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Although anesthesiology is a first-level clinical department, in the eyes of most people, we are just a supporting role
.
Take this new crown epidemic as an example, tracheal intubation is the most dangerous operation, involving almost all transmission routes, especially the legendary aerosol.
Therefore, the first-line anesthesiologists are called death squads, but they are rarely seen.
People report and follow
.
In the eyes of others, anesthesia is just a shot or intubation, and there is not much technical content.
In the eyes of a surgeon, a good anesthesiologist is: omnipotent, responsive, pours on anesthesia, wakes up with a shot, and has Many heroic deeds (successful rescue)
.
The good anesthesiologist in the eyes of the director of the anesthesiology department is: low-key, cautious, safe, not to cause trouble, not to take risks, to be independent, not to follow blindly, to report frequently, and to work indifferently; in short, the farther away from the cliff, the better.
.
Practitioners pay attention to realm and constantly break through themselves before they can become a master, and anesthesia also has different realms
.
The first realm: to maintain the stability of the breathing and circulation; the second realm: the protection of important organ functions; the third realm: to improve the prognosis of patients; the fourth realm: to form a guide, which has a broad guiding significance
.
Let me talk about the first state: to maintain a stable breathing cycle
.
This is the most basic requirement, and it seems to be easy to do
.
We often see that the indicators on the monitor are normal, but are you seeing real? For a person with a basic heart rate of 54 beats/min, you have to increase the heart rate to 84 beats/min; for a patient with high blood pressure, you give him a controlled blood pressure drop to about 90mmHg; an obese patient with a tube intubation Pulse oxygen is 100%, blood gas analysis oxygen partial pressure is 200mmHg; a lean young woman's blood pressure after anesthesia is 80mmHg, you are in a hurry, colloid, ephedrine, dopamine are all up.
.
.
Let's talk about the second level: important organs Functional protection
.
A patient with low blood pressure received fluids, pumped dopamine, reduced anesthesia, and given foot muscle relaxants.
The monitoring was very good
.
But will he know it during surgery? What is the urine output and kidney function? A patient with myocardial ischemia, have you reduced the end-breathing carbon dioxide to 20mmHg, have you considered how your heart feels? Have you paid attention to his intracranial pressure during the long-term laparoscopic surgery with the head down and the feet high? Let me talk about three levels: to improve the prognosis of patients
.
Can anesthesia improve the patient's prognosis? For example, if a parturient with pulmonary hypertension undergoes a cesarean section, you will have to go to the ICU if you are given general anesthesia.
If you have an epidural, it may be difficult during the operation, but the postoperative recovery is good
.
For example, if glioma is awakened during surgery, if it is done well, it will send charcoal in the snow.
If it is not done well, it will add fuel to the fire
.
Let's talk about the last state: to form a guide, which has universal guiding significance
.
This is too difficult.
You have to have a high degree of education, a high professional title, and a high prestige, and then the results of your research can be copied and recognized
.
I thought that Chinese medicine was more conservative and emphasized on inheritance, even hereditary
.
Later, I discovered that anesthesia is sometimes the same.
Some teachers summarized a lot of practical things, but they couldn’t promote them; the reasons are: one is that they are not good at writing articles for promotion, and the other is that even if they want to promote, they are worried about being caught because of their lack of academic status.
Siege, it is better to be rotten in the stomach, waiting for the destined person
.
It's hard to be a doctor, but it's even harder to be a good doctor
.
You have to be familiar with women and children inside and outside, have a solid professional background, have strong psychological quality, have superb communication skills, and have the ability to respond quickly; be able to face dangers, be good at summarizing, understand philosophy, know the law, and keep up with the pace of the times
.
Author: Yan Bo Editor: Jiang Jianfeng from "Entering the World of Medical Aesthetics and Anesthesia"
.
Take this new crown epidemic as an example, tracheal intubation is the most dangerous operation, involving almost all transmission routes, especially the legendary aerosol.
Therefore, the first-line anesthesiologists are called death squads, but they are rarely seen.
People report and follow
.
In the eyes of others, anesthesia is just a shot or intubation, and there is not much technical content.
In the eyes of a surgeon, a good anesthesiologist is: omnipotent, responsive, pours on anesthesia, wakes up with a shot, and has Many heroic deeds (successful rescue)
.
The good anesthesiologist in the eyes of the director of the anesthesiology department is: low-key, cautious, safe, not to cause trouble, not to take risks, to be independent, not to follow blindly, to report frequently, and to work indifferently; in short, the farther away from the cliff, the better.
.
Practitioners pay attention to realm and constantly break through themselves before they can become a master, and anesthesia also has different realms
.
The first realm: to maintain the stability of the breathing and circulation; the second realm: the protection of important organ functions; the third realm: to improve the prognosis of patients; the fourth realm: to form a guide, which has a broad guiding significance
.
Let me talk about the first state: to maintain a stable breathing cycle
.
This is the most basic requirement, and it seems to be easy to do
.
We often see that the indicators on the monitor are normal, but are you seeing real? For a person with a basic heart rate of 54 beats/min, you have to increase the heart rate to 84 beats/min; for a patient with high blood pressure, you give him a controlled blood pressure drop to about 90mmHg; an obese patient with a tube intubation Pulse oxygen is 100%, blood gas analysis oxygen partial pressure is 200mmHg; a lean young woman's blood pressure after anesthesia is 80mmHg, you are in a hurry, colloid, ephedrine, dopamine are all up.
.
.
Let's talk about the second level: important organs Functional protection
.
A patient with low blood pressure received fluids, pumped dopamine, reduced anesthesia, and given foot muscle relaxants.
The monitoring was very good
.
But will he know it during surgery? What is the urine output and kidney function? A patient with myocardial ischemia, have you reduced the end-breathing carbon dioxide to 20mmHg, have you considered how your heart feels? Have you paid attention to his intracranial pressure during the long-term laparoscopic surgery with the head down and the feet high? Let me talk about three levels: to improve the prognosis of patients
.
Can anesthesia improve the patient's prognosis? For example, if a parturient with pulmonary hypertension undergoes a cesarean section, you will have to go to the ICU if you are given general anesthesia.
If you have an epidural, it may be difficult during the operation, but the postoperative recovery is good
.
For example, if glioma is awakened during surgery, if it is done well, it will send charcoal in the snow.
If it is not done well, it will add fuel to the fire
.
Let's talk about the last state: to form a guide, which has universal guiding significance
.
This is too difficult.
You have to have a high degree of education, a high professional title, and a high prestige, and then the results of your research can be copied and recognized
.
I thought that Chinese medicine was more conservative and emphasized on inheritance, even hereditary
.
Later, I discovered that anesthesia is sometimes the same.
Some teachers summarized a lot of practical things, but they couldn’t promote them; the reasons are: one is that they are not good at writing articles for promotion, and the other is that even if they want to promote, they are worried about being caught because of their lack of academic status.
Siege, it is better to be rotten in the stomach, waiting for the destined person
.
It's hard to be a doctor, but it's even harder to be a good doctor
.
You have to be familiar with women and children inside and outside, have a solid professional background, have strong psychological quality, have superb communication skills, and have the ability to respond quickly; be able to face dangers, be good at summarizing, understand philosophy, know the law, and keep up with the pace of the times
.
Author: Yan Bo Editor: Jiang Jianfeng from "Entering the World of Medical Aesthetics and Anesthesia"
