No. Hilarious. That would be, what we call, "on the nose". 😀
You want the fabricated case I used? Here it is:
It's M&M, 7am, junior resident presenting. Mexican-themed breakfast spread this month, burritos. But there are always bagels. So, burritos and bagels.
The case: 9 y/o male sp T&A returns to hospital with blood tinged sputum, low grade fever, complaining of throat pain. Got triaged and is on his way to the OR for a re-do on a bleeder with ENT. (all being presented by young CA-1 or 2).
Preop by our junior resident: an IV and 1mg Midaz. (remember, I need to have this kid screw up, so this is the first area for debate)
Debate: do you give 1mg Midaz to a kid that might have a difficult airway? if you overdo it, he risks aspirating, yes? BUT, the kid is screaming and crying so the junior dude gave it to calm down that BP and avoid increasing any bleed rate. But, I'm told, it's debatable...
Induction: Ketamine 1.5mg/kg and Rocuronium .6mg/kg. (debate #2: should he have used Roc or Sux, Chairman screams that he should have used Sux because it's on and off faster, giving a better chance to ventilate when the time is right. Jr. Resident, seems to recall a family history of MH. Still Chairman rips him an ass over choice of paralytic.)
On the OR table, Jr. resident is now facing a can't intubate, can't ventilate situation. Bloody airway that is getting bloodier.
Calls for ENT to get a surgical airway!!!
Smash to: ENT is slamming a Nurse in his office.
Jr. Resident decides to do the trach himself, but since the airway is so ferchlempt, he intubates the tissue area, and not the airway or the esophagus btw, not that the later would help.
Hypoxia, CPR, Death. Mom distraught. In for a T&A in the morning, out in a body bag at night. Maybe mom shouldn't have insisted boy get discharged home so fast in order to get her
afternoon of alcohol drinking underway....
All meds and doses confirmed with Peds Anesthesiologist, and the case itself, remember, this is just TV folks!
Coming to a boobtube near you! : )
D712
