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The Thoracic Epidural 27 Aug 2013 | 09:58 am
For me, the thoracic epidural is one of the most challenging procedures. Although I feel quite proficient with lumbar epidurals in the low back used for labor, lower abdominal surgeries, and lower ext...
Unanticipated 26 Aug 2013 | 01:27 am
For me, the most useful predictor of whether someone will be a difficult intubation is whether he was a difficult intubation in the past. If I trust the proceduralist (or if I had previously intubated...
Whimsy 24 Aug 2013 | 10:17 am
Halfway through the graveyard shift, when I started blinking to solidify shapes and sizes, the dull buzz in my head began to crescendo into an ache, a roar. My skull, an empty room, provoked yawn afte...
Smoking 23 Aug 2013 | 06:50 am
Most of our thoracic surgery cases are a result of smoking. One of the most common indications for lobectomy is lung cancer, a direct consequence of longstanding tobacco use. The smoking history also ...
Supervision 21 Aug 2013 | 06:34 am
Last night on call, I was carrying the airway pager and was paged to supervise a critical care fellow for some intubations in the intensive care unit. ICU fellows come from many different specialties ...
Lies, Damned Lies, and... 19 Aug 2013 | 11:13 am
Statistics can be very tricky to interpret. In the news, in medicine, and in research, statistics are often bent to convey an interpretation of the data. I used to think that data was pure and unadult...
Insurance and Primary Care 17 Aug 2013 | 12:40 am
Everyone should have primary care. Everybody should be able to see a doctor, get routine check-ups, have their chronic diseases managed and treated, afford medications, receive vaccinations, get prena...
Bronchial Blockers 14 Aug 2013 | 08:47 am
Several days ago, I wrote a post on the use of double lumen tubes to achieve lung isolation. The other deice we occasionally use for lung surgeries is something called a bronchial blocker. With a norm...
How Far Do You Go? 12 Aug 2013 | 08:12 am
A gentleman with bipolar disorder intentionally walks into traffic and is hit by a high speed vehicle. Rushed to the hospital, he's found to have multiple injuries including an aortic injury, pelvic f...
Double Lumen Tubes 11 Aug 2013 | 03:54 am
How do you isolate the lungs? What techniques are there to inflate one lung and deflate the other so that a surgeon can work yet a patient can be oxygenated and ventilated? Well, one easy way is to pu...
