Titrating in Propofol at the end of the case

[Noyac]

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I'm an ENT resident, and was always taught to suction the stomach out after FESS/septoplasty/etc. And many, many times, I've tried to get the tube down and the patient starts bucking and coughing and pouring blood out of the nose all over my nice dressing.

Just the other day, I went to suction the stomach, and the anesthesiologist had left an OG in at the start of the case. I just pulled it out. I was like, "this is so easy. Why haven't we always being doing this?"

Added this to my bag of tricks for my practice.

Others may have commented on this. Anyway, I haven’t dropped an OG at the start or at the end of a FESS in yrs.
But there is a good way to prevent the coughing and bucking if you still feel it is necessary. Give some propofol about 1-2 min before. If it was given more than 5 min before then it probably won’t help.

 

[Noyac]

PACU?? pfffftttt, my pts walk straight to the uber that they requested while the intern was still closing their skin

Touche’

 

[pgg]

My patients self-extubate.

That's good, right?

 

[Noyac]

My patients self-extubate.

That's good, right?

Only if you are already home.

 

[Hork Bajir]

I discharge my patients with the tube still in, and ask them to follow up in the pulmonology clinic for extubation... although I warn them that it might fall out in the shower a few days later and that’s fine too

 

[deleted162650]

My patients self-extubate.

That's good, right?

That’s nothing. My patients self-intubate.

 

[nimbus]

Oldies but goodies. People are weird.

 

[abolt18]

Oldies but goodies. People are weird.

Love these. Would totally like to try this, honestly.

 

[anbuitachi]

Love these. Would totally like to try this, honestly.

then do it . record it too

 

[deleted171991]

Oldies but goodies. People are weird.

Both are academic airway experts who practice what they preach. Respect!

The former is Dr. Rosenblatt who creates the Airway on Demand video series for Anesthesiology News: https://www.anesthesiologynews.com/Multimedia .

 

[nimbus]

Love these. Would totally like to try this, honestly.

then do it . record it too

I predict self-intubation will go viral. The next tide pod challenge!

 

[deleted171991]

I predict self-intubation will go viral. The next tide pod challenge!

It already is. But at the wrong end.