tag:blogger.com,1999:blog-2760353953251845523.post516351691278649732..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: HealthbeatJeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger11125tag:blogger.com,1999:blog-2760353953251845523.post-16555463591159734542008-07-01T17:31:00.000-04:002008-07-01T17:31:00.000-04:00Anon from 10:01 Am- By the same token, we've seen ...Anon from 10:01 Am- By the same token, we've seen just as many patients in medical ICU's go into renal failure with toes turning blue because of a fear of "giving too much fluid" and instead cranking up the vasopressors right away. Neither "side" is perfect. Better collaboration in the future is the key, I suppose, rather than this mentality of medicine vs surgery....<BR/><BR/><BR/>I hear what youre saying Bongi...sad that there exists a perception that surgeons ought not to be able to handle an ICU...Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-62952109901469482192008-06-30T18:15:00.000-04:002008-06-30T18:15:00.000-04:00anonymous, where i work it is an easy choice. you ...anonymous, where i work it is an easy choice. you see, we do not have intensivists. recently i operated an american woman with necrotic bowel. her son was an internist. postoperatively i went to speak to him to explain that his mother would spend some time in icu. he asked me to introduce him to the intensivist.<BR/>"that would be me" i smiled.<BR/><BR/>p.s the icu nurses didn't groan and the patient did well.Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-28430373967962822192008-06-30T10:01:00.000-04:002008-06-30T10:01:00.000-04:00Enjoy your blog but it's been my experience that o...Enjoy your blog but it's been my experience that outcomes are better in post-op critical care patients with intensivists overlooking their care. I've found that surgeons, generally speaking, do not know how to manage volume and pressure settings on a vent that match the patient's specific set of lungs! <BR/><BR/>Also hemodynamics...have taken care of too many complicated post-bowel surgical patients that are flooded with fluid from surgeons that are too afraid to use a pressor.<BR/><BR/>Sorry, but experienced ICU nurses groan when the surgeon doesn't hand over the case to the intensivist for the very sick surgical patients.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-49304338170355615202008-06-29T04:54:00.000-04:002008-06-29T04:54:00.000-04:00I'm an old woman, and the very best physician I've...I'm an old woman, and the very best physician I've seen for treatment is an orthopedic surgeon. It occurred to me during my recovery (full) at home that it isn't so much the amount of time a doctor has for a patient, it's the quality of it.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-15486390368385258602008-06-28T10:51:00.000-04:002008-06-28T10:51:00.000-04:00I'm the same Bongi. Straight forward apendicitis ...I'm the same Bongi. Straight forward apendicitis on a kid, I take care of it. But younger than three, I get pediatric intensivists involved. <BR/><BR/>Pediatric surgeons, however, are one of the more anal retentive specialties around; usually they write their own orders on even very sick children in the ICU...Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-29567442472975474322008-06-28T03:02:00.000-04:002008-06-28T03:02:00.000-04:00i'm half way between. i look after all my icu pati...i'm half way between. i look after all my icu patients except the paediatric ones. i'm happy to turf them all. that may make me a proceduralist in their eyes, but actually i even try to turf the procedures on the small ones to the big city. on my patients (adults) i am a tad more than a proceduralist, as it should be.Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-81345654704203787252008-06-27T10:56:00.000-04:002008-06-27T10:56:00.000-04:00Oh Yeah, my Bad about the 1.72 Teaspoons thing, I'...Oh Yeah, my Bad about the 1.72 Teaspoons thing, I'm sure you do everything in SI Units. 3KG? Thats pretty Big actually, Try keeping a 2 LB Baby alive during a TEF repair.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-28277582620094515492008-06-27T10:52:00.000-04:002008-06-27T10:52:00.000-04:00Been There, Done That, Got the T-Shirt. You're Ma...Been There, Done That, Got the T-Shirt. You're Makin My Point, Dude.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-11632988227500407122008-06-27T10:09:00.000-04:002008-06-27T10:09:00.000-04:00"Ha Ha, take a look at Dr. Johnsons pic. I guarant..."Ha Ha, take a look at Dr. Johnsons pic. I guarantee you he Never hit a fastball or returned a punt. I know the type, hes the guy who prescribes 1.72 teaspoons of Augmentin. For God's sake hes a Pediatrician, even the sickest Kids are hard to kill even with the worst care."<BR/>Wrong on all counts. So sorry. But at least I know now to call Frank for my next 3 kg infant with septic shock and mult-system failure. Thanks.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-7478297006943831292008-06-27T07:19:00.000-04:002008-06-27T07:19:00.000-04:00Ha Ha, take a look at Dr. Johnsons pic. I guarant...Ha Ha, take a look at Dr. Johnsons pic. I guarantee you he Never hit a fastball or returned a punt. I know the type, hes the guy who prescribes 1.72 teaspoons of Augmentin. For God's sake hes a Pediatrician, even the sickest Kids are hard to kill even with the worst care.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-2811812963923045812008-06-26T20:35:00.000-04:002008-06-26T20:35:00.000-04:00Ha. Good answer. I think most training programs ar...Ha. Good answer. I think most training programs are heavy enough on trauma, which is mostly critical care these days, that surgeons should be competent at critical care, even if they then decide that they don't want to spend their time in a non-operative field.Anonymousnoreply@blogger.com