Practice changers

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dhb

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That's it i'm done: i've been using desflurane almost exclusively for 2-3 years but after reading this article i'm going cold turkey on Des
http://www.anesthesia-analgesia.org/content/111/1/92.long

inhaled anesthetic's lifetime: approximately 10 years for desflurane 😱

http://www.ncbi.nlm.nih.gov/pubmed/20935004
"On the basis of the derived 100 yr GWPs, the average climate impact per anaesthetic procedure at the University of Michigan is the same as the emission of ∼22 kg CO(2). We estimate that the global emissions of inhalation anaesthetics have a climate impact which is comparable with that from the CO(2) emissions from one coal-fired power plant or 1 million passenger cars."
:wow:

Has anybody else have these big changes in the way you practice?
 
http://news.yahoo.com/nasa-data-blow-gaping-hold-global-warming-alarmism-192334971.html

I'm not a big believer in the latest environmental hype. In the 1970's it was PC to believe in global cooling. These days its Global Warming; yes, I saw the movie by Al Gore.

I don't use N2O much for other reasons based on patient care. I avoid Des because it costs twice as much as Sevo and many times more than Iso. However, if you want to use DES daily on your SUPERSIZE it patients then go for it.

I expect in Europe where 90% plus of the population buys into the global warming scare more anesthetists will be using Sevo and avoiding N2O. FWIW, that's my usual practice anyway.
 
Price per bottle at a large private hospital

Des $164
Sevo $142
Iso $22

Iso bottle has 100mls more in it than the other two.
 
Wow, shows how naive I am. I guess I hadn't really thought too much about what happened to the volatiles after they get scavenged......I just assumed they got put through a special dessicant/activated charcoal system and not just VENTED TO THE ATMOSPHERE!!

Guess I have to do my part and convince anyone going into anesthesia to ride their bike to work while carrying a potted plant on their back 😉
 
That is hysterical. Thanks for the laugh. I'll have to forward that to some of my climate changer friends. It really is becoming a religion.
 
Sevo is much cheaper than the figure shown above. It is now generic.

Des still brand name only, therefore much costlier.
 
Price per bottle at a large private hospital

Des $164
Sevo $142
Iso $22

Iso bottle has 100mls more in it than the other two.

Seems like it'd also be helpful to know how fast you go through bottles of each, though. Especially if you're running Des or Iso at 1L total, and Sevo at 3-4.
 
Seems like it'd also be helpful to know how fast you go through bottles of each, though. Especially if you're running Des or Iso at 1L total, and Sevo at 3-4.

Precisely. The desired unit of measurment is cost-per-mac-hour and this is calculated at various fresh gas flow rates. My sense is that Des at 0.5 or 1L/min is not more expensive than sevo at the recommended 2L/min. I couldn't open the A/A link, but will look for the article.

I appreciate that some folks don't buy into global warming, despite the overwhelming support of scientists and nobel laureates. Still, aside from that evidence, we all took organic chemistry, and the first reaction in the first chapter of every organic chem book is the reaction between halogenated hydrocarbons and ozone. I don't think anyone doubts that ozone depletion is bad, right?
 
I believe the DES rep told me that if you quickly dial your DES down to 0.3 Lpm, the cost is about the same as 2 Lpm sevo. I remember the rep admitting that it was a really really low flow rate. Most of my old partners run DES at 1-2 Lpm (sigh). Also the 2 Lpm sevo rule is based on some dumb rat studies; I don't think any human being's kidney fxn has ever been hurt by lower flow rates. I still use DES in long cases and in some superfatties, but I use sevo way more.
 
That's it i'm done: i've been using desflurane almost exclusively for 2-3 years but after reading this article i'm going cold turkey on Des
http://www.anesthesia-analgesia.org/content/111/1/92.long

inhaled anesthetic's lifetime: approximately 10 years for desflurane 😱

http://www.ncbi.nlm.nih.gov/pubmed/20935004
"On the basis of the derived 100 yr GWPs, the average climate impact per anaesthetic procedure at the University of Michigan is the same as the emission of ∼22 kg CO(2). We estimate that the global emissions of inhalation anaesthetics have a climate impact which is comparable with that from the CO(2) emissions from one coal-fired power plant or 1 million passenger cars."
:wow:

Has anybody else have these big changes in the way you practice?

I love Des. La La Love it.

I get such a kick out of having the patient move over to the PACU bed at the end of the long(ish) case. That never happens for me with the other stuff.

The other day, another anesthesiologist came to give me a break but we were waking up...he stuck around a few minutes and said after he saw the guy climb over to the pacu bed "Des eh? Damn, I'll have to try that."
 
That's it i'm done: i've been using desflurane almost exclusively for 2-3 years but after reading this article i'm going cold turkey on Des
http://www.anesthesia-analgesia.org/content/111/1/92.long

inhaled anesthetic's lifetime: approximately 10 years for desflurane 😱

http://www.ncbi.nlm.nih.gov/pubmed/20935004
"On the basis of the derived 100 yr GWPs, the average climate impact per anaesthetic procedure at the University of Michigan is the same as the emission of ∼22 kg CO(2). We estimate that the global emissions of inhalation anaesthetics have a climate impact which is comparable with that from the CO(2) emissions from one coal-fired power plant or 1 million passenger cars."
:wow:

Has anybody else have these big changes in the way you practice?

If these studies are true (which is a huge stretch), then we are lucky since it is my impression only about 2% of us use Des.

Des is like Idaho. People that have been there love it and want to live there and travel there. Everyone else thinks - Why the crap would ANYONE ever go to Idaho? - and those poor suckers that live there - holy crap...poor poor people! To this I usually respond - "Exactly, Idaho sucks. Tell your friends not to move there. And also tell all your California friends that have moved there to leave."

So in conclusion - you non-Des users should continue to use Sevo and Iso, cuz Des really sucks. (Tee Hee Hee.....)
 
I believe the DES rep told me that if you quickly dial your DES down to 0.3 Lpm, the cost is about the same as 2 Lpm sevo. I remember the rep admitting that it was a really really low flow rate.

That's lower than I go ... I turn my flows down to about 0.5 Lpm (0.4 O2 and 0.1 air) immediately after the tube goes in, aiming for a FiO2 around 80, turn the DES vaporizer up to 12, and by the time they're done prepping, etDES has smoothly and gradually climbed to ~6-7%. They never get the DES tachycardia that abrupt increases in etDES sometimes causes.

I don't know how much desflurane I consume, but I'm never close to needing a vaporizer refill even after a long day.

OR and PACU time is expensive. I know that with perhaps a touch more effort, I can get pretty much the same kind of quick OR wakeup regardless of gas used, but I do believe that the DES patients are more awake, more quickly in the PACU, and I know my patients get out of PACU quickly.

I very rarely do deep extubations.

I wonder if it's coincidence that we quit having "PACU gridlock" problems the same time the iso vaporizers disappeared. Maybe it's just my own confirmation bias.
 
This is why journals can be dangerous. The A&A article is based on a mathematical theory and supposition about infrared absorption of inhaled anesthetics. A couple of problems with that, since no volatile anesthetic has ever been detected in the upper atmosphere. None, zip, nada. Additionally, since desflurane does not contain either chlorine or bromine, it has no effect on ozone. So, comparing this to other organic compounds and CO2 becomes an apples to oranges situation.
The analogy about a million cars and coal plants sounds cool, but statistics can be twisted in a lot of ways. Here's another way: Suppose the global production of CO2 yearly can be represented by a 2-D surface the size of the state of Kansas. Taking into account the possible contribution of CFC's to global warming, the percentage of volatile anesthetics in those CFC's and the market share of desflurane, the yearly contribution of desflurane to global warming may be (maybe, maybe not) an area of 300 square feet, relative to the state of Kansas. And that's assuming the article's theory is true.
It is amazing how otherwise intelligent professionals can get caught up in a hype of junk science. There are a lot of reasons to use and not to use desflurane, but global warming isn't one of them.
 
That's lower than I go ... I turn my flows down to about 0.5 Lpm (0.4 O2 and 0.1 air) immediately after the tube goes in, aiming for a FiO2 around 80, turn the DES vaporizer up to 12, and by the time they're done prepping, etDES has smoothly and gradually climbed to ~6-7%. They never get the DES tachycardia that abrupt increases in etDES sometimes causes.

This is exactly what I do, but once I get to that target etDES level, I turn off the air and reduce O2 to the minimum level needed to keep the bellows from collapsing, generally around 300 ml/min. The nitrogen from the air sticks around in the closed circuit, so although I'm running O2 only, the etO2 stays around 70-80% for the whole case.
 
Seems like it'd also be helpful to know how fast you go through bottles of each, though. Especially if you're running Des or Iso at 1L total, and Sevo at 3-4.

I did a calculation, at the request of my chairman, for our residency program based on cost per mac hour. We used the cost of the bottles at our program.

Unfortunately I don't have the figures now, but even with low flow Des, Iso was way cheaper than Des or Sevo.
 
I did a calculation, at the request of my chairman, for our residency program based on cost per mac hour. We used the cost of the bottles at our program.

Unfortunately I don't have the figures now, but even with low flow Des, Iso was way cheaper than Des or Sevo.

Yes. You are also assuming CRNAs are consistent at running super low flows with desflurane. A big assumption. Second, Generic Sevo is much cheaper than brand name Desflurane. We all agree ISO is the cheapest and can be used efficiently in long cases (turn the gas off earlier!).

I like Desflurane as OLD people wake up quickly and SUPERSIZE patients don't get saturated with Vapor. However, good technique with SEVO or even ISO can overcome a lot of shortcomings.

Dealer's choice but with LMA's I prefer Sevo.
 
Yes. You are also assuming CRNAs are consistent at running super low flows with desflurane. A big assumption. Second, Generic Sevo is much cheaper than brand name Desflurane. We all agree ISO is the cheapest and can be used efficiently in long cases (turn the gas off earlier!).

I like Desflurane as OLD people wake up quickly and SUPERSIZE patients don't get saturated with Vapor. However, good technique with SEVO or even ISO can overcome a lot of shortcomings.

Dealer's choice but with LMA's I prefer Sevo.

Whoa there Blade. Back up one step. I never even mentioned CRNAs. Nor did I mention my preference.

I was just trying to address WholeLottaGame7's comment with my experience.

If you are interested, at my residency program we only had two CRNAs. One in ASU until 3 PM, and one in the main OR from 4-8 PM (roughly). Otherwise it was attendings and residents.

Where I am now, any cost savings we may get from altering our technique will be nothing compared to the costs incurred by the inefficiencies of the system as a whole. I am also mainly supervising CRNAs at my current job. Doing my own cases is a rarity. The CRNAs have been entrenched here for a long time. So I pick my battles.
 
I don't see it as a case of believing vs not believing but just sound basic chemical science: Lavoisier said a long time ago.
We are releasing energy and greenhouse gases that have been trapped in the form of organic matter for millions of years there is no reason for global temperatures not to climb.


http://www.wernerpatels.com/2011/09/man-made-global-warming-is-a-lie-discerning-scientists-learn/

I don't buy into all the left-wing rhetoric. Man made influence on weather is MINIMAL. We should take care of our environment and limit pollution but Global Warming due to CO2 emissions is nonsense. But, I am for clean air, clean water, limited pollution, etc.

In the USA I support real GREEN Energy $$$$ in terms of Natural Gas and Clean Coal (Cleaner coal) technology. The U.S. needs to use the resources it has on hand. Wind and Solar aren't practical and will ruin our economy because we need real solutions to a real problem of IMPORTED FOREIGN OIL.
 
US-Dollar-USD-10-5-1-bills-Greenbacks-worn-front-and-back-ANON.jpg
 
If China’s carbon usage keeps pace with its economic growth, the country’s carbon dioxide emissions will reach 8 gigatons a year by 2030, which is equal to the entire world’s CO2 production today.
 
Here's the Chinese response to Left-wing Liberals who want to limit Coal powered Electricity in China and stop the Communists from becoming number one in the world:

giving-the-finger-profile.jpg
 
cheap_gas_plants.gif
Costs of energy production c.2016

By contrast, solar and wind renewables are between many times more expensive and require direct and indirect subsidies, typically burdening the poor with higher fuel bills. Unless renewable technology improves dramatically, most may simply prove themselves to be unaffordable.
You can read the full report here (36-page/1.6MB PDF). ®
 
Local San Diego weatherman and founder of the Weather Channel John Coleman is courageous. He decided several years ago to stand up against the juggeraut behind the global warming scam power grab. He has turned his stand against the leviathon global warming political movement into an almost daily activism and I must commend him.




Recently I read Coleman's brilliant piece The Amazing Story Behind the Global Warming Scam in which he details the beginnings of the movement and the deeply political nature of the cause from the start. Politics at the start was the clear motivation, not science. The entire notion of warming and the greenhouse effect started in 1957 in a scientific paper co-authored by a man named Roger Revelle of Scripps Oceanographic Institute in San Diego. According to Coleman's research, this man is the grandfather of the global warming movement, leading the groundwork lockstep with scientists, academics, celebs, politicians and pundits. This was a cause that the left loved! They could rally around a man-made pollutant (carbon-dioxide), and fund every cause their hearts desired. Paramount obviously being control of the economy. In 1963 Revelle left Scripps and went to Harvard to establish a Center for Population Studies. It was during this time and using this platform that he disseminated his warming theories and had profound impact on a particular undergrad - Albert Gore Junior.




Years later something strange happened. In 1991 Revelle (the grandfather) was forced out of Harvard and decided to rethink the theory of global warming. He co-authored a scientific article for Cosmsos magazine. He had second thoughts, wasn't quite convinced of the hypotheses and apparently didn't like the politics of it any more, feeling that governments and activists were using the issue as a way to gain footing on economic control. Indeed Revelle, the early mentor of Al Gore at Harvard lost confidence in the entire theory. It was too late, Revelle passed away from a heart attack 3 months later.
 
damns the theory of greenhouse effect upon climate through CO2. Surprising is the origins of this political scandal. Apparently it originated from a desire of Margaret Thatcher in the eighties to discredit fossil fuels in favour of nuclear power.
Even more shocking is that the entire present global warming lobby, hijacked from Thatcher by neo-Marxists and Environmentalists, has become in the hands of politicians and bureaucrats an evil “gravy train” of the millions of tax dollars pocketed in this disgusting “global warming” industry which is based upon a lie.
“Fact of the matter is that tens of thousands of jobs depend on Global Warming right now. It’s a big business.” Says Professor Patrick Michaels – Dept of Environmental Sciences – University of Virginia.
“Climate scientists need there to be a problem in order to get funding.” Says Dr Roy Spencer – Weather Satellite Team Leader – NASA.
As the film spells out for us:
Man-made global warming is no ordinary theory. It is presented in the media as having the stamp of authority of an impressive international organisation. The UN’s intergovernmental panel on climate change or IPCC.
“The IPCC like any UN body is political. The final conclusions are politically driven. It’s become a great industry in itself and if the whole global warming farrago collapsed, there would an awful lot of people out of jobs and looking for work.” Says Professor Philip Scott – Dept of Biogeography – University of London.
“This claim that the IPCC is the worlds top 1500 or 2500 scientists: you look at the bibliographies of the people and it is simply not true. There are quite a number of non-scientists. Those people that are specialists but don’t agree with the polemic and resign, and there are a number of them I know of, they are simply put on the author list and become part of this “2500 of the worlds top scientists”. We have a vested interest in causing panic, because then, money will flow to climate science.” Says Professor Paul Reiter – IPCC and Pasteur Institute of Paris.
“And to build up the number to 2500 they have to start taking reviewers and Government people and so on, anyone who has been close to them. And none of these people are asked if they agree, many of them disagree. People have decided that you have to convince other people that since no scientist disagrees - you shouldn’t disagree either. But whenever you hear that in science you know that it is pure propaganda.” Says Professor Richard Lindzen – IPCC and M.I.T.
Unfortunately as the Times notes, the whole Global Warming bandwagon has evolved into “less an issue and more a doom-laden religion demanding sacrifice to Gaia for our wicked fossil fuel-driven ways.”
“There is such intolerance. This is most politically incorrect thing possible to doubt this climate change orthodoxy.” Says Lord Lawson of Blaby (In 2005 a House of Lords enquiry was set up to examine the scientific evidence of man-made cause of Global Warming and Lord Lawson was a member of it.) He goes on to comment - "We had a very thorough enquiry and took evidence from a whole lot of people expert in this area and we produced a report. What surprised me was to discover how weak and uncertain the science was. In fact there are more and more thoughtful people, some of them a little bit frightened to come out in the open. But who quietly privately and some of them publicly are saying ‘hang on, wait a moment, this simply just does not add up’."
“I often heard it said that there is a consensus of thousands of scientists on the global warming issue and that humans are causing a catastrophic change to the climate system. Well I am one scientist and there are many that simply think that is not true.” Says Professor John Christy – Lead Author IPCC
And finally the definitive comment of the documentary must belong to Nigel Calder – the Former Editor of the New Scientist.
“I have seen and heard their spitting fury at anybody that might disagree with them, which is not the scientific way. The whole global warming business has become like a religion and people who disagree are called heretics. I am a heretic. The makers of this programme are all heretics.”
After this documentary and more publicity, hopefully not heretics for much longer!!!
 
This is why journals can be dangerous. The A&A article is based on a mathematical theory and supposition about infrared absorption of inhaled anesthetics. A couple of problems with that, since no volatile anesthetic has ever been detected in the upper atmosphere. None, zip, nada. Additionally, since desflurane does not contain either chlorine or bromine, it has no effect on ozone. So, comparing this to other organic compounds and CO2 becomes an apples to oranges situation.
The analogy about a million cars and coal plants sounds cool, but statistics can be twisted in a lot of ways. Here's another way: Suppose the global production of CO2 yearly can be represented by a 2-D surface the size of the state of Kansas. Taking into account the possible contribution of CFC's to global warming, the percentage of volatile anesthetics in those CFC's and the market share of desflurane, the yearly contribution of desflurane to global warming may be (maybe, maybe not) an area of 300 square feet, relative to the state of Kansas. And that's assuming the article's theory is true.
It is amazing how otherwise intelligent professionals can get caught up in a hype of junk science. There are a lot of reasons to use and not to use desflurane, but global warming isn't one of them.

I don't have the knowledge to debate the veracity of global warming. My point is that i'd rather use a compound that is degraded after 1 year than one that takes 10y.
 
Yes, but this is not a debate about climate change. It is about common sense and the practice of anesthesiology (or lack thereof).
 
Additionally, since desflurane does not contain either chlorine or bromine, it has no effect on ozone. So, comparing this to other organic compounds and CO2 becomes an apples to oranges situation.
.

The reaction between halogenated hydrocarbons and ozone is not limited to chlorine and bromine. The same reaction occurs with florinated compounds. It is interesting to note, too, that many supposedly ozone-safe chloro-floro-carbon-free compounds still contain either chloro-carbons or florocarbons, both of which will deplete ozone.
 
The reaction between halogenated hydrocarbons and ozone is not limited to chlorine and bromine. The same reaction occurs with florinated compounds. It is interesting to note, too, that many supposedly ozone-safe chloro-floro-carbon-free compounds still contain either chloro-carbons or florocarbons, both of which will deplete ozone.

Taking it back to MCAT....remember FONClBrISCH?? It's all based on the electronegativity, with Fluorine being the worst offender and most capable of electron-stripping Oxygen/Ozone.
 
Local San Diego weatherman and founder of the Weather Channel John Coleman is courageous. He decided several years ago to stand up against the juggeraut behind the global warming scam power grab. He has turned his stand against the leviathon global warming political movement into an almost daily activism and I must commend him.




Recently I read Coleman's brilliant piece The Amazing Story Behind the Global Warming Scam in which he details the beginnings of the movement and the deeply political nature of the cause from the start. Politics at the start was the clear motivation, not science. The entire notion of warming and the greenhouse effect started in 1957 in a scientific paper co-authored by a man named Roger Revelle of Scripps Oceanographic Institute in San Diego. According to Coleman's research, this man is the grandfather of the global warming movement, leading the groundwork lockstep with scientists, academics, celebs, politicians and pundits. This was a cause that the left loved! They could rally around a man-made pollutant (carbon-dioxide), and fund every cause their hearts desired. Paramount obviously being control of the economy. In 1963 Revelle left Scripps and went to Harvard to establish a Center for Population Studies. It was during this time and using this platform that he disseminated his warming theories and had profound impact on a particular undergrad - Albert Gore Junior.




Years later something strange happened. In 1991 Revelle (the grandfather) was forced out of Harvard and decided to rethink the theory of global warming. He co-authored a scientific article for Cosmsos magazine. He had second thoughts, wasn't quite convinced of the hypotheses and apparently didn't like the politics of it any more, feeling that governments and activists were using the issue as a way to gain footing on economic control. Indeed Revelle, the early mentor of Al Gore at Harvard lost confidence in the entire theory. It was too late, Revelle passed away from a heart attack 3 months later.

Your link doesn't work.

Here is the correct one.

Here is a rebuttal to what Coleman says.
 
Last edited:
damns the theory of greenhouse effect upon climate through CO2. Surprising is the origins of this political scandal. Apparently it originated from a desire of Margaret Thatcher in the eighties to discredit fossil fuels in favour of nuclear power.
Even more shocking is that the entire present global warming lobby, hijacked from Thatcher by neo-Marxists and Environmentalists, has become in the hands of politicians and bureaucrats an evil “gravy train” of the millions of tax dollars pocketed in this disgusting “global warming” industry which is based upon a lie.
“Fact of the matter is that tens of thousands of jobs depend on Global Warming right now. It’s a big business.” Says Professor Patrick Michaels – Dept of Environmental Sciences – University of Virginia.
“Climate scientists need there to be a problem in order to get funding.” Says Dr Roy Spencer – Weather Satellite Team Leader – NASA.
As the film spells out for us:
Man-made global warming is no ordinary theory. It is presented in the media as having the stamp of authority of an impressive international organisation. The UN’s intergovernmental panel on climate change or IPCC.
“The IPCC like any UN body is political. The final conclusions are politically driven. It’s become a great industry in itself and if the whole global warming farrago collapsed, there would an awful lot of people out of jobs and looking for work.” Says Professor Philip Scott – Dept of Biogeography – University of London.
“This claim that the IPCC is the worlds top 1500 or 2500 scientists: you look at the bibliographies of the people and it is simply not true. There are quite a number of non-scientists. Those people that are specialists but don’t agree with the polemic and resign, and there are a number of them I know of, they are simply put on the author list and become part of this “2500 of the worlds top scientists”. We have a vested interest in causing panic, because then, money will flow to climate science.” Says Professor Paul Reiter – IPCC and Pasteur Institute of Paris.
“And to build up the number to 2500 they have to start taking reviewers and Government people and so on, anyone who has been close to them. And none of these people are asked if they agree, many of them disagree. People have decided that you have to convince other people that since no scientist disagrees - you shouldn’t disagree either. But whenever you hear that in science you know that it is pure propaganda.” Says Professor Richard Lindzen – IPCC and M.I.T.
Unfortunately as the Times notes, the whole Global Warming bandwagon has evolved into “less an issue and more a doom-laden religion demanding sacrifice to Gaia for our wicked fossil fuel-driven ways.”
“There is such intolerance. This is most politically incorrect thing possible to doubt this climate change orthodoxy.” Says Lord Lawson of Blaby (In 2005 a House of Lords enquiry was set up to examine the scientific evidence of man-made cause of Global Warming and Lord Lawson was a member of it.) He goes on to comment - "We had a very thorough enquiry and took evidence from a whole lot of people expert in this area and we produced a report. What surprised me was to discover how weak and uncertain the science was. In fact there are more and more thoughtful people, some of them a little bit frightened to come out in the open. But who quietly privately and some of them publicly are saying ‘hang on, wait a moment, this simply just does not add up’."
“I often heard it said that there is a consensus of thousands of scientists on the global warming issue and that humans are causing a catastrophic change to the climate system. Well I am one scientist and there are many that simply think that is not true.” Says Professor John Christy – Lead Author IPCC
And finally the definitive comment of the documentary must belong to Nigel Calder – the Former Editor of the New Scientist.
“I have seen and heard their spitting fury at anybody that might disagree with them, which is not the scientific way. The whole global warming business has become like a religion and people who disagree are called heretics. I am a heretic. The makers of this programme are all heretics.”
After this documentary and more publicity, hopefully not heretics for much longer!!!

Here is a rebuttle to the film you quote above (I think it is from the documentary The Great Global Warming Swindle). The problem is, both sides LIE, as is pointed out in the article.

That documentary is interesting however.
 
The MCAT is not a treatise on environmental science. Chlorine and bromine contribute significantly to overall ozone depletion. Although fluorine has been shown to have the capability to participate in an analogous cycle, in the Earth's stratosphere, fluorine atoms react rapidly with water and methane to form strongly bound HF. So neither desflurane nor sevoflurane contribute to ozone depletion (assuming they were present in the stratosphere, which has never been observed). Any GWP of desflurane or sevo is based solely on the highly speculative theory of IR absorption. A better way to fight global warming would be to limit the number of "save the planet/whales/whatever" bumper stickers produced for your Prius.
 
The MCAT is not a treatise on environmental science. Chlorine and bromine contribute significantly to overall ozone depletion. Although fluorine has been shown to have the capability to participate in an analogous cycle, in the Earth's stratosphere, fluorine atoms react rapidly with water and methane to form strongly bound HF. So neither desflurane nor sevoflurane contribute to ozone depletion (assuming they were present in the stratosphere, which has never been observed). Any GWP of desflurane or sevo is based solely on the highly speculative theory of IR absorption. A better way to fight global warming would be to limit the number of "save the planet/whales/whatever" bumper stickers produced for your Prius.

Lashings humbly taken.... Like I said, the MCAT is a stupid test.
 
Greatly amused here. I'm guessing DO Anes is a chemist or physicist prior to medicine.

I do recall Penn and Teller Bull**** episode on global warming. This featured Dr Coleman who spoke about his disagreement to the anti-progress groups who tout global warming as a direct result of mankind's wasteful use of carbon resources. That was a good episode, worth watching.

Back to the debate boys.....
 
Here is a rebuttle to the film you quote above (I think it is from the documentary The Great Global Warming Swindle). The problem is, both sides LIE, as is pointed out in the article.

That documentary is interesting however.

Wait a minute Slim. My point is that Global Warming is a DEBATABLE TOPIC. That's it. This means before we start changing our daily lives and ruining our economy for JUNK SCIENCE we stop and examine the premise.

The LEFT has taken up this mantra of Human Kind causing all the world's problems; in the meantime, our former V-P is now a mega millioniare (200 million?), divorced ***** mongerer who lives on a huge estate producing tons of CO2 daily when he is not flying around on his private jet.

I love the hypocrisy and the Hubris of the Left on these matters. As for me, I'll be using all the DESFLURANE and N2O I feel necessary in my practice.
 
AL Gore was born and spent most of his life in Washington, D.C. Yesterday, he returned to the fever swamp to show he's forgotten none of his old political tricks.
Addressing the House and Senate on global warming, he put forth a litany of half-truths that he twisted into a morality tale. But the facts tell a different story. The former veep is a master politician, not a prophet or a planetary savior.
Gore's biggest rhetorical trick is saying that the Earth has a fever. He says that 10 of the hottest years in history came in the last 11 years, and this proves we must do something, because, "If your baby has a fever, you go to the doctor."



This is meaningless. The Earth has been much, much hotter in the past than today. No giant space nanny fed it medicine.
Moreover, a healthy baby has a constant temperature - that's why a fever is bad. The Earth does not have a constant temperature. It has been generally warming since the end of the Little Ice Age in the early 19th century, but that has not been uniform. It's had warming phases (the 1920s and 1930) and cooling phases (the 1940s to 1970s).
It's also had periods like today, when temperatures are flat - there hasn't been much warming since 1998. Yes, it's warmer today than it was a hundred years ago, but that's not necessarily a bad thing. Talking about fevers is misleading, but it's a great rhetorical trick.
And when it comes to the economics of the issue, Gore is way outside the mainstream. Appearing before a House committee, he said that changing the American economy in the way he proposes - a plan of freezes, taxes, market controls and regulations that would represent a massive expansion of government control over the economy - would not be costly.
Yet he also endorsed the ill-fated Kyoto Protocol (which he helped negotiate). The U.S. Energy Information Administration calculates that Kyoto would reduce U.S. gross domestic product by $100 billion to $400 billion a year.
Gore is a very wealthy man, but it's hard to see why he can't recognize that this is a lot of money lost - and a lot of jobs lost and a lot of families going cold and hungry.
How does Gore address this point? He doesn't; he simply avoids it, with highfalutin rhetoric. It's not just the Earth's "fever" and our supposed moral duty to cure it; he says our descendants will either condemn us as blind or praise us for our moral courage. He also makes veiled references to himself as Churchill, while all around him others appease fascism.
It's not subtle stuff - nor accurate.
If you establish that the Earth is warming, it doesn't necessarily follow that we have a moral duty to reduce emissions. What should follow is an informed debate about the costs and benefits of various policies to address that warming - reducing emissions is just one possible answer. Another debate should focus on those policies' economic costs.
Al Gore doesn't want to have those debates, because the majority of evidence suggests that emissions reduction will be very costly and will have little effect. Kyoto, fully enacted by all its parties, would for all its cost reduce global warming by a mere 0.07 degrees Celsius by 2050 - a barely detectable amount.
Meanwhile, 2 billion people around the world go without electricity. About 3 million die each year because of fumes given off by primitive stoves. The U.S. economy sneezes when gasoline hits $3 a gallon.
If we have a moral duty, it's to keep energy affordable here and to expand access to it overseas. That's the real moral truth, however inconvenient for Al Gore.
 
Al Gore's latest eco-treatise, Our Choice: A Plan To Solve the Climate Crisis, is set to hit stores Tuesday. The former vice-president says he will donate 100 percent of the proceeds from the book to the the Alliance for Climate Protection, a green group.

But it turns out that the book money is small potatoes compared to what Gore could earn from his various eco-friendly investments. As a partner at Silicon Valley venture capital heavyweight Kleiner Perkins Caulfield & Byers, Gore is poised to reap hundreds of millions from investments in the companies that will benefit from the government's increased emphasis on green technology. According to The New York Times's John Broder, Gore could become the world's first "carbon billionaire."Gore has been one of the most outspoken critics of global warming and a powerful advocate of carbon-reducing measures. As such, he has become a hero of the left -- a man revered for warning Americans to curb their carbon footprint and reduce their impact on the Earth.

"Our Choice offers the most up-to-date and deepest thinking on climate change across a variety of disciplines," Gore said in a statement. "The need for this book is more urgent than ever, and I am proud to be working with Rodale, a company that for more than six decades has been at the forefront of environmental responsibility, to bring these solutions to a global audience."

Gore argues that in a market economy, "every one of the solutions to climate crisis will be more effective and much easier to implement if a price is placed on CO2 and other global warming pollutants," and likens the current sub-prime mortgage crisis to "the one we will face if we continue making investments in sub-prime carbon assets," according to publisher Rodale.

"The bottom line is that business and markets cannot operate in isolation from society and the environment -- we need 'sustainable capitalism,'" Gore said. And Gore has been practicing a particularly profitable form of capitalism of late.
 

So it's classic Al Gore. He talks about a "criminal generation that selfishly and blithely" dumps "global-warming pollution into the atmosphere as if it were an open sewer." However, if personal energy usage was "criminal," Al Gore might be at the top of "America's Most Wanted List," see chart above. Terms that come to mind to describe Al Gore's carbon footprint include "Bigfoot," "Paul Bunyan," "Brobdingnagian," "Sasquatch," or "the elephant in the room." To paraphrase blues pianist Mose Allison, "If polluting was criminal, he'd live a life of crime."

Maybe the article could have been titled, "We Can't Wish Away Climate Change, But We Can Reduce Our Personal Carbon Footprint, But Only If We Really Want To: I'm Not Willing to Change My Lifestyle, But the Rest of You Should."
 
Climate realists around the world have contended for years that the real goal of alarmists such as Nobel Laureate Al Gore and his followers is to use the fear of man-made global warming to redistribute wealth.On Monday, one of Gore's leading scientific resources, Goddard Institute for Space Studies chief James Hansen, sent a letter to Barack and Michelle Obama specifically urging the president-elect to enact a tax on carbon emissions that would take money from higher-income Americans and distribute the proceeds to the less fortunate.
 
Leftists have misled the public for years


Bob Malito | Posted: Thursday, April 7, 2011 2:00 am | (71) Comments
Font Size:Default font sizeLarger font size I would like to address Ariel Beverly's compassionate March 6 letter, "Let's do our part to save the Earth," regarding climate change.
I don't know your age, but for decades, dating back to the 1970s, there has been a political group of progressive leftists that saw an opportunity in climate change to turn that into a way for our government to seize more power and control over the way we live our lives.
Look up the definition of a progressive leftist, which this current administration is made up of. It will start to make sense once you understand the politics of global warming.
The progressives, along with a compliant liberal media and liberal teachers at all levels of education, have been brainwashing the populace since the 1970s. There is just as much evidence, if not more, to refute global warming as there is to make a serious case for it.
Trees are a renewable resource and federal regulations regarding automobiles and factories put into effect back in the 1970s and 1980s are more than enough to keep this planet healthy. Global warming is a ruse by the left to gain more control through increased regulations and taxes.
The planet is not dying; she can take care of herself! Believe me. She's been through a lot worse.



Read more: http://www.qctimes.com/news/opinion...0c6-11e0-9e58-001cc4c03286.html#ixzz1ZHWRavWx
 
Like most Americans I am a reasonable fellow. I support Clean air, clean water, good food, a nice bottle of wine, sound energy policy, etc.

The goal of the LEFT is to control the economy and redistribute wealth. The Global Warming scare is a ruse to accomplish the real goal: Socialism on a Global scale.

Since the science behind the ruse isn't solid the LEFT resorts to attacks, name calling and ridiculous studies to scare the public.

I ain't scared. I'm for a free USA with a sound energy and environmental policy. This means I support the latest, greatest, cleanest Coal power plants, Natural Gas and Nuclear.😱😱👍 I do not support Soros and his Leftist Cronies including... well you know who. We need to stop this Green nonsense and return to a great America. This means a Natural Gas Act and conversion of cars, trucks, etc to the resources we have an abundance of.

As for Global Warming... Let's start with Al Gore.
 
Climate policy has almost nothing to do anymore with environmental protection, says the German economist and IPCC official Ottmar Edenhofer.


Lawmaker: Climate change just ruse to control population


Dr. Theon also testified that: "My own belief concerning anthropogenic [man-made] climate change is that models do not realistically simulate the climate system because there are many very important sub-grid scale processes that the models either replicate poorly or completely omit". He observed: "Furthermore, some scientists have manipulated the observed data to justify their model results. In doing so, they neither explain what they have modeled in the observations, nor explain how they did it…this is contrary to the way science should be done." He then went on to say "Thus, there is no rational justification for using climate model forecasts to determine public policy".
 
.....Gore's biggest rhetorical trick is saying that the Earth has a fever. He says that 10 of the hottest years in history came in the last 11 years, and this proves we must do something, because, "If your baby has a fever, you go to the doctor."



This is meaningless. The Earth has been much, much hotter in the past than today. No giant space nanny fed it medicine.........

🤣🤣🤣

That part in bold has to be the best retort yet. Love it.
 
🤣🤣🤣

That part in bold has to be the best retort yet. Love it.


BLADE's awesome, when he wants to reply and/or argue his case whether its on GOLD, CRNAs, and obviously CLIMATE CHANGE its like he has the "ridiculous amount of informational study/articles that support my viewpoint to forum blast with" iPhone app.:laugh:
 
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