What are /r/anesthesiology's favorite Products & Services?

From 3.5 billion Reddit comments

Marino’s ICU Book - get the real deal and don’t buy pocket reference books.

Marino's The ICU Book: Print + Ebook with Updates (ICU Book (Marino)) https://www.amazon.com/dp/1451121180/ref=cm_sw_r_cp_api_i_bWs0DbQ90QXY6

https://www.amazon.com/Anesthesia-Made-Easy-Survival-Rotation/dp/0989840131/ref=nodl_

This is a super quick read I used for audition rotations when I was a medical student. It’s an easy, light read, hits the major points and creates a solid foundation to build on.

My residency gave me this book, and I think it’s pretty solid. I don’t do much peds these days, but I keep it around to reference when they pop up.

https://www.amazon.com/Pediatric-Anesthesia-Practice-Cambridge-Clinicians-ebook/dp/B007NW1F3Y/ref=nodl_

LorAnn SS flavors in 1 dram bottles (.0125 fl oz - 3.7ml) -5 pack includes - Watermelon, Strawberry, Cotton Candy, Bubble Gum, and Peach https://www.amazon.com/dp/B00Y3L0W1Y/ref=cm_sw_r_cp_api_glt_fabc_MJ73FB9N76MWQ49KSSTB?_encoding=UTF8&psc=1

Learn side affects to the common opioids, PCA drugs, and conversion dosaging is a big one

When you are swapping pt between IV, PO, etc or other agents - being able to know the conversion amounts as well as uptake and PK are very crucial

In Australia we have a cool app that ANZCA (the college) made - lets you punch in everything they are on. it converts it all down to base morphine dose/day - and from there it lets you extrapolate out alt agents and the amount needed to match that dose.

https://play.google.com/store/apps/details?id=au.edu.anzca.opioidcalculatorapp&hl=en\_AU&gl=US

I preferred these. The etsy/cloth route definitely looks cooler with the customizable fabric, but the fabric didn't breath well, especially for a longer shift. These bad boys look like a do-rag, but are comfortable all shift long.

these scrub caps are great

Nice job, once again, Max. I think what is more useful for a medical student who is interested in anesthesiology is to get a handbook as opposed to a textbook. My favorite was the Mass Gen. It's a nice concise overview that doesn't get into excessive detail but is a nice resource for people getting into it.

I don’t know if this is a regional difference in language, but you’re talking about the difference between high flow and low flow oxygen deliver devices. It’s not about exceeding minute volume, it’s about exceeding inspiratory flow. Peak inspiratory flow for adults is pretty variable depending on age, strength, and disease severity, but has been reported anywhere from 30LPM to >200LPM.

Using the same terminology as you, a device is only fixed flow (what I would call high flow) if it exceeds inspiratory demand. Once the patient can exceed the delivered flow, they’re entraining room air. If they’re only exceeding the flow for a small fraction of the breath, the amount of air entrained is meaningless. Venturi masks perform better at low FiO2 as you’ve demonstrated. At an FiO2 of 28, the ratio of air to oxygen is 10:1. At 30 it’s 8:1. At 40 it’s 3:1. This would be in comparison to HFNC, which sort of maxes out at 60L, but allows independent control of FiO2 and flow.

https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-021-00949-8#:~:text=Peak%20inspiratory%20flow%20during%20tidal%20breathing,-Our%20findings%20showed&text=In%20two%20recently%20published%20studies,resistance%20of%20an%20en....

https://www.semanticscholar.org/paper/Peak-Inspiratory-Flows-of-Adults-Exercising-at-and-Anderson-Cassidy/9fd82ba8a6d4929daf94db10e67d3ad82fa87f40

I picked up these and they fit well on my big head without fogging up. Plus lots of designs for those who want to look fresh in the hospital

My biggest advice is to get ahold of a spine model (something like this: https://www.amazon.com/Axis-Scientific-Flexible-Vertebral-Arteries/dp/B00KZO89PE/ref=asc_df_B00KZO89PE/). Hopefully your program or an attending has one. Understand the anatomy of the lumbar spine and cement the 3d model of it and refer to it mentally when you're doing the procedures. So when you encounter difficulty during an epidural placement, you don't just blindly poke around, but hypothesize where you are make corrections in an educated way.

I don’t do all the different blocks, but when I was learning to do epidurals, one anesthesiologist gave me an article about how many times you had to perform a procedure before you became proficient and it was literally over 1000 times.

Also, with the hand ventilating, it can be difficult because you have to have similar strength in your non dominant hand as you have in your dominant hand. You can get a hand strengthener and build up the strength in both hands. Something like this: https://smile.amazon.com/KDG-Strengthener-Adjustable-Resistance-Exerciser，Grip/dp/B087X35JJ8/ref=sr_1_6?crid=1Z0GA8PN2ZJ1&keywords=hand+strengthener&qid=1657959713&sprefix=Hand+stre%2Caps%2C99&sr=8-6

In addition to truelearn I used ASA's ACE questions. You should be able to get a resident membership and I think I paid $80 for a 100 questions that I charged to my book fund. There are also old ACE questions floating around on the internet that one of my co-residents sent out in a dropbox link when we were going through it. I personally also found Yao & Artusio's Anesthesiology: Problem-Oriented Patient Management to be quite useful. It is a book written for oral boards but I really liked the case based and question-answer format as I found it challenged me and really helped me to remember things better.

I have a single device that is a pen, a light (for Mallampati exams and when I drop things in dark OR corners) that you just tap to activate, and a stylus. Got a couple as swag at a conference and they've lasted me for years.

https://www.amazon.com/dp/B09TWD7RWP/

Also, I carry a couple hemostats for when you can't untwist IV tubing.

Get this one.

Lewis N. Clark Men's Travel Comfort Eye Mask with Adjustable Straps, Black, Single https://www.amazon.com/dp/B000SKXRNO/ref=cm_sw_r_apan_glt_fabc_TE7Y69JX0HHQ36ZDJHAB?_encoding=UTF8&psc=1

I would strongly recommend the book Gasenomics, which I read on the flight to my first interview. It covers this topic in detail, and also discusses the business of anesthesia (which is rarely discussed in academic programs).

It's not something you can really 'work' out. In the sense that it's not an absolute calculation. Fresh gas flow depends on the nature of the operation and what you're trying to achieve.

Around here it's very common to use minimal flows (0.5-0.7L) throughout the lengthy bits of the procedure after induction. After induction I may have a few mins on high flows whilst bagging the patient (10L), and then rapidly turn it down to 6, then 2, then minimal flows within about 10 mins.

Depending on the machine you have, you can even target FiO2 and ETvapour and the system does it all for you to reduce gas flows and costs.

In case you're interested, there's a British made app that simulates vapour usage (and cost) and environmental impact based on FGF and vapouriser concentrations. It's available on Android. https://play.google.com/store/apps/details?id=com.sleekwater.anaesthesia

A colleague of mine just came out with a book. https://www.amazon.com/Vigilance-Anesthesiologists-Notes-Thriving-Uncertainty/dp/1544521065

Stanford guide is great. This is a quick easy read that helps with differentials on the fly. I know it says board review but it’s basic stuff. https://www.amazon.com/Anesthesia-Oral-Board-Review-Knocking-ebook/dp/B00AHTN6C8

i'm a big fan of Duke's. Bullet points, no bullshit. covers a lot of the fundamentals, macro and micro. has helped me shine on multiple rotations, including non-anesthesia.

https://www.amazon.com/Dukes-Anesthesia-Secrets-James-Duke-ebook/dp/B00SY4H3ZO

I would like to recommend this app for TIVA simulation: iTIVA. You can download it for android phones. It has protocols for many IV drugs used in anesthesiology. https://play.google.com/store/apps/details?id=com.raigo.itivaplus&hl=es

Another potential handbook that was useful for me...super concise and hits on a surprisingly large amount of stuff...I read it before starting my CA-1 year.

https://www.amazon.com/Anesthesia-Crash-Course-Charles-Horton/dp/0195371879/ref=nodl_

I bought these as a resident https://smile.amazon.com/Black-Wraparound-Radiation-Protection-Glasses/dp/B003Z9817W/ref=mp_s_a_1_11?dchild=1&keywords=lead+glasses+radiation+protection&qid=1596388045&sprefix=lead+glasses&sr=8-11 I did ask the rad tech to shoot a picture to make sure they weren’t just heavy glasses.

Now I have some from Burlington Medical Supplies that my work bought for me with my lead. I like my Burlington ones better (fit better), but I don’t know how much they cost.

During my fellowship I wore them daily, but none of the staff members (of the multidisciplinary pain center) did.

I’m actually looking to purchase some of my own, I was looking at these. Good choice or better alternatives?

one 2 one real time pairing. https://www.amazon.com/PRESTAN-PP-AM-100M-MS-Professional-CPR-AED-Training/dp/B007HOAM9Q/ref=sxts_sxwds-bia-wc-p13n1_0?crid=33ZA1ET61R5F1&cv_ct_cx=cpr+manikins&dchild=1&keywords=cpr+manikins&pd_rd_i=B007HOAM9Q&pd_rd_r=032e6dea-...

Have been using the same set up since 2019.

We now added a difficult airway scenario with another set up that is also on a budget. I will be doing an episode soon.

I like the “Faust”, if that is what you’re looking for... it has chapter of 2 pages per subject.

https://www.amazon.com/Fausts-Anesthesiology-Review-Michael-Murray/dp/1437713696

Edit: didn’t see you were looking for rural emergencies, sorry. You might want to check any military handbooks though. I have a USMC anesthesia field manual which is very handy, I got it from a colleague, so I don’t know where to buy it.

There are lots of rural/mountain/military anesthesia manuals which aren’t large like ‘de lange’

Here are 300 mcg tabs.

I did some research on herbals/supplements in CRNA school. Sorry I don't have a resource for you now.