Part 1 appeared here on Christmas day.
When I read it I realized there was an excellent application of this technique which served me well in the operating room during the 38 years I administered anesthesia and taught the art and science of the specialty.
The most frequent scenario in which doing nothing was best was during anesthesia induction.
A lot happens in a short period of time once propofol (or sodium thiopental, back in the dark ages when I did my residency) is given to induce anesthesia, followed by a muscle relaxant.
Cardiac arrhythmias, overwhelmingly PVCs (premature ventricular contractions) frequently occur, perhaps 5% of the time, right after induction, while the breathing bag is being used to hand ventilate the patient with 100% oxygen.
[above, a PVC on an EKG]
Among new residents, there's a strong predilection to reach for 100mg of lidocaine — the #1 anti-arrhymic drug — in its prepackaged injection ampoule to treat the PVCs.
99% of the time, if you just keep squeezing the bag, the PVCs go away on their own after a minute or two.
Why do more?
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