How do injections work?
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+JuggerNaut+
- Posts: 22175
- Joined: Sun Oct 14, 2001 7:00 am
wimp. i had 4 pulled in one sitting with just the injections at the jaw.SplishSplash wrote:They gave me the choice. I chose not to experience the whole ordeal, and I was pretty happy about that decision later on.Deji wrote:Why unconscious anyway? When they pulled my tooth, they only did a local anaesthesia.
Also, it was 4 teeth, not just one.
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Guest
I can have a soothing voiceGeebs wrote:Shit, if you did that to me you'd need to double the dosesaturn wrote:nope, I just talk to them slowly and softly about thinking about relaxing thingsDenz wrote:Do you make your patients count backwards?
Do they do a full induction for dental work? I thought they just went for sedation and then local. In which case it'd be midazolam, which seems to take about 10 seconds.
Then again, as you can tell, I just knock people out for fracture and dislocation reductions, my anaesthetics is pretty damn weak.
At the daycare operation rooms (whatever you NHS brits call it) the dental surgeons do some extractions under full narcose.
How much midazolam do you use? The only time I saw anesthesiologists use intravenous midazolam, was at the thoracic surgery centre. I think they injected around 10 mg which worked even more quickly than propofol. Then they were connected to a continuous midazolam infusion.
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Billy Bellend
- Posts: 456
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SplishSplash
- Posts: 4467
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My dad is on continuous midazolam. I thought 3,5 ml an hour. Has been like that for a while.saturn wrote:I can have a soothing voiceGeebs wrote:Shit, if you did that to me you'd need to double the dosesaturn wrote: nope, I just talk to them slowly and softly about thinking about relaxing things
Do they do a full induction for dental work? I thought they just went for sedation and then local. In which case it'd be midazolam, which seems to take about 10 seconds.
Then again, as you can tell, I just knock people out for fracture and dislocation reductions, my anaesthetics is pretty damn weak.
At the daycare operation rooms (whatever you NHS brits call it) the dental surgeons do some extractions under full narcose.
How much midazolam do you use? The only time I saw anesthesiologists use intravenous midazolam, was at the thoracic surgery centre. I think they injected around 10 mg which worked even more quickly than propofol. Then they were connected to a continuous midazolam infusion.
I just titrate according to response; start with 2 or 3 mg, then work up, but you don't want to give more than 10 in one go. If I'm pulling shoulders or fractures, I tend to shoot them up on 50mg pethidine first - gives some more muscle relaxation, and means you don't have to use as much midazolam. The more relaxed they are, the less likely you are to break something. It's the only time I like to use pethidine, 'cos the whole point is that it wears off quickly; otherwise, I hate the stuff.saturn wrote:How much midazolam do you use? The only time I saw anesthesiologists use intravenous midazolam, was at the thoracic surgery centre. I think they injected around 10 mg which worked even more quickly than propofol. Then they were connected to a continuous midazolam infusion.
If you're doing a shoulder and you still can't get it in on 10mg midazolam, it's time to get the orthos on and do it in theatre. Last guy I couldn't do needed an open reduction.....
2 months on intensive care. Stabile critical was the term used for one and a half month but he still isn't out of the woods yet.Geebs wrote:Crikes, I take it that he's not too well. Sorry to hear about that.Survivor wrote:My dad is on continuous midazolam. I thought 3,5 ml an hour. Has been like that for a while.
He woke up monday after they suddenly cut his dormicum. Can't talk due to a breathingaid in his throath. Now he misses 2 months of his life and can't ask questions. You can see it in his face.
I've worked a while on intensive care, pretty shite environment for patients, too much going around them, always noise and lights.Survivor wrote:2 months on intensive care. Stabile critical was the term used for one and a half month but he still isn't out of the woods yet.Geebs wrote:Crikes, I take it that he's not too well. Sorry to hear about that.Survivor wrote:My dad is on continuous midazolam. I thought 3,5 ml an hour. Has been like that for a while.
He woke up monday after they suddenly cut his dormicum. Can't talk due to a breathingaid in his throath. Now he misses 2 months of his life and can't ask questions. You can see it in his face.
I hope he'll recover finely, 2 months sedation isn't just something.
rofl, the only time I've ever used pethidine was for pregnant women with intense labour pain.Geebs wrote:I just titrate according to response; start with 2 or 3 mg, then work up, but you don't want to give more than 10 in one go. If I'm pulling shoulders or fractures, I tend to shoot them up on 50mg pethidine first - gives some more muscle relaxation, and means you don't have to use as much midazolam. The more relaxed they are, the less likely you are to break something. It's the only time I like to use pethidine, 'cos the whole point is that it wears off quickly; otherwise, I hate the stuff.saturn wrote:How much midazolam do you use? The only time I saw anesthesiologists use intravenous midazolam, was at the thoracic surgery centre. I think they injected around 10 mg which worked even more quickly than propofol. Then they were connected to a continuous midazolam infusion.
If you're doing a shoulder and you still can't get it in on 10mg midazolam, it's time to get the orthos on and do it in theatre. Last guy I couldn't do needed an open reduction.....
i must admit, I've never pulled a shoulder or fracture.....that'll be fun in the future when i'm doing ER shifts
It's all about the traction. Most of the different manoevres are to some extent a bit bullshit; or at least, they don't work unless you've got everything nicely relaxed and given a good couple of minutes' pull.
Generally speaking, we only get the anaesthetists in the ER either when someone's come in in respiratory failure and needs ventilatory support (most of them don't get it on the basis that they've got chronic respiratory failure and they'd never get weaned off), or during the trauma calls, when it's extremely helpful to have someone who knows what they're doing at the head end, because they can usually stop the orthopedic registrar from doing anything particularly stupid
Generally speaking, we only get the anaesthetists in the ER either when someone's come in in respiratory failure and needs ventilatory support (most of them don't get it on the basis that they've got chronic respiratory failure and they'd never get weaned off), or during the trauma calls, when it's extremely helpful to have someone who knows what they're doing at the head end, because they can usually stop the orthopedic registrar from doing anything particularly stupid
:icon26:DRuM wrote:Do you still see him?MaCaBr3 wrote:A dentist got arrested because he sedated his patients and inserted his penis in their mouth afterwards.
[i]And shepherds we shall be, for thee my Lord for thee, Power hath descended forth from thy hand, that our feet may swiftly carry out thy command, we shall flow a river forth to thee, and teeming with souls shall it ever be. In nomine patris, et fili, et spiritus sancti.[/i]