I disagree, this male is a Moron and the disparaging remark I am making is because untrained professionals or lay People will watch this and think this is a party trick. Like eating the Tide Pods, or swallowing bleach, or playing the Assassin Game with water guns. We have enough people coming into the ER, OR, and Trauma center trying to practice medicine without being properly Trained and could kill themselves. When this idiot decided to inhale the soap liquid into the Endotracheal Tube he could have aspirated and Died!; That is an inaccurate and precarious method of exposing people to unnecessary RISKY Practices! He needs to be Sanctioned by the AMA and Licence Permanently Removed!;End of Story. Good Riddance!
The sacrifice for medical education is exemplary. An outstanding demonstration of courage and the desire to teach students. You most definitely get the gold star after this demonstration.
I have a patient with severe ankylosing spondylitis, unable to move his neck and back, scheduled for umbilical hernia surgery. We will try to perform an awake intubation. Your video and insight for the procedure is priceless
Hey everyone, this is Ian here! I just wanted to elaborate on a few things that I didn't mention in the video. 1. Administering IV glycopyrrolate or another antimuscarinic is important not only for improving your view on the fiberoptic scope, but also for increasing the efficacy of your topicalization by drying the laryngopharyngeal mucosa. 2. Although I implied it, I should explicitly state that when performing a transtracheal block, your target injection site is through the cricothyroid membrane. You want to aspirate as you advance the needle and STOP advancing once you aspirate air in order to avoid lacerating the posterior tracheal mucosa. Also, it is helpful to have patients at least partially expire before injecting and then subsequently take a deep inspiration to trigger a robust cough, which will help aerosolize the local onto the inferior aspect of the vocal cords. A secondary benefit of performing transtracheal blocks is that they offer you some experience locating and entering the cricothyroid membrane, which may be a life-saving skill if you ever need to perform a cricothyrotomy in can't intubate/can't ventilate scenario.
For a 17-year-old who considers joining the emergency service, I can definitely tell you that this video was extremely helpful. Would definitely like to see more videos like this in the future! ❤
Thanks for doing this. I'm an anesthesiologist who didn't do transtracheal blocks in residency, but I took a job at a cancer hospital and I've had to do them a couple times this year and found they work great. I am starting to gain trust in my awake fiber optic technique but not sure if I will even believe in it enough to try it on myself 😂. Thanks again for a great video
Most definitely! I am glad you enjoyed the video and appreciate you sharing your experiences. Since leaving residency, I have been very surprised that so few of my colleagues got the opportunity to practice airway blocks or topical-only awake intubations during training! Granted, I have only ever done transtracheal blocks, but I think they are incredibly useful, especially if you need to rapidly secure an abysmal airway, as you have undoubtedly experienced. I also think it's helpful to show trainees just how well airway topicalization/blocks can work if you take just a little bit of time. Finally, I think it can help patient buy-in if you let them know that you've done it to yourself to no ill effect 😁.
You should have connected yourself to the ventilator, and given us an ETCO2. You know. Connect to the ventilator, go on Volume control, and then stay after a few minutes, discontinue mechanical ventilation, and propperly extubate yourself.
Late comment but, I understand that you cant talk while intubated because it goes through your vocal cords, but what happens if you tried really hard to talk, would it hurt? would you be able to make any noise at all?
Does not look fun, but no where even close to as bad as the doctor that preformed his own IO. That is like an IV but with a 16ga needle and a cordless drill into the bone. I had it done twice a few minutes a part just below my knee. You can not mentally prepare for that kind of pain. Then the guy drills hole one and says...." You are going to hate me.. Dry hole we need to do it again." But I thought that was going to be the worst of it as I screamed like a little baby, but it turned out the pushing of the meds into it was so much more painful than even the drill. I had meds pushed into it for 6 hours wide awake. Just an IV but into a bone instead of a vein. Never never ever again while I am a wake!!!
Sir can u give me ur mb no. ? U r really very much enthusiastic in teaching..My self Dr Hitesh Thumar Consultant Anesthetist & We r also running one Anesthesia Skill Development Academy..So hope we can helpout each others for same purpose Thank you
Clearly a combination of essential oils and powerful crystals... Nah, the numbing medicine blocks the signals from the nerves (CN IX, afferent) that trigger the gag reflex (CN X, efferent).
As a doctor I can say, you are legend sir.
Hahaha, I appreciate the sentiment, but I'm just a simple country doc trying to spread some knowledge 😄.
I disagree, this male is a Moron and the disparaging remark I am making is because untrained professionals or lay People will watch this and think this is a party trick. Like eating the Tide Pods, or swallowing bleach, or playing the Assassin Game with water guns. We have enough people coming into the ER, OR, and Trauma center trying to practice medicine without being properly Trained and could kill themselves. When this idiot decided to inhale the soap liquid into the Endotracheal Tube he could have aspirated and Died!; That is an inaccurate and precarious method of exposing people to unnecessary RISKY Practices! He needs to be Sanctioned by the AMA and Licence Permanently Removed!;End of Story. Good Riddance!
Would love to see another! That was amazing.
Max, I'd like to see you do it!
Based
The sacrifice for medical education is exemplary. An outstanding demonstration of courage and the desire to teach students. You most definitely get the gold star after this demonstration.
I have a patient with severe ankylosing spondylitis, unable to move his neck and back, scheduled for umbilical hernia surgery.
We will try to perform an awake intubation.
Your video and insight for the procedure is priceless
How did the case go for you? Hope my pearls were helpful for you and the patient!
This doc seems like a dude who is really smart but also partied in college.
Hey everyone, this is Ian here! I just wanted to elaborate on a few things that I didn't mention in the video.
1. Administering IV glycopyrrolate or another antimuscarinic is important not only for improving your view on the fiberoptic scope, but also for increasing the efficacy of your topicalization by drying the laryngopharyngeal mucosa.
2. Although I implied it, I should explicitly state that when performing a transtracheal block, your target injection site is through the cricothyroid membrane. You want to aspirate as you advance the needle and STOP advancing once you aspirate air in order to avoid lacerating the posterior tracheal mucosa. Also, it is helpful to have patients at least partially expire before injecting and then subsequently take a deep inspiration to trigger a robust cough, which will help aerosolize the local onto the inferior aspect of the vocal cords. A secondary benefit of performing transtracheal blocks is that they offer you some experience locating and entering the cricothyroid membrane, which may be a life-saving skill if you ever need to perform a cricothyrotomy in can't intubate/can't ventilate scenario.
There is no way I could do that. There is one way I could be awake while that is being done. He is amazing!
he truly is amazing, thanks Monica
For a 17-year-old who considers joining the emergency service, I can definitely tell you that this video was extremely helpful. Would definitely like to see more videos like this in the future! ❤
Haven't seen such a passionate doctor like you sir .... My Respect towards your work ❤️👍🏻
Thanks for doing this. I'm an anesthesiologist who didn't do transtracheal blocks in residency, but I took a job at a cancer hospital and I've had to do them a couple times this year and found they work great. I am starting to gain trust in my awake fiber optic technique but not sure if I will even believe in it enough to try it on myself 😂. Thanks again for a great video
Most definitely! I am glad you enjoyed the video and appreciate you sharing your experiences. Since leaving residency, I have been very surprised that so few of my colleagues got the opportunity to practice airway blocks or topical-only awake intubations during training! Granted, I have only ever done transtracheal blocks, but I think they are incredibly useful, especially if you need to rapidly secure an abysmal airway, as you have undoubtedly experienced. I also think it's helpful to show trainees just how well airway topicalization/blocks can work if you take just a little bit of time. Finally, I think it can help patient buy-in if you let them know that you've done it to yourself to no ill effect 😁.
Omg, that was gnarly!! Keep em coming, that was awesome!!
that was a perfect job im anesthesilogist too it needs a lot of courage
This was very very very interesting keep going We need MORRRRE !
This is amazing, you’re a legend 💪🏼
You should have connected yourself to the ventilator, and given us an ETCO2. You know. Connect to the ventilator, go on Volume control, and then stay after a few minutes, discontinue mechanical ventilation, and propperly extubate yourself.
that's the easy part, Peter!
Even better, maybe I'll throw myself on APRV in the next video while placing a RIC in my EJ for a real good time.
@@xChickenoftheSeax YES. TOU SHOULD. PLEASE
@@peterfslife Even more better, I'll see if I can find an eager med student who is desperate for a CV bullet to serve as the vict... I mean model.
Would love to see more videos on this topic! Thank you!
An absolute legend Sir, much respect
It's kind of funny to watch how his voice gets hoarser and hoarser
#lidocaine
This is incredible sir 👏
no, nirmaljit, YOU are incredible
THIS WAS AMAZING.
Some of these tricks might come in handy in a non-clinical setting too ...
😏
Just gripped my shit while watching this. Good job.
way to protect the goods! thanks for watching
So.. next up tracheostomy?
I'm a masochist but I'm not crazy 🤪
Astonishing
The definition of hard. This man eats lightning and shits thunder.
Late comment but, I understand that you cant talk while intubated because it goes through your vocal cords, but what happens if you tried really hard to talk, would it hurt? would you be able to make any noise at all?
no noise. doesn't hurt
That was incredible. As a second year med student, I aspire to be you haha
go surgery
He looks like a paramedic with that stache lol
Sir, u r legend
Perfect
russians make it without lidocain and with a standard laryngoscope
that's too bad. hopefully someday they'll catch up!
@@MedSchoolMadeEasy was a joke mate
Does not look fun, but no where even close to as bad as the doctor that preformed his own IO. That is like an IV but with a 16ga needle and a cordless drill into the bone. I had it done twice a few minutes a part just below my knee. You can not mentally prepare for that kind of pain. Then the guy drills hole one and says...." You are going to hate me.. Dry hole we need to do it again." But I thought that was going to be the worst of it as I screamed like a little baby, but it turned out the pushing of the meds into it was so much more painful than even the drill. I had meds pushed into it for 6 hours wide awake. Just an IV but into a bone instead of a vein. Never never ever again while I am a wake!!!
😄superb sir
Well…now I know that’s off the table.
hardcore!
Haha! Stud!
This is sick
we all are sick
Sir can u give me ur mb no. ? U r really very much enthusiastic in teaching..My self Dr Hitesh Thumar Consultant Anesthetist & We r also running one Anesthesia Skill Development Academy..So hope we can helpout each others for same purpose
Thank you
Wtf
The casual tone in which he says that you would get to see resuscitation if he starts getting seizures legendary🫡
How are you not gagging wtf
Clearly a combination of essential oils and powerful crystals... Nah, the numbing medicine blocks the signals from the nerves (CN IX, afferent) that trigger the gag reflex (CN X, efferent).
all of the lidocaine administered during the first half of the video helps