Anesthesiologist reaction to "anesthesia challenge"
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- Опубліковано 19 чер 2024
- What is wrong in this anesthesia video that has been viewed millions of times? Let's watch together as I explain some basic DOs and DON'Ts of anesthesiology.
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0:00 Start
00:29 Context
01:18 Pre-induction problems
02:52 Induction issues
05:18 Airway atrocities
05:51 Not-so-vital signs?
07:34 Takeaway points
Music: Subtle Swagger by Ron Gelinas: / atmospheric-music-portal
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
#Anesthesiology #Residency #MedicalSchool - Наука та технологія
So, in other words, the anesthesiologist who did this is criminally negligent.
No, but I can see why you and others would think that, considering the video.
@@SkydivingSquid Did you not watch the video? Like everything he did was wrong and if something actually happened to the patient it would of been the anaesthesiolgist fault
@@mmchicken1 I watched it. That is a big IF in your statement. If I go 56 in a 55 and get into a crash, I'm technically wrong, but if nothing happens, then.... Point I am making is, we can sit here all day and listen to a med student preach "the by the book way" or we can realize that experience and in-practice are very different.
@@SkydivingSquid You are leaving out some major stuff here Skydiving Squid...
1) The doctor is letting the patient have control over the anesthesia... just wrong on any level.. common sense.
2) The fact that there is a camera in there for entertainment purposes... takes focus away from what the surgeons should be doing... not one single neuron should lose focus in an operating room... no matter the odds. As an example, I can drive my car with my knee, but in doing so... I am putting other drivers at risk.. no matter how unlikely.
3) I surely wouldn't want you packing my chute... wouldn't trust you for all the money in the world.
criminal negligence requires damage/harm to be caused. this is just regular negligence, possibly malpractice.
I had surgery on my hand a few years ago and asked if I could put myself out. “Absolutely…” I was told “…as soon as I make it safe for you to do that.” Then came the blood pressure cuff, ECG leads, pulse ox sensor and a few minutes with the oxygen mask. Then, when the doc was satisfied with the situation, she handed me that same syringe and said jokingly “Knock yourself out!”
That’s the way to do it
That's so cool
"knock yourself out", probably the funniest quote from an anesthesiologist in that context.
interesting way to handle it.
Both the patient and the Anesthesiologist are under full control of the situation.
The patient is fully informed about what is happening - seeing that you remember the details.
See, that I’m ok with.
I’d want this guy to put me to sleep. The whole index finger with the oxygen checker thing. The small detail that most people wouldn’t pay attention to. He’s on top of it. Good luck to you brother.
👍
@@lulumoon6942 ill never understand people who give a thumbs up like this in response to someone who wasnt even talking to or about them LMFAO
@@spimbles it means they are agreeing with the above mentioned comment. And this is social media so anybody can chime in and agree yes thumbs up.
@@spimblesWhat are you talking about? As the commenter above me pointed out, it signals you agree with what is said.
@@spimbles I'll never understand people who get upset over perceiving an engagement as wrongful because the replier were neither the recipient nor sender of the original message, then proceed to make a reply stating their frustration, contradicting their own argument
I just had surgery and did the "how high can I count before going under?" 5. It was 5. Funny thing is I woke up counting😂😂
Same. That’s the only “game” I’ve ever had…they didn’t have me count, they just had me talk and I don’t even remember what I was saying (or trying to say)
My first surgery i remember only getting to one, but right after I fell, I woke up in the hospital room, it felt like I timeskipped
😂😂 awesome
Yep, I've had surgery several times in my life, and I know that game well. I go under ridiculously fast though - I hear them say "Okay, I want you to count backwards for me, from ten down to one," and I don't even get to say "ten" - I'm out before I can even form the word.
I was in a dental office where they were preparing to put me under. A big screen with my vital signs was mounted on the wall in front of the chair so that I could see everything. I told the nurses "This is better than cable TV! I can make my vitals go up or down by thinking angry or happy thoughts!" That got a laugh from them and after watching the screen for a few seconds one of them said "Please don't do that!"
Letting a patient self-administer anaesthesia, neglecting safety, hygiene procedures and checking vital signs, filming ‘anaesthesia challenges’ - is anaesthesia a game to them?? Good job explaining just how incompetent, neglectful and irresponsible the guys in the video were
That’s what I thought. This shouldn‘t be a game/joke. 🤷🏻♀️
Letting a patient self-administer anesthesia is not harmful, if done correctly. I agree with the rest of your statement, but pushing a plunger through an already started IV has very little risk if any.
Hello malpractice
Yeah, I wonder what the heck procedure the guy was having, anyway.
With access to this facility and it's tools/medicine, someone is responsible, right?
I am surprised someones medical license and credentials aren't revoked, over this stunt.
We provide the same level of care for animals! We never induce a patient until we have an EKG and a Doppler in place for blood pressure monitoring along with pre oxygenating for 3-5 min as long as they tolerate it. Thank you for promoting standard of care!
That's so interesting! Thanks for sharing
yep. consistent monitoring by a nurse from before, to induction, to recovery.
EXACTLY what I was going to say! We follow the same procedures in vet care and to see this video is beyond disturbing!
@@MaxFeinsteinMD where did you find the original version of this video? Would love to use as a teaching tool for my students!
Yes! Thank you! We do exactly what he described for feline and canine patients. That video was hard to watch and cringey from start to finish. I don’t understand how that hospital felt comfortable posting that to the internet.
As a person who's been under general anesthesia enough for two lifetimes (3 ENT surgeries, 1 thyroid surgery, brain and spinal surgery and induced coma, radical exodontia, wisdom teeth) I respect the fact you put safety first. I've signed an informed consent that was slightly shorter than War and Peace with the words "death or paralysis" used almost as frequently as the word "and." I've survived some pretty horrible crap, I don't want to be taken out because someone got lazy and forgot to turn on the stuff that makes you not die.
"Kevin Dawson" OMG! I'm going to go through double hip replacement in a week. I never had surgery in my life.
@@obscurelyvague Worst I've had is nausea. It's pretty safe these days.
@@obscurelyvague Don't worry, if you die, you won't be able to notice. On a serious note though, I've had general anesthesia and I remember they told me to breathe in and count to ten. I remember counting to two or three and the next thing I know, they were laying me down on the hospital bed outside of the operating room and moving me back to my room. The wound started to hurt a little, but it wasn't anything terrible (especially compared to the pain from the complicated appendicitis that got me there in the first place). Then I was immediately given pain medication and while all the drugs were wearing off, I spent about two days being sleepy and slightly dizzy. That was pretty much it. It wasn't comfortable, but it was tolerable. Stuff was really nice and supportive too. I was just as nervous. You will handle it. Good luck.
7 thats it?
@@morganschiller2288 For some, that's small. However, I made up for quantity by having a life-changing, financially crippling suboccipital craniotomy and cervical laminectomy with a little duraplasty thrown in.
I had surgery in august and as I was going under, I remember saying “my eyes feel funny” and the anesthesiologist said, “good that means it’s working” 😂
I was told, " You might feel like your head is spinning." In that moment, it was of the utmost importance to tell the anesthesiologist: "My head really is spinning," and then it was lights out 😀 We are weird enough in general, but give us good meds and the weirdness gets turned up to 💯
i started to giggle uncontrollably as i was being drugged, anesthesiologist asked "what's so funny?" i answered "everything!" genuinely my last memory from the OR.
I had surgery yesterday and did not have time to comment, everything went dark as it should and I did not feel a thing!!! The staff were wonderful!!
I've watched tons of reaction videos by "med-fluencers" and this video is by far the best one I've seen. Not over the top with every single reaction but so informational. The calm disappointment and explanation was great. I had watched this video a while ago and really didn't pick up on a lot of things that you talked about here.
Thanks Jordan I appreciate it! So much disappointment lol.
That is bc we all can't accurately judge other specialties. We all have rough ideas but the details can only be fully appreciated by ppl in that field. I do pathology so I understood all the concept and broad strokes, but all of the small details was cool for me to learn. My patients don't have much reaction to anything I do.
When you say "med-influencers," that would make me not to want to go to that doctor and pass the word along. I don't understand why Tik Tok is such a huge thing, that grown up medical doctors start making games and challenges.
@@karend169 I mean often they’re just regular people who want attention or choose to ignore safety for fun. That said idk if you should discredit doctors who are on social media bc most of the time they seem like people who wanna share their education with the public
@@louisp8561 Most doctors are smart. The dumb ones go on Rogan
I am a nurse who retired last year after almost 40 years in practice. Thank you for this critique of this insane video. Many times in the OR in my career and I have to say thankfully I have never witnessed this level of malpractice. Thank God this young man obviously made it safely through surgery, otherwise they would have had a great Form of evidence to convict this anesthesiologist of what was blatant malpractice.
I'm a retired scrub tech. I scared my husband with the amount of ranting coming from me on EVERYTHING that was being done wrong. I would have bailed out of that room as fast as possible and done a formal write-up, then never set foot in a room with him again. Luckily the worst I ever had to deal with regarding anesthesia was reminding them that the rest of us wear masks like professionals, so they can, too. Like you, I'm just glad the kid pulled through.
You should read my explanation of my cancer surgery a few comments above yours.
You are really going to say you truthfully have never seen this level of preparation? Because it happens all the time.
@@TheCountessAsuka Thank you
I'm sure no surgery was done on the guy on the table, and no one in the cast of characters took any of it seriously. Just a group of orderlies having some fun during lunch break.
I was a critical care/ER nurse for 35 years and this video makes me extremely anxious/angry. Reminds me of physicians in a hurry to do a procedure who would rush in and start slamming drugs before the pt is even hooked up to a monitor/VS baseline taken/IV checked for patency, etc. So glad I am retired! And yes, I was always grateful when a conscientous/skilled practitioner such as yourself came along!
I have a major phobia of anesthesia and needles in general because of a traumatic experience with oral surgery when I was younger (story below), but your thorough explanations of everything were really helpful in helping me understand all of the work that goes into making sure someone stays safe during surgery. Planning on watching more of your videos to see if I can help ease my fears.
So when I was about 8, I was getting a second set of 4 teeth removed because of concerns of teeth not growing in properly unless the baby teeth were removed. A few years prior, I had the same surgery on different teeth and, being a child who was already afraid of needles, screamed and cried when they injected me before taking me to the operating room to completely put me under. So, this time I asked the anesthesiologist when she came out to talk to my parents if there would be any shots and she said no, that I didn't have to worry about any needles. A little while later, here comes my dad with an alcohol wipe, which I knew meant there would be a shot. The anesthesiologist walked me back to an office room and sat me on a chair while my dad tried to hold me as she administered the injection. I panicked and pulled my arm out of my dad's hold, causing the needle to rip a gash a couple of inches long in my shoulder as I fell off of the chair. I'm nearly 18 and still have the scar, and now when I get any kind of vaccine at the doctor's office, I have to be given anxiety medication, numbing gel on my legs, and at least 3 nurses have to hold me down on the table to make sure I don't panic, and even then I still cry like a little kid.
Long story short, maybe DON'T lie to an incredibly anxious child because you might just traumatize them for life!
OH thats terrible
You should still have the same aversion to vax if you are smart!
Good grief! I am so sorry that happened to you! When my daughter was about 3 or 4 years old, she got an abscessed tooth. The dentist’s assistant took her to a room without me (said it would be better for her if I waited in the lobby). Years later, I found out that when she told them she could still feel it and they didn’t listen, she screamed and they put a hand over her mouth! I was livid when she told me years later. If I had know when it happened,I would have pitched a fit with them! I don’t know why she didn’t tell me then.
@@DonnaTheDogGroomer that's so awful what :(
NEVER NEVER NEVER allow the dentist to take your child, at any point, without you. Certain nurses will try, even at amazing offices that have agreed to let you accompany your child beforehand. I had terrible experiences, that I didn’t tell my mother about until I was older(the Dentist slapped me on the leg really hard when I moved or made a noise during injections). Then my son, age 2, had tonsils so large they touched. When they tilted his head back and put a block in the back of his mouth to hold his mouth open he couldn’t breathe. I was there and as he struggled they insisted on holding him down. We all thought he was panicking from fear. I let it go on too long because I felt so thankful they let me back with him(against their policy🙄) I finally stopped them and he told me he couldn’t breathe… the Dentist THEN looked at his tonsils! He was immediately sent to a children’s hospital to have them removed. Never let anyone convince you that your child will “do better” without you. You are paying these Doctors and nurses, they work for you… you tell them politely what your child’s needs are! We all seem to look at them as Gods and are afraid to speak up 🤷♀️
I remember watching that video a while ago and to be honest, as a person with little medical understanding, this is beyond concerning. Thanks for what you do Doc. Love the channel.
Same, wondered if it was faked, or I hoped!
This reminds me of a "game" some of the kids in my neighborhood played in middle school where they would do rapid deep breaths and then stand up and hold their breath while a friend pushed on their chest to restrict blood flow, in order to pass out. I never understood it, but these guys are basically those kids, all growed up.
this is exactly what i thought when i saw the title of the video… it was soo much worse
Little did they know that I was causing minor brain damage because they weren’t getting oxygen to the brain. So I guess maybe that explains why that “game” became so popular because they were “fried?”
@@MichaelOrtega I was in middle school in the mid 90s and I remember they had to make announcements threatening to punish kids for "playing" this "game". They were so serious about it they even explained to us scientifically what was happening when kids did this and why it was dangerous.
Ugh me and my friends did that a few times. We put our hands on the sides of our necks, though :( scary stuff.
WTF. Never heard about it. Here in Czechia, we had alcohol for that. In the 8th grade (~14 yo), one guy who was sitting in the front drinked some six beers (half a litre each) in the morning before the school started and then threw up on the teacher's desk during the class. I was more civilized, so I didn't throw up until I was 15 and it was into a bucket when I got back home. It was roughly at that time that my dad taught me to eat some fatty food such as bacon or salami before drinking and I had no more accidents. Glory to our fathers! Cheers!
Surgeon here. If I saw this for my patient, I would’ve thrown a shit fit, called another anesthesiologist in, kicked out the current anesthesiologist, completed my case, and then march to the CEOs office.
Lol in the UK you wouldn't be allowed in the anaesthetic room while we are anaesthetising. As the person in the theatre in charge of the patient's life the only person kicking anyone out or stopping theatre is us.
@@MegaPoliyo if you're arguing that you wouldn't stop what's going in this video. you need your license pulled. plain and simple. and are the reason the world laughs at the UK's health system.
@@bbsbbsairsoft4841 You missed his entire point. Sigh.....
@@bigmacdaddy1234 i think they both missed all points. This entire section is ridiculous infighting and childish polemics. Only thing missing is „no you, no you!“.
Overarching point is: if you‘re a doc (and not a POS) you stop colleagues that are actively putting patients in danger.
@@MegaPoliyo and you think thats a brag?
I underwent anesthesia a couple months ago, very glad to see they did everything right, had me hooked up to all the measuring tools. Not sure which finger. I always wondered about "let's have you breathe into the mask a couple minutes before we're actually ready to start" and now I know why, it's good and it's called pre-oxygenation! Thank you.
Dr. Feinstein, nothing wrong with doing reaction videos, especially when you provide so much added value! Thanks for the video :)
Totally agree 😎 Ha, love the Dr's reaction! Nearly tachycardic! How come that initial video got 2m views? Great learning moment for everyone 👏
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As someone who has to have frequent surgeries, I hope I never come across an anesthesiologist this unprofessional.
As a nurse, I have 😊
Just proves that you MUST look at these type of videos with a serious reality check as to WHO is producing them and how realistic are the circumstances..... Great work Doc, Thanks.
I'm actually quite shocked. I've had 14 surgeries and my children have had several as well. Every single anesthesiologist I've ever interacted with seemed to be the most caring, concerned, and careful out of all the specialties. They're my favorite kind of doctor and I can't imagine any of them acting so unprofessionally.
I remember the first and only time I received anesthesia for my wisdom teeth over 10 yrs ago. It was a surreal experience. One moment I was talking to what I think was a nurse with the anesthesiologist and then I was waking up. It was almost like going under water and coming back up again. I felt no pain even after a few days and felt weirdly euphoric
depending on what medicine you were given, sometimes ketamine is used as an anesthetic. ketamine is actually used for depression (amongst other things, like pain management) and gives you very happy and VERY euphoric feelings. ketamine targets a different “happy hormone” called glutamate, and that’s why you feel loopy and euphoric. i’m currently using it for treatment resistant depression (of course legally and in a doctors office), but i feel exactly how you just described! it’s pretty interesting stuff in my opinion!! i’m not a medical professional but i do have lots of experience with anesthesia and ketamine!
you lucky , i woke up in the middle of the job , said to the gay dentist , i wanted to go to bathroom , he said i will go with you , and me under anesthesia i said something like , no you f'ing gay won't go with you in a toilet ... he didn't wanted to finish the job on me after that . True story .
4 wisdom teeth removed only local anesthesia (shot) was awake the hole time. The scariest thing was hearing them basically rip the teeth from my skull.
@@Shad2k8 And you're a homophobic bigot!
Markus ! U must be one of them gays ?
As someone who has restrictive lung disease, I appreciate you talking about how important it is to have a good anesthesiologist.
How is this doctor in practice???? This is super scary. Thank you for being so informative. I hope if I ever need another surgery in my life (fingers crossed I don't!). But I hope I have an anesthesiologist just like you!
Grandfathered in. A lot of old physicians in the field grow lax over time, but the people around them respect them too much due to their experience to call out obvious mistakes. (Mind you, this is not all older physicians, but it happens)
I loved every minute, thanks Max, you're good to have in the medical field. My dad's a retired anesthesiologist. Great video, awesome detail.
Love how this guy just crams that LMA in too. F for style, F for safety, F for professionalism
Idk why any anesthesia provider would record themselves doing something so stupid
Maybe it was the patient's idea and he asked them to record. If we learned anything from this, it's to make sure that guy is never our anesthesiologist because 😬
Propofol ain’t no joke. I went in for a colonoscopy, and as soon as it was delivered, my vision went blurry and I remember my eyelids closing so slowly. Then I was out. Didn’t feel weird or anything after. I don’t want to fight my anesthesia. I want to be out!
I just had surgery and i remember them doing everything you mentioned to do (thank god) but it's kinda cool to know what it all actually does!! They explained what all the devices were and that I was just breathing oxygen through the mask, but cool to get to learn a bit more!
I think the biggest thing I noticed when I first saw this was the lack of gloves in an OR, thats insane! I have had more surgeries than I can count, most major ones being 3 kidney transplants and 1 liver transplants and I have never seen anyone enter a clean OR without full protection ie. gloves, mask, sometimes shield mask, those disposable scrubs, the hair and shoe slip covers and more, this bugs me.
Agree... I have seen better use of PPE by medical staff treating their families members for injuries.
3 Kidneys and. liver? You should seriously play the lottery
@@dirtydingus5465 Bad idea. He would win and lose his ticket before being able to claim it.
Yes! I have also had a number of surgeries. I watched this video in horror. The anesthesiologist even wiped his nose with his ungloved hand and untied mask.
Freshly sanitized hands are more likely to be clean that gloves out of an open box. As a not participating person in the OR there is no reason to put on gloves, except when you are manipulating something. So gloves=clean isn‘t the whole truth.
preoxygenation is something i'd never even considered, but once you say it makes total sense. thanks for the excellent vid as always!
Never even considered? Really bruh? Are you in the medical field?
@@gustavgurke3389 I am but that's not something that's really taught in med school.
Can't too much oxygen be fatal?
@@StJudee That’s over a prolonged period of time, not a couple minutes prior to anesthesia.
@@StJudee partial pressure is everything, 100% O2 at regular atmospheric pressures is fine
Probably just me. But I don't want my physicians doing Tik toks when I am putting my life in their hands.
It isn't just you buddy.
I am in love with anesthesiology. Thank you so much for this video. You’ve done nothing more than making my interest grow bigger.
You remind me of my pain management Doctor. That is so comforting to know that there are those in your profession who take it seriously. For without you a surgeon can't do it's job.
People don't realize how many hours of study and internship hours you have to do what you do .
Alot of anesthesiologist go into pain management too and still do OR shifts.
I work with one of Max's old coworkers that does it.
You can assume that people like the questionable anesthesiologist in the "challenge video" are few and far between in the medical profession. Too much is at stake.
what are you on? Percoset?
I love how you explain everything in layman’s terms for us non-medical people. I find this so fascinating…I had a high spinal with my 2nd c-section and have just been a sponge for anesthesia information ever since. I find your profession to be so interesting. Love the video!
I had trouble waking up from anesthesia years ago and at the time I thought it was no big deal because it was day surgery. I was wrong and now have a fear of it.
Well done, Dr. Feinstein. I love residents. They explain things so well. I'm glad you're educating patients.
Really interesting reaction video. Very informative. I agree with you, patient safety is top priority. I’m currently an undergrad student and I’m prepping like crazy for med school. I aspire to become an anesthesiologist. I hope to one day help our society advance in the understanding of anesthesia and it’s practice. Personal thanks to you for your keen care and eye for detail, also for good practice. And thanks for this video 🙏🏽
I didn’t even know about some of these pre anesthesia safety practices especially pre-oxygenating. Watching vet videos like I normally do, would never have taught me that. I remember being surprised when I was given oxygen prior to my wisdom teeth surgery as I knew they would just have to take it off again to do it. It’s nice to know why.
I so wish this guy would have been in my surgical team. They couldn’t give me anesthesia due to having sleep apnea. No blood pressure cuff on my arm. No oxygen before giving me fentanyl knowing I have a condition called Multiple Chemical Sensitivity-I have extreme intolerances to chemicals, tons of them and I have absolutely no tolerance to opioids and never have. Apparently I had some type of reaction to some med that a drs office or hospital accidentally mentioned and quickly changed the subject. They put 2 things in my WLE surgical spot which is why it got infected and wouldn’t heal. Then I woke up continually dying of respiratory failure a dozen times just that I remembered waking up, only taking one breath then nothingness. A lady at my feet sitting in a chair would occasionally say “breathe” in a ton like she hated me. (I’ve never met her before or since that moment I was way overly drugged.) I remember barely waking up a dozen times just that I remember, eyes not open, just nothing happening mentally and unable to do anything to snap myself out of it just like junkies on UA-cam dying. She only shook me once and sat down the rest of the time despite the extreme seriousness of this happening. She finally said “sit up”, I ended up lunged over. It was when she told me to take a deep breath that I realized while basically coming out of the comatose that my brain needed oxygen to live and I’d be able to go from there so I started Wim Hoff breathing techniques even though I’ve never done that or lamas, I’ve never even had a child. So I started breathing as deep and fast as I could to save my own life and it worked. Surgeon kept refusing to take a culture despite having a big infected hole in my leg for months while chronically ill with many illnesses besides cancer. It’s fucking crazy I had to go through that over having cancer. And I was too scared to talk to patient advocates because I know I might need another (cancer) surgery and might not have an option but to stay with that medical team.
That’s horrible, those doctors are despicable.
@@EclipticRaisin Almost every single time I’ve seen a dr in the 7yrs I’ve been chronically ill, they’re atrocious. I was just in the ER 2 nights ago and they blew me off with a bladder infection and almost kicked me out of I couldn’t pee from fasting for labs. They refused water saying a CT wouldn’t work and refused me if I refused to get one. No meds. It’s a good thing natural medicine works so well at least until I can find a dr to actually help me.
Wow. My husband has OSA and this was never once mention by any of his sleep doctors as a possible complication. He's never had to have surgery, thankfully, but I would have never even known to look out for this if it weren't for your post! It seems like a pretty important thing to warn about in case of an emergency.
what you said didn't make much sense here. I do hope you are better and I also hope you do realize that just having diabetes alone will increase your surgical infection rate 3-5 times the non diabetic patient. That being said, I have never heard a anesthesiologist cancel doing a case due to sleep apnea
@@Cosmystery It is strange. Considering sleep apnea patients are sometimes set up with a CPAP machine at home. You'd think a normal oxygen supply or intubation technique would solve the lack of oxygen. Very sus.
I was just under a general anesthetic and right before I clocked out, I was telling the anesthesiologist to watch your channel and observe how professional and thorough your videos are. I’m here in the Houston Texas area.
Love your commitment to safety and accuracy. Docs like you give me hope for the future ☺️
Your videos have helped me quite a bit. I had surgery two weeks ago, a lumpectomy, and knowing what anesthesia was all about helped me with the anxiety. And watching this video just now also helped me as well as the last thing I remember after my anesthesiologist said "lay back and enjoy the dizzy" was thinking how odd it was that the mask they put over my face felt soft. Now I know why. Thanks again! I was hoping that you might have experience with nerve blocks and could make a video about that or point me to one that you have already made. In my case, because I have a history of substance abuse, my surgeon and anesthesiologist agreed to give me a nerve block to avoid narcotic pain killers. Specifically my records show that I had a Pecs 1, a Pecs 2, and a serratus. I was SO happy with this, I literally had no pain at all, so I wonder why it isn't used more. Also, can you explain the difference in sizes of intubation tubes? My records show that they tried one size and then had to use another.
Love your attitude Dr Feinstein! I can tell you LOVE your work!
This is very interesting!! Loved the way you made this video, great job!!
Thank you so much Max for this video. It was so irresponsible of the other docs in the video to have allowed this young man to self-anesthetize without first having taken the precautions you mentioned. AND they recorded it - wow.
I have been under general 6 times and they have always followed the procedure you described, thank goodness! I had a crash c-section, where I was prepped while being pushed down the hall and baby was born in under 5 minutes, and they still followed the protocol. The original video made me nervous that I will have a delinquent anesthesiologist someday :/
I’ve been a vet tech for years and I’ve always wondered about this video. Thanks for all the info.
Thank you for your explanation of the proper standard of care! Hugs from a nurse in Florida.
Thank you for picking this apart!! I'm not an anesthesiologist but I've had many surgeries and have learned alot. This video that I've seen before made alarm bells in my head go off too.
Love watching these videos! So interesting to learn and get educated a bit on this! Thanks 😊
I am amazed at how good you are at your craft. I could say I am inspired even; yes, you are an inspiration to anyone who wants to be good at something.
I am subscribing simply for the fact that you called out other “med-fluencers” and their clickbait thumbnails “😱” Also, great breakdown. Simple, straight to the point, and informative.
Thank you very much for warning what we are watching on daily basis. Job is well done.
The utmost issue of this video is the complete disdain not only for the safety standards that were neglected, but also for the patient’s privacy and for the seriousness our profession should be based on. Shame is an understatement.
Not sure who your criticism is directed to, but seeing how this is not his patient and the video is already on the Internet, I don't see how this anesthesiologist has done anything wrong
@@Permuh comment is not about Max, it's about the practitioner shooting the subject video.
@@Y.M... Coming back to the comment/video, it is much more obvious now hehe. Thx!
Agreed on everything you outlined, except the comment re: patient privacy. Clearly the patient is aware of being filmed, and if I'm not mistaken, the "anesthesia challenge" involves seeing how long the patient can awake before zonking out. Seeing as it's one of those social media-type challenges, I would assume this patient has requested to have himself filmed performing this challenge, and even uploaded himself.
@@prima808, I’m taking into account my reality in Brazil. Our medical ethical code prohibits sharing patient images, except for scientific purposes, even if they consent to it. In case of consented scientific use of their image, all effort must be made to difficult their identification.
Another excellent educational video -- many thanks, Dr. Max!
Thank you for sharing! Your channel is helpful to me as a student vet assistant who is learning about veterinary anesthesiology. We use many of the same anesthetics that are used in human medicine.
That's so awesome! I'd love to interview a vet anesthesiology some day.
I start a heart tracing, baseline vitals, heat supports, and preoxygenation before even placing the IV in my dental office.
I’ve had over 18 surgeries and the first lot I never had an oxygen mask on, and the last few ones they insisted I wear it before I was put out. I love chatting just before I get knocked out and the mask prevents me from doing that. But now I understand why. Thank you
This was a really informative video! I had anaesthesia many years ago, and it was nice to learn about the whys of what I remember happening before I went under. The longer I watched, though, the more horrified I was about the practice in the video you were reacting to!
You are so professional and nice..
As a doctor I do really respect you, as a patient I wish to be treated from a doctor like you..
I've had 23 surgeries for an assortment of injuries. I never had any worries until my Mom died in a colonoscopy procedure. Most recently , my last words before I went under were "Don't let me stop breathing" .
With the info you've provided I will be more comfortable when they hook everything up before the the sleep medicine.... Oxygen tubes and Electronic baselines ,, CHECK.
That video is terrifying. I was given that anesthesia and had a reaction. I woke up in an ambulance from the surgery center to the hospital and luckily received emergency treatment in the ambulance. That guy is lucky to have survived, if he did! Quackery.
Dr. Feinstein, thank you for your video. Your patients are extremely lucky.
Never thought an intelligent reaction video would exist. You show how it's done both in sincerity and expert knowledge with needless gawping like a goldfish and shrieking like Miss Piggy on helium. Best reaction video!
I never realized how important the anesthesiologist is until I started working in ICU. That's the person who keeps you alive! Thanks to all the great anesthesiologists out there!
Yep. After I left the hospital, the first provider I wrote a check to was the anesthesiologist. Dude calmly put me out while I was bleeding to death and brought me out alive. Second check was to the vascular surgeon who was also great.
@@queenbunnyfoofoo6112 I hope everything is OK now, I'm glad you had a great team working for you.
@@katherineg9396Thank you for your kind words. My guardian angel definately got a few grey hairs that night!😂 I did recover completely. I really enjoy watching Dr. Max....he's not only very knowledgeable, but is great at explaining things in easy to understand terms.
we are usually never commended for "good job", but easily blamed if anything happens wrong. indeed, an anesthesiologist is the patient's "guardian angel" in the OR
I’ve had some really amazing anesthesiologists a few times, we do recognize what you do I promise! It can make a huge difference when I know the anesthesiologist cares. I’ve also met some who kinda scared me, very creepy, spoke like they knew less about medicine than I do. Thank you for what you do
I had 3 GAs within 8 weeks and 3 different anaesthetists. Each time it was fantastic! Friendly, caring and so comfortable - best sleeps ever! Woke up fresh as a daisy! All safety points you hi light were adhered to. I was pain free after all of them ( 2 minors and a major). I’m sure their professionalism and care has played a massive part in me being able to approach my cancer treatment positively!
I love this bc as patients we don’t know what proper protocol is. Thanks for this.
When I had my Surgery there was so much stuff done it was all over whelming what i was trying to understand. On the OR table, EKG leads, IV, body and arms strapped like I was on a cross. Oxygen/gas mask and all other kinds of things. The doctors and everyone in there made me so comfortable and un afraid. I remember talking to them and the last thing I remember is hearing Good Night. When I woke up in the recovery room, the pain was more than I could stand. The nurses were scrambling around and giving me pain meds and kept on it till I was comfortable. I never had any surgery at all, and now I just under went a Bilateral AK Amputation 12/13/2021. Everyone lied to me and said when you come out of it, you won't even know what happened.
As a respiratory therapist, this made me highly anxious. 😭
yeah, this level of quality deserves a sub
This video was terrifying. I hope I'll find an anesthesiologist like you the moment I eventually need in my life.
I had back surgery recently and they used a non-rebreather mask on me to pre oxygenate me and the last thing I remember is suffocating. I am pretty sure that is not supposed to be used. I also woke up with a large bruise under my tongue and my throat was so swollen I could not drink. I really wish it was mandatory that all operations be video recorded.
Would you consider doing a video about how anesthesia protocols differ for trached patients, and under which circumstances you still choose to intubate someone with a trach? Thank you!
I have a surgery coming up in the near future. I am a fan of UA-cam and found myself on your site. Thank You for putting together this series I feel a lot better about getting surgery. I hope that my anesthesia doctor is as good as you. Ric
This was an amazing and informative video explanation. I love your calm demeanor too. You got a new follower :)
As someone who had some alarming issues throughout a more recent surgery, it stresses me out how little they did with vitals and oxygenating. Even though at first my vitals were normal, they quickly flipped after going under. The fact they would’ve had no prior knowledge of his condition is terrifying
I have actually seen this video that you're talking about in its entirety you pointed out quite a few things got a typical viewer or patient wouldn't even think of it was great to see your reaction and your thoughts on this video. I can clearly say that this anesthesiologist was quite careless when I saw the video for the first time I kind of did think about him not wearing gloves. What do you have one question was it okay for him to allow the patient to administer his own propofol. I don't see anything wrong with that but what do you think? Thank you very much for making this video and pointing out the mistakes that this guy made cuz these are things that I never picked up on when I first saw the video being the fact that I'm not any physiologist but just the patient these are things I would have never thought of.
Thank You so Much Doctor. We need more Doctors like you in this miserable world .
Right!! They did my vitals and had an oxygen mask on me during my c section. They were calling out my vitals to the doctor as well during the procedure. They did so well. I felt safe. My team was great!
When my mom was 4 years old she had her appendix out and the anesthesiologist didn't give her enough to knock her out, just to paralyze her. She felt the entire surgery but wasn't able to move or scream for help - total nightmare fuel and it absolutely traumatized her.
It wasn't until years later when she was in a bar and smelled scotch for the first time that she realized she had actually smelled it before - when she was 4 years old getting surgery. So clearly the on-call anesthesiologist was drunk. Seeing shit like this makes my blood boil. If you have the privilege of having another person's life in your hands, you better fxcking treat it like your own life is on that table.
Is the anesthesiologist, Barry Miller?
He has a UA-cam Channel and he's definitely a bit of a cowboy in the OR.
He also doesn't believe in pre-oxygenating his patients if they are otherwise healthy because he believes it to be traumatizing to the patient. He bases that on the fact he personally doesn't like having the mask put on his face.
Honestly, I would bolt from the OR the second that man introduced himself as the anesthesiologist. I'm still recovering from the PTSD from having an anesthesiologist like him.
When I complained after I woke up, he and the surgeon came to my room, tod me I had a reaction to the anethesia and promised me I would never be given that drug again. Then they belittled me for "making a big deal out of nothing." and somehow managed to erase any reference to the incident from my medical records.
At the time, I required emergency surgery several times every year, so imagine my distress when I lay in pre-op being assured there was no record of me ever having an adverse reaction during surgery. I brought the issue up every time for years but it took years before someone listened to me and finally figured out what he likely did to me.
Don't tell me to sue. That simply doesn't happen where I live unless perhaps, if a small child is left permanently disabled due to extreme, gross negligence.
I take great solos knowing that, as old as he was at the time, he is likely dead or in diapers today.
I hope his nursing home sucked!
This is not Barry Miller (he’s a CRNA, not an anesthesiologist) but preoxygenating before inducing anesthesia is a standard of care that, when not met, would likely not be legally defensible in the event a poor outcome resulted.
Dude, you’re such a nerd. But at the same time, I love your videos! Congratulations on your success and wish you continued success! ❤️
Doctor Feinstein. I've really enjoyed your videos. As an "old person," 82 years old, with Prostate and Bladder cancer, I've been in the OR quite a few times. In fact, in another week, I'm back in the OR for more Bladder lesions to be removed - 4th time - now about every 3 or 4 months.
I was stunned watching this Doctor readying this patient for surgery. And the patient administering the anesthesia? Wow. From your videos, I knew there were a lot of "pre-game" items not being covered. As an old "flyer," I think he needed a "checklist" to ensure the patient was prepared. He was not.
I now am a bit apprehensive about my upcoming OR visit. I know, now, I will be more aware of what should be happening prior to receiving my anesthesia. For me you have done a great service. And I thank you for that. Patients are very lucky when they see you walk through the door, prior to the operation, to discuss what will be the game plan. Thank you, sir.
This gives me so much anxiety as a fellow anesthesia resident
Same, I’m in Europe, and I’ve never seen anaesthesia induction this irresponsible…
Nice reveiw! I’ve seen this video long time ago and noticed some issues, too. You were very thorough with your analisys.
I have a couple more questions:
1. Why push laryngeal mask with inflated cuff?
2. As far as I see, the syringe is filled with approx 40 cc of propofol, which makes it 400 mg in case of 1% propofol. Oo
And with no BP monitoring….
That seems to be a 20 cc syringe, which is the standard volume of the propofol vials. Nevertheless, considering the patient’s estimate weight, 150 mg or even a little less would be enough if it was given the time to the drug reach it’s point of equilibrium in the target tissue( i.e. the brain). Those who are used to administer total IV anesthesia under the BIS monitoring are aware that we can induce with less than what’s usually given when the induction is accelerated by a bolus injection.
I also let the LM partially inflated with roughly the same volume it comes with. I feel that it makes the edges rounder enough to prevent scratching the palate. Not neglecting it’s lubrication, of course. I avoid using lidocaine gel because I don’t want the palate and pharynx numbed when the patient awakens.
I agree with what @Henrique Laydner said. Some people insert LMAs with the cuff completely inflated, others partially inflated, others empty. All a matter of practice. And yes I think this is a 20CC syringe so total dose of propofol 200mg.
Thanks for this video. I remember when I first came across the video you are reviewing I commented about how dangerous it was - particularly commenting on pre oxygenation - and I was attacked by other posters. They really need to watch this.
Dr. Max, thank you for breaking this one down. I saw the video before, but wondered about why this was even considered by the hospital? I am surprised the hospital even allowed this to happen.
Very informative info Dr. Max. Since April till Jan of this year I went under anesthesia three times. I did not take a look about my surroundings, but I hope that the anesthesiologist was more professional than in this v clip. Is this anesthesiologist operating in a US hospital?
Always enjoy your videos even though I am not in the medical field.
Hi there, I don't know where exactly it's from, but I would guess it's in a US hospital or outpatient surgery center since both the anesthesiologist and patient speak with American English accents. Thanks for watching!
Scary and horrifying!!!! Thank you fir pointing out all the risky issues these numb nuts were involved with. If they have medical licenses they should be tajen away!
I had anesthesia yesterday and my surgeon and nurse did all the things you mentioned. The only exception was they did put the oxygen meter on my index finger but they strapped that arm down so I could not move it when I woke up. I was only semi asleep as I could hear everything going on but no pain. It was a dental implant being placed. Thanks for your video.
this is my surgery, I'm suing both my doctors because of this. Thanks doctor!
LQTS PATIENT HERE! 👋🏻
Oh goodness NO…😦😬
I have anesthesia every 3 months for feeding tube replacement procedures (or sooner if I’m having issues with my tubes before my scheduled appointment) and if my anesthesiologist skipped any steps or didn’t get all monitors and equipment for vitals and oxygenation set up (they actually allow me to hold my own masks often but they ensure I’m positioning it correctly) and attached to me beforehand it’d absolutely worsen my anxiety. Since I have Long QT Syndrome (THANK YOU FOR MENTIONING IT IN THIS VIDEO!!!) there’s extra caution with me already and careful consideration for how low my blood pressure is on my beta blocker, my potassium levels (always low because of severe Gastroparesis), and the drugs used. Before my last procedure my nurse anesthetist actually put EVERYTHING on me while I was just sitting in my pre-op room so I’d be ready to go, including the oxygen cannula in my nose under my mask.
I’ve had a respiratory failure before after a surgery so I genuinely am concerned about this so called “challenge”…
Thank you for reacting responsibly and making sure this info is out there because I often find that people perceive anesthesia as this humorous, casual, entertaining experience when it really is a matter of safety. This is definitely the type of reaction video I like to see! It gave you a chance to showcase something new but with all the excellent education we’re used to seeing from you and it’s very appreciated! My heart was pounding from the panic watching the little clips of that video as you were reacting to it. HUGE YIKES!!! 😱
You said it perfectly: "I often find that people perceive anesthesia as this humorous, casual, entertaining experience when it really is a matter of safety." 100% correct
When I used to have to have have biopsies they always had me all hooked up to the machines before they even gave me anesthesia or medicine to calm me down.
Max you are so calm I am not in the medical world in any shape or form but love your manner and voice. Challenges for fun by medical professionals is a worry
Wow very good points made. Thank you for sharing :)
Jeeeezus. As someone with POTS and severe Dysautonomia who was heavily symptomatic yet undiagnosed before all of my major surgeries in life… this was terrifying. Made my heart race (even more) and bp drop just watching it!😬
Dr. Feinstein, are you available for career guidance for med students interested in anesthesia? Thank you!
If you have any specific questions, I'm happy to try to answer them. DM me on Instagram
this video and this guy's entire channel is so underrated
The whole thing about you putting the oxygen monitor on the ring finger instead of the index shows me what calibre of a doctor you are. Kudos to you. 🙌🏻