Operating Room Equipment that Anesthesiologists need to Understand
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- Äas pĆidĂĄn 29. 06. 2024
- How does special operating room equipment affect anesthesia care of patients? In this video, I highlight some of the anesthetic considerations of neurosurgery, robotic surgery, and other types of surgery that have unique equipment in the operating room.
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0:00 Start
1:27 Neurosurgery
4:28 Robotic surgery
7:51 Spine surgery
9:01 C-sections
10:23 Genitourinary surgery
11:59 Music
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Find Max Feinstein, MD online:
Instagram: @MaxMFeinstein
Twitter: @MaxMFeinstein
Website: www.MaxFeinsteinMD.com
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Music
Subtle Swagger by Ron Gelinas Chillout Lounge | / atmospheric-music-portal
Music promoted by www.free-stock-music.com
Creative Commons Attribution 3.0 Unported License
creativecommons.org/licenses/...
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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.
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#Anesthesiology #Residency #MedicalSchool - VÄda a technologie
Iâm having robotic surgery later this morning and honestly this helped calm my nerves a bit, thank you! Your videos are great đ
Best wishes for your surgery!
@@MaxFeinsteinMD Thank you đđ»đ!
@@christinabalbuena458 How did it go?
@@christinabalbuena458 That well? Wow.
I just had my robotic hysterectomy last week. Good insight into your field. I remember during one of my OR clinical rotations decades ago, one famous neurosurgeon required that classical music would be playing when he entered the theater. Good experience.
As a pediatric neurosurgery patient, this was very interesting and informative! Thank you!
Glad you enjoyed, thanks for watching!
@@MaxFeinsteinMD would you know if a patient had a seizure on the table if you gave them a paralytic ? Could you tell with those forehead stickers ? lol sorry I have no clue what they are called.
@@user-iw1oj6to4r A Bis Monitor and EEG I think
That donut ct scanner looks delicious đ
I thought so, too. Might be stale, though.
Haha yes now I really want a donut.
Anesthesiologists are probably very tired at the end of the day. U guys focus on the monitor so much. Like driving for a while u get tired from focusing
Wow, so much insight I am really interested in anesthesia, as a medical student, and this definitely enlightens the specialty! Thanks for the awesome content!
You're very welcome! Glad this has been a good way of seeing more of the specialty- that's the goal.
I'm in my fifth year in medical university in Europe. I have been considering anesthesiology for some time, and your videos have additionally pushed my opinion towards the field. Thank you for the fun and informative videos, forever a subscriber!
Do it do it! Haha thanks for watching, glad you found the videos helpful!
As a pediatric brain tumor survivor this was really interesting to watch. I know for me I was laying on my stomach as my tumor was in my cerebellum
Wow I can't even imagine. Glad to know you made it through!
You are so amazing! You need your own tv show. Thank you for making people feel better.
Thanks for the nice feedback!
You nailed it on the segment on neurosurgery! Iâm undergoing my second DBS (Right thalamic lead placement) on the 18th of May. My left thalamic was performed on Oct 20, 2020. I have gone from not being able to write and perform everyday functions to having almost no tremor on my right side at all! The ensuite CT scanner will assist them in finding the âsweet spotâ place the lead!
As a PREmed student, I enjoy watching your videos. They are very informative and give me a sense of "I can do this." (:
I'm a final year Anesthesia resident in india. It's really interesting to see how anesthesia is practiced in other countries through your informative channel!
What a nice young man! I have been in the operating room many times and did not pay a lot of attention to who does what. I use to get canula oxygen but last time I got some kind of breathing tube. It sparked my interest and I found you on CZcams. I have binge watched all your videos. Your presentation is so interesting to me. I am retired (72). Thanks for your kindness. The knowledge is great!
Hi David, I really appreciate the nice feedback! Glad you enjoyed learning more about anesthesia through these videos, it's something that not many people know much about despite how interesting it is!
I am glad to learn! You always meet the anesthesiologist before the doctor and surgery but I never knew what questions I could ask. One time I did ask what medication I was getting and he said Propofol. I always try to see how long I can stay awake. Lol. I also like to look around the operating room to see if I can see the instruments they will use. Thanks to you, next time I will ask a lot more questions. I always got a cannula for oxygen until last time. They put me to sleep without oxygen. I know I got some type of breathing tube after I was out. I use to pass out if I saw a needle! Haha. I am not afraid anymore. I will be watching your postings. Have a Great day and thanks again.
As a med student, I simply adore your videos! I am studying in Germany and I work as a Student Helper in the OR, assisting in Gynecological Surgeries and listening to you gives me a lot of joy, as I rarely chat with the anesthesiologists. This only makes me more interested in their work, so thank you!
Thanks for watching! Glad you enjoyed the videos. You should chat up the anesthesiologists (when they look relatively unoccupied) and I bet they'd be excited to share some insight into what they do. That's how I got into the field! Best wishes to you.
@@MaxFeinsteinMD Well now Iâll have plenty to ask them, because you got me interested in the subject :)
You channel is a lot of help. Because I want to be an anesthesiologist in the future and Iâm only in high school. your helping me with an early start thx!!
Hi Tibou, that's awesome to hear! Best of luck on your future career in anesthesiology!
Interesting topic! I havenât seen any other CZcams videos on this topic. I was able to learn a few new things! Thank you for taking the time to put out this content! I very much enjoy your videos đ.
Glad you enjoyed them! Thanks for the nice feedback.
As a former pediatric cancer patient I enjoy all of your content
Thank you and best wishes for your treatments, Grant!
Another great video Max! I'm so grateful your videos have stayed educational to the medical school and residency levels :)
Thanks very much! Yes, I'd like to keep the videos made primarily for medical students, although at some point I may make some intended for patients who are curious about anesthesia. We'll see!
Wow, thatâs a whole lot of information you all need to know. But as a patient who has been on the table countless times, Iâm sure thankful you all know everything you have to know. Being someone who has had dozens of surgeries on the head alone, man, Iâm quite thankful that you all are so thorough and knowledgeable. Who knows what would go wrong if I was in the care of someone who was a quack.
Glad you've had positive experiences with your surgeries! Thanks for the nice feedback, I appreciate it.
Brilliantly explication đđȘđ» Iâm a medical student from Ecuador đȘđš I admire you! I really interested in anesthesiology resident all because your videos !!
Glad you enjoyed! Thanks for watching. I actually spent a year in Cali, Colombia, very close to Ecuador but never made it across the border. Hopefully one of these days!
I definitely did not realize how much goes into anesthesia. This was super interesting! I love all of your videos!
Hi Alyssa, even I had no idea how much went into anesthesia until I did a rotation in medical school. Glad you're enjoying the videos! Thanks for watching.
Awesome video Dr. Max. Really nice insight on some of the things you would never think of outside of that scenario
Thanks for the nice feedback Rory!
Thank you for your efforts trying to teach us! I've learned a lot while I'm still a med student
Thank you again Dr. Feinstein. I knew that you had to know about medications, reactions with other meds, what medications a patient takes and body weight. I did not know the mind blowing amount of all these other factors you have to learn and remember. Holy crap!
First it was AM/FM radios, then boomboxes, then really nice stereos with CD players and sound systems with speakers in the walls & ceilings to Bluetooth playlists. A wide variety of musical choices; from surgeons who want absolute quiet to surgeons that play some unique music & played it extra loud. Music played during the day vs. during emergency surgery at 0300. I was amazed how the RN âa.k.a. The DJâ could change the music from classic rock to a mellow jazz and make some surgeons calm down. But alas, I worked in a different time & culture of the OR. Back when different surgeons (& their behaviors) were tolerated. I do miss it all, especially being scrubbed the whole shift & relieving person after person at the end of their shifts. RN (ret), CNOR (E)
Interesting as always! Love your job
I'm a teacher, nothing close to what you do everyday.. and yet I can't stop watching your videos. Thanks for being so informative!
Great, super thorough video. I'm an inpatient pharmacist, and I fell in love with sedation/pain/paralytic management during my ICU rotations. I really appreciate all that you do to help educate the general community, in such a friendly and inviting way. Keep up the amazing work!
Thanks for the nice feedback! I am always very happy to have a pharmacist on rounds with us whenever I do ICU rotations. You all know *so much* and offer a really unique understanding to the team.
Of course!! That's also so kind of you to say. I think anesthesiologists know and respect medications to a similar degree as us pharmacists do, which I've always admired. I love the collaborative aspects of rounds, and love being able to interact with you all as well. Love your videos, I look forward to the future videos to come!
As a prospective MD student!! I just have to say your videos are very very informative! Almost makes us feel as if weâre present there with you!!! Superb!!!!
Glad you're enjoying them! Best wishes on your journey to becoming an MD.
My days in the OR mid 1950âs, the anaesthetist had a Boyleâs anaesthetic machine, no electricity required. Other equipment in the OR was a diathermy unit, suction pump, and not much else requiring electricity. Things changed when we started open heart surgery using the Melrose By-Pass Machine-1957. Over the past 12 months I have had several spinal surgeries-so very familiar with the equipment in a neuro theatre as a patient-having a good look round, thanks to my anaesthetist. A huge contrast to my OR days so long ago. Greetings from Tasmania Australia. Very interesting series.
Thanks for the explanation.
Iâm preparing for a procedure and understanding some nuts and bolts is comforting to me.
Your videos are extremely well done and fascinating. Your presentation and diction are excellent.
Wonderful video. You are a gifted educator. Oh and by the way that Bose speaker delivers some terrific tunes. Several people in my family have that one.
Thanks for the nice feedback! Glad you enjoyed the video. I agree, that Bose speaker is fantastic for how small it is!
I love these in detail videos!
Glad you enjoyed! Thanks for watching.
Wow! This video was very informative and interesting as well!:)
Glad you enjoyed it
This is a great video. I am a medical equipment planner. I plan all of the eq in hospitals. OR and anesthesia eq is some of the most critical eq we plan. I talk with anesthesia about what is needed but I donât often know exactly why itâs needed. This a great info. I laugh about the provider chairs because the chairs are often a very important piece of eq to get correct. Of course for comfort.
Ive worked in the theatre environment. Iâve had two gynae surgeries, two ankle arthriscopies and an ankle replacement with spinal. Usually with a shot of madaz, after a bit the anaesthetist realises Iâm ok and Iâve had my own screen to watch what is happening and discussions with the surgeon! Love spinals!! No post anaesthetic complication!
Then youâd know it is Midaz...short for Midazolam. Also many complications from spinal...
Wow you sure make it interesting to become an anesthesiologist!. Thank you for all your information. I feel better about going into sedation from now on.
Thank you so much ! You are a great teacher!
Thanks for watching, Sharon!
Very interesting I never have thought about this extremely important part of surgery
Very well explained.thank you so much đ
Glad it was helpful!
Thanks! This is amazing!!!! All types of cool careers.
Your content and presentation is exceptionall! What a great service younprovudeâđ
This is one of your older videos but I've been watching a lot of them. I had spine surgery and was intubated and and probably paralyzed and I was given some serious drugs and had a hard time coming down in the recovery room and an outpatient procedure turned into a 3 day hospital stay. I cried for no reason, I couldn't see right, I couldn't think right and I threw up after I'd been taken to my room. In the OR when the Dr. asked "are you ready" I was going to say "good night" but I was out the instant I said "yes, I'm ready."
I had a shunt implanted in 2004, and I remember coming into the operating room to Queen, we will rock you. It was great
This really helps me when reporting and supporting anesthesia services and the administrative side of medicine.
Dr. Feinstein is my friend. We have never met and he doesn't know it yet, but he is, and we will work together soon.
As someone who's first surgery was awake at 14. I soon learned to get over that fear of surgery ever again.
It was the malignant hyperthermia biopsy.
Even many adults who undergo multiple surgeries don't get over their fear!
@@MaxFeinsteinMD you all do an amazing job! Thank you.
I also think getting thrown in the deep end helped.
I tested negative thank god. But when family history comes up, it's always one of those oh god moments.
Love your spirit bro!
@12:00 the last surgery I had, I went in, the surgeon himself was in his early 60s... I get wheeled into the OR and hear rap music being played, I myself like all types of music, but truly I laughed and it helped put me at ease. Laughter is the best medicine and truly it pulled any anxiety off of me, and as you have said that is a big deal.
When my wife had a C-section it was interesting to watch the anesthesiologist. He just exuded calm and confidence and it was like God up there at the head of the table. I was very impressed.
Omg this is very informative!
Glad you enjoyed!
Excellent video.
Thanks David, appreciate you following along since the beginning!
Another great video.
Ty this has helped iam having gallbladder surgery on 26th of August I am complex case with some server health issues plus high chance due to state of gallbladder they hoping key hole but been warned it might be open as I've had a server pneumothorax in the past they are worried about the pressure with me bottom of lung never re inflated
9:51 Partner / Husband passing out during C-Section . Maybe to have a special chair for them that has " safety belts " . To keep them in the chair , not falling into the surgical field or onto the floor , but being fully restrained , but comfortable enough .
You're a book of knowledge
I wish! I'm just trying to absorb actual books of knowledge haha.
Max, would you talk about precautions taken to prevent injury, specifically related to POSITIONING?
A review of equipment needed would be helpful.
Thank you.
I recently had a kidney stone procedure and told my anesthesiologist that he was the most important member in the OR since he was responsible for putting me under but also waking me up.
I think everyone in the OR plays an important role-- without the surgeon, anesthesiologist, or nurses, they surgery couldn't happen, so everyone is essential!
You are the business
Awesome dr
Hey Max, with the working around the CT scanner do you have to use longer lines or "extensions " perhaps? And are there quick couplers to disconnect those connections?
Love your channel, very cool to watch.
Hi Wayne, we do use extensions on our IV tubing, and our ventilator circuit tubing is accordion-like so we can extend it pretty far. Our monitor cables are pretty long by default, so we don't need extensions. Thanks for watching!
I just had and Oophorectomy, on one ovary from a cyst that was about 10cm. After waking up in the recovery room then into my own room, no one told me I had like red little marks all over my forehead and side of forehead. They said it was a side effect from the position I was in during the surgery? Like a popped blood vessels? Also thought it was crazy that no one told me, I found out from my partner taking a picture of me then I looked at it and Iâm like whatâs all over my face! Wasnât a good thing to something unexpected that no one, or the nurses told me about until I brought it up to them
My husband watched my entire csection. I asked about 20 min after our son was born if they were almost finished.... âyour stomach is laying on your chestâ. đ€Šđ»ââïž
I have had an anterior/posterior spine surgery, a lithotripsy, & hysterectomy.... been in all these positions! Geez.
Very informative
That doughnut made me hungry for sweets! LOL Great vid. Explained very well. Thank you. What kind of music do you listen to while on a case?
Yes I got a donut craving while making this lol. Thanks for the nice feedback.
I have a go-to Spotify station called "Operating Room Mix", but I've also been known to put on Bad Bunny radio. Also like to throw in tropical house, especially in ortho rooms because they seem to be particularly down with house music hah.
Also other neurosurgery suites have intraoperative MRI. You need medical equipment that are MR-compatible or MR-conditional (but it needs to be distanced from the giant magnet).
Cool! I've given anesthesia during MRI but not for neurosurgery.
Max: *Spends hours filming and editing video*
Me after watching it in 13 minutes: MOAR!
Haha my rate limiting step is the editing which takes much longer than it probably should
@@MaxFeinsteinMD It's no problem - I enjoy your videos/insights you provide about anesthesiology and appreciate the work you put in. Keep up the great work!
How many slices was the ct scanner u showed in the vid? Very cool. I know a lot about this stuff and very interesting. How many mri scanners do u have at the hospital and what field strength? I know ur an anesthesiologist but I would love to know how many mri scanners this hospital has. Take care bud
I like your matter of fact presentations. I have been a patient many times. I was so curious one time
that I actually talked the Anesthesiologist into letting me push the Mdazzlem or was it propofol into my I.V. & less than a minute later was Goodnight.
How do you decide what drugs to use and how to set the OR table and other things when the person will get more than one procedure done at the same time? Thank you for the video; it was very interesting!
Not very often would be have 2 different types of surgery at the one time, electively. Setup of the bed etc depends on location of surgical area on body and where the doctors will stand so there is enough room for the trolleys of equipment too
I had no idea there was so much involved in being an anesthesiologist
Hi Dr. Feinstein,
I have watched all your videos on here and Iâm hooked and find them fascinating. Iâm getting ready to have back surgery on 9/7. Iâm having a Laminectomy on my L4/L5. I noticed you touched a bit on how the Prone position is a difficult and very intricate situation with watching intubation and leads. Iâm a big person, Iâm 6â0 and Iâm on the overweight side of the scale, but Iâm pretty healthy as far as co morbidities go. Anything tips? Also Iâm usually a hard stick (for IVâs). So Even though this is my like 16th surgery with general, Im a little nervous with the position and placement of IV.
Thank you for all your content! I absolutely love watching it and you have such a great demeanor and knowledge. A very calming sense about all things anesthesia. Sure wish you were gonna be my Anesthesiologist!
Stay well, and continue making great content.
LeeAnn- Las Vegas,NV
Hi LeeAnn, I totally understand your concerns, and I think these are great questions to discuss with your anesthesiologist prior to surgery. While I canât provide any specifics, itâs extremely likely that your anesthesiologist is very accustomed to these types of surgeries and how to safely position patients for them.
So very interesting. Thank you
Are patients always intubated?
Throat or neck surgery?
Didn't expect surgeons to have a gamer chair at the robot controls lol
Doctor, Who decides what/who's music is played in the OR? Especially if you are using the overhead vs tableside speakers.
In my experience, whoever starts playing music first is the one who keeps playing it. It's usually not a contentious issue as long as everyone in the room is okay with music during the case.
You should do a video on CRNA or interview a CRNA.
That's a great idea, I'd like to one of these days.
Can you make a video about anesthesia assistants , about they do and how a day looks for them and you
I would like for you to make a video of spinal surgery and anesthesia and all it takes to get the patients ready for surgery I had lower back surgery and I donât remember to much about the tings they done to me before surgery I recall just same things they were doing to me
Being totally honest..there ppl who talk and talk their entire vid, an if its in the bckground, their voice just cuts right into my focus. With Dr.F..can listen em for hours..đ
The robotics chair is a rebranded "gaming chair" (really a racing seat), that's hilarious
Can you do a vidoe for Anesthesia used for sedated MRI
I was placed in a prone position when I had an elbow ORIF to repair my olecranon process. I wondered how they maintain those things when you are face down. They put me out before they moved me to the operating table.
Do you plan on making a video about the mid-level encroachment debate or anything related? Iâd love to hear your thoughts!
Hello. If a patient needed to be defribulated who would do this? You or the surgeon? And would you be tag teaming interventions? Thank you.
That would be the anesthesiologist, contrary to what Greyâs Anatomy would have most people believe haha.
Thanks. Your videos are amazing.
đ c section! đđ. Classical music is nice â€
I would put some Funeral Doom Metal through that speakers during a surgery, if I would be an aenesteziologist. Best to have a propper atmosphere.
What is cell saver and when/why do we see it?
The first time I watched this channel, I thought he said he was a resident from âOutside a hospital in New York City!â
Our CT scanner is called an O arm and opens up like a big C.
Hi. Dr.Max. can you share /video on OR Recovery. Recovery area still under Anes Dr right? Type of recovery? Terms PACU(post Anes) compare to just Recovery(normal). Recovery for surgical/endoscopy etc. Type of monitoring equipment. Medical gasses. Some area in recovery required GA machine? Thanks.
This is a great idea, thank you Yusl! I will eventually make a video about PACU and the role and anesthesiologists have.
Have you done and Hydrocephalus surgeries and is it harder to do things when several different surgeons are all in there?
what do you do when people wake up during surgery? does it happen often? I heard once someone felt all the pain during there surgery. how often does that happen?
Hi Charlize, these are great questions. Itâs intuitive to think about being anesthetized as a binary thing, where someone is either awake/conscious/remembering or completely under general anesthesia. In reality, anesthesia is more of a continuum, and typically patients are so deeply anesthetized for surgery that thereâs no quick way of being fully conscious or making new memories. Itâs not unusual for a patient to become âlightâ during surgery, in which case we simply give a little more of whichever med(s) weâre using for anesthesia. That lightness may manifest as a bit of purposeless muscle movement or increased blood pressure, but itâs extraordinarily rare for anyone to have any subjectively meaningful about of consciousness until we turn off the anesthesia. Hope that helps!
Very interesting. Iâve had numerous surgeries and General anesthesia makes me very nauseous. After my hysterectomy, I threw up for hours. What causes that?
Sorry you've had that experience. I'm not sure what mechanisms underlie post-op nausea/vomiting, but I can tell you that some of the top risk factors include the following, which it sounds like you meet at least a few: Young, female, non-smoker, gynecologic surgery.
I once had surgery and it took alot to wake me up. Long time in recovery. Any sudjestions????
In another instance of surgery, they said I talked alot at least tried to.
Can you make a video of your life outside work?
That's a good idea, it's definitely something I'll think about in the future!
Max likes music in the OR.
Surgeon: Turn that crap off!
Nurse to Surgeon: Donât make Max angry... You wouldnât like him when heâs angry.
Maxâ eyes start to glow green
Surgeon: Turn it up! Letâs BOOOOGAY!
LOL thanks for writing my next video script
Hi big fan!
ALSO, What is the hardest year on the Anesthesiologist career? I feel like Its the 4-year Studying.
Thanks for following along! I'll have to get back to you in a couple years about which one is the hardest. But from talking with my seniors, it seems like they get easier as you move along in residency.
The anesthesiologist needs to be a "jack of all trades."
I have prostate cancer so Iâm about to have that organ removed robotically. Thatâs why this was a very interesting discussion for me. Maybe I should not be watching your videos, because knowing how complex anesthesiology is makes me very nervous.
Maybe it will be reassuring to know that your anesthesiologist will have extensive training to be able to keep you safe and comfortable during surgery. Best wishes for your surgery!
Max, are there additional hemodynamic implications of steep trendelenburg for prolonged periods of time?
One of the big ones I didnât discuss in this video is significantly increased airway pressures because the abdominal contents are pressing against the diaphragm. This has the same implications as laparoscopic and robotic surgery (decreased venous return to the heart). There may be other implications that I havenât learned about yet tho!
@@MaxFeinsteinMD Got it. I was pimped by an OB attending regarding the use of NG tubes by anesthesiologists after difficult intubations when trendelenburg would be used in Gyn surgeries. Maybe the same principal of the abdominal organs (air filled stomach) pressing back onto the diaphragm?
I have a question. When a cardiac bypass machine ia used, why are the lungs not ventilated allowing collapsed lungs?
Do surgeons ever complain about music playing overhead or usually enjoy it as well? Iâve had many many surgeries and never would have guessed music would be playing in there lol. I always assume itâs quiet with the doctor occasionally giving orders and what not
Dr Feinstein, you were talking about a partner getting woozy during a C section...have you ever gotten sick during a surgery and had to leave the operating room?
Great question- hasn't happened to me yet, but if it does, my first move would be to call for backup anesthesia help and hand over the reigns to someone else.
How many drugs did you need to memorize and how hard was it to remember all of them when practicing?
Depends what you mean by memorize- there are so many facts about one single drug (brand name, generic name, mechanism of action, duration of action, alpha half-life, beta half-life, side effects etc etc) but I donât know all of that information for each drug yet. I know a lot about the drugs I use most commonly, and a reasonable amount about other drugs. Overall, Iâd say Iâve studied maybe 150-200 different drugs.