Ether - Enhancing Anesthesia Education

Dr. Kyle Harrison Uses LMA as Conduit for Aintree Catheter-assisted Intubation

Dr. Kyle Harrison shares his tips on using an LMA as a conduit for endotracheal intubation using the Aintree catheter. Please click on the photo above to view the multimedia presentation.

Pedro Tanaka Teaches Retrograde Wire Intubation Technique

Dr. Pedro Tanaka gives a great demonstration on establishing an airway using a retrograde wire technique. Please click on the photo above to view his lecture given at the Advanced Airway Workshop in Beijing!

Jeremy Collins Teaches McGrath Video Laryngoscope

Dr. Jeremy Collins gave a great lecture and demonstration on the use of the McGrath video laryngoscope. Please click on the photo above to view a multimedia presentation of his lecture!

Hands on Advanced Airway Workshop

Today marked the beginning of the hands-on portion of the airway workshop. Swarms of Chinese anesthesiologists flocked to six different advanced airway stations staffed by Stanford Anesthesia faculty.

Dr. Kyle Harrison demonstrated the technique of utilizing an LMA as a conduit for Aintree catheter-guided intubation.

Dr. Jeremy Collins demonstrated three techniques: McGrath video laryngoscope, Airtraq, and the Glidescope.

Dr. Pedro Tanaka demonstrated retrograde wire intubation as well as percutaneous tracheostomy.

Dr. Lee Hanowell demonstrated fiberoptic intubation techniques. And Dr. Cosmin Guta demonstrated the light wand and rigid Levitan FPS (first pass success) technique.

Stanford Anesthesia in Beijing

Stanford Anesthesia is in Beijing conducting an airway workshop in conjunction with the faculty at Peking Union Medical College. The workshop is scheduled for November 6 - November 8, 2009. Faculty members, Dr. Jeremy Collins, Dr. Larry Chu, Dr. Lee Hanowell, Dr. Kyle Harrison, Dr. Pedro Tanaka, and Dr. Vladimir Nekhendzy were invited to attend and participate in the meeting.

The first day of the meeting started with opening ceremonies began with introductions from numerous luminaries in Chinese anesthesia, and Chairmen from various departments across the country.

This was followed by a highly innovative "live demonstration" where video cameras in the Peking Union Medical College operating rooms captured placement of an endotracheal tube using a Glidescope in real time to the audience in the lecture hall. Dr. Vladimir Nekhendzy was invited into the operating rooms to provide his expert opinion and feedback to faculty regarding the use of the Glidescope in the demonstration.

Several very interesting cases were presented by the Chinese faculty and discussed by Drs. Jeremy Collins, Vladimir Nekhendzy and Lee Hanowell. One particularly interesting case involved anesthesia for a patient with complete airway obstruction due to laryngeal polyps. The audio and slides from the discussion are available on the difficult airway portion of Ether.

I will be live-blogging from the workshop while we are here in Beijing. Please check back often for additional updates. See you back in the US soon!

Ether Quiz #6: The Parturient for Surgery

Welcome to the sixth Ether Quiz. I'm happy to announce our first Ether Quiz produced by a "virtual" visiting faculty member. I've invited Dr. Andrea Fuller, Assistant Professor; University of Colorado at Denver Health Sciences Center; Department of Anesthesiology to present this month's quiz.

Dr. Fuller is a member of the obstetric anesthesia faculty at UCHSC. The goal of these short trivia questions is to engage our readers and spark a life-long interest in anesthesia education. The game is simple: post your answer in the comments section below (make sure to include your name and email). Comments are not displayed immediately so that everyone has a fair chance to play. The first correct answer (as indicated by the comment timestamp) is the winner.

The prize: a $5 Starbucks gift card and bragging rights in the next Ether update! Only Stanford anesthesia residents and fellows are eligible to get the prize. All correct answers will receive acknowledgment in the next Ether update!

Please note, your comments will be posted for the contest, but will not be shown to visitors so that everyone can have a chance to play. The answer will be posted next month.

To play, click on the "Comments" link below and fill out the contact form and your answer.

Answer to Ether Quiz #5

Answer
Please see the graphic above for the answers to Ether Quiz #5. You can also view the interviews online by clicking here.

Quiz #4 Rankings (Resident Win in Bold)

Overall Rankings (All Time)

Ether Quiz #5: How well do you know your attending?

Welcome to the fifth Ether Quiz. The goal of these short trivia questions is to engage our readers and spark a life-long interest in anesthesia education. The game is simple: post your answer in the comments section below (make sure to include your name and email). Comments are not displayed immediately so that everyone has a fair chance to play. The first correct answer (as indicated by the comment timestamp) is the winner.

The prize: a $5 Starbucks gift card and bragging rights in the next Ether update! Only Stanford anesthesia residents and fellows are eligible to get the prize. All correct answers will receive acknowledgment in the next Ether update!

Please note, your comments will be posted for the contest, but will not be shown to visitors so that everyone can have a chance to play. The answer will be posted next month.

To play, click on the "Comments" link below and fill out the contact form and your answer.

Answer to Ether Quiz #4

Answer

The most likely cause of this patient's immediate deterioration is sudden mitral regurgitation secondary to papillary muscle dysfunction resulting in the characteristic "V" wave on the PCWP tracing. On POD#1, the most likely cause of the papillary muscle dysfunction would be from myocardial ischemia. On POD#3, the most likely cause of the finding is mitral regurgitation secondary to papillary muscle rupture. This constellation of findings is due to myocardial infarction causing initial papillary muscle ischemia which leads to eventual rupture of the chordae several days later. The important teaching point is that myocardial ischemia resulting in papillary muscle dysfunction is potentially reversible through timely and appropriate medical interventions. However, chordal rupture of the papillary muscle is a surgical emergency and requires mitral valve replacement or repair.

Quiz #4 Rankings (Resident Win in Bold)

All Time Rankings

Recipes for Neuraxial Anesthesia

QUESTION: A Stanford anesthesia resident writes:

Everyone seems to have a different recipe for spinals. I have checked the few books I have (more on the way) and was wondering if there was a good paper or reference for what local you use, how much, +/- opioid. Same for epidurals (I have not done OB yet). Now that I can get the needle in I can start to worry about what to actually give them. (: