@@MaxFeinsteinMD I love seeing all of this. I'm a tele/ICU nurse working towards med school and eventually Anesthesiology and your videos are awesome for my OR hunger, lol.
It puts me at ease knowing anesthesiologists are being trained to identify and fix atypical problems like an equipment malfunction. This is something I have never considered going wrong in the OR.
I'm an Anesthesiologist from India. Keep up the good work about spreading awareness about the 'behind the curtains' work that we do 👍👍 . Anesthesia is all about Anticipation , preparedness, and in such situations we have to be cool,calm and swift !
This video came just in time. I’m a premed and was beginning to question how I could ever be responsible for someone’s life especially in a time sensitive situation. But, this reassured me that I will one day get all the training necessary and that there’s nothing to be nervous about. Thanks Dr. Feinstein.
Hi Claude, I'm glad this video came right in time! There are definitely stressful times as a doctor, but being able to rely on the training you've gone through makes it possible to handle. I wish you well in your journey!
You are a natural teacher. You will I’m sure pass on your knowledge to many coming after you. Also I would feel so confident in your hands. Thanks for this channel!
Got so much respect for you man. I had my first ever operation today at the age of 34. I had my tonsils removed and I was nervous beforehand as i'd never been put to sleep before. The anaesthetist made me feel at ease before they put me to sleep and I know you guys do a very important job. The NHS here in the UK are incredible and i'm very thankful that we have a national health service so that we can get free health care.
I am a 4th year medical student applying to anesthesiology and am starting my anesthesia elective next week. This video is so informative and fun to watch! I love how you explained the different component of the monitor. Thanks for sharing!
I had a melanoma WLE surgery and 2 lymph’s removed. They couldn’t do anesthesia because I have sleep apnea so they gave me fentanyl knowing I have extreme chemical sensitivities to many chemicals others can handle all the time. After surgery, they moved me/my table to a wall and a lady shook me to get me to breathe then only sat down telling me to breathe every once in a while. She was too lazy to stay standing up to move me despite me taking only one breath and I wouldn’t breathe again! I remember the dozen moments she’d say to breathe in a really bitchy tone and then nothingness again. Finally she told me to sit up which helped but I was slumped over, then finally she said to breathe deep-that finally put a thought into my head (the only one) that I needed oxygen to live and snap out of this so I started doing Wim Hoff rapid, deep breathing to save my own life. It was HORRIBLE. I knew not to complain to the hospital as I might need them again later with all my many serious health problems. Doesn’t that sound horrible? It seriously makes me feel less than dirt being ignored having respiratory failure over and over an sober and over and nurses saw me not breathing walking by and they saw me just dead basically after taking out my vent. I also probably found out I had an allergic reaction to some drug one phlebotomist accidentally told me while looking at my records. Then after my WLE split open and was infected, it pushed out 2 foreign objects; a black square plastic looking thing and blue/ turquoise yarn like girls used in the 50-70’s like in the Brady Bunch. I don’t even own turquoise clothes. So much medical abuse and it’s haunted me since. Why would they even do all that? Why not tell me I had a reaction? Do they seriously think I don’t remember basically dying a dozen times like a junkie? Who can I maybe later make a formal complaint to? I’m just scared with having Medicaid I’d be forced to go there again for surgery later for some reason.
@@youfinallyfoundwaldo1364 - You didn't actually die. If you are conscious enough to be scared of not breathing, you are too conscious to die. Opioid overdose would render you unconscious. Plus, they have Naloxone, so you were never in any danger. I'm sorry it was so scary though, most of the time people are euphoric on opioids.
@@youfinallyfoundwaldo1364 um, I think you’re just here for some attention, clearly. I couldn’t even read the entire novel you wrote because it was just all so ridiculous and made zero sense. But in the beginning, You keep saying you were “dying” because you “couldn’t breathe,” but then you mention being on a vent. Well, you don’t NEED to breathe if you’re on a vent. And I don’t know of any hospitals that would even put a vent IN under mild sedation alone. Again, so many things just do not add up. I’d go elsewhere (where there aren’t smart people who will see through your crazy ramblings right away) and see if THEY believe you.
Interesting to say the least. I’ve always wondered how dire situations would be handled. The fact that you can call for assistance and fellow anesthesiologists come running is outstanding. You all do keep us alive during surgery! Our fate is in yours and those in the OR’s hands. Thank you!
I have to admit the mental image of an 'avengers assemble' scenario of all the nearby anesthesiologists made me laugh even though I'm sure it wouldn't be funny in an emergency. It is a huge relief that they can summon several extra pairs of hands and eyes as backup if needed.
This reminds me of airplane pilot training where you learn to deal with abnormal and emergency situations then practice those procedures. Then, the day you experience said emergency, its no big deal because its not your first time recognizing the problem then working through its solution...I am not a medical professional but I latched onto your channel because I recently was a guest for a couple of days at the local hospital. Although I ended up not needing to visit the operating room, you have given me a lot of confidence that I would have been in good hands if that did happen. Thanks for making these high-quality, informative videos. I know its a lot of work for you to create them.
I don't know whether you're aware, but there are often many parallels drawn between flying and anesthesia. Completely agree with what you said. Glad you didn't need to go to the operating room and you're back out of the hospital. Thanks for following along with these videos!
These educational segments are awesome. I feel that many patients would be much less afraid to go into surgery if they had this knowledge. Kudos to you, the anesthesia department and hospital.
Thank you for sharing! I feel so much more comfortable after looking at your channel. I had 2 open heart surgeries and always had that fear of not waking up. Unfortunately I might need a third surgery. For the most part I now feel more secured in knowing what anesthesiologist do and how you focus on the patient. Well Done Dr. Feinstein!
Thanks for watching! Glad you found these videos helpful and have a better sense of how closely anesthesiologists watch over their patients during surgery.
I can honestly say that your anesthesiologist is just or more important than a surgeon. I have been a nurse for over 30 yrs. When I had surgery myself I picked the surgeon and anesthesiologist.
Insightful video. I am head of Biomedical engineering at a hospital with 18 theatres. We had a similar problem, but the ventilator monitor on your GE blew. We had no idea what the vent was doing. Luckily we were closing. So the anaesthatist switched from mechanical ventilation to bagging, bagged the patient and we turned the gas all the way down until the MAC reading on the patient monitor went down to zero. In South africa we don't have resident and attending. The all self employed and work individually. So the first line is to call a biomedical engineer into theatre and assess and assist the doctor. Luckily I was able to swop out the machine for the rest of the day and replace the screen that afternoon. We are no changing all our GEs for Dragers.
I’ve had one major surgery and several minor procedures done, and this video gives me much respect for the Person Behind the Drape. It’s smart to train for the worst case, one in a lifetime occurrence, unlikely problem and be prepared than to be caught flat footed when the unexpected occurs. Good teacher!
Omg thank u so much for sharing this, as an aspiring doctor learning how to deal with unforeseen emergencies is essential! Ur systematic and calculated response was inspiring :)
Wow! Your calm bright even personality makes you such an amazing asset to their program. I can tell you from experience many are not as empathetic and highly doubt as level headed. You are extremely impressive. 😊
They REALLY need people with your extensive training in Dental offices that practice Sedation. Most of those people are terrible at what they do. This level of training is amazing.
I personally wouldn’t feel comfortable being given sedating medication by anyone who doesn’t have training and experience with advanced airway management.
Max Feinstein, MD why is it so common at dental offices that keep giving sedation to their patients? Many dental office even given general anesthesia during dental implants.
You’re not wrong. Plus I’ve seen cases where sedation dentistry has ended in patients in cardiac arrest due to unknown underlying issues that without preop testing aren’t discovered until to late. I was a stickler with who I chose for myself or my kids(their dentist refuses to do sedation dentistry on children outside of the actual hospital).
I’m an Anesthesia Technologist. I had taken my daughter to our dentist to have her 4 “wisdoms” removed. Near the end of her surgery, a car struck and knocked out the electrical power box outside of the small medical building. All of the lights and equipment shut off. The dentist immediately inform me that everything was ok, the surgery part had ended and my daughter was waking up. I noticed that my daughter was hooked up to a “transport monitor” showing a black screen. I asked the dentist why wasn’t the monitor on. He answered that all the electricity was out, as if I hadn’t noticed. I told him that the monitor should be on because it should have a battery back-up. He replied, “These have batteries?!!” Apparently the staff never knew what that “long rectangular thing” was and had kept it in a drawer instead of the monitor.
@@alanibarra1234 "goodbye, and you don't need to remind me about the bill, I'm not going to pay you. But see the bright side, you will avoid a lawsuit. Maybe."
Love this channel. Worked 50 years as a surgical tech. I always told people not to plug any surgical equipment in to the anesthesia machine or circuits !
This channel is awesome. Thank you for what you do, as well as the education you provide. I’m only ever going to be a patient, but it’s great to know what goes on behind the scenes.
Years ago, when I worked at a hospital as an electronics technician intern, during a surgery, they were using a blood circulation machine, and the fuse went. One of the technicians had to suit and scrub up, and sit on a stool, pushing the reset every few seconds, during the whole surgery. When the operation was over, the machine went into our lab where it was cleaned and repaired. The operation was successful and the patient was none the wiser.
As someone who has had 31 operations, 17 of which were on my head alone I have to say I love watching you videos. As someone who has spent the majority of my life in hospitals and ORs I alway enjoy seeing different equipment and the different setups in each one. While like you said most setups are identical I have seen some set up a bit different and with individual touches depending on what they like or need. Thank you sir for what you do, keep up the great hard work and keep making awesome videos. It’d be so fun to do a video with you somehow and talk to you about different medical procedures and stuff lime that. Keep being awesome.
When scary emergency situations like this pop up, then the most important thing is to always keep your cool. Then you need to depend upon your training for emergency situations like a machine outage. Job well done! You did exactly what you should do in a frightening situation, and that’s the best anyone can ask of you.
Thanks for the info. I live in Thailand as a teacher. I have an ex-college roommate and best friend who is currently working as an anesthesiologist in Scottsdale, AZ. His name is Jerry Tobias. What is interesting about Jerry is that he dislocated his 4th and 5th Vertebra in a gymnastics accident while we were roommates in college (we were both on the varsity team) and was paralyzed for months. He experienced a miracle and regained all function. Quite a person Jerry Tobias. I am happy to learn what type of things he does as an anesthesiologist from your vids. Thanks.
When the going gets tough....... the tough get going...... remaining calm in the face of an emergency, common sense which isn’t so common these days..... you Sir no doubt will be an excellent teacher...already are. All the best to you.......Not a Dr but got a lot of experience with isoflurane a long time ago. Was taught basically by OJT, and self study. I found the discipline very interesting so I learned as much as I could,and was very fortunate to have someone spend the time with me. Raptors not people :-)
Through all of the “procedures” I have had (just had #40) I have never had an issue with an anesthesiologist, they have all seemed to be relaxed and on top of everything. They actually inspired confidence, that’s a good thing when you’re dealing with a. major surgery.
Hi! That's a lot of procedures!! I have never had a general anesthesia. I have a phobia about it but I need stuff done! Are you ever aware of the tube in your neck when you come back around? A friend said she was and if felt like she was choking. Scared me. Also heard that it hurts your arm a real lot when the anesthesia goes into your veins. Am i overthinking it all?
@@QueenNoTeetha151 I had the same concerns...talked to the surgeon and the anesthesiologist about these concerns. They explained exactly what was going to happen and I didn't feel or remember a thing.
@@phillipvansickle4220 Oh thats encouraging! I am glad it went well for you and it sure helps to know that! Hopefully I will be the same. Better to live in hope as they say than die in despair! lol
@@QueenNoTeetha151 I was terrified when I checked in. I let the staff know it was my first time and that I was extremely nervous. They put me at ease and made me feel very comfortable. The anesthesia itself was a strange experience. Not terrifying, but very peaceful...like waking up from the best nap I had ever taken in my life. Like you, I had put the procedure off for a long time until I finally had to get it done. I have to go under again for another procedure. I'm definitely less hesitant about it now.
I have so much more respect for anesthesiologists since finding this channel. There sole focus is keeping you alive and comfortable during the most vulnerable hours of your life.
During surgery, everyone that is working in the room and usually talking, but are acutely aware of what is happening at all times, once that monitor’s beeps change even in the slightest, all staff is aware and concerned. The Circulating Nurse may even make that “emergency” phone call before the anesthesiologist asks them to as the O.R. Works as “team” and knows to “anticipate needs” and are always prepared.
Thank you for what you do and thanks to all those support you, letting you show all the equipment. That’s so helpful and amazing. I’m an anesthesia technician going to school to be a CRNA. I appreciate you!
I am so happy that there are good Dr.s such as yourself and very happy that Mount Sinai has put out wonderfully helpful videos as well. I wish all anesthesiologist were as well trained as you! I've met some horrible ones that's for sure!
Back in the mid 80s my mom was in the hospital with multiple health issues. One day a Dr. had ordered an IV to be administered. She had many collapsed veins, and the nurses were having a very difficult time finding a vein to "poke", including one of the Doctors who were in the ward. After a while they called in an Anesthesiologist to find a vein: he found one in less than two minutes, and made it look like "a walk in the park". I was really impressed, and since then have had a great appreciation for those individuals.
Great videos! As a tech nerd I wanted to give a minor correction. You referenced “blown fuse” a few times. It is very possible equipment would have fuses in them, but not the hospital power supply that feeds electrical receptacles. Those are protected by “circuit breakers”. Google the difference. While a minor technically, to an electrical geek like me it is not trivial. If you said “there is a blown fuse and I need it fixed stat before the patient crashes”, I would start looking on the back of equipment for the little fuse holders. The exception being a huge machine that pulls massive power might have a fuseable disconnect on the wall (looks like a bull switch). It seems from this experience basic electrical calculations would be helpful for doctors plugging in equipment. Each device should have a nameplate on it with the power demands. Look for “amps”. If amps is missing then look for “VA” (volt amps) or watts. Divide VA or watts by the voltage of the outlet (not the voltage marked on the machine as most accept multiple voltages) to calculate amps. Example 1200va would be 10 amps in the USA. 120 volts is for a standard outlet in USA. Add up the amps of all the devices you are plugging in and multiply by 125% as this allows for the necessary adjustments for “continuous load”. Example 5 amp machine + 5 amp machine = 10 amps. 10x 125% = 12.5 amps. A “normal electrical receptacle” circuit in a hospital in the USA would be rated for 20 amps, so the 12.5 amps calculated is acceptable. So all devices plugged in to receptacles on one branch circuit X 125% should not exceed 20 amps. Lastly you gotta make sure you are not fooled by more than one electrical receptacle (outlet) being wired to the same breaker. Every hospital I’ve been in has great labels on the Cover plate of the electrical receptacles. The number indicates the breaker. So learn the OR to see if each receptacle is on a dedicated breaker or if there is a pattern. The labeled circuit breaker numbers on outlets will be your friend when a breaker blows. Unplug all non mission critical devices and find an outlet with a different number and plug in the most mission critical device first, and add devices monitoring if any one added device blows the breaker as it could be a failed equipment device that is pulling more power than the nameplate. Perhaps bringing in the hospital electrician for a one day “crash course” would be wise for medical professionals to learn basic electrical troubleshooting and load calculations to avoid the incident on this video which was completely avoidable with basic electrical knowledge. Also, you used the term “short circuit” incorrectly. A short circuit means the electricity passed thru the wires before it reached its load, often because of a failed connection or cut wire. If you tell a hospital electrician “we have a short circuit” instead of turning the power back on, he will refuse as he could be blown up at the electrical panel due to an arc flash when flipping power on to a shorted out circuit. He would demand to fix the short first. Instead you simply “lost power due to overloading a circuit “. That would tell the electrician that some load needs to be moved to a different circuit and power restored. Thanks for your videos, learned a lot!!! :-)
This is really helpful information, thank you for taking the time to point out these details! I agree it would be a great idea to get a crash course from a hospital electrician.
We keep transport monitors in all the pods just in case we get this scenario. Take your pdm out of the monitor in the OR and put it in the transport. Back up in 30 seconds. You did great with what you had available. Great video.
I have worked for 20+ years in a very large ER here in the USA and it is nice to see a doctor who cares to educate non-physicians. Most care so little for "non docs" that after my 20+ years only two know my name.
It's good to know you prepped for this. I asked my pre op nurse what would happen of someone started randomly shooting up the hospitial or tried taking my Dr hostage what would happen. I have ptsd i think of catastrophic situations a lot. She assured me that they lock that area and it's hard for her even to get back there so it is protected area.
Really informative! I recently had emergency triple CABG....your RUclips gave me serious pause to (again) thank the team that saved my life! Awesome presentation!
He is very Right , once a problem came up with the monitoring and the ventilator while I was checking the patient , but what surprised me was that the OR was filled with ppl and nobody noticed or cared , then i knew I'm the only responsible for the patient's life
Appreciate that this video exists. Seems like most organizations won't allow any recording let alone like this. Informed people are generally happy and I appreciate knowing how this was handled. Stressful for all I'm sure
This is a great informative video. My hubby is a Biomed/ Clinical engineer. He is the one who work on the anesthesia equipment. He has been called into so many surgeries while patients are on the table.
You’ve given me the best reassurance about anesthesiology I’ve ever heard as a patient. Oxygen Carbon Dioxide Circulation Temperature Protocol in the OR Emergency procedures frequently reviewed Thank you to Mount Sinai for the transparency.
When I was the simulation professor at a nursing college, I spent a lot of time creating unexpected problems for my students. What if the power goes out during a procedure? What if your patient codes during a procedure? What if family members become violent? What if? What if? What if? It is so critical to have simulation in medical training. It doesn’t have to be a high def state-of-the-art facility. It can be an analog dummy in a 1980s track suit. But 99% of the time the panicked students placed the ambu mask upside down or did compressions distal or on top of the xiphoid process. Half of the time they were so focused on inserting a Foley or hanging heparin that they didn’t even notice that the monitors were alarming. Everyone in the medical field benefits from a lot of hours in the sim lab. I hope that education moves away from the virtual and into the live sim. Great video!!! I learn so much from your videos and I very much appreciate what you do. ❤️🙏🏽❤️
Dr. Feinstein, this is a great channel; thank you for it. You represent anesthesiology and Mt. Sinai very well. I'll second Josh's observation that Mt. Sinai helps everyone in this area.
This was a really great video! I was always scared about anesthesia because of the scary emergencies everyone refers to but this really made me appreciate that residency training is there to help you prepare for those moments. Really going to give anesthesia another look while in med school, thanks Dr. Feinstein :)
Thanks for the nice feedback! Yes, the training really kicks in and helps mitigate situations that would otherwise feel scary. I hope you enjoy your experience in anesthesia during med school!
Everyone always tells me how appreciative they are for my being calm in a crisis so I totally believe that if I were a doctor that is what I would’ve trained to be! Also I love seeing stories like this because my sister is a clinical engineer in charge of medical equipment installations and/or troubleshooting in hospitals and I find it completely fascinating to learn about all of the behind the scenes things like that which go on in hospitals that never get noticed/mentioned/talked about very much. Interesting stuff!
Nice job. I remember being told that my heart rate dropped during surgery. My doctor apparently asked the anesthesiologist was was up and he said I’m handling it.
I absolutely love your content! My 11 year old daughter has been really contemplating becoming an anesthesiologist so I’m excited to share your channel with her. You’re an excellent teacher!
This is such a helpful video, specifically the background on monitoring equipment! I am a scribe in the ED and I did not know how to interpret the monitoring equipment even though I see it every time I work. Thank you for this video! Subscribed and looking forward to your future vids!
I went into the hospital and had amazingly low blood pressure which they had to use lots of pressers. I think I recall while I was quite loopy that they hooked me up to a piece of equipment that had real time blood pressure readings. They also were using a special ultrasound to demonstrate getting a perfect IV done by monitoring the vein and needle. I seem to recall one specific person being called and demonstrating the equipment on me to other doctors and nurses.
You're doing a great thing. Having been in a hospital and being monitored before I was familiar with 4 out of 8 parameters. Completing my understanding of the monitoring equip. really makes me feel comfortable as a patient. You also have a smooth ease to understand voice. You could give Mike Rowe a run for his money.
I AM A RETIRED OPERATING ROOM NURSE. I BEGAN MY CAREER IN THE O.R. AT AGE 18 AS A SURGICAL OPERATING ROOM TECHNICIAN. I FIND YOUR VLOGS VERY INFORMATIVE. I ESPECIALLY LIKED THE VIDEO ON VETERINARIAN ANESTHESIA. I FOUND THE VETERINARIAN ANESTHESIOLOGIST TO BE GREATLY KNOWLEDGABLE AND LEARNED A LOT FROM THAT VIDEO. I WOULD LIKE YOU TO MAKE A VIDEO ON EMERGENCY OPERATING ROOM INCIDENTS. I SUGGEST, WHAT ANESTHESIA DOES WHEN A FIRE OCCURS ON THE PATIENT. THIS HAPPENED IN THE OPERATING ROOM WHERE I WORKED. I WAS NOT PRESENT DURING THE FIRE BUT WE ALL LEARNED FROM THIS UNFORTUNATE EXPERIENCE. THANK YOU AGAIN FOR YOUR INFORMATIVE VIDEOS.
I find that really fascinating, I've never encountered such myself during the course of my work, but one thing I did find fascinating was the concern regarding IV access. I had a robotic procedure done and because I hate hand IVs, there was a concern regarding IV access because they, at least at the hospital I had the procedure done at, strap down your arms close to your body and put foam around them to protect you from the robot as a protective measure, and that restricted their access to my IC because it was an AC IV, and they placed a hand IV while I was asleep to prevent issues that may have arisen.
Hi Michael, it's not uncommon for people to feel strongly opposed to IVs (nobody ever *wants* one, it's just a continuum of how much people don't want them). In those cases, we do exactly what you described-- get the most tolerable IV while the patient is awake, then get a second one once they're under anesthesia. We also take the same approach when we need one or two really big IVs but are having a difficult time finding a big enough veins. Interestingly, anesthesia causes veins to get wider so it's a lot easier to place additional IVs after someone is under anesthesia.
@@MaxFeinsteinMD Yeah, I deal with trauma patients mostly, so they are fairly easy going about it, especially when you tell them you can help with their pain lol. But I go to AC IVs by default, and than hand if that fails. It really depends, as we often get people with poor vasculature.
I've had outpatient surgery in early 2011 where I had to be put under general anesthesia at a hospital. I wouldn't want to be in a situation where, if I required surgery and was under anesthesia and the power went out in the OR, I would've been scared shitless. It's no wonder I have a major case of nosecomephobia. 2011 wouldn't be the last time I underwent anesthesia, however...
But if you were under anesthesia. You would be lucky to not remember or even know the power went out. Atleast hopefully lol. But I can totally get your worries and fears as I think deep down a lot of us have them also. Hopefully you remain well and can avoid the OR love! ☺️
But if you were under anesthesia. You would be lucky to not remember or even know the power went out. Atleast hopefully lol. But I can totally get your worries and fears as I think deep down a lot of us have them also. Hopefully you remain well and can avoid the OR love! ☺️
I am so happy that you have these videos they really enlighten us as to what's all involved in a surgery. Thank you showing us how important all functions of a surgery can entail
Great video, Dr. Feinstein! Keep them coming... this video in particular has great detail not often discussed in other anesthesia related videos I’ve seen.
Thanks for watching! Yes, I thought there was a lot of opportunity to discuss in greater detail what anesthesiologists do - I haven't seen a lot of it on RUclips.
OMG, I was seeing my orthopedic surgeon for a post-op, my state had just gone through a crazy overnight snow storm where a third of residents lost service. The alarm goes off, & all these OR folks are fire drilling outside in nothing but scrubs! They were freezing.
Great video. I remember the adrenaline rush hearing the "All Hands" alarm on the PA system speakers then subsequently getting knocked over by 4 attendings running past me in the operating room hallway
Yes I’ve been in one peds case when the attending called an all hands, come to think of it, maybe that was the one where you got run over by the 4 attendings.
Max Feinstein, MD Have you done a question and answer video yet? As a parent of a child with a disability that requires general anaesthetics from time to time I would find that really helpful 🙂
It’s always the little things, last month in a case the oximetry fell from 100 to 80 and we just couldn’t figure out why, after 5 very stressful minutes we finally notice that the oximeter was a little bit off the finger, I moved it a little and boom 100% again
As a medical electronics technician with 33 + years of experience, I’ve been dragged into theaters many times in an emergency. The first rule of fault finding is look. Regards, Paul (Uk)
Thanks for making this video and keeping up with the channel. Im working towards my CRNA. I appreciate the time you take to tell us your stories. Stay safe and stay healthy!
I’m a chef and i have been cooking since i was 3 but everytime i watch a video of yours I want to become a anesthesiologist it seems so fun and I love helping people. But I love cooking even more so I think I am going to leave it to the professionals😉
Great stuff. Have you ever addressed the measures an anesthesiologist takes to prevent fire, with all the flammable things and potential causes of fire in the operating room?
Always....oxygen and airway or oral or facial surgery and the use of a cautery or diathermy can cause an airway fire. U may reduce o2 amount in total or concentration by mixing more air. Also flammable skin preps and diathermy can cause a fire or burn
Thank u dr.max for sharing your knowledge and I'm so happy with it because soon I'll become anethesiologist if ever I can pass. Hopefully you can share more to us💕
❤️😎 Family member is an anesthesiologist, and the most easy going guy, but I see him as an undercover general, because when crisis hits, he gets things DONE! 🔥💪
In the UK your ODP (operating department practitioner) they are a nurse trained in Anaesthetics only or could be a scrub nurse trained in Anaesthetics and will sort you out in emergency, if things get really bad and standby generators don’t kick in we have a large torch on top of the anaesthetic machine. But that’s for more for surgeons use.
Love your channel and am hugely impressed by everyone's composure under pressure! Does that seem to come mainly through training in disaster scenarios, or some are naturally gifted, or a combination thereof?
Huge respect for anesthesiologists. But if that happens in our hospital, the surgeon would have gone balistic if anesthesia said to stop the otherwise stable surgery because the monitors stopped working..
Surgery is a team effort that should involve everyone working together to solve problems that come up. Sometimes a surgery needs to be put on pause for patient safety, and the surgeon most of all should understand that!
My anesthetist had a issue where all their monitors randomly decided to go full metric on Her. In her words "It got quite sporty for the Surgeon but I said it's ok..I was educated in Britian,He's fine'. I didn't know Anesthesia had a "oh S**t' number. Nice
@10:00 - No. A "short circuit" was not experienced at any time. An overload condition of a fused circuit results in a blown fuse (or tripped breaker). That is the result of too much current draw by connected equipment. A "short circuit" is a condition in which the source voltage is momentarily connected to the ground. Meaning, if you plug a fork in to an outlet, a short occurs. No load is seen by the source. A 'short circuit' is a direct path from source voltage to ground, or a short over a partial load to ground. Either way, it is a fault which needs repair, not just re-assigning of loads. By your account, what happened here, was a circuit over-load. More current (electrons flowing) was demanded by the plugged-in load (your stuff) than the wires, switches, breakers, fuses and maybe transformers could handle, and a safety mechanism shut you down. Mostly: People use the term "short circuit" as ubiquitously as people use the term "back pain". Usually they are incorrect.
Very interesting, in my day using a simple Boyle’s machine, and mark one eyeballs, we never faced that possibility. My how things have moved on, and what you perceive as your best friend could in a split second, become the opposite. Turn the power off and the modern world comes to a standstill-for what may seem like an eternity anyway. Thanks for sharing your time & presentation as a present day anaesthetist.
Max, I was a nurse for 30 years and a healthcare consultant for 19 and this video gave me new insight into the depth of anesthesia training and responsibilities. Do most of you go on to do pain management in your career?
Most do not go into pain but most that choose to do a fellowship pick pain medicine. But when you add up the ones who don't fellowship and don't fellowship into pain it's more than those who do
Huge respect to yourself, but also to Mount Sinai in allowing this sort of stuff, a lot of places don't and it's massively appreciated
Yes I agree 100%, I've gotten a lot of support from the hospital press department as well as the department of anesthesia!
@@MaxFeinsteinMD that's so cool!
@@MaxFeinsteinMD I love seeing all of this. I'm a tele/ICU nurse working towards med school and eventually Anesthesiology and your videos are awesome for my OR hunger, lol.
@@MaxFeinsteinMD Excellent video
Respect 100😎
It puts me at ease knowing anesthesiologists are being trained to identify and fix atypical problems like an equipment malfunction. This is something I have never considered going wrong in the OR.
I wouldn't have thought about it either until I started residency!
Mostly the nurses or techs that do the saving, trouble shooting and fetching new equipment
This is by far the most realistic anesthesiology RUclips channel. I’m loving it!
Thanks so much!
@@happycouch501 You do not tell the anaesthesiologist what too do !!!
I'm an Anesthesiologist from India. Keep up the good work about spreading awareness about the 'behind the curtains' work that we do 👍👍 . Anesthesia is all about Anticipation , preparedness, and in such situations we have to be cool,calm and swift !
Couldn't agree more with your description of what anesthesia is all about! Thanks for watching.
I love India
@@Coffeeisnecessarynowpepper she won't marry u
This video came just in time. I’m a premed and was beginning to question how I could ever be responsible for someone’s life especially in a time sensitive situation. But, this reassured me that I will one day get all the training necessary and that there’s nothing to be nervous about. Thanks Dr. Feinstein.
Hi Claude, I'm glad this video came right in time! There are definitely stressful times as a doctor, but being able to rely on the training you've gone through makes it possible to handle. I wish you well in your journey!
You are a natural teacher. You will I’m sure pass on your knowledge to many coming after you. Also I would feel so confident in your hands. Thanks for this channel!
Thanks for the nice feedback and for watching my videos!
Got so much respect for you man. I had my first ever operation today at the age of 34. I had my tonsils removed and I was nervous beforehand as i'd never been put to sleep before. The anaesthetist made me feel at ease before they put me to sleep and I know you guys do a very important job. The NHS here in the UK are incredible and i'm very thankful that we have a national health service so that we can get free health care.
I am a 4th year medical student applying to anesthesiology and am starting my anesthesia elective next week. This video is so informative and fun to watch! I love how you explained the different component of the monitor. Thanks for sharing!
Glad you enjoyed the video, best wishes for your rotation!
I had a melanoma WLE surgery and 2 lymph’s removed. They couldn’t do anesthesia because I have sleep apnea so they gave me fentanyl knowing I have extreme chemical sensitivities to many chemicals others can handle all the time. After surgery, they moved me/my table to a wall and a lady shook me to get me to breathe then only sat down telling me to breathe every once in a while. She was too lazy to stay standing up to move me despite me taking only one breath and I wouldn’t breathe again! I remember the dozen moments she’d say to breathe in a really bitchy tone and then nothingness again. Finally she told me to sit up which helped but I was slumped over, then finally she said to breathe deep-that finally put a thought into my head (the only one) that I needed oxygen to live and snap out of this so I started doing Wim Hoff rapid, deep breathing to save my own life. It was HORRIBLE. I knew not to complain to the hospital as I might need them again later with all my many serious health problems. Doesn’t that sound horrible? It seriously makes me feel less than dirt being ignored having respiratory failure over and over an sober and over and nurses saw me not breathing walking by and they saw me just dead basically after taking out my vent. I also probably found out I had an allergic reaction to some drug one phlebotomist accidentally told me while looking at my records. Then after my WLE split open and was infected, it pushed out 2 foreign objects; a black square plastic looking thing and blue/ turquoise yarn like girls used in the 50-70’s like in the Brady Bunch. I don’t even own turquoise clothes. So much medical abuse and it’s haunted me since. Why would they even do all that? Why not tell me I had a reaction? Do they seriously think I don’t remember basically dying a dozen times like a junkie? Who can I maybe later make a formal complaint to? I’m just scared with having Medicaid I’d be forced to go there again for surgery later for some reason.
@@youfinallyfoundwaldo1364 - You didn't actually die. If you are conscious enough to be scared of not breathing, you are too conscious to die. Opioid overdose would render you unconscious. Plus, they have Naloxone, so you were never in any danger. I'm sorry it was so scary though, most of the time people are euphoric on opioids.
@@youfinallyfoundwaldo1364 um, I think you’re just here for some attention, clearly. I couldn’t even read the entire novel you wrote because it was just all so ridiculous and made zero sense. But in the beginning, You keep saying you were “dying” because you “couldn’t breathe,” but then you mention being on a vent. Well, you don’t NEED to breathe if you’re on a vent. And I don’t know of any hospitals that would even put a vent IN under mild sedation alone. Again, so many things just do not add up. I’d go elsewhere (where there aren’t smart people who will see through your crazy ramblings right away) and see if THEY believe you.
@@ElectronFieldPulse see the comment I left
Interesting to say the least. I’ve always wondered how dire situations would be handled. The fact that you can call for assistance and fellow anesthesiologists come running is outstanding. You all do keep us alive during surgery! Our fate is in yours and those in the OR’s hands. Thank you!
Very nice of you to say! Thanks for following along with the videos.
My Loving GOD through his Loving Son my JESUS CHRIST has my life in his hands🙏🏾🙏🏾🙏🏾🙏🏾😇😇😇😇❤️❤️❤️❤️🙏🏾🙏🏾🙏🏾🙏🏾😇😇
I have to admit the mental image of an 'avengers assemble' scenario of all the nearby anesthesiologists made me laugh even though I'm sure it wouldn't be funny in an emergency. It is a huge relief that they can summon several extra pairs of hands and eyes as backup if needed.
I have so much respect for anaesthesiologists out of all the specialties. Things may go wrong but you guys handle it so calmly !!
Oh and shout out to Mount Sinai Hospital - NY for allowing you to film these very important and informative videos!
Yes 100% agree. Very grateful that they’ve been so supportive.
This reminds me of airplane pilot training where you learn to deal with abnormal and emergency situations then practice those procedures. Then, the day you experience said emergency, its no big deal because its not your first time recognizing the problem then working through its solution...I am not a medical professional but I latched onto your channel because I recently was a guest for a couple of days at the local hospital. Although I ended up not needing to visit the operating room, you have given me a lot of confidence that I would have been in good hands if that did happen. Thanks for making these high-quality, informative videos. I know its a lot of work for you to create them.
I don't know whether you're aware, but there are often many parallels drawn between flying and anesthesia. Completely agree with what you said. Glad you didn't need to go to the operating room and you're back out of the hospital. Thanks for following along with these videos!
The Elaine Bromiley case showed how medicine could learn from the airline industry's safety procedures.
These educational segments are awesome. I feel that many patients would be much less afraid to go into surgery if they had this knowledge. Kudos to you, the anesthesia department and hospital.
Thanks! Yes I'm lucky my department and hospital have been very supportive.
Thank you for sharing! I feel so much more comfortable after looking at your channel. I had 2 open heart surgeries and always had that fear of not waking up.
Unfortunately I might need a third surgery. For the most part I now feel more secured in knowing what anesthesiologist do and how you focus on the patient. Well Done Dr. Feinstein!
Thanks for watching! Glad you found these videos helpful and have a better sense of how closely anesthesiologists watch over their patients during surgery.
I can honestly say that your anesthesiologist is just or more important than a surgeon. I have been a nurse for over 30 yrs. When I had surgery myself I picked the surgeon and anesthesiologist.
Insightful video. I am head of Biomedical engineering at a hospital with 18 theatres. We had a similar problem, but the ventilator monitor on your GE blew. We had no idea what the vent was doing. Luckily we were closing. So the anaesthatist switched from mechanical ventilation to bagging, bagged the patient and we turned the gas all the way down until the MAC reading on the patient monitor went down to zero. In South africa we don't have resident and attending. The all self employed and work individually. So the first line is to call a biomedical engineer into theatre and assess and assist the doctor. Luckily I was able to swop out the machine for the rest of the day and replace the screen that afternoon. We are no changing all our GEs for Dragers.
I’ve had one major surgery and several minor procedures done, and this video gives me much respect for the Person Behind the Drape. It’s smart to train for the worst case, one in a lifetime occurrence, unlikely problem and be prepared than to be caught flat footed when the unexpected occurs. Good teacher!
Omg thank u so much for sharing this, as an aspiring doctor learning how to deal with unforeseen emergencies is essential! Ur systematic and calculated response was inspiring :)
Glad you found it inspirational! I appreciate your nice feedback.
Wow! Your calm bright even personality makes you such an amazing asset to their program. I can tell you from experience many are not as empathetic and highly doubt as level headed. You are extremely impressive. 😊
They REALLY need people with your extensive training in Dental offices that practice Sedation. Most of those people are terrible at what they do. This level of training is amazing.
I personally wouldn’t feel comfortable being given sedating medication by anyone who doesn’t have training and experience with advanced airway management.
Max Feinstein, MD why is it so common at dental offices that keep giving sedation to their patients? Many dental office even given general anesthesia during dental implants.
You’re not wrong. Plus I’ve seen cases where sedation dentistry has ended in patients in cardiac arrest due to unknown underlying issues that without preop testing aren’t discovered until to late. I was a stickler with who I chose for myself or my kids(their dentist refuses to do sedation dentistry on children outside of the actual hospital).
I’m an Anesthesia Technologist. I had taken my daughter to our dentist to have her 4 “wisdoms” removed. Near the end of her surgery, a car struck and knocked out the electrical power box outside of the small medical building. All of the lights and equipment shut off. The dentist immediately inform me that everything was ok, the surgery part had ended and my daughter was waking up. I noticed that my daughter was hooked up to a “transport monitor” showing a black screen. I asked the dentist why wasn’t the monitor on. He answered that all the electricity was out, as if I hadn’t noticed. I told him that the monitor should be on because it should have a battery back-up. He replied, “These have batteries?!!” Apparently the staff never knew what that “long rectangular thing” was and had kept it in a drawer instead of the monitor.
@@alanibarra1234 "goodbye, and you don't need to remind me about the bill, I'm not going to pay you. But see the bright side, you will avoid a lawsuit. Maybe."
Love this channel. Worked 50 years as a surgical tech. I always told people not to plug any surgical equipment in to the anesthesia machine or circuits !
This channel is awesome. Thank you for what you do, as well as the education you provide. I’m only ever going to be a patient, but it’s great to know what goes on behind the scenes.
Years ago, when I worked at a hospital as an electronics technician intern, during a surgery, they were using a blood circulation machine, and the fuse went. One of the technicians had to suit and scrub up, and sit on a stool, pushing the reset every few seconds, during the whole surgery. When the operation was over, the machine went into our lab where it was cleaned and repaired. The operation was successful and the patient was none the wiser.
As someone who has had 31 operations, 17 of which were on my head alone I have to say I love watching you videos. As someone who has spent the majority of my life in hospitals and ORs I alway enjoy seeing different equipment and the different setups in each one. While like you said most setups are identical I have seen some set up a bit different and with individual touches depending on what they like or need. Thank you sir for what you do, keep up the great hard work and keep making awesome videos. It’d be so fun to do a video with you somehow and talk to you about different medical procedures and stuff lime that. Keep being awesome.
When scary emergency situations like this pop up, then the most important thing is to always keep your cool. Then you need to depend upon your training for emergency situations like a machine outage. Job well done! You did exactly what you should do in a frightening situation, and that’s the best anyone can ask of you.
Thanks for the info. I live in Thailand as a teacher. I have an ex-college roommate and best friend who is currently working as an anesthesiologist in Scottsdale, AZ. His name is Jerry Tobias. What is interesting about Jerry is that he dislocated his 4th and 5th Vertebra in a gymnastics accident while we were roommates in college (we were both on the varsity team) and was paralyzed for months. He experienced a miracle and regained all function. Quite a person Jerry Tobias. I am happy to learn what type of things he does as an anesthesiologist from your vids. Thanks.
Jerry sounds like a lucky guy! Glad to know this video has shed a little light on his work. Thanks for watching.
Amazing!! Please say hi to Jerry
When the going gets tough....... the tough get going...... remaining calm in the face of an emergency, common sense which isn’t so common these days..... you Sir no doubt will be an excellent teacher...already are. All the best to you.......Not a Dr but got a lot of experience with isoflurane a long time ago. Was taught basically by OJT, and self study. I found the discipline very interesting so I learned as much as I could,and was very fortunate to have someone spend the time with me. Raptors not people :-)
Very cool, thanks for sharing! Is your username a throwback to Macintosh blades? What is OJT? Thanks for the nice feedback!
Through all of the “procedures” I have had (just had #40) I have never had an issue with an anesthesiologist, they have all seemed to be relaxed and on top of everything. They actually inspired confidence, that’s a good thing when you’re dealing with a. major surgery.
Hi! That's a lot of procedures!! I have never had a general anesthesia. I have a phobia about it but I need stuff done! Are you ever aware of the tube in your neck when you come back around? A friend said she was and if felt like she was choking. Scared me. Also heard that it hurts your arm a real lot when the anesthesia goes into your veins. Am i overthinking it all?
@@QueenNoTeetha151 I had the same concerns...talked to the surgeon and the anesthesiologist about these concerns. They explained exactly what was going to happen and I didn't feel or remember a thing.
@@phillipvansickle4220 Oh thats encouraging! I am glad it went well for you and it sure helps to know that! Hopefully I will be the same. Better to live in hope as they say than die in despair! lol
@@QueenNoTeetha151 I was terrified when I checked in. I let the staff know it was my first time and that I was extremely nervous. They put me at ease and made me feel very comfortable. The anesthesia itself was a strange experience. Not terrifying, but very peaceful...like waking up from the best nap I had ever taken in my life. Like you, I had put the procedure off for a long time until I finally had to get it done. I have to go under again for another procedure. I'm definitely less hesitant about it now.
I have so much more respect for anesthesiologists since finding this channel. There sole focus is keeping you alive and comfortable during the most vulnerable hours of your life.
During surgery, everyone that is working in the room and usually talking, but are acutely aware of what is happening at all times, once that monitor’s beeps change even in the slightest, all staff is aware and concerned. The Circulating Nurse may even make that “emergency” phone call before the anesthesiologist asks them to as the O.R. Works as “team” and knows to “anticipate needs” and are always prepared.
Thank you for what you do and thanks to all those support you, letting you show all the equipment. That’s so helpful and amazing. I’m an anesthesia technician going to school to be a CRNA. I appreciate you!
I am so happy that there are good Dr.s such as yourself and very happy that Mount Sinai has put out wonderfully helpful videos as well. I wish all anesthesiologist were as well trained as you! I've met some horrible ones that's for sure!
Back in the mid 80s my mom was in the hospital with multiple health issues. One day a Dr. had ordered an IV to be administered. She had many collapsed veins, and the nurses were having a very difficult time finding a vein to "poke", including one of the Doctors who were in the ward. After a while they called in an Anesthesiologist to find a vein: he found one in less than two minutes, and made it look like "a walk in the park". I was really impressed, and since then have had a great appreciation for those individuals.
Great videos! As a tech nerd I wanted to give a minor correction. You referenced “blown fuse” a few times. It is very possible equipment would have fuses in them, but not the hospital power supply that feeds electrical receptacles. Those are protected by “circuit breakers”. Google the difference. While a minor technically, to an electrical geek like me it is not trivial. If you said “there is a blown fuse and I need it fixed stat before the patient crashes”, I would start looking on the back of equipment for the little fuse holders. The exception being a huge machine that pulls massive power might have a fuseable disconnect on the wall (looks like a bull switch).
It seems from this experience basic electrical calculations would be helpful for doctors plugging in equipment. Each device should have a nameplate on it with the power demands. Look for “amps”. If amps is missing then look for “VA” (volt amps) or watts. Divide VA or watts by the voltage of the outlet (not the voltage marked on the machine as most accept multiple voltages) to calculate amps. Example 1200va would be 10 amps in the USA. 120 volts is for a standard outlet in USA. Add up the amps of all the devices you are plugging in and multiply by 125% as this allows for the necessary adjustments for “continuous load”. Example 5 amp machine + 5 amp machine = 10 amps. 10x 125% = 12.5 amps. A “normal electrical receptacle” circuit in a hospital in the USA would be rated for 20 amps, so the 12.5 amps calculated is acceptable. So all devices plugged in to receptacles on one branch circuit X 125% should not exceed 20 amps.
Lastly you gotta make sure you are not fooled by more than one electrical receptacle (outlet) being wired to the same breaker. Every hospital I’ve been in has great labels on the Cover plate of the electrical receptacles. The number indicates the breaker. So learn the OR to see if each receptacle is on a dedicated breaker or if there is a pattern.
The labeled circuit breaker numbers on outlets will be your friend when a breaker blows. Unplug all non mission critical devices and find an outlet with a different number and plug in the most mission critical device first, and add devices monitoring if any one added device blows the breaker as it could be a failed equipment device that is pulling more power than the nameplate.
Perhaps bringing in the hospital electrician for a one day “crash course” would be wise for medical professionals to learn basic electrical troubleshooting and load calculations to avoid the incident on this video which was completely avoidable with basic electrical knowledge.
Also, you used the term “short circuit” incorrectly. A short circuit means the electricity passed thru the wires before it reached its load, often because of a failed connection or cut wire. If you tell a hospital electrician “we have a short circuit” instead of turning the power back on, he will refuse as he could be blown up at the electrical panel due to an arc flash when flipping power on to a shorted out circuit. He would demand to fix the short first. Instead you simply “lost power due to overloading a circuit “. That would tell the electrician that some load needs to be moved to a different circuit and power restored. Thanks for your videos, learned a lot!!! :-)
This is really helpful information, thank you for taking the time to point out these details! I agree it would be a great idea to get a crash course from a hospital electrician.
We keep transport monitors in all the pods just in case we get this scenario. Take your pdm out of the monitor in the OR and put it in the transport. Back up in 30 seconds. You did great with what you had available. Great video.
Please keep making videos like this! They're educational, realistic, and super helpful to those interested in anesthesia (aka me)
That’s the plan! Let me know if there are any specific topics you’d like to see videos about, too.
I have worked for 20+ years in a very large ER here in the USA and it is nice to see a doctor who cares to educate non-physicians. Most care so little for "non docs" that after my 20+ years only two know my name.
It's good to know you prepped for this. I asked my pre op nurse what would happen of someone started randomly shooting up the hospitial or tried taking my Dr hostage what would happen. I have ptsd i think of catastrophic situations a lot. She assured me that they lock that area and it's hard for her even to get back there so it is protected area.
Really informative! I recently had emergency triple CABG....your RUclips gave me serious pause to (again) thank the team that saved my life! Awesome presentation!
Thanks for watching. Glad your surgery went well!
Great channel. I am also an Anesthesia intern . I wish our hospital had the same setup that you people have .
Love from Pakistan
Thanks for watching and good luck with the rest of your intern year!
You handled my Dads case at Mount Sinai, he was in good hands, thank you!
Max, thank you for demonstrating what your EMR looks like and the historical purpose.
He is very Right , once a problem came up with the monitoring and the ventilator while I was checking the patient , but what surprised me was that the OR was filled with ppl and nobody noticed or cared , then i knew I'm the only responsible for the patient's life
Appreciate that this video exists. Seems like most organizations won't allow any recording let alone like this. Informed people are generally happy and I appreciate knowing how this was handled. Stressful for all I'm sure
Although I'm a paramedic, if I ever decided to go through anesthesia school, I would want you as my mentor... Always stay on your 'toes'! Great video!
I first got interested in medicine when I was shadowing EMTs and paramedics, always thought that would be so cool. Thanks for watching!
This is a great informative video. My hubby is a Biomed/ Clinical engineer. He is the one who work on the anesthesia equipment. He has been called into so many surgeries while patients are on the table.
That's so interesting! It'd be cool to talk with a clinical engineer and learn about their experiences. Thanks for watching!
You’ve given me the best reassurance about anesthesiology I’ve ever heard as a patient.
Oxygen
Carbon Dioxide
Circulation
Temperature
Protocol in the OR
Emergency procedures frequently reviewed
Thank you to Mount Sinai for the transparency.
When I was the simulation professor at a nursing college, I spent a lot of time creating unexpected problems for my students. What if the power goes out during a procedure? What if your patient codes during a procedure? What if family members become violent? What if? What if? What if? It is so critical to have simulation in medical training. It doesn’t have to be a high def state-of-the-art facility. It can be an analog dummy in a 1980s track suit. But 99% of the time the panicked students placed the ambu mask upside down or did compressions distal or on top of the xiphoid process. Half of the time they were so focused on inserting a Foley or hanging heparin that they didn’t even notice that the monitors were alarming. Everyone in the medical field benefits from a lot of hours in the sim lab. I hope that education moves away from the virtual and into the live sim. Great video!!! I learn so much from your videos and I very much appreciate what you do. ❤️🙏🏽❤️
Dr. Feinstein, this is a great channel; thank you for it.
You represent anesthesiology and Mt. Sinai very well.
I'll second Josh's observation that Mt. Sinai helps everyone in this area.
This was a really great video! I was always scared about anesthesia because of the scary emergencies everyone refers to but this really made me appreciate that residency training is there to help you prepare for those moments. Really going to give anesthesia another look while in med school, thanks Dr. Feinstein :)
Thanks for the nice feedback! Yes, the training really kicks in and helps mitigate situations that would otherwise feel scary. I hope you enjoy your experience in anesthesia during med school!
Everyone always tells me how appreciative they are for my being calm in a crisis so I totally believe that if I were a doctor that is what I would’ve trained to be! Also I love seeing stories like this because my sister is a clinical engineer in charge of medical equipment installations and/or troubleshooting in hospitals and I find it completely fascinating to learn about all of the behind the scenes things like that which go on in hospitals that never get noticed/mentioned/talked about very much. Interesting stuff!
My granddaughter has always wanted to be an anastelogist. She is in gifted and has never had a B. Thank you for this.
Nice job. I remember being told that my heart rate dropped during surgery. My doctor apparently asked the anesthesiologist was was up and he said I’m handling it.
I absolutely love your content! My 11 year old daughter has been really contemplating becoming an anesthesiologist so I’m excited to share your channel with her. You’re an excellent teacher!
Thanks for your hard work in college and Med school which enables you to help your patients. Great videos too!
You are very knowledgeable and give me reassurance. That if this ever happened that it has been trained thoroughly. You make great well made videos.
This is such a helpful video, specifically the background on monitoring equipment! I am a scribe in the ED and I did not know how to interpret the monitoring equipment even though I see it every time I work. Thank you for this video! Subscribed and looking forward to your future vids!
Thanks for watching Lily! I rotated through the ED as an intern and really appreciated when there were scribes there to help.
I am not in the medical field, but I find this so interesting
I went into the hospital and had amazingly low blood pressure which they had to use lots of pressers. I think I recall while I was quite loopy that they hooked me up to a piece of equipment that had real time blood pressure readings. They also were using a special ultrasound to demonstrate getting a perfect IV done by monitoring the vein and needle. I seem to recall one specific person being called and demonstrating the equipment on me to other doctors and nurses.
Much respect Dr.! Ive had many surgeries and i know how much you and your job keeps me and many others alive!❤
You're doing a great thing. Having been in a hospital and being monitored before I was familiar with 4 out of 8 parameters. Completing my understanding of the monitoring equip. really makes me feel comfortable as a patient. You also have a smooth ease to understand voice. You could give Mike Rowe a run for his money.
I AM A RETIRED OPERATING ROOM NURSE. I BEGAN MY CAREER IN THE O.R. AT AGE 18 AS A SURGICAL OPERATING ROOM TECHNICIAN. I FIND YOUR VLOGS VERY INFORMATIVE. I ESPECIALLY LIKED THE VIDEO ON VETERINARIAN ANESTHESIA. I FOUND THE VETERINARIAN ANESTHESIOLOGIST TO BE GREATLY KNOWLEDGABLE AND LEARNED A LOT FROM THAT VIDEO. I WOULD LIKE YOU TO MAKE A VIDEO ON EMERGENCY OPERATING ROOM INCIDENTS. I SUGGEST, WHAT ANESTHESIA DOES WHEN A FIRE OCCURS ON THE PATIENT. THIS HAPPENED IN THE OPERATING ROOM WHERE I WORKED. I WAS NOT PRESENT DURING THE FIRE BUT WE ALL LEARNED FROM THIS UNFORTUNATE EXPERIENCE. THANK YOU AGAIN FOR YOUR INFORMATIVE VIDEOS.
Thank God for people like you and the training you receive.
I find that really fascinating, I've never encountered such myself during the course of my work, but one thing I did find fascinating was the concern regarding IV access. I had a robotic procedure done and because I hate hand IVs, there was a concern regarding IV access because they, at least at the hospital I had the procedure done at, strap down your arms close to your body and put foam around them to protect you from the robot as a protective measure, and that restricted their access to my IC because it was an AC IV, and they placed a hand IV while I was asleep to prevent issues that may have arisen.
Hi Michael, it's not uncommon for people to feel strongly opposed to IVs (nobody ever *wants* one, it's just a continuum of how much people don't want them). In those cases, we do exactly what you described-- get the most tolerable IV while the patient is awake, then get a second one once they're under anesthesia.
We also take the same approach when we need one or two really big IVs but are having a difficult time finding a big enough veins. Interestingly, anesthesia causes veins to get wider so it's a lot easier to place additional IVs after someone is under anesthesia.
@@MaxFeinsteinMD Yeah, I deal with trauma patients mostly, so they are fairly easy going about it, especially when you tell them you can help with their pain lol. But I go to AC IVs by default, and than hand if that fails. It really depends, as we often get people with poor vasculature.
Max you did a great job explaining and breaking down what happened.. nice video!
Thanks very much, glad you enjoyed!
I've had outpatient surgery in early 2011 where I had to be put under general anesthesia at a hospital. I wouldn't want to be in a situation where, if I required surgery and was under anesthesia and the power went out in the OR, I would've been scared shitless. It's no wonder I have a major case of nosecomephobia. 2011 wouldn't be the last time I underwent anesthesia, however...
Yes the hospital can definitely be a daunting place. I hope you're doing well health-wise!
But if you were under anesthesia. You would be lucky to not remember or even know the power went out. Atleast hopefully lol. But I can totally get your worries and fears as I think deep down a lot of us have them also. Hopefully you remain well and can avoid the OR love! ☺️
But if you were under anesthesia. You would be lucky to not remember or even know the power went out. Atleast hopefully lol. But I can totally get your worries and fears as I think deep down a lot of us have them also. Hopefully you remain well and can avoid the OR love! ☺️
I am so happy that you have these videos they really enlighten us as to what's all involved in a surgery. Thank you showing us how important all functions of a surgery can entail
Max, I always love to listen to you. I am watching three years from one this came out.
Your description is so comforting to me and possible patients. Thank you for your professionalism!
My wife is a resident anesthesiologist in Africa. Power outages are just part of the routine!
Anesthesiologists are true heroes!
Great video, Dr. Feinstein! Keep them coming... this video in particular has great detail not often discussed in other anesthesia related videos I’ve seen.
Thanks for watching! Yes, I thought there was a lot of opportunity to discuss in greater detail what anesthesiologists do - I haven't seen a lot of it on RUclips.
I'm so glad we have simulation training, really comes in useful for these kinds of emergencies!
Couldn’t agree more!
OMG, I was seeing my orthopedic surgeon for a post-op, my state had just gone through a crazy overnight snow storm where a third of residents lost service. The alarm goes off, & all these OR folks are fire drilling outside in nothing but scrubs! They were freezing.
I really appreciate all the effort you put on your videos! Thank you so much
It’s my pleasure, they’re fun to make and I’m glad you enjoyed!
@@MaxFeinsteinMD I am learning a lot from the comments too! Thanks Doc!
Great video. I remember the adrenaline rush hearing the "All Hands" alarm on the PA system speakers then subsequently getting knocked over by 4 attendings running past me in the operating room hallway
Yes I’ve been in one peds case when the attending called an all hands, come to think of it, maybe that was the one where you got run over by the 4 attendings.
@@MaxFeinsteinMD nah. It was a Neuro OR, and happened during induction
Great video, as someone who has had ten surgeries but still gets nervous going under general anaesthetic I found this really helpful. Thanks so much
Glad it was helpful!
Max Feinstein, MD Have you done a question and answer video yet? As a parent of a child with a disability that requires general anaesthetics from time to time I would find that really helpful 🙂
Wow, Max. Was it incredibly exciting story and I love the way it was handled. I really enjoy your videos. Keep them coming.
It’s always the little things, last month in a case the oximetry fell from 100 to 80 and we just couldn’t figure out why, after 5 very stressful minutes we finally notice that the oximeter was a little bit off the finger, I moved it a little and boom 100% again
Agreed, it’s often the tiniest detail that can throw something off. That pulse ox situation is very familiar to me haha.
bravo! excellent job dealing with an unexpected malfunction
As a medical electronics technician with 33 + years of experience, I’ve been dragged into theaters many times in an emergency. The first rule of fault finding is look. Regards, Paul (Uk)
Liked and subscribed. Starting CRNA school in august. This is super helpful
Oh,my God. I think this was quite frightening, but atleast awakening.
Thanks so much Dr Max.
I like your reasoning of situations.
Thanks for making this video and keeping up with the channel. Im working towards my CRNA. I appreciate the time you take to tell us your stories. Stay safe and stay healthy!
Thanks for watching! I appreciate the nice feedback.
I’m a chef and i have been cooking since i was 3 but everytime i watch a video of yours I want to become a anesthesiologist it seems so fun and I love helping people. But I love cooking even more so I think I am going to leave it to the professionals😉
Great stuff. Have you ever addressed the measures an anesthesiologist takes to prevent fire, with all the flammable things and potential causes of fire in the operating room?
Always....oxygen and airway or oral or facial surgery and the use of a cautery or diathermy can cause an airway fire. U may reduce o2 amount in total or concentration by mixing more air. Also flammable skin preps and diathermy can cause a fire or burn
As a commercial/ industrial service electrician this video hit different...😱⚡
Good stuff Doc...👍
Thank u dr.max for sharing your knowledge and I'm so happy with it because soon I'll become anethesiologist if ever I can pass. Hopefully you can share more to us💕
Thank you for following along!
glad to see you're getting more subs!
Yeah me too! Thanks for following along from the beginning.
❤️😎 Family member is an anesthesiologist, and the most easy going guy, but I see him as an undercover general, because when crisis hits, he gets things DONE! 🔥💪
In the UK your ODP (operating department practitioner) they are a nurse trained in Anaesthetics only or could be a scrub nurse trained in Anaesthetics and will sort you out in emergency, if things get really bad and standby generators don’t kick in we have a large torch on top of the anaesthetic machine. But that’s for more for surgeons use.
I agree with the other comments... this is a awesome channel! It's not only informative but it's very interesting as well. I am loving it too! :)
Love your channel and am hugely impressed by everyone's composure under pressure! Does that seem to come mainly through training in disaster scenarios, or some are naturally gifted, or a combination thereof?
Huge respect for anesthesiologists. But if that happens in our hospital, the surgeon would have gone balistic if anesthesia said to stop the otherwise stable surgery because the monitors stopped working..
Surgery is a team effort that should involve everyone working together to solve problems that come up. Sometimes a surgery needs to be put on pause for patient safety, and the surgeon most of all should understand that!
My anesthetist had a issue where all their monitors randomly decided to go full metric on Her. In her words "It got quite sporty for the Surgeon but I said it's ok..I was educated in Britian,He's fine'. I didn't know Anesthesia had a "oh S**t' number. Nice
@10:00 - No. A "short circuit" was not experienced at any time. An overload condition of a fused circuit results in a blown fuse (or tripped breaker). That is the result of too much current draw by connected equipment.
A "short circuit" is a condition in which the source voltage is momentarily connected to the ground.
Meaning, if you plug a fork in to an outlet, a short occurs. No load is seen by the source. A 'short circuit' is a direct path from source voltage to ground, or a short over a partial load to ground. Either way, it is a fault which needs repair, not just re-assigning of loads.
By your account, what happened here, was a circuit over-load. More current (electrons flowing) was demanded by the plugged-in load (your stuff) than the wires, switches, breakers, fuses and maybe transformers could handle, and a safety mechanism shut you down.
Mostly: People use the term "short circuit" as ubiquitously as people use the term "back pain". Usually they are incorrect.
Very interesting, in my day using a simple Boyle’s machine, and mark one eyeballs, we never faced that possibility. My how things have moved on, and what you perceive as your best friend could in a split second, become the opposite. Turn the power off and the modern world comes to a standstill-for what may seem like an eternity anyway. Thanks for sharing your time & presentation as a present day anaesthetist.
Max, I was a nurse for 30 years and a healthcare consultant for 19 and this video gave me new insight into the depth of anesthesia training and responsibilities. Do most of you go on to do pain management in your career?
Most do not go into pain but most that choose to do a fellowship pick pain medicine. But when you add up the ones who don't fellowship and don't fellowship into pain it's more than those who do
Awesome channel! I am interested in CAA school and love learning more about this awesome field.
Thanks for watching, and good luck with your journey to CAA school!
You are a hero, just saying.... We depend on people like you.