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  1. Dapperduane

    Vial cap particles drawn into syringe

    Here's another that happened to me just a couple days ago... the speck at about 0.5ml. I only needed 5ml so I injected slow and made sure it stayed put.
  2. Dapperduane

    Vial cap particles drawn into syringe

    Usually the particle sticks to the sidewall and then I carefully push the syringe as I keep an eye on it. With the propofol I was able to squirt it back into the vial. I presume the particles are just swallowed up by tissue somewhere in the body (lungs), I hope they don't cause some kind of...
  3. Dapperduane

    Vial cap particles drawn into syringe

    Has anyone ever noticed a tiny bit of the synthetic rubber floating inside their syringe after piercing the vial with a needle. I've seen it so many times that I've decided to snap some pictures (It's easiest to see in the propofol syringe). I've seen this mostly with blunt needle access and...
  4. Dapperduane

    Medical Residency selection committees favor MDs over DOs?

    An article from healthimaging.com reports that ~90% of radiology residents questioned said that selection committees favored MDs over DOs. What is your take on this? Could it be that MDs generally have more education or "creds" under their name such as research to justify this? I mean they all...
  5. Dapperduane

    Ultrasound-guided popliteal sciatic nerve block positioning

    Some people like to do these prone. I feel it is safer if the knee is flexed because this gives some slack to the sciatic nerve, allowing it to move if you accidentally "bump" it. So if you do it prone, be sure to put some pillows under the lower leg to create that flex.
  6. Dapperduane

    Ultrasound-guided popliteal sciatic nerve block positioning

    Mindray was demonstrating their new ultrasound equipment and I was able to use it for a popliteal block. I didn't think the image was anything amazing but I was impressed with all of the features on the machine. It continuously records video so that I could pull images and video clips from...
  7. Dapperduane

    Anesthesiology board exam study course reviews: Jensen (Anesthesiology Review) vs. George (Ultimate Board Prep)

    First a little background about me. I am a pretty decent written test taker, studied engineering in college and excelled in math and sciences. The anesthesia written exam was not hard for me; through college and medical school I did well on most written exams with little preparation. That said...
  8. Dapperduane

    Arizona becomes another opt-out state to allow CRNAs to practice independently

    It's probably all political since the rural hospitals were already using 100% CRNAs, the supervision came from the surgeons and other physicians. Here is the letter...
  9. Dapperduane

    Clinical Update article from 02/01/2020 Anesthesiology News about NMBD and reversals

    So I decided to open up one of those clinical update leaflets from the anesthesiology news magazine to gain a CME... I read this article and I totally came up with different commentary than they did... 16-year-old, healthy male wrestler had a tympanoplasty in an ASC 200 mg of propofol 50 mg of...
  10. Dapperduane

    You're in AZ?? What group?

    You're in AZ?? What group?
  11. Dapperduane

    I'll use atomized phenylephrine if I don't have afrin.

    I'll use atomized phenylephrine if I don't have afrin.
  12. Dapperduane

    ASA survey showing that many are forced into lower contracts.

    Well this comes as no surprise, give insurance providers (legalized mafia??) a little legislative support by making out of network harder to do and they take advantage. This was published by the American society of Anesthesiologists. ASA Survey Shows Health Insurers Abruptly Terminating...
  13. Dapperduane

    Rivian R1T vs Tesla Cybertruck

    So I know I might be there only one in the forum who sees this, at least for a while, but I've been drawn to wanting a truck for quite a while. I usually have to borrow a truck because my driver is a used Nissan leaf that puts me in the HOV Lane. I love the instant acceleration that an EV...
  14. Dapperduane

    ASA Survey Results for Commercial Fees Paid for Anesthesia Services – 2019

    The 2019 survey is out. Click here for the link to the ASA post.
  15. Dapperduane

    Physician burnout

    I blame the corporate life; Wall Street has bought up too many doctors practices and now they are all working too many hours for less. Finally, they realize that time is the most precious commodity and that they sold it. From Discover on Google...
  16. Dapperduane

    Cognitive function after surgery with regional or general anesthesia.

    In the journal Alzheimer's & Dementia, a study showed that there is cognitive dysfunction in both regional only and general anesthesia patients, albeit the GA group had memory decline as well. it seems intuitive that the general anesthesia group would suffer cognitive dysfunction and memory...
  17. Dapperduane

    University of Minnesota says no to off-label use of Exparel

    I just wish I had a speaking gig like this. $800k for the last few years must have been very nice! On the topic of Exparel, I have only seen limited use here in Arizona...Perhaps it will gain traction since we are all "guilty" of overprescribing opioids per our government...
  18. Dapperduane

    A4 Anesthesia Associates of Ann Arbor duking it out with Trinity

    Looks like they got a restraining order against Trinity. How interesting that the CEO of the health system is also on the BCBS board of Michigan. Anti trust lawsuit anyone? https://www.beckersasc.com/anesthesia/michigan-anesthesia-practice-halts-health-system-s-illegal-hiring-practices.html
  19. Dapperduane

    A4 Anesthesia Associates of Ann Arbor duking it out with Trinity

    Interesting article here, I wonder if A4 is skimming too much off the top and is upsetting their workforce. It would be nice to hear some insider input.