I'm such a dinosaur
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I've commented on how things are progressing in medicine and anesthesiology. The move toward regional anesthesia and blocks has been relentless in the last 10 years. I was never trained in these techniques and learned to most of my blocks "blind." Similarly, sticking a needle into the internal jugular vein, placing an epidural were all done by "feel," skill and experience.
The advent of ultrasonography has changed all that. The idea of actually being able to SEE the vein you're trying to find.
Amazing.
An ad came across my twitter feed this afternoon. A handheld ultrasound probe that links to your phone. You can see the heart, great vessels, whatever with something the size of a baseball.
Amazing, brave new world.
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@Mik said in I'm such a dinosaur:
I knew about using ultrasound but not on a phone.
That's sort of my point. When I would do blocks (femoral nerve block) if I couldn't find the nerve, I'd ask for the ultrasound machine to be WHEELED in so I could (perhaps) see where I was putting the needle. The machine was on a cart.
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I used to be pretty good with a needle.
As a resident, I was at about 80% successful with axillary blocks.
Internal jugular? About 95%.
Arterial lines? Even better.
Epidurals/Spinals? I can count on the fingers of one hand (well, maybe two) the number I couldn't get in - even if it took me a while.
I saw a tweet by an anesthesiologist who said she was 100% successful with epidurals/spinals, and never bothered to "touch" the patient to find where the bones were - using ultrasound.
I was good in my day, but that sun has set, and I'm a dinosaur.
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And I imagine you have mixed emotions about that.
It’s not great to be the ‘dinosaur’, but at the same time it’s great to see progress.
@jon-nyc said in I'm such a dinosaur:
It’s not great to be the ‘dinosaur’, but at the same time it’s great to see progress.
You've said that before.
When our group lost its contact, one of my partners ended up in a place with a LARGE group.
He said, "You wouldn't believe where these young guys are sticking needles with ultrasound."
I feel like, today, I could no longer practice. That's probably a good thing, now that I'm years out.
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@jon-nyc said in I'm such a dinosaur:
Yeah but you’d learn the new tricks in 4-6 weeks.
Exactly. It is pretty obvious that you are a smart guy, and if you continued to work in your specialty, you would have picked up these new things as they came along.
I'm sure a doctor that retired about the time you started, and was still alive when you retired would be amazed at the advances that had taken place over the time of your career.
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goddamn blocks add ten minutes to getting the case going. Bah humbug.
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goddamn blocks add ten minutes to getting the case going. Bah humbug.
@bachophile said in I'm such a dinosaur:
goddamn blocks add ten minutes to getting the case going. Bah humbug.
And how much time do they save in postop care?
