is perfect...especially because the cute, smiling face is that of a NURSE, rather than a physician (they couldn't find any smiling physicians; note that the USAF anesthesiologist has a mask on to hide his rictus of pain from damage to the terminal end of his alimentary canal caused by ill leadership and toxic mismanglement).

 

[resxn]

P.S. For you non-anesthesiologists, diethyl ether is no longer used anywhere in the First or Second Worlds on humans, due to its flammability and other adverse clinical characteristics (airway irritability, emetogenicity). Sodium thiopental is similarly almost never used in clinical anesthesia, except in places (such as military bases) where saving a few bucks makes the use of propofol for induction of general anesthesia undesirable. Oh, and it's sodium pentothal, not pentathol. Other than that, the web page is perfect...especially because the cute, smiling face is that of a NURSE, rather than a physician (they couldn't find any smiling physicians; note that the USAF anesthesiologist has a mask on to hide his rictus of pain from damage to the terminal end of his alimentary canal caused by ill leadership and toxic mismanglement).

Classic. I at least checked the ENT description and although written for 2nd graders (which is what they treat me like) it had no grossly inapporpriate misinformation.

On second thought, R, perhaps they are trying to throw foreign intelligence agencies off by providing misinformation on purpose. Like, you know, when they purposely provide air to a desatting NICU baby for 40 minutes before the staff realizes the tank is air and not O2. Misinformation--it confuses the enemy.

Oh, wait, that's right, I'm the MD. I'm the enemy.

 

[MedicalCorpse]

Classic. I at least checked the ENT description and although written for 2nd graders (which is what they treat me like) it had no grossly inapporpriate misinformation.

On second thought, R, perhaps they are trying to throw foreign intelligence agencies off by providing misinformation on purpose. Like, you know, when they purposely provide air to a desatting NICU baby for 40 minutes before the staff realizes the tank is air and not O2. Misinformation--it confuses the enemy.

Oh, wait, that's right, I'm the MD. I'm the enemy.

So that was the reason for this: http://www.medicalcorpse.com/stork.html

Dezinformatsiya: It's Not Just for The USSR Anymore!
http://www.heretical.com/miscella/dinform.html

--
R

 

[FliteSurgn]

"Air Force surgeons are among the best in the world."

That's why I got out, I just couldn't keep up with that reputation.

 

[DD214_DOC]

"Air Force surgeons are among the best in the world."

That's why I got out, I just couldn't keep up with that reputation.

Even I couldn't help but laugh at this.

 

[orbitsurgMD]

"You will also determine which anesthetics should be used, record your observations and administer such anesthetics as ether, sodium pentathol and nitrous oxide while maintaining life support of patients under your care."

Brilliant! They have discovered time travel.

 

[FliteSurgn]

As a critical care physician,

"You will treat patients suffering from surgical shock, postoperative hemorrhages, respiratory failure, and other complications. "

What complications? Those are some of the best surgeons in the world!

 

[Homunculus]

i wanted to go to the "chat with a recruiter" section but you have to register and i didn't feel so inclined at the moment.

and as far as the NICU resuscitation-- it's definitely a good illustration of checking all your stuff prior to resuscitation, and if something ain't right to step back and reassess everything. sad story. family awarded 16+mil.

http://the.honoluluadvertiser.com/article/2006/Feb/06/ln/FP602060322.html

http://www.armytimes.com/story.php?f=1-213079-1526819.php

http://www.examiner.com/a-353260~_16_5_m_awarded_to_family_of_baby_brain_damaged_at_hospital.html

lawyer's cut was 25%. damn.

that story along with the infamous "clindamycin push" incident (which, at least the legend tells it, was pushed by an anesthesiologist i think-- know about this one rob?) are known to almost every peds person i've run into.

not that it is military specific-- these things happen in civilian centers, too. it's just, like the first article states, the offenders are protected more in the federal environment.

--your friendly neighborhood resusc-a-baby-ing caveman

 

[pgg]

that story along with the infamous "clindamycin push" incident (which, at least the legend tells it, was pushed by an anesthesiologist i think-- know about this one rob?) are known to almost every peds person i've run into.

It was a 3rd year resident at Walter Reed, and he also falsified the anesthesia record and continued to lie about the incident for several months. Ultimately, he was court martialed and kicked out of the Army for the the false statements rather than the error itself.

 

[MedicalCorpse]

It was a 3rd year resident at Walter Reed, and he also falsified the anesthesia record and continued to lie about the incident for several months. Ultimately, he was court martialed and kicked out of the Army for the the false statements rather than the error itself.

I hate to say this, Homunculus...

You don't know how much I hate to say this, but...

Re: the Tyra case:

What pgg said is true.

--
R

 

[7by11thenout]

according to "older" anesthesiologist I have trained under many people have and used to "push" clinda before that case and actually even after that case I have seen "older" anesthesiologist "push" the drug, myself. The problem was that the Resident who pushed the drug lied and falsified the record, and then felt guilty and owned up to it later on his own - to the young lady's family.....


She had a cardiomyopathy that was not previously diagnosed according to the path report which likely led to her demise and the fact that "tachycardia" after this "event" was treated with b-blockers instead of realizing that this was either cardiogenic or anaph. shock which "tachycardia" is a GOOD THING and TACHYCARDIA in a young person although is a sign of something bad is not usually a reason to just jump to treat with B-Blockers....One should find the cause and eliminate the cause not mask the symptom. I got this info from people who did the case review, and other residents who were at WRAMC at the time who got the full M&m review, as well as I trained under some of the staff that were involved including the ENT surgeon and the staff Anesthesiologist and all the stories seem to match.

LESSON FOR ALL YOU STUDENTS/RESIDENTS:
Bottom line is DONT LIE ON THE RECORD.... (Or anywhere else for that matter) Crap happens intra-op and we may not always know what the cause is - but if you do something - document it with your justification don’t lie

 

[NavyFP]

according to "older" anesthesiologist I have trained under many people have and used to "push" clinda before that case and actually even after that case I have seen "older" anesthesiologist "push" the drug, myself. The problem was that the Resident who pushed the drug lied and falsified the record, and then felt guilty and owned up to it later on his own - to the young lady's family.....


She had a cardiomyopathy that was not previously diagnosed according to the path report which likely led to her demise and the fact that "tachycardia" after this "event" was treated with b-blockers instead of realizing that this was either cardiogenic or anaph. shock which "tachycardia" is a GOOD THING and TACHYCARDIA in a young person although is a sign of something bad is not usually a reason to just jump to treat with B-Blockers....One should find the cause and eliminate the cause not mask the symptom. I got this info from people who did the case review, and other residents who were at WRAMC at the time who got the full M&m review, as well as I trained under some of the staff that were involved including the ENT surgeon and the staff Anesthesiologist and all the stories seem to match.

LESSON FOR ALL YOU STUDENTS/RESIDENTS:
Bottom line is DONT LIE ON THE RECORD.... (Or anywhere else for that matter) Crap happens intra-op and we may not always know what the cause is - but if you do something - document it with your justification don’t lie

I never did figure out what she was going in for. (I know poor grammar)
You are correct, never lie on the record. Stuff happens and you can weather stuff, not deciet.

 

[MedicalCorpse]

LESSON FOR ALL YOU STUDENTS/RESIDENTS:
Bottom line is DONT LIE ON THE RECORD.... (Or anywhere else for that matter) Crap happens intra-op and we may not always know what the cause is - but if you do something - document it with your justification don’t lie

Word.

--
R

 

[former military]

"By Joining the Air Force You Win Big Time". I received this piece of junk mail today. Here are some quotes....
"You get lots of perks"
"You can get that training you've always wanted"
"You continue to build a guaranteed retirement plan"
"Now, Get off the bench into the game!"
you can chat on line with an E-advisor at AFReserve.custhelp.com

sweet... my urology friend and former partner told me that the SGH, Col Biotch, ordered him to change the deployment status of a gen surgeon so he could be deployed. This, against the urologic advice of my former partner, the AF urologic consultant to the surgeon general, and the Neuro urology guru at Wilford Hall. Patient received medieval treatment by national urologist in Qatar which is so far below the standard of care it should be criminal. A battle of wills won by the Travis AFB SGH, the same one who put me on call 24/7 for months and refused to disengage any patients so I could practicee safely. So you may think you can practice the standard of care and you can if it coincides with AF agenda. So, in response to the AF Reserve brochure I received I would have to say....

I am going to stay on the bench and not have middle eastern urologist shove 40 fr steel rods up my urethra....
I think I will stay on the bench....and keep my urine yellow instead of clumping up the ketchup.

 

[MedicalCorpse]

not that it is military specific-- these things happen in civilian centers, too. it's just, like the first article states, the offenders are protected more in the federal environment.

Here's an essential quote from the Army Times article:

"Plaintiff attorney Mark Davis, who noted that his law firm over the years has won all 15 or so of its Tripler malpractice cases that went to trial, said common issues tended to surface: understaffing, poor continuity of care, lapses in record-keeping, inadequate supervision of personnel."

1) Understaffing.
2) Poor continuity of care.
3) Inadequate supervision
(lapses in record-keeping, while bad, don't usually kill)

I must emphasize Inadequate Supervision (caps intentional). Having interns and FP residents run the Andrews ICU by themselves, without any attending at all, was a permanently bad thing for several patients. Calling anesthesia to help put in central lines because the internist is "uncomfortable" with this basic task, or to have anesthesia help DECIDE whether to intubate a patient, is not good medicine. Similarly, no matter how intelligent and skilled a surgeon is, there's a difference between someone one day out of residency and ten years out of residency (presuming that the "ten year" doc has actually kept up with clinical medicine, rather than taking the military's preferred route of flying a desk, doing e-mail, and reprimanding more capable subordinates).

Also, although it seems like a no-brainer, two clinical anesthesiologists plus one O-6 who shows up to work 25% of the time cannot possibly do the job that 10 anesthesiologists plus a different O-6 who showed up 25% of the time could do the year before. We proved that at Andrews after 9/11. The military loves to "do more with less", which sounds really good, until you try to jump out of an airplane with "less" parachute, or dive with "less" oxygen.

--
R

 

[DropkickMurphy]

Classic. I at least checked the ENT description and although written for 2nd graders (which is what they treat me like) it had no grossly inapporpriate misinformation.

On second thought, R, perhaps they are trying to throw foreign intelligence agencies off by providing misinformation on purpose. Like, you know, when they purposely provide air to a desatting NICU baby for 40 minutes before the staff realizes the tank is air and not O2. Misinformation--it confuses the enemy.

Oh, wait, that's right, I'm the MD. I'm the enemy.

How in the hell do you pull that one off? Seeing as 1. the tanks are totally different colors and 2. the regulators are designed to not be interchangable

Oh, wait.....it's that "in the ongoing race between the attempt to produce an idiot proof medical device and the Air Force trying to recruit better idiots, the Air Force seems to always come out ahead" thing isn't it?

 

[DropkickMurphy]

So that was the reason for this: http://www.medicalcorpse.com/stork.html

Dezinformatsiya: It's Not Just for The USSR Anymore!
http://www.heretical.com/miscella/dinform.html

--
R

Oh, if it happened at Andrews then I definitely know how it happened...

 

[MedicalCorpse]

Oh, if it happened at Andrews then I definitely know how it happened...

Jones's 28th Law of Medicine:

Lots of silk tape can defeat any and all Pin Index Safety Systems.

--
R

 

[MedicalCorpse]

Nobody told me that today's Air Force anesthesiologists are allowed, nay, encouraged to use ether and sodium pentathol (sic!) in their daily practices!

http://www.airforce.com/careers/job.php?catg_id=3&sub_catg_id=1&af_job_id=63

Where do I go to sign up again???

A chastened and chagrined,

Never say that I am not contributing to the Air Force mission as a disgruntled, ex-military, Patriotic Disabled American Veteran. How long do you think it will take the maroons to change the embarrassingly idiotic web page? Guesses?

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SubjectYo, Do you realize that your anesthesiologist recruitment page here: http://w...
Discussion Thread
Response (Mike)10/30/2006 09:36 AM Thanks!
Customer (Rob Jones)10/28/2006 10:57 PM

Yo, Do you realize that your anesthesiologist recruitment page here:
http://www.airforce.com/careers/job.php?catg_id=3&sub_catg_id=1&af_job_id=63

Was written by a ***** E-1?

Ether has not been used in clinical practice in the U.S. since approximately 1980.

It's "pentothal", not "pentathol".

This is no way to recruit anesthesiologists...doncha wish someone with a brain had been retained?

http://www.medicalcorpse.com

--
R. Jones, M.D.
Ex-LtCol, USAF, MC
Harvard '85, USU '90, WHMC Residency '94
Civilian '05
Former Medical Director of Anesthesia, Travis AFB
Former Assistant Chief Anesthesiologist, Andrews AFB
Left the USAF after 15 years toward retirement with nothing.
webmasterATmedicalcorpseD0Tcom

http://www.medicalcorpse.com

Question Reference #061028-000054
Category Level 1: Officer
Date Created: 10/28/2006 10:57 PM
Last Updated: 10/30/2006 09:36 AM
Status: Solved
Age Range: 35 - 54
Zipcode: 02138
Air Force Program: Prior Service