Induction of general anesthesia explained step by step

[@MichaelMinhLeMD]

Absolute blast to be a part of this video - we're witnessing the coming of the greatest Anesthesiologist educator of the 21st century

[@MaxFeinsteinMD]

Thanks for the great idea and for running the simulator!

[@andrewpatrick4254]

@@MichaelMinhLeMD Dr. Le-bouncer aka guy at the door

[@southparklion]

You're not going to win any Emmys for Best Circulating Nurse without playing music and surfing Facebook.

[@valeriecarpenter3800]

Agree

[@NDMD]

Ok this is so sick. Literally making the videos I would want to make in the future, and I don't think I'm ever going to be able to top your simplicity and unique way of educating patients and future anesthesiologists alike. Bravo Max 👏

[@richardsimms251]

A hospital cannot function without these guys. Lucky to have them !!

[@brendensolis5349]

Dr. Feinstein, you are a true star of the medical community. Please don't ever stop making content, this is truly priceless.

[@wotan10950]

Very informative. I have had too many surgeries in the last five years, but the most difficult one was the cardiac ablation. After the operation, which lasted five hours, the surgeon said that the first thing he does when the patient goes under is to try to induce A-fib. He said, “But you immediately went into A-fib spontaneously on your own!” I said, “I try to help out wherever I can.”

[@DanielElwell]

Same happened to me with that procedure!

[@Just1Nora]

I laughed probably too hard at this. I say very similar things. "Just trying to make y'all's lives easier." Is probably my go to. I haven't had a cardiac ablation, but I've had between half a dozen and a dozen various procedures with sedation or general anesthesia. A bunch more if you count non-sedated infusions. I always try my best to keep things smooth on my end. 😅 MPs have things hard/stressful enough without me causing problems.

[@Whyamisomisrable12]

What's A_fib

[@DanielElwell]

@@Whyamisomisrable12 a-fib is short for atrial fibrillation, which is a type of irregular heartbeat

[@bethb9248]

Great. I'm going in for one of these in two days and now I'm scared of this part too. Ugh.

[@bethb9248]

I just had a pulsed field cardiac ablation for AFib three days ago. I tortured myself for weeks with anxiety. I kept finding out about things I'd never heard of, like propofol burning, waking during intubation or extubation, teeth getting broken from intubation and, worst of all, being awake during anesthesia. Being helpless and paralyzed, the idea of it, made me an absolute wreck for weeks. But somehow, learning through these videos exactly how things are done and why, understanding how well anesthesiologists are trained, that started to give me some comfort and confidence in the procedure. I was still a semi-wreck at the hospital, but conferring with the anesthesiologist helped -- thank god she was patient and understanding with me -- and then everyone in the procedure room likewise being kind and patient and understanding helped tremendously. I felt safe and protected. When the anesthesiologist said "Okay, I'm going to give you the calming medicine," I knew that would be the midazolam, and I expected to feel a slow fading out but WOW, it was lights out, bam! lol It felt like only ten or fifteen minutes later I was waking up, warm and cozy in the PACU with zero pain, zero nausea, zero shivering, zero of all the problems I worried about. (I was out for 2 hours 30 minutes.) I had pretty significant throat pain for two days and was surprised at the marks on the back of my throat, and I had a cut on the inside of my mouth, but that was it. I'm just amazed at how well it all went. I've studied the doctor's postop report, and there were TWELVE different medications used. Now I know what they all are and, believe me, I appreciate each one of them! :) This is a long post, but for anyone who's fearful, too, I hope you get a little comfort from this. Talk to your doctor and trust in them. They're amazing. They have to be or they wouldn't be in the job they're in. And thank you, Dr. Feinstein, for your calming, thorough presentation of information.

[@Hiyori___]

My dream job when I was younger was to become an anesthesiologist. I didn't become one but that doesn't mean I cannot enjoy such high-quality related content. The internet is an amazing thing. Thank you for this video Doctor.

[@millenniumbryan]

Max, I have a video suggestion for you: I've been watching my 600lb life and wonder if you can make a video explaining the challenges of anesthesising a bariatric patient

[@kenpokid10]

Seconded, I think this has potential to be pretty interesting!

[@sarahgoldie7994]

thrid that

[@ChrisRRT]

Fourth that

[@misterhat5823]

I read that as 600lb wife.

[@PaulLoveless-Cincinnati]

I also agree this would be interesting. Airway management and heart monitoring is probably number 1 concern on a bariatric patient.

[@KirstinRN]

Love the mannequin’s eyes shutting on cue at 4:06. That’s such a cool lab simulation set-up you have there!

[@AmandaMagana]

as a med student interested in anesthesiology so grateful this content exists! tysm

[@notgump1312]

My OR rotations were by far my favorite part of clinicals for Paramedic school. Getting to shadow anesthesiologists and practice intubation under their skilled observation was such a great experience to have as a student. I got a ton of good advice from the doctors.

[@F-R78]

Hi Max. I'm lying in my hospital room in England, about to face an anaesthetic today in a few hours. I've never had one before and I'm really nervous about it. I'm totally blind woman, nearly 40. So obviously from the visual side of things, I can't actually see your videos. But I don't need to, your commentary is brilliant. Thanks! But watching your videos has comforted me somewhat. And there are a few concerns I have which you seem to have addressed in your videos so I want to check them out. Needless to say I can't sleep, and it's now 4 am just gone.

[@JamesYuen-bh5lq]

Do not trust someone that says totally

[@jennykvox]

Anesthesiologists are my heroes (retired Paramedic and current ER RN). They’re the top of the top!

[@jo1e-de-v1vre]

Incredible video, doctor! I appreciate you showing the uninterrupted anesthetizing before your annotated one. Would love to see more videos like this, showing complications patients may encounter.

[@geoneerayad9025]

i’m genuinely so thankful that you do this type of content doc. you don’t understand how much it helps. not just understanding anesthesia but also motivating me to become a doctor! i’m a first gen eldest daughter from egypt and it’s been a dream since i was little girl to become a doctor. im a rising senior in high school right now and i’ve been researching everything about my future! so these types of videos are EXTREMELY helpful 💗 thank you for all you do!

[@Nunofurdambiznez]

Absolutely fascinating stuff!! Had no idea the anesthesiologist was doing all those things during surgery!

[@Retiredtraveler1961]

Very nice job Max. I’m a retired RN with 40 years experience trained in ACLS and ATLS. I’ve had surgery several times. I appreciate you explaining in detail your sequence of actions and the drugs used.

[@feversol]

Thank you. I’ve seen a few of your other videos. This one is especially important to me as I’m having a parotidectomy in four days. I like to know what is going to happen and what to expect. In understanding this process, I know I may feel a mild sore throat in the day or so after surgery and know that it is expected and normal. I’ve had several surgeries without really understanding the paralyzing part. Again, I want you to know that your videos are appreciated apparently by a wide range of people as well as us patients who have no medical background. That is probably why you make them but I did want to express my appreciation. I’m anxious about this upcoming surgery. I’ve had no issue with anesthesia but I still like to know what you folks will be doing while the lady is filleting my face.

[@kthewhite7453]

Agreed. I've always found anaesthesiologist to be the least aspect explained to a patient during surgery and waking up with an unexpected and unplanned sore throat, or the taste of chemicals everytime you exhale is kinda annoying. I've had so many questions about anaesthesia that was finally answered in this video.

[@jaydenp4975]

I had surgery 4 days ago and had major anxiety. The doctor injected clear stuff that made me feel drunk. Then it was lights out. I had no oxygen mask while awake. Guess they knocked me out first? I was still on the gurney and freaked out when wheeled in and saw the buffet table of “tools” to be used. Omg I was terrified. Woke up groggy and head back and forth. Had oxygen in nose and leg compressors on. Sore throat for 2 days from tube. Hard to swallow and severe abdominal pain. Had laparoscopic gall bladder surgery. Felling better day by day but this has been not what i expected.

[@mhenderson9311]

I also saw no oxygen mask while awake. General surgery.

[@sherryannstowell271]

Dr. Feinstein, thank you so much for your very informative videos, especially this one but I’ve also learned a lot from your other videos as well. Recently, i got hip replacement surgery, and the information you provided on your videos helped to ease my mind regarding the whole process of sedation. Generally speaking, I’m an anxious person but watching your videos (over and over) I felt so assured going through the induction process that my mind was eased. I went comfortably down saying to myself, “ok, he said something about the oxygen mask…yes he was right about the ‘warmth’ sensation of the propylfol/milk of amnesia…” it was a positive experience going through the whole process, and I thank you for providing that information to ease my mind. God bless you.

[@Vintagecouturebags1]

I have had anemia for the last five years, which I just now found out is due to Cameron lesions caused by a huge hiatal hernia. I am terrified of surgery. I am 55 years old and I’ve never had surgery. I guess you could say I have PTSD from it when my sister went under anesthesia and never came out of it and passed away.This has definitely convinced me to not have the surgery! I had no idea that you literally quit breathing!

[@eugenio5774]

how interesting! I underwent surgery to remove my gallbladder one week ago, the anesthesia worked so incredibly fast! from when they put the oxygen mask on me, I barely had the time to say "my head is spinning, what's happ-" and I woke up in the recovery room.

[@vidad3820]

Just here to say congrats! I've been watching your content for quite some time, and it's pretty cool to hear you say "I'm an anesthesiologist," rather than a resident. :)

[@KishoreRajput32]

Awesome Video, I am Anaesthesiologist Assistant (AA) from India 🇮🇳

[@eddyvideostar]

Dear Kishore, Would bradycardia hinder the qualifications for a patient's surgery?

[@darriontunstall3708]

Wow this video was very very cool and amazing! I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college because of my cerebral palsy, I really wanted to be a anesthesiologist, it takes a special person to be a anesthesiologist or CRNA and you’re one of them, I look up to all anesthesiologist and CRNA! I really enjoyed this video! I have had 15 years because of my cerebral palsy, that’s one reason I wanted to be an anesthesiologist and I love the hilarious patient and I love helping people! You rock

[@92944889294488]

As a 4th year student preparing for auditions this was so helpful thank you Doctor!!

[@mhenderson9311]

Dr Feinstein, just want to say how much I appreciate you sharing these videos with the public as well as with students! Last year I had surgery and I certainly didn’t expect a "Spanish Inquisition” pre-surgery from the anesthesia resident! Almost as if I was on street drugs and didn’t want to admit it! I had no questions to ask, so I kept quiet and didn't have much idea what was going on. It all makes a lot more sense now.

[@FrankLucas-eq1os]

I recently started my anaethesia appointment & your videos helped me in big way. Thank you.

[@joannetucker1538]

You guys are amazing. That looks terrifying in terms of responsibilities and things that can go wrong

[@wxkat]

When I had general anesthesia for a tympanoplasty/mastoidectomy in March, the last thing I consciously remember was the anesthesiologist injecting midazolam into the IV. I had a brief memory/dream of talking to a couple people about the surgery while I was lying on a gurney, then found myself in recovery. The surgery took almost 5 hours but to me felt like no more than a couple minutes.

[@awhatsname]

I have gallbladder surgery coming up, and I am most worried about the anesthesia part (and picking up Covid during a surgery again, ugg). This was a very cool and informative video! It's nice to know about the Propofol burning. When I received it during a previous procedure, I wasn't given any heads up that a drug was being administered so the last thing I remembered before falling asleep was the pain and thinking "oh !%$* something is wrong".

[@tylervalentine6401]

this is really cool video and then seeing in a first person point of view is even cooler!! thank you so much for sharing all your awesome videos and for putting all the effort in making them!

[@Godfavorsmi]

As a respiratory therapist it’s most important that the tube is secured but I do not approve of the tape job 😭 my dentist informed me of considering AA school vs dental school; which has been a long time goal/ passion of mine, but this is something definitely worth considering !🤩🤩

[@ckuethe]

my anaesthesiologist just called to ask if I have any questions before my surgery tomorrow. I resisted the urge to say "I'm a KZbin certified anesthesiologist from watching Max's videos!" It was nice to have the opportunity to ask for more specific information from my actual doctor, with a bit of background to help me ask smart questions and understand the replies.

[@LindaDeo]

0:35 did the manequim blink?? 😮

[@blackboy-f5z]

Awesome ! Lucid explanation Lemme mention some things that you missed while doing induction & intubation: • starting inhalational agent • Inflating ETT ballon

[@todoz11]

I have no connection to the field of anesthesiology or any kind of medical field for that matter, but I always find your videos fascinating - both for their subject matter and your calm manner of explaining things. Also made me less nervous about undergoing general anesthesia should I ever need it, just from seeing the breadth of knowledge and expertise that you guys and gals have. If I had been a little younger, your videos may well have inspired me to pursue a career in medicine. You seem like a great doctor, but you're clearly also a great educator. Thanks for all the time and effort you put into this channel :)

[@pamelah2152]

WOW! Thank you, Dr Max!!! AWESOME VID!!! Can you please enlighten us on how anesthesia handles a patient with sleep apnea? I've always wondered about that.

[@reddbendd]

They will be paralyzed; they will not be breathing at all, likely, sleep apnea is not going to affect the outcome if everything goes as done in the video

[@CharleysAquaticNook]

@@reddbenddThere are still major considerations and precautions that an anesthesiologist takes for someone with sleep apnea.

[@jakebrandonm.andalrnd7254]

I have encountered your channel even before I entered med school, during the times when I was taking up my masters wherein I minored in Biochem. Always loved biochem and pharma so thats the reason why I considered Anesthesiology if ever I become a doctor. Now, I am on my 4th yr medical school (Junior Internship here in the Philippines) and my first rotation is Anesthesiology. I am a fan ever since! Albeit I am considering pursuing IM-Endocrinology after my Senior Internship and board exam (yes, we have 2 years of internship here in the Philippines before we take the boards 😭), I am still amazed about the field of Anesthesia. Enjoying my rotation so far, and I totally relate to this video as this is also what I have been observing so far in GA.

[@GreggBB]

wonderful video! So much information about what you do and all the things you have to pay attention to. Loved this!

[@timothyb949]

That's so amazing... I've been on the table a few times in the last few years. I always feel safe.

[@jbreezy101]

Here’s hoping you have no more of those moments remaining!

[@crazygirl_irl]

Max, I love your videos but I don't have plans to become anesthesiologist, just watching for entertainment. Can you please make a video explaining if a fire in hospital happens and what are the steps for if is someone is under general anesthesia in the OR during serious STAT surgery? I don't remember if you have a video explaining this but I know you have done one if a patient needs to be transported from one floor to another for example MRI.

[@michellenainkristinabusch1221]

He has a video with that

[@ZumarKhan-vk7ct]

The most awaited vid since prescribing your channel, no doubt you have educated a lot about basics of anesthesialogy but as human we always want a ful ready made package ....lol Thank you for uploading ,plz do special cases same way for those working at peripheral areas in developing countries Nd are not blessed with any mentor or supervisor. Merci beaucoup.

[@Charminar520]

so interesting to see what my uncle does. tysm for posting!

[@jeffm9227]

Awesome video, doc. Thanks for doing it.

[@kyle9008]

As an M1 interested in anesthesia, this was awesome to see

[@svellah4388]

I'm interested in anesthesiology, so this video was extremely helpful. You always make your videos top-notch. Absolutely fantastic, high-quality content. I've been subscribed to you for quite some time now, and can only hope you'll keep releasing superb videos! Thank you!

[@Whyamisomisrable12]

This is intubation I watched videos like this today I am training to be a doctor and this teached me everything I need to know thanks doctor

[@brandonsrebnik2980]

Dr. Max your videos are top notch!

[@elliottschwartz7]

Very interesting to see how a patient is anesthisized it's a detailed way of saving a person's life or just putting him to sleep

[@fitsumgetachew9396]

Thanks alot doc ❤❤❤, please make more skill based videos like this

[@terrycallow2979]

Thank you Doctor Feinstein, I've been under a few times and always wanted to know the ins and outs of what goes on, even if it was of course a brief summary of the work you do.

[@amythomas1124]

I’ve had seven major surgeries from December 2014 to May 2024. I don’t remember ever anything in the operating room. Nothing before, nothing afterwards. I’ve always been asleep before I ever get to the operating room, with the exception of when I had emergency surgery in 2017, when my colon had ruptured! But even then, I don’t remember much, other than being transferred from my hospital bed to the operating table. I think the medications to relax me, always knock me out cold, ha.

[@lorifrederick2367]

The eye blink of your "patient" was not a figment of my imagination. Glad i really saw it when he was going under. I thought i was seeing things 😊

[@Inirit]

I had 13 experiences in the last two months being put to sleep and every time they put the oxygen mask on and assured me it was just oxygen I always wondered if maybe it wasn't just oxygen and that was just a little fib tactic to keep me calm, or maybe it was a stretch of the truth where it would start out as just oxygen but soon change to something else. Looks like it was probably just oxygen lol, thanks for the informative video. It's also interesting to learn more about the use of fentanyl. I knew fentanyl was sometimes used in a medical context to control pain, but the way you present its application it sounds like this is more common than I thought? Perhaps this is why I always felt extremely floaty and weird for about 20 seconds before getting knocked out, like I was sinking into the bed and floating on a cloud.

[@dylanjkvogt1989]

fantastic video! this is the best overview I've seen. I'm motivated and inspired to become an anesthesiologist! thank you!!

[@puffyelvis5895]

My resting heart rate is 45, but prior to surgery it’s always elevated above 60 due to preoperative anxiety. I make it a habit of telling the anesthesiologist that I have exercise induced bradycardia prior to anesthesia so they don’t freak out and think they’ve overdosed me. I’ve had several physicians thank me for the heads during the preoperative interview.

[@valeriecarpenter3800]

Thank you so much for your anesthesia series. I had spinal fusion surgery in Feb 2024 - not sure what anesthesia cocktail they gave me but my mind was significantly effected. Couldn't even rember how to turn my iPhone on. Is that a normal side effect? Your series helped me be a lot less apprehensive about general anesthesia. Great series and great information. 😀

[@717Nora]

I would like them to explain why general anesthesia affects memory adversely especially in the elderly and how can it be prevented.

[@estelleadamski308]

I had GA twice in 13 days. The 1st time, I was given something to "relax" me as soon as I entered the OR and it knocked me out. I never remember getting on the table or breathing thru the mask. I didn't like that at all. The next time I asked the anesthesiologist not to put me" under "until I got on the table and at least took breathes in the mask. He did as I requested and I liked it much better. Afterwards, when I wake up ,I always remember the exact second I go "out". Most ppl don't remember, but, I always do. Why is that? Thxs for the info.

[@JoeDFWAviation]

I always remembered going into the OR and then going to sleep. I then remember waking up in recovery. One time I think I remember waking in the OR but after surgery.

[@estelleadamski308]

@@JoeDFWAviation You have me beat. I have never remembered waking up in the OR, only in PACU. When I had my THR I only remember waking up in my room, many hrs. later.

[@JoeDFWAviation]

@@estelleadamski308 occasionally I woke up directly in my ICU room (I’ve had 50 surgeries but not all of them were GA)

[@estelleadamski308]

@@JoeDFWAviation WOW! That's a lot of surgeries. I've never been in ICU (thankfully) I did get sepsis MRSA and was in the hospital for 6 wks. but, I was stable so no ICU. I've had 15 surgeries and hopefully that's all.

[@DylanH255]

I’m not in the medical field but I really enjoy your channel - I find it fascinating and you present things nicely. Video idea: explaining all the different beeps/noises coming from the equipment generally in the OR. Across your videos I’ve heard some noises I’m not familiar with and I’m really curious haha. For example from another video I think there were 3 beeps that escalated in pitch, and this repeated periodically throughout the video. It was in an empty or prepped OR.

[@gopats14]

Can you please do a video about why anesthetic medications work the way they do and what goes on inside the patient’s body. For example, how does propofol induce unconsciousness and what does it do to the brain and body?

[@PaulLoveless-Cincinnati]

If I am correct - scientists do not know the exact mechanism of action for propafol. It works on the GABA receptors but the mechanism is not completely understood.

[@diode_wow]

2 words: Medicosis Perfectionalis That channel will satisfy your every curiosity in regards to pharmacology, anatomy, physiology, etc.

[@ShonMardani]

The secret is C12 H18 O , and no Nitrogen.

[@salve1185]

Please make a video of the different audio or sounds from the anesthesia machine like the sound when the patient’s blood pressure is abnormally high or low or if the oxygen saturation is abnormally low or if the heart has abnormal beat or rhythm etc.

[@Meme-w1v]

Thank you soooo much doctor now I can attend any induction with full of confidence.plz doctor try to make Vedio to continue surgery till the extubation.thank you

[@wol_ves]

It would actually be interesting to hear about your typical ETT tape routine lol... I've seen patients end up with injuries around their lips after surgery, and while it's probably not much compared to recovering from surgical wounds, it is still another annoying thing for them to deal with and we should definitely work to avoid it if possible. Especially as someone going into a field that will have to intubate patients from time to time but probably not often enough to learn all the little tips, knowing how you do this would actually be super helpful!

[@GeneralFork1Over]

I'd also like to know about this :) No part of the process is too small or "boring"; it's all a valuable learning opportunity.

[@Mayurbhedru]

Injury around lip is during intubation, usually.

[@CharleysAquaticNook]

@@MayurbhedruThere would be zero reasons why an ETT around the lips would cause injury: that’s incorrect.

[@ShonMardani]

Thank you for the video. In my opinion the concepts of gas exchange based on pressure differences also having O2 and CO2 in the blood as gases which form bubbles are invalid and false, are there any other hypotheses out there? Atmospheric pressure continually changes based on wind, temperature and the elevation of the ground, it is almost impossible that O2 and CO2 as gases pass by each other in and out blood inside the Alveolus. Another problem is that the same pressure pushes O2 into blood and pulls the CO2 out, it doesn't make sense. Also we can not measure the CO2 or O2 gas volumes in the blood, the only gas forming in the blood after compressing and decompressing it is Nitrogen bubbles after a deep dive and rapid ascending in the water.

[@khadirabdilahi2433]

Awesome to watch as anesthetist jn somali

[@tinyphillips6521]

Amazing I just had 3 hernias repaired. I had no idea all this went on. One day could you address patients that have NO memory for several days following surgery. 😊😊😊

[@413smr]

When I had my gallbladder removed, I was told afterwards by the anesthesiologist that I was "difficult to intubate." I mentioned this to the surgeon at a follow up visit and she vaguely responded, Oh yeah something wasn't where we thought it would be" Where could "it" have gone? /s It added 30 min. to the surgery but I was blissfully unaware. :-)

[@ianpedersen2739]

I’m an RN and everyone keeps telling me that I should’ve become a CRNA but I don’t know if it’s right for me. I’m so torn between all the possible careers as an RN. I constantly come back to these videos because they are so informative and helpful in my decision making. Thank you for helping me understand what anesthesia providers do and think.

[@allyu274]

If you haven’t already, definitely shadow!! I was on the fence about becoming one, until I shadowed and truly enjoyed watching what the CRNA did

[@ianpedersen2739]

@@allyu274 thank you! Im in the process of filling out the necessary forms for shadowing

[@Chilli_Tea]

cant wait to prank one of my boys with this, cheers Max!

[@jessicafan4614]

Hi, Doc. Thanks for this amazing teaching video again.

[@frankiepizzo4499]

Great video Dr. Feinstein! Could you do a future video on different wakeup strategies? I think that would be cool to see as well!

[@jarmstrong8540]

Max I've read that Midazolam affects memory. I've always refused it from my orthopedic surgeries and I did just fine. Tell me is it really necessary to administer it ?

[@teh-maxh]

What mooed at 2:26?

[@debbismith-moore8940]

Ok, now I really want to see the actual OCD method of applying the tape (being quite OCD myself 😂)!

[@SoftservePOV]

Great video! You should make one about using a bronchoscope or trans esophageal echocardiogram and how to find ejection fraction

[@felixcat4346]

This was exactly the kind of surgery I had that Mount Sinai several years back

[@prabhleenkaur9157]

This is awesome and very very helpful, 2week in CA-1 here! Thank you so much!! Also, it would be very helpful if you could do the same for emergence, and please show how you tape your tubes, I'm figuring out what I like at this point!

[@marosvarga9198]

Great video! Hopefully we'll also see other parts of general anesthesia. As you mentioned in the video I'd like to ask you for video related to sounds and beepings of the machines and their function. We didn't have this topic much covered in the school and I was always confused whether it's pathological or not. Especially low tone beep-beep-beep randomly occuring during operation :D

[@Just1Nora]

Very thorough and informative, though I know I'm not the target audience, lol. The blinking eyes of the training dummy is a bit unsettling, but still neat. I see so many vids where people are asked to count down, but I've never been asked to do so, to my knowledge/memory anyway, and this feels much more familiar, but with the advantage of seeing the parts after which I've never seen.

[@ShonMardani]

Thank you for the video. In my opinion the concepts of gas exchange based on pressure differences also having O2 and CO2 in the blood as gases which form bubbles are invalid and false, are there any other hypotheses out there? Atmospheric pressure continually changes based on wind, temperature and the elevation of the ground, it is almost impossible that O2 and CO2 as gases pass by each other in and out blood inside the Alveolus. Another problem is that the same pressure pushes O2 into blood and pulls the CO2 out, it doesn't make sense. Also we can not measure the CO2 or O2 gas volumes in the blood, the only gas forming in the blood after compressing and decompressing it is Nitrogen bubbles after a deep dive and rapid ascending in the water.

[@daniel2001]

When I had my colectomy in 2019 the anaesthetist said "Ok, we'll get started now". Knowing the propofol was going in and that I had only moments I had to say "once more unto the breach dear friends!" Last memory before waking up was the anaesthetist laughing. A week later one of the nurses from the high dependency unit I had been on for a couple of days after surgery brought another patient to the ward I was on. She recognised me and said that she'd accidentally woken me up whilst doing something. Apparently I opened one eye and said "I was dreaming about kittens. How f***ing dare you interrupt my dream!" and then went back to sleep. She thought it was funny, although I was mortified (I'm always nice to people who help me).

[@FutureDoco]

Max, I saw that you're doing peds too! That;s awesome! I'm 14 and I've wanted to be in medicine since I was around 4 (dad's a paramedic, he inspired me). And 2 years ago, I found out about pediatric anesthesiology. I'm going to do all that's in my power to be a paediatric anesthesiologist when I'm older. Do you have any advice, or tips or tricks? I want to follow in your footsteps! You're such an inspiration! Who knows, maybe one day I'll be your resident.

[@MaxFeinsteinMD]

That's awesome! My advice is to focus on doing well in school and pursue hobbies that interest you (eg. clubs, sports) whether or not they're related to medicine. Then in college, of course take pre-med classes, but you can additionally take coursework that isn't related to medicine. I'm sure there's a lot of good advice you can see on KZbin, but overall my takeaway message is to focus on both your coursework and doing what makes you happy. Best wishes on your journey!

[@UncoordinatedPixie]

Mine was nothing like this. I was barely on the OR table when the CRNA said here comes the good stuff and next thing I know I woke up in post op in a crapload of pain. My surgeon was very anti pain meds.

[@Trader87]

yesterday had an surgery and i was very nervous once i was in the O.R. To be honest you dont feel nothing . just leave the doctors doing their job and once they start gives you the drugs through IV you'll be out in maximum 1 minute . 3 hours later woke up in recovery room like nothing happened. Next time i'll go in the O.R. like in holiday.

[@SueChase-ny4tk]

How do you connect the tape to the breathing tube IF we’re having lip mouth reconstruction from cancer

[@VarvaraPe]

Hi! New Anesthesiology resident here. Would be interested in your typical tape routine. Not boring at all ! Thanks for your videos :)

[@jeffm9227]

I'm curious how you decide when to use an LMA instead of a trach tube.

[@t.h.8475]

I had spinal surgery last year. I was wheeled in the surgical suite and was sitting next to the table. I knew immediately that my anesthesiologist was behind me, and he put something in my IV. I asked him if he had put something in my IV. That's the last thing I remember.

[@TomBreazeal]

Show us the OCD tape job! :)

[@LM-iq8pp]

This is straightforward impressive, Dr Feinstein! What are your thoughts on THRIVE, do you think the benefits are great enough for the effort?

[@HeyLetsTalkAboutIt]

Great video Doc. Very informative and super interesting.

[@earlstudios]

I"m getting ambilical hernia surgery in a week and I watched this to make me feel better but now i'm absolutely terrified and having a full on panic attack.

[@ckuethe]

just wait until you find video of demonstrating your exact procedure.

[@earlstudios]

@@ckuethe I'm 6 weeks out from the procedure and it was honestly, the best time i've had in a while. there was nothing really to be nervous about. The shot me up with something before they wheeled me in, and the table slide under the light someone maybe said somethign to me and then I woke up in recovery. not loopy, groggy or drugged, just super relaxed happy. at least for me, I never experienced any of this, I must have been out or the drugs wiped my memory. 10/10 would do it again.

[@ckuethe]

here comes the midazolam and... oh, the surgery is done already? that was easy. I found videos of my procedure, which were really interesting, but I'm the sort of person who can watch Air Crash Investigations right before getting on a plane.

[@StudentDrGigi]

Hi Max, medical student here very interested in specialising in anaesthesia. I really like your videos and would appreciate if you made one about the future of anaesthesia / the effect on mid-level encroachment (CRNA) etc. on job outlook for physicians. Thank you!

[@jennykvox]

Can you talk about considerations and adjustments in intubation techniques for patients who have cervical herniations and stenosis?

[@AmaniMohamed-s6z]

Really i appreciate you doctod

[@sorphin]

Propofol can definitely be unpleasant. First surgery I ever had, they used it, I was like "Why is my arm burning?" (Didn't really get to ask before I was out since I was "out" in seconds, but asked later)... Never felt it in any later surgery, but I'm sure they used it which means they probably were more careful about it.

[@butterpecanisfire]

How does the simulation know which drug is being injected?

[@L13-i8o]

Hi Dr. Feinstein, quick question... what are your thoughts on turning on the anasthetic gas while bag masking and when checking that you are where you are suppose to be with the ETT?

[@Bahiyyabadriya.]

I enjoy this point of view Thank You!