Premedication at before bed time

A good night sleeping pill

During an intra-articular procedure or right knee for a young & healthy foreigner, everything was smooth as silk until...
Big Surgeon : Prepare for dressing, and Slap, and please release the touniquet
OR Nurse : There is a second dose for Cefazolin for him
Unkind Consultant got the antibiotics ready and administered, and screamed out loud to Anaesthesia Resident " What's the hell is going on?? The end tidal carbon dioxide is at 48, what level did you record last time?"
1st year Resident  was stunned and told "33 mmHg."
Unkind C : is it from the exhausted sodalime? looking at that colour
R1 disagreed, so UC spoke out "That should be long time ago, not immediate rise."
UC : Does it come from your inadequate IPPV setting?
R1 raised the RR from 16 to 18/min, and told 'No".
UC : So, what intervention has been recently applied to him?
R1 : Touniquet ?? UC : Tell me the textbook you have at home.
R1 : Baby Miller. UC : Good, there should be at least one table on this issue, read it tonight before going to bed, OK??

R2 entered the room later on, and was told that her junior was ordered to get a sleeping Table(t) tonight.

External Audit

The faculty has been under audit process since this morning, there has been a four-people committee working on this challenge. The vice dean for undergraduate education has been questioned a lot, however, as a team member, there is always a help available to answer some difficult questions from all preclinical and clinical department representatives.

In the afternoon session, the clinical departments including department of anesthesiology were interviewed in a big room. When I entered the room, the topic was about grade designment, how often, which method to judge the learners' score, how to announce the grade, etc.

We were also interviewed about log book, competencies in laboratory skills, hand skills, and they also asked about the 21st century skills how to improve it both in the students and also more important the teachers.

Critical Care Conference in Thailand 4th, Just ended

The 4th CCCiT was organised in Dusit Thani Pattaya on Thursday 27th to Saturday 29th June, it was quite a success for the organising committe because the number of participants rose to double from 200 in the first year to more than 400 this year.

The new concept of Shock management was discussed and presented, some are
1. Early organ support such as CRRT not wait for Creatinine to more than 10 before initiation
2. "Less is More" concept not too much fluid volume because mortality can be higher in the loading patient group
3. Choice of catecholamines can determine the outcome Noradrenaline is better than dopamine
4. The vasopressin analogue should be given early but not a replacement to catecholamine
5.  New concept of massive blood transfusion in trauma

Simulation based Education

The first vid clip was for the fresh up the consultants so that they were up to date with cardiopulmonary resuscitation. While the second clip was a rehearsal for the scientific meeting.

An essential skill for Every MD graduate

Insertion of an intravenous catheter is a must skill for an MD graduate, however, it need repeated training. Time after time you can do much better, first of all, you need a good old experience hand, so that the vessel you chose would not move when you puncture it.

Our Family Ceremony; We love our teachers

Today in our department has organised a family party, just to say "thank you to our beloved teachers".

Here are some samples of the event, in the lunchtime we had lunch together to say good bye to the new graduates and welcome newcomers.

Report discussion : The Oral Presentation

Report Discussion by MedStudent about what they think and translate anaesthesia service into their presentation.............

Each student will have 15 minutes to discuss about preoperative medical problems their patients have, and what to do or prepare for their patients so that we can avoid perioperative complications. They also have to discuss the choice of anaesthesia which way they should proceed, and also postoperative management, any problems and pain control.

Some questions may be asked according to time available such as......

MS : oxygen was administer 3 lpm....
ABC : what does it mean? at what levels of inspired concentration you gave to your patient? you did not give a clue on which apparatus you utilised, you may harm your patient if you used a simple facemask...
MS : oxygen 3 lpm via a nasal cannula...
ABC : that sounds better and we can imagine that

MS : anaesthetic was maintained by.... oxygen and air are given at the rate of 1 lpm each......
ABC : just would love to know the FiO2 level you mentioned, can you tell us please...
MS : .........(silence is definitely not golden '')
ABC : that's all right, it is quite unexpected by you being asked this question ไม่ได้เก็งข้อสอบข้อนี้มากระมัง!!!