Hi Max i am a 82 year old retired😀😀 anesthesiologist/intensivist from the Netherlands. I really enjoy your video's and the multifaceted approach you use to be on top of everything you might encounter. Super and good luck in your career. By the way i worked in Elmhurst in 1972 .
@@thomasa4239 the air pressure bag is simply there to pressurize a saline bag, it does not perform any readings and had no electronic parts. The transducer plate is part of the arterial line that he primed, which reads the pressure.
As someone that has had several surgeries over the years, I have a whole new appreciation for the anesthesiologist that were present. Thank you for your videos.
Looking at all of the technology and medical equipment you have at your disposal, makes me realize how fortunate we are to live in a country that can provide it.
@@Blueraymoo in canada, you need time, lots of it. We pay with time. Which can be so long that many go to the US because you can be seen sometimes 1 year faster.
those are pretty standard for a proper teaching hospital. difference is other countries with universal healthcare don't bill you a million dollars for live saving treatments
So cool what you guys get to do. I’m an icu nurse and get to mess around with a lot of these drugs but not in the volume and density that you do. That’s a lot to manage at once, great job man
Don't forget you are being watched by people far above clinical management. Make sure to dispose those schedule substances properly; including that Ketamine that seems to be a mysteriously mystery...
As anaesthesiologist as well but working in Europe I love to watch your videos to compare the differences. honestly Im so glad that our nurses do all the preperation, machine checking and medication. You just call them, say what you want and its done. I really love my staff ❤
I'm a veterinary anesthesiology resident, and I really love comparing the differences (and similarities!) between our fields. Best of luck as you wrap up training and transition to being an attending yourself! 🙂
Here’s a new perspective for you! I’m an Epic Anesthesia analyst and as crazy as this sounds, I enjoy watching your videos because it helps me to get a better perspective of how your day goes and how you run your cases, why you use certain equipment, etc. I find that the better I understand my users, the better I can support them and ensure they have the tools they need. I see myself as part of your team and have gone to bat many times for my team when other clinical areas want to make changes that impact anesthesia when they don’t understand why Anesthesia does something a certain way. Im sure it comes from many years of working with surgeons, but certainly a unique reason I appreciate your channel!
I have a major surgery coming up soon and your videos are putting me at ease about the care I'll be receiving. Thank you for sharing such an open window of your experiences and expertise!
Ever since I was in high school I wanted to become a cardiothoracic surgeon… your videos piqued my interest in anesthesiology and now that’s what I want to do. I just went back to school after taking off 10 years and I’ll be 33 next month. One year left to finish my B.S. in Biology so I can apply to medical school
@@maysmoukdad7877 You can only practice in a handful of states as AA. CRNAs hate them and are lobbying against them at all costs lol. Doctors love them tho
I'm relatively sure that not every anesthesiologist is as personable as you are, but I certainly hope that they are as meticulous and knowledgeable !!! 😊👍
I've interacted with maybe 5 anesthesiologists prior to surgery and a few prior to colonoscopy. They were all completely personable, save for one colonoscopy anesthetist. The grumpy guy was just dour and didn't want to hear me explain my special needs (don't gimme high flow O2 unless absolutely necessary). He later went to prison for 8 to 21 years for giving patients hepatitis by reusing non-reusable drugs and equipment).
@@CarolLynnWilliams Yeah. 40,000 patients were told to get tested for HIV and Hepatitis when they found out what had been going on at that clinic and several patients died from contracted Hep C. The owner of the place died in prison after being convicted of 2nd degree murder (he had ordered the anesthetist to do these things to save money).
@@frotoe9289 So I guess you're talking about a Surgical Center. Some are okay, but you never know. I am a fringe health professional and have advised all of my people to choose a doctor who works out of a hospital. At least they have a better chance of sterilized and sanitized protocols due to more legal awareness and less reliance on cost savings.
I'm not even sure how your videos ended up being suggested to me, but I am so so glad they did!! I am a doula who has seen both my parents through cancer surgeries, supporting several surgical. births with clients over the years and I have more family members and friends with surgeries coming up. For me, as someone who's clinical skills basically end with first aid, watching your videos really helps me feel reassured and that confidence in knowing how some of this stuff works helps me relax a bit and put a bit more trust in the teams caring for my people. It's reassuring. Yes, I still ask all the BRAIN questions to make decisions, but it means so much to know how much goes into prepping for caring for patients. Thank you so much.
4th year?? wow i remember when you were a 1st year hehe Im a 1st year anestesia resident in barcelona (vall dhebron) ☺️ i watched your videos ever since i decided to quit GI to persue anaesthesia Thanks Max!
I require 2 kidney procedures each year involving general anesthesia. From your videos, I have a better understanding and appreciation for what the anesthesiologist's role is in my procedures, thanks.
Thanks for sharing, great video! Also a great reminder to me of the importance of my blood donations seeing you prepare for the potential need of blood for the emergency case, wow, great example of cause and effect. I never see the end results on the other side of my donations but that helps to make it so much more real and meaningful, thanks!
I’ve had multiple surgeries and really appreciate my anesthesiologists! They always have a good sense of humor, meet with me before the surgery and tell me their plan. The last surgery I had the anesthesiologist even gave me a pill called mironal for anxiety and after surgery appetite boost. Which I thought was different but actually helped me lol.
I just wanted to say as someone who found this as a patient and possibly (if my health doesn't impede it) medical student I find all this information so interesting. I had huge anxiety about anesthesia since I have a huge fear of death and in some ways there are similarities (no time perception, loss of control, hoe foreign of an experience it is, etc) but your vids helped a ton, and now that I'm through surgery (20 feb '22) I still struggle with health issues but your videos are a great distraction for someone who's curious and just wants to learn. Thanks Max! I heard you finished residency too, grats!
Residency, those wonderful years that thankfully never come back. The worst shift I’ve had was the one I traded off so I could use my post-shift day off to take a 2h flight to attend a Aerosmith concert, get back to the airport to sleep there and take the first flight in the early morning to come back to the routine shift. Thankfully my attending had been my senior resident and was ok with me getting a little bit late. Turns out 14 years later, 3 months ago, I asked him to anesthetize my wife to remove a meningioma with the neurosurgeon I work with. Why that was my worst shift? We had a ruptured AAA, so no sleep at all.
6:17 The hospital Anthesiaets had a long case...me. I had a liver that needs transplanting SO they started at 5 30 to 6 PM and I think it last till early morning...After watching this, I feel bad for putting those people through hell. I'm not sure if they deserved that long of an transplant BUT they did it and I'm still here on this earth.
You are just awesome! I bet all the staff love u. ❤️ gosh your junior residents are blessed with your teaching skills. Are there any particular cases that give u palpitations? Love ❤️ your videos.your pts are blessed to have u.
I’m 3 months into my career as a Residency Program Manager for a Family Med residency. I really enjoy seeing other specialties residency experiences. Thanks for posting these videos!
I appreciate that you just jumped in with procedures rather than the other ones other docs like to post of them waking up, making coffee, etc.... One Question: I have pulmonary hypertension (mild at this point) - can you talk about what precautions you have to take when a patient has that and needing a general? Is there ever a time you just say you can't do the procedure especially if it is elective?
I grew up in and out of hospital due to tricuspid atresia and Ive always loved the anesthesia team at Mayo clinic where I go, and they’re just fun and they treat me so well
Bro the city of New York has a bigger population then Sweden you are comparing apples with oranges plus I’d say his schedule is pretty good he does his call shift has is off completely when he is done until the next day id say that’s pretty good Edit: also I am referring to NYC metro which is 18.86M in population
Although I'm primarily interested in surgery rather than anaesthesia, I found your vids very informative since I like everything about the ORs and anaesthesia is my second priority I guess 🥰
This is such an awesome video. Dr. Feinstein is what I would want for my anesthesia. Also I could not help laughing when he was woken for that emergency he looked like he was out cold and then impromptu cardio for getting what I assume was a major Trauma Event requiring surgery. I am so glad I found Dr. F's videos.
Thank you for your content, Dr. Max! I'm looking into anesthesia as a medicine specialty, and your content inspires my interest! I'm beginning a bit later in the game at age 32 but I've had some exposure to medicine within allied healthcare (since age 19). I'm looking at programs in Louisiana to pursue my passion, so wish me luck!
found your video today and I love it, especially where we have to squint to see your fur baby. I love my dog too. I'm studying to be a anaesthesia Tech... Love your work and how much you simplify something so hard. Very helpful! Thanks again.
laughing....yep....in Nam, we used to call yawl ... The Gas Passer. Grin. all in good fun. I've seen doctors act the fool and throw instruments across the OR... and I've seen Doctors take the time to explain what and how they are doing certain cases. I loved it. Most of the time. The human body is an incredible piece of work....and it can take a lickin and still continue to be kickin.
Getting to RSI trauma in the field is fun as far as the medicine part and it seems difficult having to keep track of on scene meds I use or in the ambo or the helicopter I just started throwing my caps, tubes, ampules, pre-set a few IV’s, prep IO if intubation becomes an issue but learning so much from your videos and thank you for the awesome tips! ❤
i appreciate videos detailing different specialities within the medical and dental fields. I hope to go to dental school in the next few years, and I remember when I first stumbled upon your videos, my first thought was you had a great smile. Fast forward and I see that you carry toothpaste and a toothbrush with you, it is all making sense!!
Wow that was awesome and so so amazing! I enjoyed it! Thanks for sharing! I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college to be a anesthesiologist because of my cerebral palsy! I’m 32!
Have you ever done a video on pediatric anesthesiology? I'd love it if you would do a video on that if you haven't already! :) I love how Mt Sinai really values their staff's wellbeing btw, where I live it doesn't seem to be the same unfortunately...
My trust was damaged 💔 in Reno nv , the A was made cause he was at a party when called I still have nightmares , and had a bruised eye socket and nose and cheek ..he was mad I had some thing stuck in my throat and had waited 13 hrs in er and of course everything was swollen .... I'll never bee the same I think I'd rather pass at home than go through what I did ,ps also when I got home in Oregon my doctor was shocked with what happened to me . Most are good thank you for yr hard work and when needed standing up to the doctors... Denise ❤️
my dad has been in an out of so many surgeries over the last couple years and while i always appreciated the anesthesiologists visiting beforehand i always felt like a) i didnt know what to ask and b) i wasnt quite sure what all they were doing. i figured there must have been a lot involved in maintaining sedation and paralysis and breathing and vitals etc, but i just never really had a good grasp of the specifics because you dont see what anesthesiologists do. like, im there in his room when doctors and nurses rush in during an emergency and i see the drugs they give him and im able to ask follow up questions after. i see nurses giving him dialysis and im in the room with them asking questions and being taught about the process and how to proceed in the future. with anesthesiology, you just do not see that, so for me it always felt like there was a disconnect between these doctors and their team and my dad's care. your channel has really been eye-opening, you do so so much and i just really appreciate you and everyone in your specialty. thank you.
Usually the break person will only be there when the case is cruising along (not at beginning or end of case). Report usually takes a few mins, depending on the complexity of patient and surgery
My anesthesiologist for my partial thoracotomy to excise a post-mediastinal ectopic thyroid tumor told me to NEVER allow an A-line while I am conscious. That case took 14 hours (three biopsies included). Before a permanent port was implanted, I would not agree to let anyone use those veins on my right wrist.
nice content as always Dr. Feinstein. Tough I got a question: I'm from EU and usually here we (nurses and doctors) wear our scrubs, provided and cleaned by the hospitaL, directly inside the hospital in an appropriate locker room. Why do I see videos from USA healt care workers that dress their sccrubs at home, before heading work and than wearing it off back at home? isn't it risky for both patiences and workers moving around germs hospital-home? And how workers can provide a proper scrub's cleaning - disinfection from germs/blood etc? Here is actually forbidden to wear scrubs outside hospital, clean or not clean, to prevent spreading diseases. And hospital or healt care structure takes care to clean and disinfect used scrubs everyday and provide a fresh clean one to workers everyday. Also healt care worker's time spent to dress and undress their scrubs is payed (10 minutes per day, ok, aint much, but still, fun fact). sorry for my bad english and have a nice day.
I am a board certified anesthesiologist from Germany. It’s interesting to see the differences. How many ORs do you have? How many anesthesiologists on call? (Seniority of those on call?) Don’t you have help setting up for the surgery? We usually work with a nurse that helps during induction/nerve blocks/extubation..
Hello! I'm not certain about the exact figure, but I believe we have in the neighborhood of 50 operating rooms plus about as many "other" anesthetizing locations (endoscopy, interventional radiology, etc.). I'm not sure if this is a US-specific and/or New York and/or residency-specific characteristic, but nurses do not participate in preparation of anesthesia equipment. I believe that in other parts of the US, nurses and/or anesthesia techs help in the OR while patients are in the room. We do have anesthesia techs who helps stock equipment, but they are not typically in the room during patient care.
I’m also an anesthesiologist in Germany, and it surprised me too that you have to do the whole setup by yourself. And one more difference: propofol is not a controlled drug here like opioids.
@@qichuan6158 Thanks to all 3 of you! Also German and had excellent care from anesthesiologists in my life, most recently for a c section. They were kind, professional and talked me through all they did. Dr. Feinstein's videos are really informative, he is just the kind of person you want when you are put under.
Now that I have been doing IOM for a good year. I'm so happy before I even stepped foot in the OR I started watching your vids. I have had so many CRNA's and MDA's that I make it a point to always ask for their name, introduce myself and request what may be needed for my case. I'm a lot less terrified of saying the wrong thing and I always ask where I can set up and I'm getting much better at were my pods and leads were. I remember I was first so scared of saying the wrong thing. Then I realized I'm at a teaching hospital with some very kind and patient OR staff.
This is so cool. Like obviously you're too busy I don't even know how you have time to make video s but like can you talk to hospital doctors about like what is it like being a doctor. Like if the community has questions about like general life support from hospitals and prevention is there like a information session with doctors. Like I go to a clinic and I never really cared who my primary doctor is but like as I'm getting older its so annoying that I can never find a approachable comprehensive medical professional to talk to.
Dr Feinstein, maybe you covered this question in a video that I missed. How do you put a Jane/John Doe under General Anesthesia if they enter the ER unconscious requiring immediate surgery? You have no medical history, current medications, you have limited data, but the patient has significant chest trauma and a surgeon needs to get inside.
Great video as always! As someone who's about to start paramedic school, I'm curious if you ever help train paramedics in intubation when they're on OR rotations.
I've worked with both over my career as an ICU nurse. Biggest difference? If the patient comes back from the OR and they're warm, you had a CRNA. If they're cold, you had an Anesthesiologist.
Max, I love your channel. The only thing that popped into my mind is that Haribro products are not vegetarian. They contain either beef or pork gelatin.
I know that they need to work so many hours to get their verity of cases and experience as soon as possible to be successful , The flip side is the risk of mistakes and burnout. I wish they could be limited unless it’s an absolute emergency. If I were undergoing surgery I want a well rested and happy team taking care of me.
Glad you've gotten a chance to experience our bagels and discovered the hype was very much real lol. Been a New Yorker all my life, if there's anything we do right -- it's bagels and pizza.
Max, when you mentioned the blood bank preparing the blood products, are those going to be actually sitting in a freezer within the OR itself where you can immediately grab them, or do they stay at the blood bank but just on “standby”?
Those 250ml bags of pressors, are those ready and prepared by pharmacy for you guys to take? I find this absolutely fascinating. We have to draw up all katecholamines from scratch except the 10ml emergency syringes of epinephrine and norepinephrine which are typically used during codes. Seems very efficient to have those already drawn up for you
Yes, we are fortunate to have our pharmacy prepare these. As far as I'm aware, it's a safety mechanism to reduce the likelihood of medication errors, specifically with dilutions.
Hi Max i am a 82 year old retired😀😀 anesthesiologist/intensivist from the Netherlands.
I really enjoy your video's and the multifaceted approach you use to be on top of everything you might encounter.
Super and good luck in your career.
By the way i worked in Elmhurst in 1972 .
I don't believe you
@@Joeyratatouille
Your opinion is not important
@@TSchum40 Coming from the fake internet anesthesiologist.
Let’s keep the discourse civil
@@wurtzgood the only thing civil here will be the lawsuit I serve you for that yee yee ass haircut. Silence.
Labeling the chair "Anesthesiology" further revealed the first the case wasn't an ortho case, in which case you would have labeled it "Gas-bro"
Excellent observation
@@MaxFeinsteinMD using oxygen on the bag will screw it up and you won’t get an accurate reading. The manufacturer is right
@@thomasa4239 are you a doctor
@@MaxFeinsteinMD good video man wished all doctors cared like that
@@thomasa4239 the air pressure bag is simply there to pressurize a saline bag, it does not perform any readings and had no electronic parts. The transducer plate is part of the arterial line that he primed, which reads the pressure.
As someone that has had several surgeries over the years, I have a whole new appreciation for the anesthesiologist that were present. Thank you for your videos.
Looking at all of the technology and medical equipment you have at your disposal, makes me realize how fortunate we are to live in a country that can provide it.
What do you mean?
if you have money and good insurance...
@@Blueraymooi mean anybody in America can have access to those machines
@@Blueraymoo in canada, you need time, lots of it. We pay with time. Which can be so long that many go to the US because you can be seen sometimes 1 year faster.
those are pretty standard for a proper teaching hospital. difference is other countries with universal healthcare don't bill you a million dollars for live saving treatments
I have never heard of a doctor giving local anesthetic before giving an IV. That is next level and shows your tremendous care for your patients!
You are always so great at explaining things. I’m a nurse in Florida and I love to work with doctors like you!
So cool what you guys get to do. I’m an icu nurse and get to mess around with a lot of these drugs but not in the volume and density that you do. That’s a lot to manage at once, great job man
Don't forget you are being watched by people far above clinical management. Make sure to dispose those schedule substances properly; including that Ketamine that seems to be a mysteriously mystery...
As anaesthesiologist as well but working in Europe I love to watch your videos to compare the differences. honestly Im so glad that our nurses do all the preperation, machine checking and medication. You just call them, say what you want and its done. I really love my staff ❤
I'm a veterinary anesthesiology resident, and I really love comparing the differences (and similarities!) between our fields. Best of luck as you wrap up training and transition to being an attending yourself! 🙂
For dogs? I did it with on the job training. Ket/Val then 2.5% turn it off to wake up. Your welcome, cert is in the mail
@@jimjab3631 clearly you have no clue how much more complicated it is in dogs and cats...
👋🏻 fellow veterinary anesthesiology resident! I agree that it's super cool to compare and get the human med perspective!
Here’s a new perspective for you! I’m an Epic Anesthesia analyst and as crazy as this sounds, I enjoy watching your videos because it helps me to get a better perspective of how your day goes and how you run your cases, why you use certain equipment, etc. I find that the better I understand my users, the better I can support them and ensure they have the tools they need. I see myself as part of your team and have gone to bat many times for my team when other clinical areas want to make changes that impact anesthesia when they don’t understand why Anesthesia does something a certain way. Im sure it comes from many years of working with surgeons, but certainly a unique reason I appreciate your channel!
surmising Epic is a brand name and surmising you're epic too.
I have a major surgery coming up soon and your videos are putting me at ease about the care I'll be receiving. Thank you for sharing such an open window of your experiences and expertise!
Ever since I was in high school I wanted to become a cardiothoracic surgeon… your videos piqued my interest in anesthesiology and now that’s what I want to do. I just went back to school after taking off 10 years and I’ll be 33 next month. One year left to finish my B.S. in Biology so I can apply to medical school
Hope you crush it, good luck!!(:
@@ethanroberts3207 thank you! 😊
Better late than never! Congratulations in advance! I knw you’ll be a great doctor and anesthesiologist
@@alexisdior90have you heard of CAAs? Look into that if u wanna go into anesthesia guaranteed without the length of med school and residency
@@maysmoukdad7877 You can only practice in a handful of states as AA. CRNAs hate them and are lobbying against them at all costs lol. Doctors love them tho
I'm relatively sure that not every anesthesiologist is as personable as you are, but I certainly hope that they are as meticulous and knowledgeable !!! 😊👍
I've interacted with maybe 5 anesthesiologists prior to surgery and a few prior to colonoscopy. They were all completely personable, save for one colonoscopy anesthetist. The grumpy guy was just dour and didn't want to hear me explain my special needs (don't gimme high flow O2 unless absolutely necessary). He later went to prison for 8 to 21 years for giving patients hepatitis by reusing non-reusable drugs and equipment).
@@frotoe9289 YIKES 😵😩😝
@@CarolLynnWilliams Yeah. 40,000 patients were told to get tested for HIV and Hepatitis when they found out what had been going on at that clinic and several patients died from contracted Hep C. The owner of the place died in prison after being convicted of 2nd degree murder (he had ordered the anesthetist to do these things to save money).
@@frotoe9289 So I guess you're talking about a Surgical Center. Some are okay, but you never know. I am a fringe health professional and have advised all of my people to choose a doctor who works out of a hospital. At least they have a better chance of sterilized and sanitized protocols due to more legal awareness and less reliance on cost savings.
The local anesthetic before putting in an IV is so thoughtful
I'm not even sure how your videos ended up being suggested to me, but I am so so glad they did!! I am a doula who has seen both my parents through cancer surgeries, supporting several surgical. births with clients over the years and I have more family members and friends with surgeries coming up. For me, as someone who's clinical skills basically end with first aid, watching your videos really helps me feel reassured and that confidence in knowing how some of this stuff works helps me relax a bit and put a bit more trust in the teams caring for my people. It's reassuring. Yes, I still ask all the BRAIN questions to make decisions, but it means so much to know how much goes into prepping for caring for patients. Thank you so much.
4th year?? wow i remember when you were a 1st year hehe
Im a 1st year anestesia resident in barcelona (vall dhebron) ☺️ i watched your videos ever since i decided to quit GI to persue anaesthesia
Thanks Max!
I was one of the developers of the patient monitor in the OR. It’s wonderful to see these in use helping patients and caregivers.
I require 2 kidney procedures each year involving general anesthesia. From your videos, I have a better understanding and appreciation for what the anesthesiologist's role is in my procedures, thanks.
What procedures exactly
@@skyhappy Bilateral stents
Thanks for sharing, great video! Also a great reminder to me of the importance of my blood donations seeing you prepare for the potential need of blood for the emergency case, wow, great example of cause and effect. I never see the end results on the other side of my donations but that helps to make it so much more real and meaningful, thanks!
I get a text when my donated blood gets used. Maybe your local blood center can get that set up for you. It's pretty cool.
@@TR-wm3sg I get emails from mine when mine is used, it just makes it more real seeing it in action!
The disappointment from the seltzer water vs the gummy bears lmao. "It's fine." Just coping your way through it.
I’ve had multiple surgeries and really appreciate my anesthesiologists! They always have a good sense of humor, meet with me before the surgery and tell me their plan. The last surgery I had the anesthesiologist even gave me a pill called mironal for anxiety and after surgery appetite boost. Which I thought was different but actually helped me lol.
I just wanted to say as someone who found this as a patient and possibly (if my health doesn't impede it) medical student I find all this information so interesting. I had huge anxiety about anesthesia since I have a huge fear of death and in some ways there are similarities (no time perception, loss of control, hoe foreign of an experience it is, etc) but your vids helped a ton, and now that I'm through surgery (20 feb '22) I still struggle with health issues but your videos are a great distraction for someone who's curious and just wants to learn. Thanks Max! I heard you finished residency too, grats!
Residency, those wonderful years that thankfully never come back.
The worst shift I’ve had was the one I traded off so I could use my post-shift day off to take a 2h flight to attend a Aerosmith concert, get back to the airport to sleep there and take the first flight in the early morning to come back to the routine shift. Thankfully my attending had been my senior resident and was ok with me getting a little bit late. Turns out 14 years later, 3 months ago, I asked him to anesthetize my wife to remove a meningioma with the neurosurgeon I work with.
Why that was my worst shift? We had a ruptured AAA, so no sleep at all.
6:17 The hospital Anthesiaets had a long case...me. I had a liver that needs transplanting SO they started at 5 30 to 6 PM and I think it last till early morning...After watching this, I feel bad for putting those people through hell. I'm not sure if they deserved that long of an transplant BUT they did it and I'm still here on this earth.
Pressure bag trick... Mind blown! 🥺
My late Aunt Ann Wise was an anesthesiologist in SPOHN hospital in Corpus Christi, Texas for many years. Long ago. She was a trailblazer!
I like seeing your scrub caps--they are very fun. Having had open heart surgery your segments explain is much I didn't know or consider. Thank you.
You are just awesome! I bet all the staff love u. ❤️ gosh your junior residents are blessed with your teaching skills. Are there any particular cases that give u palpitations? Love ❤️ your videos.your pts are blessed to have u.
I’m 3 months into my career as a Residency Program Manager for a Family Med residency. I really enjoy seeing other specialties residency experiences. Thanks for posting these videos!
Nice video to see what on call is like for 24hrs also a Big thanks to MSH For letting you do the UA-cam videos
So cool that you were able to capture the naming of the Mt. Sinai chair of anesthesiology!
I appreciate that you just jumped in with procedures rather than the other ones other docs like to post of them waking up, making coffee, etc.... One Question: I have pulmonary hypertension (mild at this point) - can you talk about what precautions you have to take when a patient has that and needing a general? Is there ever a time you just say you can't do the procedure especially if it is elective?
I can’t get enough of these videos. Thank you
I grew up in and out of hospital due to tricuspid atresia and Ive always loved the anesthesia team at Mayo clinic where I go, and they’re just fun and they treat me so well
That's nuts, no wonder you guys earn so much over the pond. I'm going to remain here in Sweden and work my 40h/week schedule.
Bro the city of New York has a bigger population then Sweden you are comparing apples with oranges plus I’d say his schedule is pretty good he does his call shift has is off completely when he is done until the next day id say that’s pretty good
Edit: also I am referring to NYC metro which is 18.86M in population
After they become an attending they can work 40 hours and make 400k lol
You are a top shelf doctor
Although I'm primarily interested in surgery rather than anaesthesia, I found your vids very informative since I like everything about the ORs and anaesthesia is my second priority I guess 🥰
i love when you do these types of videos. ill be a nurse soon and anesthesia is a big interest of mine.
Max you're a true inspiration🙌🙌
Very Charming doctor anesthesia❣👍
A very informative video with a great format.
Super interesting video! Thanks for taking the time to make it! It looks like you are REALLY good at what you do by the way!!! 🥳🥳🥳👍🤩🌷
This is such an awesome video. Dr. Feinstein is what I would want for my anesthesia. Also I could not help laughing when he was woken for that emergency he looked like he was out cold and then impromptu cardio for getting what I assume was a major Trauma Event requiring surgery. I am so glad I found Dr. F's videos.
Thank you for your content, Dr. Max! I'm looking into anesthesia as a medicine specialty, and your content inspires my interest! I'm beginning a bit later in the game at age 32 but I've had some exposure to medicine within allied healthcare (since age 19). I'm looking at programs in Louisiana to pursue my passion, so wish me luck!
found your video today and I love it, especially where we have to squint to see your fur baby. I love my dog too. I'm studying to be a anaesthesia Tech... Love your work and how much you simplify something so hard. Very helpful! Thanks again.
I love watching this man
Hello thank you for taking us along! I enjoy your videos
laughing....yep....in Nam, we used to call yawl ... The Gas Passer. Grin. all in good fun. I've seen doctors act the fool and throw instruments across the OR... and I've seen Doctors take the time to explain what and how they are doing certain cases. I loved it. Most of the time. The human body is an incredible piece of work....and it can take a lickin and still continue to be kickin.
You are epic sir, your videos are educational and relaxing to watch
Getting to RSI trauma in the field is fun as far as the medicine part and it seems difficult having to keep track of on scene meds I use or in the ambo or the helicopter I just started throwing my caps, tubes, ampules, pre-set a few IV’s, prep IO if intubation becomes an issue but learning so much from your videos and thank you for the awesome tips! ❤
Love your videos. Had simply no idea how much an anesthesiologist was responsible for during surgery.
Now I understand why the anesthesiologist bill was more than the surgeon when I had surgery.
i appreciate videos detailing different specialities within the medical and dental fields. I hope to go to dental school in the next few years, and I remember when I first stumbled upon your videos, my first thought was you had a great smile. Fast forward and I see that you carry toothpaste and a toothbrush with you, it is all making sense!!
Great video! Happy to have my question featured too haha. Merry Christmas
Don't inflate your pressure bag before you've spiked it. It can introduce microbubbles into the system and skew your BP readings
I flush the line thoroughly after I spike it, as one should do whether or not the pressure bag is inflated before spiking.
Wow that was awesome and so so amazing! I enjoyed it! Thanks for sharing! I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college to be a anesthesiologist because of my cerebral palsy! I’m 32!
Have you ever done a video on pediatric anesthesiology? I'd love it if you would do a video on that if you haven't already! :) I love how Mt Sinai really values their staff's wellbeing btw, where I live it doesn't seem to be the same unfortunately...
My trust was damaged 💔 in Reno nv , the A was made cause he was at a party when called I still have nightmares , and had a bruised eye socket and nose and cheek ..he was mad I had some thing stuck in my throat and had waited 13 hrs in er and of course everything was swollen .... I'll never bee the same I think I'd rather pass at home than go through what I did ,ps also when I got home in Oregon my doctor was shocked with what happened to me . Most are good thank you for yr hard work and when needed standing up to the doctors... Denise ❤️
my dad has been in an out of so many surgeries over the last couple years and while i always appreciated the anesthesiologists visiting beforehand i always felt like a) i didnt know what to ask and b) i wasnt quite sure what all they were doing. i figured there must have been a lot involved in maintaining sedation and paralysis and breathing and vitals etc, but i just never really had a good grasp of the specifics because you dont see what anesthesiologists do.
like, im there in his room when doctors and nurses rush in during an emergency and i see the drugs they give him and im able to ask follow up questions after. i see nurses giving him dialysis and im in the room with them asking questions and being taught about the process and how to proceed in the future. with anesthesiology, you just do not see that, so for me it always felt like there was a disconnect between these doctors and their team and my dad's care.
your channel has really been eye-opening, you do so so much and i just really appreciate you and everyone in your specialty. thank you.
Thank you! This explained a lot of what kind of anastestia that they used with me. I had colon resection surgery in May.
When you take a break, how much time is needed to update your replacement and how do you deal with problems or anomalies that happen?
Usually the break person will only be there when the case is cruising along (not at beginning or end of case). Report usually takes a few mins, depending on the complexity of patient and surgery
My anesthesiologist for my partial thoracotomy to excise a post-mediastinal ectopic thyroid tumor told me to NEVER allow an A-line while I am conscious. That case took 14 hours (three biopsies included). Before a permanent port was implanted, I would not agree to let anyone use those veins on my right wrist.
nice content as always Dr. Feinstein. Tough I got a question: I'm from EU and usually here we (nurses and doctors) wear our scrubs, provided and cleaned by the hospitaL, directly inside the hospital in an appropriate locker room. Why do I see videos from USA healt care workers that dress their sccrubs at home, before heading work and than wearing it off back at home? isn't it risky for both patiences and workers moving around germs hospital-home? And how workers can provide a proper scrub's cleaning - disinfection from germs/blood etc?
Here is actually forbidden to wear scrubs outside hospital, clean or not clean, to prevent spreading diseases. And hospital or healt care structure takes care to clean and disinfect used scrubs everyday and provide a fresh clean one to workers everyday.
Also healt care worker's time spent to dress and undress their scrubs is payed (10 minutes per day, ok, aint much, but still, fun fact).
sorry for my bad english and have a nice day.
hats off to Dr's like you !
Hi max my dad was a anaesthesia he’s passed now he trained at the Middlesex hospital UK
I am a board certified anesthesiologist from Germany. It’s interesting to see the differences. How many ORs do you have? How many anesthesiologists on call? (Seniority of those on call?)
Don’t you have help setting up for the surgery? We usually work with a nurse that helps during induction/nerve blocks/extubation..
Hello! I'm not certain about the exact figure, but I believe we have in the neighborhood of 50 operating rooms plus about as many "other" anesthetizing locations (endoscopy, interventional radiology, etc.). I'm not sure if this is a US-specific and/or New York and/or residency-specific characteristic, but nurses do not participate in preparation of anesthesia equipment. I believe that in other parts of the US, nurses and/or anesthesia techs help in the OR while patients are in the room. We do have anesthesia techs who helps stock equipment, but they are not typically in the room during patient care.
I’m also an anesthesiologist in Germany, and it surprised me too that you have to do the whole setup by yourself. And one more difference: propofol is not a controlled drug here like opioids.
@@qichuan6158 Thanks to all 3 of you! Also German and had excellent care from anesthesiologists in my life, most recently for a c section. They were kind, professional and talked me through all they did. Dr. Feinstein's videos are really informative, he is just the kind of person you want when you are put under.
It's for residency only. Usually, if you are an attending, a CRNA or resident does all the setups for you
Now that I have been doing IOM for a good year. I'm so happy before I even stepped foot in the OR I started watching your vids. I have had so many CRNA's and MDA's that I make it a point to always ask for their name, introduce myself and request what may be needed for my case. I'm a lot less terrified of saying the wrong thing and I always ask where I can set up and I'm getting much better at were my pods and leads were. I remember I was first so scared of saying the wrong thing. Then I realized I'm at a teaching hospital with some very kind and patient OR staff.
This is so cool. Like obviously you're too busy I don't even know how you have time to make video s but like can you talk to hospital doctors about like what is it like being a doctor. Like if the community has questions about like general life support from hospitals and prevention is there like a information session with doctors. Like I go to a clinic and I never really cared who my primary doctor is but like as I'm getting older its so annoying that I can never find a approachable comprehensive medical professional to talk to.
greatest anesthesiologist of all time - singlehandedly converted me to the field
- recovering ortho bro
Dr Feinstein, maybe you covered this question in a video that I missed.
How do you put a Jane/John Doe under General Anesthesia if they enter the ER unconscious requiring immediate surgery?
You have no medical history, current medications, you have limited data, but the patient has significant chest trauma and a surgeon needs to get inside.
OR recycling??? Fantastic!!!!!
Going to release a whole video about that in the coming months!
Bless you Max!
Please do more videos like this!
If you are a vegetarian you should probably keep away from Haribo anywhay as they contain gelatine. Great video as always! :)
They used to make sugar-free Haribo gummies. They had certain, uh, side effects though.
I have Malignant Hyperthermia so this was very interesting to watch.
Great video as always! As someone who's about to start paramedic school, I'm curious if you ever help train paramedics in intubation when they're on OR rotations.
I love your videos! We would love to see an anesthesiologist vs CRNA video of comparisons, differences, etc.
I've worked with both over my career as an ICU nurse. Biggest difference? If the patient comes back from the OR and they're warm, you had a CRNA. If they're cold, you had an Anesthesiologist.
Max, I love your channel. The only thing that popped into my mind is that Haribro products are not vegetarian. They contain either beef or pork gelatin.
I know that they need to work so many hours to get their verity of cases and experience as soon as possible to be successful , The flip side is the risk of mistakes and burnout.
I wish they could be limited unless it’s an absolute emergency. If I were undergoing surgery I want a well rested and happy team taking care of me.
I know this is an old video, but this video made me subscribe to you. I like you best in this video. Thanks doc!
kool i want to go to med school one day but ill need to go to college again which is what i am trying to do now lol
wow you had the best attendings in the world, food for everyone everyday?? so generous😮 i've never seen anything like that
Was the first case a carotid endarterectomy? The prep sounded very familiar 😁
:D
Hey.. fellow New Yorker here. Just found your channel! currently binge watching haha
keep it up 🤗
Hope the splenectomy went well. Rapid infusers are the best and portable blood salvage machines 😊
I have a question too
By eating so much cake and snacks, aren't you afraid to end up on the same operating tables you are used to 😔
Very valid question. Generally I try to keep a healthy diet, but on call, having snacks is something that keeps me going.
Glad you've gotten a chance to experience our bagels and discovered the hype was very much real lol. Been a New Yorker all my life, if there's anything we do right -- it's bagels and pizza.
Max, when you mentioned the blood bank preparing the blood products, are those going to be actually sitting in a freezer within the OR itself where you can immediately grab them, or do they stay at the blood bank but just on “standby”?
For this case, they were in the refrigerator immediately next to the OR. For other less urgent cases, we would keep them on standby in the blood bank.
Thank you for so much for explaining this!
The local anesthetic for IV placement is genius! I wish i would’ve had that done a few times my veins got threaded, collapsed, or blown out lol 😂
what an exciting, rewarding job...Maybe in my next life.........
Those 250ml bags of pressors, are those ready and prepared by pharmacy for you guys to take? I find this absolutely fascinating. We have to draw up all katecholamines from scratch except the 10ml emergency syringes of epinephrine and norepinephrine which are typically used during codes. Seems very efficient to have those already drawn up for you
Yes, we are fortunate to have our pharmacy prepare these. As far as I'm aware, it's a safety mechanism to reduce the likelihood of medication errors, specifically with dilutions.
@@MaxFeinsteinMD that makes total sense. Thank you for your answer!
How is 5 hour a full night of sleep??? I'm amazed...thank you for the video.
Im a nurse but I find your videos so interesting
I´m surprised, here in Argentina the attending anesthesiologist also buys food for all residents on call.l Nice!
Max, love your videos. Can you make a video on the different providers of anesthesia (MD, AA, CRNA) and your thoughts on it. Thanks.
You know you're getting abused when 5 hours is a full night's sleep
If you collect a drug from the pharmacy but don't make use of it, can they take it back or is nothing allowed to be placed back into the pharmacy?
I have been an attending for 20 years. You are an excellent resident. If you want a good job in Sunny Florida let me know