Rare emergency training for anesthesiologists

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How do anesthesiologists learn how to handle emergencies so rare that they may never even be experienced in a lifetime? In this video, I show how residents learn - and teach - how to deal with operating room emergencies.
0:00 Start
0:38 Introduction
2:19 Simulation
4:45 Mt. Sinai Anesthesiology
Music:
Subtle Swagger by Ron Gelinas: / atmospheric-music-portal
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
#Anesthesiology #Residency #MedicalSchool

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Опубликовано:

15 июн 2024

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Комментарии : 60

@ComfyChaos Год назад

Congrats on becoming a chief resident, Dr. Max! Well deserved! 😊

@darriontunstall3708 Год назад

Congrats on becoming the chief residency! You’re awesome! I would like to see the simulation lab! It takes a special person and special skill to be a anesthesiologist or CRNA and you’re one of them! I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college because of my cerebral palsy, I really wanted to be a anesthesiologist physician

@AvalonCN Год назад

Congratulations on becoming a chief resident Dr. Feinstein! Well deserved. Another great video as well.

@crohnspoops2673 Год назад

Keeping the patient in V-tach for the rest of the video had me amused, but also stressed.

@clarasmom9440 Год назад

Lol.

@Waad005 Год назад

Your channel is so underrated!

@abbeygemeinhart1278 11 месяцев назад

Congrats on becoming chief resident!

@Juju-wk7yv 11 месяцев назад

Congratulations, Max! You are a natural teacher. You will be an excellent Chief Resident.

@KCJerry1950 Год назад

So cool Chief Resident! A friend who is a perfusionist was telling me about a chest fire in the OR the other day.

@starfishgurl1984 Год назад

Congrats chief! Amazing how the role of sim labs have become vital in the learning and teaching processes of med school and beyond amazing stuff!

@wardtaylore 11 месяцев назад

Congratulations! Been following your channel since you started. So ready to start CA1 year next month!

@Israella_ Год назад

Congratulations maxxxxxxx!!!! Congratulations on your new appointment!!!!!!💕💕💕💕💕🥳🥳🥳🥳

@barbarawhitehurst3262 11 месяцев назад

Hello Dr. Feinstein. First, I would like to say Congrats on your career growth and new professional title as a chief resident. Your insight on your channel is a reflection of your experience and training. Secondly, as a new subscriber to your channel, I have reviewed some of your videos and found them all to be insightful. In fact, I found your video on Anesthesia preparation to be one that provides me with some explanation of what took place or should have occurred four months ago while I was preprepared to undergo General Anesthesia for a Upper Endoscopy procedure for my throat. Unfortunately, I had an adverse effect and experienced a cardiac event that required me to be monitored in the ICU. I have several procedures in the past that required GeneralAnesthesia, with no major adverse effects. However, had some issues with Digestive disorders i.e., Gastroparesis ( Moderate Delayed Gastric emptying), Pancreatic Trypsin Deficiency , Dysphagia, and Vocal cord dysfunction ( Vocal cords are bowed). Cardiac (mild bradycardia , baseline 51 heart rate)and low blood pressure (107/ 64. (85/45 the lowest reported) while under, but resolved while in recovery) and a small PFO. I do have a complex medical history. Primarily Digestive Disorders ( , Bowed vocal cords, and dysphagia , and laryngeal spasms of the esophagus) Respiratory (mild asthma,) a ICA aneurysm (4 mm),and Cranial Facial Dystonia.( random abnormal muscle spasms of face and mouth). However, nothing prepared me for the unthinkable during preparation for an upper endoscopy. Hence, during preparation of anesthesia, I know that at least something was administered because I begin to feel remember feeling a little sleepy, and the next thing I remembered was feeling the worst abdominal cramping I have ever experienced, the pain was so intense, the last thinking I need to scream out to let the team know that something is wrong. Next thing I remember waking up to several physicians around my bedside on the patient cardiac floor asking if I rembered being in the ER with the Rapid Response Team as well as ICU. They initially denied that I wasn’t given anything, but later told my husband they did administer Propofol. Then they began to ask me If I had been under emotional stress recently or did I have pain before my procedure. The answers to both questions were no, but did point out that I have chronic abdominal pain due to my digestive disorder Gastroparesis, but no new pain. In addition, there were no recent emotional stress issues . Then I was informed my blood pressure was 275/ 135; Heart Rate was in the 230s , and my Troponin was Over 3,000( Three Thousand), the ultrasound and echo were abnormal, but since the catherization showed no blockages and my heart was in and odd shape, they believe I had a Rare Heart Attack called a Takotsubo. Please give me your opinion on what May have actually caused this rare attack. I truly believe it was the Propofol. 😢

@user-nm9lz3hy5n Год назад

Congratulations! You are a great teacher 🎉

@bassethound1 Год назад

Hey, Chief! Your RU-vid family is proud of you!

@davidadams9391 Год назад

You’re a smart teacher Dr Max!

@musiimefosca6714 Год назад

Congratulations, on your selection as chief resident 🎉🎉😊.

@joandeimling7681 Год назад

Congratulations Dr. Max

@paulpoppenfuse7071 Год назад

Thank you I'm learning a lot

@keithnichols7926 Год назад

A good way to organize and complete your understanding of a subject is to teach it to others. Unless you and your students are totally unprepared, the students will point out your deficiencies.

@george7672 Год назад

Very interesting!

@ronaldporras Год назад

Doc please cover what it’s going on with the air in New York and how will you prepare. Hope everything is good

@patriciaschuster1371 11 месяцев назад

Great news for you...and us,

@reeniesfavorites Год назад

Congratulations!

@Lukamey Год назад

I am an anesthesiology resident in Austria and I could just dream of such a simulation room. We don’t have that here 🥺

@Ms.Opinionated Год назад

Love the flex "chief resident"

@kevinbelanger4134 Год назад

Congratulations on becoming a chief resident

@HikeForLife23 Год назад

Can you do an OR Tour for a Pericardiectomy? I had one past month, and im interested in what was all needed. Thsnks

@macking104 Год назад

related: in 1993 I had elective arthroscopic knee surgery under general. As I was being wheeled from the preop to operating room, a nurse said that my blood protein was extremely low. Low enough that they seriously considered Not doing the surgery- but decided to do it anyways. in 1995, another doctor said I had bradycardia (resting pulse about 42) How bad was that decision to do surgery? On the detailed bill, I noticed they billed insurance/me for 10 units of a anesthesia med (should have been 1). another doctor said if they gave me 10, I wouldn’t be asking the question! doctor retired the next year. the hospital doesn’t exist anymore.

@charesepelham7682 Год назад

It’s pretty unusual to cancel a routine surgery for low protein. We see “somewhat” low protein all the time, and while it’s not ideal, and patients do tend to heal better with a normal protein, we do surgery frequently on people who don’t have good protein levels. It must have been extremely low to think of canceling surgery, especially for a rather “routine” knee scope. My questions Would be, “why is the protein so terribly low that you would consider canceling surgery? What is the cause of that low protein? Exactly how low was the protein? Were any other lab blood tests abnormal?” Low protein occurs in malnutrition, malabsorption, kidney disease, liver disease, and autoimmune disease. Do we need to correct the protein and or treat any other disease entity or problem prior to proceeding with surgery? More questions would be, “why is the resting heart rate 42? Is the blood pressure preserved? Is the patient an athlete, or sedentary or just mildly active? Is there some sort of heart block? What does EKG look like?” If the patient is a very fit athlete, it’s possible the normal heart rate could be quite low. It’s usually more in the 50s, though, rather than 42 but I have seen 42 as a normal resting heart rate for an athlete. Sorry, I can’t truly answer the question without more information and sorry, but I don’t know anything at all about anesthesia billing! So I’m not any help! It’s unusual to have a nurse notice a low protein. Most anesthesiologists don’t notice or barely notice that! Nurses normally notice a high or low blood sugar, because the nurses usually check that for diabetic patients.

@jonathanzellner906 Год назад

Congratulations! But you deserve it!

@whynotjustmyusername 5 месяцев назад

3:41 The most terrifying thing on that monitor is the fact that some monster set the pulse oxy to yellow. Who associates oxygen or fresh air with yellow?!

@p33kin89 Год назад

CONGRATS ON CHIEF R!!!!!!!!

@hingz9282 Год назад

Is there an simulation bank with premade cases? Of do you develope these scenarious from scratch ?!

@rudolphna54 Год назад

I have a question actually, I had ORIF on my ankle a couple years ago, and that required the use of a nerve block in my knee, and prior to that the anesthesiologist gave me fentanyl to reduce the pain from the needle for the nerve block. I realized this doesn't seem to be covered much since it seems like typically the fentanyl is given during the anesthesia, not prior. Is this a common situation?

@lt.leukaemia3532 Год назад

In the UK at least, it seems to be dependent on different Anaesthetists on whether they choose to or not to. Most that I have worked with routinely give fentanyl before a GA and before regional anaesthesia as well. Like you said, it helps with pain but can also help the patient relax and keep still.

@eranshachar9954 Год назад

I wonder 3 things- 1.When you are a resident do you consider an independent doctor? 2.If there is an airway fire and you have to detach the machine. How do you give the patient air? I mean a person under general anesthesia has no ability to breathe on his own. 3.How do you respond during surgery if you see a blood pressure too high/too low?

@charesepelham7682 Год назад

Only have time right now to briefly respond to one question; blood pressure. We need to know why the blood pressure is low or high. The treatment will be different, depending on the cause. For example, the blood pressure could be low do to a volume deficit. Maybe the patient is dehydrated. Maybe the patient has had vomiting, or diarrhea, or has just felt so bad they haven’t taken any liquids. Maybe the patient is septic. Maybe the patient has had a spinal anesthetic or an epidural anesthetic and is dropping blood pressure because of that. Maybe the patient has low blood volume because they have been bleeding. Maybe blood pressure is low due to medication that was given to induce Anesthesia , but it also dropped the blood pressure. Maybe it’s an anaphylactic allergic reaction. There are all kinds of reasons for the blood pressure to be too low or even too high. Depending on the cause of the problem, if the blood pressure is too low, you may need to give IV fluids, you may need to give blood products, and there are different medication that are used according to the cause of the high or low blood pressure, accounting for other illnesses, the patient may have, and according to the heart rate as well. Sorry it’s a rather complex answer to a simple question!

@charesepelham7682 Год назад

No, a “ resident” is not completely independent. The resident still learning. You are not 100% independent until you are an “attending “ physician. A resident physician, works with, and is put on call with an attending physician. In Anesthesiology, in the US, the attending physician works with anywhere from one to a maximum of four resident physicians. Anesthesiology residency in the United States, is four years. Do you have either a clinical pay here, or a year of family, practice or internal medicine, and then three years of anesthesiology residency. Anesthesiology residence are CA1, CA2 and CA 3. That is, a CA1 it’s just starting out the first year. CA2 is the second year, abs CA 3 is the third year. Chief residents are chosen from the CA3 residents. A Chief resident has a strong fund of knowledge and is clinically very good. It’s an accomplishment!

@eranshachar9954 Год назад

@@charesepelham7682 No man nothing to be sorry about. I love the amazing detailed answer thank you very much. I am not a doctor just a science lover and fascinated and wants to learn more about anesthesia which is why I am watching Max's videos. Well done to Max and I am sure he will be a great doctor with his attitude. Anesthesia seems such a hard field to master in medicine. Such people should get more respect for doing a job of keeping people alive/saving them. I been thru general anesthesia couple of times and always came out in a good condition. Anesthesia doctors are not thrilled to knock me out as on the paper I have asthma despite not having attacks for a long time. It is a light asthma thank god.

@sandergoossens7678 Год назад

Here in Belgium basic medicine school is 6 years, with then a specialisation of another 4 to 7 years, depending on what you choose. Anesthesiologie is a 5 year specialisation here. Not that long ago the basic course was even 7 years on its own. I am kinda surprised the doesn't take that long in the USA... Maybe a future video idea talking about the course of becoming a doctor in the US? Maybe even comparing it with other countries around the world?

@benjaminnhlam2867 Год назад

Medical school is 4 years in North America but this is on top of a Bachelor's degree before that already (typically 3-4 years)

@benjaminnhlam2867 Год назад

So that's a minimum of 7 to 8 years of post-high school education before any specialty training.

@mcrchickenluvr Год назад

You’re close. In the US you go through premed for 4 years first. Then you do another 3-4 years of med school. You also have internships and fellowships. How long your fellowship lasts depends on what your specialty is.

@sandergoossens7678 Год назад

@@benjaminnhlam2867 Ah I didn't know that! Thanks for the info!

@benjaminnhlam2867 Год назад

@@mcrchickenluvr fellowships are not always necessary though, only in Internal medicine and subspecialties if one is interested (Max wants to do one in peds anesthesia, for example). Afaik, all MD schools in the US are 4 years. Some Canadian schools have 3-year MD programs. And both countries have pathways that allow "premeds" with 3 years of undergrad to get in (not as common though).

@808melz Год назад

What in your opinon makes a good or nurse?

@spvillano Год назад

Would that the simulator wasn't rare training! In the military, we found patient simulators to be invaluable for training everyone from medics to physicians. After such a massive effort and expense, our infantry found that training to be quite invaluable to them as well. Although, I'm fairly certain that I could manage to kill the anesthesiology simulator in a New York minute. Not my field, so beyond my depth by far. Although, I'd enjoy trying fiberoptic intubation. Did traditional intubation, I've performed digital intubation a couple of times (long story there, used an oropharyngeal airway to protect my digits from any incident), never got to work with the fiberoptic before I retired. "It's a laryngoscope, not a pry bar, dammit!"...

@jeffdo9195 Год назад

Is there RECURRENT training on this?

@southaussiegarbo2054 Год назад

Me gets 10 ads before vid load 😆

@Spartacus.D Год назад

Congrats on chief residency, just wanna pick your brain, do u think its possible for a deaf person (has a cochlear implant) to become a anesthesiologist?

@tinamorris01 Год назад

If you put your mind to it. Don’t let a disability hold you back. ❤ I’m going into child life to work in hospitals with children and I have multiple brain tumors and a deformity on my ankle that makes it hard to walk but I know that’s the job I want to do for the rest of my career