The unexpectedly dangerous part of anesthesiology

[@ivyedan7183]

I crashed in pacu 8 years ago...it took a whole team to move me to ICU..thank you for all you do...I'm alive today because so many Drs and nurses cared..

[@mustlovedogs5569]

U automatically get a team of at least 3 if needed so don’t feel too special. Everyone has different jobs

[@ivyedan7183]

@@mustlovedogs5569 I don't feel special, but I really appreciate every single one of the team I got...

[@erinnorwood6124]

@@ivyedan7183 you can feel special 🙂

[@billchaffee535]

In recent years I have noticed that oxygen concentrates are used more. What are the advantages and disadvantages vs bottled oxygen?

[@NDMD]

Whoa really love the 1 take with the timer to show the real time transport time 👏

[@MaxFeinsteinMD]

(It was not actually one take, but I edited it to make it seem like it was 😅) the timer was a realistic capture of the time to transport on that route though

[@michaelle545]

@@MaxFeinsteinMD Don't share the movie magic Max... now you have my questioning whether Santa's real

[@NDMD]

@@MaxFeinsteinMD had me fooled at least😂the idea is awesome tho. i know how hard it is to film in the hospital

[@Jasmine-zy8lx]

i am 34 years old female and have never been admitted to hospital or underwent any type of surgery, but i know for a human beings, these operations are inevitable, they will happen to almost everyone at a point in their life time. watching your videos always prepare myself for the unexpected. God Bless you Dr. Feinstein.

[@Sarge92]

errr not really alot of people go there entire lives without ever getting surgery hell the only reason I even had a surgery was I was too young to manually set a broken arm so they just popped me under for 5 minutes and I woke up in a cast my parents watched I counted down from 5 got to 0 they waited about a minute then CRACK ok wake him up and it was done had I of been older they'd of just given me some painkillers and done that right then and there in the emergency room

[@halreneau6343]

I wish u were taking care of me during my up coming surgeries especially my gallbladder removal if it comes to that

[@simhthmss]

I needed to have my sinuses drilled out, I'm very glad that I wasn't conscious for any of it. Propofol then darkness, then awake.

[@VHSDJ]

Thank you very much for this brilliant demonstration while explaining everything you have to take care about. I work as an anaesthesiologist in Germany, I don't want to get started on how often I see colleagues of other disciplines transporting critically ill patients through the entire hospital complex without being properly equipped or even monitoring every vital sign... Some of them I saw transporting intubated patients who were supposed to be connected to a working ventilator, but when I pointed out that the ventilator wasn't even turned on they just started ranting about me letting them do their job... (it was a person known for anger issues and incompetency) Further down the hallway I saw him at least turning the machine on

[@gins8781]

How stressful that must be. I’m an ILD patient and one of my greatest fears is poor communication between care teams. I fear being unconscious and having an anesthesiologist apply too much PEEP and accelerating existing lung damage. I carry an advanced medical directive, but I am painfully aware of how hubris can override reason when dealing with complicated medical issues.

[@joandeimling7681]

I am scheduled for total reverse shoulder replacement in 7days. I had the other shoulder replaced Feb 2022. At that time I watched all your videos plus a bunch on the actual surgery. I am rewatching as I felt infinitely prepared last time and had a remarkable recovery. Thank You for the knowledge you impart on us civilians.

[@darlenegriffin4700]

What a very caring individual. You are just what it takes to be an Anesthesiologist. Kudos to you Dr. 👏

[@jackaman1474]

Quite right, and important information. I had my own "travel bag" much like yours and I've taught 30-plus years of ICU staff that "road trips" are by far the most hazardous thing we do, and accordingly, the CT room is the most dangerous place in the hospital for critical care patients. Nicely done video, Max.

[@Stripping_Bolts]

How the hell do you have time to film and edit these videos?? I'm an engineer and I'm trying to start making videos too (about motorcycles) but finding the time, and mainly energy, to make and edit videos is tough. Can't imagine doing what you're doing as a resident! Props to you man, I wish I went to med school.

[@pedrolopes3542]

"I wish I went to med school" no you don't.

[@BirdiesGoCherp]

Med school and a career in medicine is literal hell. You don't wish you went to med school. I'm an anaesthesiology resident and my brother is a mechanical engineer. The grass is always greener on the other side.

[@Sarge92]

@@BirdiesGoCherp to be fair some of the things I've heard about you guys and med school I kinda am inclined to agree with you the fact you have to pay large sums of money just to get a residency placement is beyond stupid

[@BirdiesGoCherp]

@@Sarge92 thankfully I'm not in the usa so I don't have to pay money for residency. I got into anaesthesiology residency imat my university hospital and it's a dumb amount of work. Last week I had a 104 hour work week, this week's at 80 hours. Typing this during the middle of my 32 hour shift.

[@TzeiEm]

@@BirdiesGoCherp That sounds dangerous to be working such a lot of hours! I don't know where you are located or how things work in your country, but in my country and hospital a lot of responsibility is given to the nurses so that we don't have to overwork our anaesthesiologists. Here they usually have ~8 hour shifts and occasionally a 24h shift to ensure we have enough of them after office hours

[@Pete7330]

Great video. It brought back memories from two years ago when I survived level 1 trauma and 8 surgeries. Mounting your camera on the gurney was genius.

[@CharlotteB01]

Love this! I think the best anesthesiologists are those that prepare for all situations. And you seem to make that a priority. Great job!

[@gilesbowman1189]

It's the nurse anesthetists that do the anesthesia not an MD!! This guy and his video's are eye wash.

[@rjyeezy76]

All anesthesiologists are M.D.s They are the ones who prepare and administer the the anesthesia and make necessary adjustments during the procedure (keep the patient alive).

[@michaelm5601]

You’re a great Dad! Working hard to give your Daughter a better life as the cost of every day expenses are constantly rising…. I had to quit school in 11 grade, my father broke his pelvis and both legs. I wanted to go to arts school, but i leaned how to connect high steel. Afraid of heights too.

[@missmaddypaige]

Max-You should check out the SuperNO2VA Et mask. Love it for transporting patients that you know are going to obstruct. Stents the airways open with just O2 and has a Jackson Reese to serve as rescue ventilation

[@JonC341]

I guess this also explains why my local hospital has someone carry a small backpack with a lot of airway management equipment, from recovery to their room after surgery. ( Not a med professional but find it interesting). BTW, love the video and how your presentation!

[@karlkascha1261]

Always great information. When I had a craniotomy for a meningioma, I remember going from the recovery room to radiology for an MRI. I felt every expansion joint and elevator threshold. It was a regular patient transport person who took me there. Yes, I was on portable telemetry and oxygen. I don't remember the trip from radiology to the ICU.

[@m8trxd]

The facilities that I've worked in have policies that anyone needing telemetry monitoring must have an RN accompany them for any transport. If you're intubated, a respiratory therapist also

[@karlkascha1261]

@@m8trxd That's what I would have thought, but I was in no condition to argue. Lol

[@linnsoltwedel]

The regular transport personell have some courses and stuff as well. And they are trained in situations that can happen, and who ever sent you are to blame because they are the once deciding if you need a nurse or doctor by your side.

[@doristhecoder765]

Great video Dr. Max! I help coders who don't have the ability to dialogue with providers understand the aspects of what goes on in the OR and what anesthesia does. This is a great compliment to that.

[@markarca6360]

The key thing here is to keep tabs on the vital signs of the patient and have uninterrupted monitoring during intra-hospital transport. Many companies offer patient monitoring solutions that do the same thing. You have a smaller monitor (transport monitor) that you can plug to a larger monitor in the OR, ICU, or PACU as a multiparameter module. He has shown a GE Healthcare Carescape B450 on 1:37. Other hospitals use the smaller Carescape One that you can plug to a bigger Carescape monitor (B450, B650, or B850).

[@kipthompson8774]

Thank you for your Channel I really enjoy it I was an EMS as a paramedic for almost 30 years so I'm also familiar the only equipment you're talking about and I too have intubated hundreds if not thousands of patient from the scene to the hospital so I know where you're coming from thank you again you're amazing

[@Zipzap1313]

Your voice is so soothing, I know I'd be able to feel calm when I was being cared for by you~💕💕💕 And as someone who's been in hospitals A LOT from babyhood, kidhood, to now, I NOW have answers to all these things they have used countless times on me throughout my life~💕💕💕

[@MrVin720]

You videos are very educational even for laypeople like me. You are helping people with a fear of surgery have a sense of peace!

[@Bot-tm7hs]

that camera placement makes this feel too real, it's making me nervous about my virtual surgery when we arrive at the OR

[@darriontunstall3708]

Great info, I always learn a lot from you!! You rock man! You inspired me so much, I’m so excited about starting donating to the anesthesiologist Foundation next month, since it was hard for me to go to college after I graduated high school in 08 because of my cerebral palsy, I really love Anesthesiology!

[@colb9260]

I wonder how he got the staff to clear the hallways for the video. That's really cool Max. I wish I found your videos when I started anaesthesia but I'm still learning

[@Butch33]

Thanks doctor it's always good to know these things. I recently had a colonoscopy and the anesthesiologist never introduced himself. It wasn't my first time so I didn't have a whole lot of questions but it would have been nice.

[@jeffreywahl4238]

Max, this is another interesting and informative video / travelogue! I suspect that most people think that the only hospital site you go to after the OR is a PACU or ICU. Interventional radiology isn't a place that one thinks as a destination post-operatively. Interestingly, Children's Hospital of UPMC has a new $10 million operating room with its own intraoperative MRI scanner in the room. It is being used primarily for complex neurosurgical cases, eliminating the need for the "road trip" which your video so capably described.

[@jeffreywahl4238]

@Jim Allen I’m hardly a tech expert on these matters, but I’m aware that the scanner is shielded from the OR with Fort Knox level protection until it’s needed in the room. I’m certain there’s info out the on this novel configuration.

[@Mistersky46]

Great tips and explanation! Med student here. On my pediatrics rotation we were transporting a 1 year old patient with respiratory failure due to RSV from the OR to the ICU after intubation, when suddenly the O2 tank ran empty. Apparently nobody checked before we left! Luckily we just passed an empty bed with a full oxygen tank so after a short panic we quickly swapped them and continued without any problems. It was a short distance to the ICU so the second option would have probably been just making a run for it. Next time we'd bring a spare one just in case.

[@tgs9034]

Currently a Student nurse who is rotating on a Post surgical Cardiac ICU floor, its insaine what you experience but your in great hands all the nurses know so much and when you get to the floor you have 12+ staff members setting everything up to get you situated amazing care you see now in medicine. Transporting patients at least here most are intubated they normally use the BVM most of the time and keep a constant rescue breaths on the patient while in transport but other than that everything is monitored from rythem to pulse ox etc through a zoll it was quite an experience. I also saw my fair share of OR experiences aswell with a circulator nurse quite funny that I was too close to the door the one time and when the door opened I got hit by the anesthesiologist but other than that it was enjoying to watch and see what they do during surgery.

[@sherrydawson6253]

This was ssuch a great video. 👍 especially checking the 02 tanks. As a former nurse I can't tell u how many times I'd receive a pt to find the pt had a empty 02 tankk during transportation. We rarely saw a anesthesiologist as part of a pt being transported from OR. Your facility must be so proud of you. Your already top notch 👌 👏 it must be such a blessing to work with you.

[@cherylj755]

I found this channel researching my colonoscopy. I find this young man uniquely fascinating. I plan on telling my anesthesiologist about him before my next colonoscopy. 😁🤗👍

[@philippal8666]

We got the ventilator stuck outside the lift, the patient inside and the doors closing for ‘emergency override’, we had a bag and mask and oxygen plus back ups. Muscles worked to throw ventilator in. All was well. Lift a bit battered.

[@michellenainkristinabusch1221]

Propofol and I have gotten to know each other pretty well. I often have had it when I've gone into status epilepticus. It's saved my life quite a few times

[@anti-ethniccleansing465]

Sounds fun though lol. Getting drugged is the ONLY enjoyable part about surgery.

[@Apache32D]

I appreciate these guys making sure I don’t wake up during surgery

[@danmiller2177]

Thanks for all your 🎥!!!👍👍👍👍👍

[@atburke6258]

You do an excellent job of explaining complex situations in an easy to understand way. A T Burke

[@Iggypiggyylover2123]

They done it with me a lot of times especially the time when my body try to kick out the port, and they had to take anesthesia and give it to me right away when they were transporting me

[@jessicabarsse3701]

I had surgery and the anesthesiologist that I unfortunately had couldn't put me to sleep with the 1st med he gave me and said Jesus! And then pushed a whole thing of proporfol in me and smacked me! Of course this was obviously absolutely unprofessional and just horrible of him but he acted like I was using up his own personal supply! I feel like a lot of these guys are drug addicts! A horrifying experience that was! At least this guy seems good 👍

[@RitaMBuda-tz6bi]

That's horrible. So sorry this happened to you. I had surgery 8 weeks ago and I have no idea who my anesthesiologist was. Never met him or I don't recall meeting him. I think I was out like a light even before I got to the OR because I don't remember a damn thing before or after the surgery. Nevertheless, I was traumatized by the whole thing and will never never have surgery again as long as I live.

[@mccluskey_xyz]

Took the same journey yesterday. OR to IR and then to Neuro ICU. I always have a “travel bag” w/ ambu, airway supplies, & emergency drugs.

[@kevinshannon9917]

I was surprised he didn’t show the call backpack he unpacked in a previous video.

[@uTube486]

Doing a great job doctor. My daughter is 3/4 through med school, and your videos help me understand the job(s). (I never finished high school) (Adding "me" is the edit)

[@Darklovesto]

Congrats, on a future doctor daughter. hopefully my parents will be in your shoes in a few years!

[@steve8992]

proud papa

[@Doc_McStuffins]

And now she's likely a doctor. Either way, congrats to you both! And it's very special that you go out of your way to learn what your little girl is experiencing ❤

[@uTube486]

@@Doc_McStuffins She'll be at CHOP in Philly. 4~5 hour train ride 4 me.

[@K8Stuff]

Another important thing to remember: know where you are going. If you are new to the hospital make sure you orient yourself / ask where it is you need to go rather than guessing. Don’t want to take the scenic route !

[@tstan91]

Great job! My biggest recommendation is to be mindful of some of the medical jargon, acronyms, initialisms and abbreviations. I look forward to your next video

[@jeffchristianson-ziebell]

Dr Feinstein rocks!

[@wp2727]

The IR department at my hospital is right next to the main OR and ICU. But MRI is in the basement next to ED. Which is probably why I try to avoid it like the plague.

[@Hanniekinz]

Oh man, our neuro OR, CT, and ICU are within 1 or 2 floors of each other. I can’t image 8! I always crank the monitor volume up!

[@tracymcgrath1192]

Special breed you anesthesiologists are ❤❤❤

[@fadeskywards1245]

Hello, dr Max. First of all, I'd like to thank you for posting these videos. They are indeed very inspiring. Second, I'd appreciate if you'd consider making a video on things that every anestesiologist HAS to know (what to do and what not to do in certain situations etc.).

[@elizabethkuchta5097]

❤

[@iblesbosuok]

Some 911 survivors suffered very serious injuries. They have to undergo many stages of surgery. So many stages of surgery they had to undergo, they were conditioned into a coma. How the anesthetists conditioned them to be in a coma and how to wake them up from the coma? Thank you

[@DavidTiptonJr]

Fun video style! I'm impressed you did this with so few edits and cuts.

[@dmc01]

Great video max. Why are radiologists always relegated to the deepest depth of hospitals? Are they an afterthought? More space for the big machines? Shielding? Perhaps radiologists just feel safer where it is most darkest and don't need to don their above-ground sunglasses?

[@jimmysavile69]

I think it's so the machines work to the best ability

[@henriquelaydner4080]

Definitely room for the machinery, radiation insulation, easier access for installation and maintenance, being closer to the ED, which requires diagnostic imagery more often than other places in the hospital.

[@mikeschulte4271]

It’s most likely for radiation shielding and it’s easier to build concrete walls and lead lined walls in the basement because u don’t have to worry about the floors below it supporting all that weight.

[@mutated__donkey5840]

I want to become an IR and said "hell yeah" out loud when he said the suite was in the basement 💀

[@colb9260]

@Jim Allen 🤣🤣🤣🤣that's true. Next question would be, is it waterproof?

[@stevehornett4896]

Another great video, Max! Very insightful! Thank you for continuing to do these videos.

[@lenelloyd4443]

Coming home from placement to see you've posted! I'm a med student in my 1st year of clinicals (we have 3 in NZ so I feel very much like a baby) and we don't get a heap of anaesthetics time. Your videos really peaked an interest for me, talking to the anaesthesitists is secretly my favourite part of being in theatre now hahah. Such an interesting job - everyone has been so welcoming and passionate! Not to mention your content has been really helpful in orienting me. Thank you!!

[@james-hardyrorimpandey1063]

Hey I'm in Nz too! are you at UoA or UoO?

[@locumjobsonline]

Thanks for sharing this helpful information with other anesthesiologists!

[@onenessseeker5683]

I hate being put to sleep it's so scary! I done it 3 times. Basically it's like being dead

[@RitaMBuda-tz6bi]

You're so right. I absolutely hate anesthesia and never never want to have any kind of surgery again ever.

[@davidgarfunkel1]

Very good point about the unique danger of transporting sick people. In one of our units, the recovery room closes earlier than the operating room. I have woken people up after many hours of intense surgery and had to transport them 10 minutes through hallways and elevators. I make sure they are wide awake and super stable before we leave the OR on those cases, which sometimes adds quite a bit of time. Basically, I do the first part of the recovery before leaving the safety of the OR.

[@Startupsandsushi]

Awesome production quality!

[@M1911jln]

Last year, while in the hospital after surgery for pancreatitis, I developed cellulitis. One morning my blood pressure dropped to 80/60. One of the scariest thing for me was when the nurses placed a portable cardiac monitor on me and one nurse and two surgery residents took me to an emergent CT and then to ICU. I understood why the three of them were transporting me rather than an orderly - because they were afraid I would become unstable. I greatly appreciate that they took the required precautions to keep me safe during transport, but it underlined to me that I was in a bad way. That was a bad day.

[@maylah9]

I'm going to have open heart surgery at Mayo clinic in Rochester Minnesota. I've been researching pre and post operation procedures.

[@Love-ql7rd]

You forgot the forever not-well-rolling IV pole with tons of pumps! LoL! As we are also expected to manage and push that often. Great video. Loved the timer.

[@lachyt5247]

Every time, one sticky wheel so the whole thing starts rotating wrapping all the lines around itself

[@mikeschulte4271]

Wow that sounds sooo much worse then when u get the shopping 🛒 cart with the fucked wheel that always turns the way u don’t want lol

[@Love-ql7rd]

It is! The bad ones threaten to tip over and if you go through a doorway that is low the top gets caught and damn near tips over too! It can actually be quite challenging! Definitely keeps us on our toes!@@mikeschulte4271

[@Love-ql7rd]

@@lachyt5247 Haha, I know that panic all too well!

[@mikeschulte4271]

Well I would rather get a fucked up cart wheel at a grocery store then tip over an IV pump with critical drugs keeping a patient alive and the pump tips breaks and we r all screwed. Hope ur family and u r doing well

[@phina8392]

I always watch these, and normally a day after a 15 hour shift, but sometimes read him as Frankenstein when I’m tired. Hope he has a good s.o.h.

[@alicea8074]

I would just like to say, your video are always very informative ,interesting, and funny I like watching them. keep up the good work! God Bless.

[@hannahcrazyhawk]

Wonderful video. It's fascinating to see especially after what I went through with my craniotomy. Thank you!

[@AdvancedBoerboels4.24.7]

I can only imagine the look on everybodys faces when I woke up with no pain control screaming my head off at the top of my lungs and they had to turn around and take me to an isolation room to finish waking up. My surgeon told me he got harrassed for 3 weeks about it. I opted for no nerve block due to previous issues and unfortunately those responsib,le for pain control at that point had already gone home. I also lost my ability to see and thought I was already in the morgue because no one talked to me. I heard them all around me but no one acknowledged me no matter how loud I was. So finally I asked if they would take me out of the drawer if I am not dead. Ptsd was so bad that when I was finally home and able to sleep I did not hear a knock on the door from home health worker. She panicked , called the police. A cop complete with gun at the ready, health worker and 2 neighbors charged into my bedroom after breaking in my house and woke me from my first wonderful bit of deep sleep in 3 weeks! Next week I get the same surgery again other side. Nobody is looking forward to this!!!!

[@danasessions9252]

Your videos are so informative! Always enjoy watching them!

[@lifeonlowbatteries8153]

Four and a half minutes? Wow that’s a big hospital!

[@MaxFeinsteinMD]

Over 1,100 beds!

[@sarahcrain8083]

@@MaxFeinsteinMD That is about the size of the University of Alabama Hospital, here in Birmingham. So large it could be it's own city. The place is huge.

[@mikeschulte4271]

Who does all the laundry? On site or send it out? If onsite that would be a cool vid to see

[@shaunnh2a585]

I find this similar to an ambulance check. Making sure you have what you need before leaving home 🚑

[@Dexter-mw5ru]

Mad skill in not bumping the bed into any corners while talking AND staring into the camera

[@MaxFeinsteinMD]

Thank you! Years of driving stretchers down narrow NYC hallways 😅

[@mikeschulte4271]

I have ridden in Stryker stretchers before just like this one, it’s kinda fun especially when they go fast .

[@ElliePearl]

Critical care nurses do this every day. Schlepping all over the hospital with intubated patients, tons of drips, and trying to cram into tight elevators along with the respiratory therapist. I'll never forget hearing a horror story from a fellow nurse about the time an IV pump with multiple pressors fell off the pole in the elevator and all the drips detached. I would have died. Don't forget to check that your pump is tightened securely on the pole! Another helpful tip of the day. ✌️

[@andream9470]

I suspect there were a couple doctors and nurses squirreled away in a room watching you talk to the camera and giggling.

[@DailySquadProductions]

As someone who's had a whole lot of surgeries throughout my life, I owe my life to anesthesiologists. Haven't had one do me wrong yet.

[@lindawilliams8067]

Back in 2019 I had a hysterectomy I felt searing pain saying the pain the pain my head moving side to side could not open my eyes , but for the few seconds before they injected me I guess I went under . When it was over I told them it felt like a hot red poker not even an apology. This was in a London hospital

[@texan2u]

WOW - I'm 73 years ago and have had a few surgeries, (none critical), and I'd like to give Dr Feinstein a big hug )sure sterile ) after watching this.

[@musman9853]

As always great video! Definitely hadn't thought at all about this aspect

[@simonrokeby8583]

RT here Max! What's your threshold for bringing portable suction? I personallly always bring one, mostly due to the older generation of RTs and their horror stories of getting stuck in elevators without it. Interesting content as always. Will you be persuing a fellowship?

[@JohnnyWishbone85]

4:02 - I'm relieved your bags have peep valves. I'm a critical care paramedic, and I live in a more or less continuous, low-state of being appalled at how many critical care facilities don't have peep valves on their bags. It's like if this isn't the sort of thing you're paying attention to and staying on top of, what are you even doing with your life?

[@Mokun413]

Sorry stupid question, but what's a peep valve?

[@JohnnyWishbone85]

@@Mokun413 -- Not a stupid question, it's a great question. To start with, "peep" is an acronym that stands for "positive end expiratory pressure." Usually, when you release the bag on a bag-valve-mask ventilation device air is allowed to exit the patient's lungs and return to (roughly) the same pressure as the atmosphere around them (and you, presumably). A peep valve stops enough of the air from rushing out of the patient's lungs so that the pressure inside them is a little bit higher than atmospheric, usually at least 4 mmHg (or 5 mb), sometimes quite a bit more (the unit of measurement actually used is cmH2O). There are more than a few reasons why we might want to do this, but that is a *completely* different comment.

[@Mokun413]

@@JohnnyWishbone85 Interesting, seems worth looking into. Thanks for the reply!

[@kasforai]

My surgeon asked me today while on IV and having a panic attack, how long has it been since you broke your nose? I went to an emergency 15 days ago, she could have easily found that on my document. I told her 3 weeks by mistake, after surgery she said I couldn't do much because it has been 3 weeks your nose has healed my brother is a witness, can I sue this BAD surgeon?

[@bobbybooshae8720]

Can you do a video on the tools used during a surgery ? I work at a medical device manufacturer and wonder if you guys use our products

[@archemicon960]

Thanks doc! Love your informative vids. SUBSCRIBED.

[@jaywhite2023]

Another great video doc. Your videos are so informative

[@brianbolduc6143]

thank you!

[@heartland96a]

What is the apparatus that appears to have a seat with the machine arching over head with screens or scanners that was behind you in the basement operating suite? What is its function

[@projectnemesi5950]

QUESTION! I had a crazy reaction to anesthesia. I had an upper endoscopy, and they put me on Propofol (and probably some other stuff). When they pushed the drugs, the room started to kinda move and my eyes got blurry, but I never fell asleep or lost consciousness. Instead, I started to become unable to breath in about 30 seconds, and I used my last breaths to tell them. At first they didn't react, but when they realized my O2 was dropping, they put a oxygen mask on me and completely knocked me out (or I passed out from lack of oxygen). I was told they had to incubate me after that. I have no idea what went wrong, but I have PTSD from it.

[@saragarska6335]

I know my reply is really late, but I don't like to breathe on my own when sedated, either. I've had 3 surgeries that started off as only sedation and ended up with intubation. I wasn't given more of an explanation than that, but I hope it might help a little to know you're not alone and that this type of reaction happens to some people. My body is terribly uncooperative so I usually expect things not to go to plan, and I'm very fortunate that I don't have any memory of those three instances. That would be so scary and I'm sorry you went through that.

[@KH-3414]

What is intubated? I had a colonoscopy and they only twilighted me but I woke up and they had my notes that next time they need to use propopol. Why would that happen? I think my circulation isn't that good maybe and my breathing?

[@anti-ethniccleansing465]

@@KH-3414 With twilight, you shouldn’t have passed out. Odd. Incubation is when they stick a tube down your windpipe and force you to breathe with a machine.

[@anti-ethniccleansing465]

That reminds me of my worst asthma attack. It came on sooo fast and strong. Luckily I wasn’t living alone then, and my mother was able to hear me with my last breath. I said as loud as I could muster, using the rest of my energy and oxygen “CALL 911!” I heard her respond “what?” And then I promptly face planted onto our cement driveway. Thank god she came to me to ask me to repeat myself, as then she immediately saw me unconscious on the ground, next to my asthma breathing machine. I didn’t wake up until I was in the ER (which is a long ways away from my house at the time, so the fire department and paramedics were serious miracle workers to keep me alive until I got to the hospital!). However, once I gained consciousness, I felt like I was dying all over again… VERY SCARY!! I couldn’t even respond to yes/no questions the doctors would ask. They had a heckuva time getting the attack under control and the doctor later told me that they were about to intubate me too, however the very last medicine they had as an option to use luckily worked, and I began slowly recovering at that point so I just barely avoided intubation. It is very scary to feel that suffocation, and indeed is unforgettable. Luckily I have never had to be hospitalized for an asthma attack ever since.

[@projectnemesi5950]

@@anti-ethniccleansing465 One thing to know that will keep your peace of mind, is that even though you may lose consciousness, your brain can still preserve itself with just enough oxygen. And if you are in a hospital setting, your pretty much safe, although it feels like hell.

[@daisymae1963]

I had stomach cancer and had my stomach removed and rebuilt with my small intestines I have has multiple surgeries and when I do wake up I feel sick to my stomach. I always wanted to see the inside of the operating room but never have I'm always out

[@ChristmasEve777]

Wow! It never occurred to me that one can take a "long journey" just within the confines of a single hospital. I guess it makes sense when it's a critically ill patient you're moving. Anything can happen at a moment's notice.

[@tanya5322]

I just looked at a map…. Guessing from the city map, my trip from the OR, back up to my room in the hospital might have been two or close to three blocks.

[@nurshark10]

Thanks for informing us! Very interesting. Great job!

[@dennisharvey8179]

I excited for when you do a video on mh a condition I have that I had to find out about the hard way. I want to hear more about it all the hospital told me about it is to let the doctors know I have it if I have to have surgery and that it is really rare the doctor told me I was the first patient he ever seen with it and I was the first patient the hospital had treated with it since the 1980s.

[@MaxFeinsteinMD]

I’m in the early stages of making that video right now!

[@dennisharvey8179]

@@MaxFeinsteinMD nice im looking forward to it if you have any questions about my experience with mh feel free to ask. I don't know much about the issue itself but it did bring the start of me being in a coma and in the icu for 40 some odd days lol

[@suzannekaram1995]

Thank you for these exceptionally informative insights into anesthesia. You would not believe how many times I have had anesthesia!! You can ask me anything😂

[@johnl.38]

The number of times I've been handed empty o2 tanks for transport is scary high The pro move for transport is the one handed jaw thrust while palpating the carotid and trachea with that hand

[@MaxFeinsteinMD]

LOL absolutely

[@kgrfirdjy]

I routinely made sure all portable and back-up oxygen tanks were full when I worked as a nurse on a cardiothoracic surgery unit. Such a precaution really can be scary if overlooked if someone suddenly has breathing problems or is dependent on supplementary oxygen.

[@amsimms77]

Quick question. Have you dealt with putting someone with narcolepsy under anesthesia? I have narcolepsy and was curious to if there are any differences in the experience, intubation, meds used, testing beforehand, etc. At 45 I’ve never been put to sleep and the thought of it really scares me. Watching your videos gives me a little bit of “ease” thinking about it.

[@hoopesjessica]

Good question.

[@lachyt5247]

Given in this scenario you're transporting a Pt. from neurosurg, would you generally choose succinylcholine as the standard paralytic for crash intubation, given the increased risk of intracranial pressure (which is already present in many neurosurgical cases)? I would have thought rocuronium might be preferable despite the slightly reduced effectiveness for intubating conditions.

[@MaxFeinsteinMD]

Great question. Despite this being the standard teaching, there’s not actually great evidence that succinylcholine increases ICP.

[@skulqerX]

But that sweet fast succinyl offset though . Its a big plus but with some downsides

[@sidheeqsid7090]

As of i know eventhough scholine increes ICP, there is not a huge difference as we intubate with roc/vec we have to deal with more sympathetic stimulation than scholine ,resulting in increased icp, so my conclusion is that its not a deal breaker he choose scholine

[@chocolatelover4481]

But if you give rocuronium in high dosages, doesn‘t it come close to the effectivness of succinycholin

[@MaxFeinsteinMD]

Yes but succinylcholine still is faster

[@lisamoreland707]

Good info Max!

[@kthewhite7453]

How were you able to film in the hospital without capturing a single other person in your videos? Do you have to plan these video routes with hospital admin for confidentiality purposes?

[@MaxFeinsteinMD]

Late night on a weekend! I do follow the hospital guidelines for social media which include not showing patients or patient information in videos. I actually filmed this in multiple takes but just edited it to look like one so I didn’t get anyone else in it!

[@RoryRenee24]

Thank you for your work daddy max

[@Hamaden1962]

Very informative. Thank you.

[@chadiverson9291]

Fortunate in my hospital not to have to make that trip. We have a hybrid OR where both the open surgery and catheterization can be done in the same room

[@ReclusiveMountainMan]

Love it. A lot can happen in 4-5 minutes. ;)

[@debraarnold3703]

I was slightly sedated (pre-op cocktail) and put to sleep with glasses I breathed. Odorless. 3 breaths and I was out. Long Surgery, and was kept asleep with many gasses. A little Queezy in post op, in significant pain that the team helped me with, I did well. I'd fasted 2 full days prior with only clear liquids so no vomiting. That mask and gasses to put me out was kind of cool. 2019. Otherwise I've been knocked out with propofol, and then kept asleep with numerous gasses, for long surgeries. My Colonoscopy and upper endoscopy is only propofol now, which is much better than how they did them in like 2003 which was Demerol and Valium -- where most people do not go out. I didn't. It sucked. Now propofol in GI scopes is a quick in and out procedure - you're out and quickly you're awake within 10 minutes of being aroused as you're wheeled out for a very short time to completion, and into pre-op. Within an hour you are getting dressed. It's all good. Anesthesia has come a long way since ether which was hideous. I hope GI scopes are continued with propofol. The other way was an hour longer, and suffering the air being pumped into your lower GI to move the scope through, or gagging during upper endoscopy.

[@lene1193]

I also sometimes put my hand over people's mouth and nose...some of them recovered.

[@thewholeroll]

Really interesting as always. Can Max or one of the doctors in the house answer one curiosity I have? Do the scenes you see in medical dramas of staff jumping onto the gurney and straddling the patient doing chest compressions while still rushing to the destination actually ever happen in real life? Or is it just a bit of dramatic license?

[@MaxFeinsteinMD]

Very rare but occasionally yes

[@thewholeroll]

@@MaxFeinsteinMD thanks Max!

[@kimberlyfadim1703]

You make a good transporter!

[@michaeltyree567]

All of your videos are interesting.

[@danav3387]

I went under 1 time for a small surgery (gall bladder). I was sick for 2 days after. I liken it to the worst hange over that would not go away for 2 days. Any surgery I ever go thru again will be one that is decoded for me because I can't say no to. Disgustingly sick is my experience with Anastasia.

[@paulstelian97]

I had to go under for an appendectomy with complications (had to deal with peritonitis) and the nurses helpfully explained that for certain kinds of anesthesia coffee is a good way to ease e.g. headaches and other related issues. You still don't want to overdo it but in a proper dose it was recommended to me, and it did feel helpful.

[@think3rofficial]

When handling paralytic agents, is there ever a risk of immediate and serious harm from needle stick incidents?

[@ChaseWatkins.]

Bro, this is nurses life every day.

[@stephenfoster2532]

Thats what I was going to say!