Discover and read the best of Twitter Threads about #surged
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Surgery rotations are one-of-a-kind experiences.
In some ways it resembles an endurance race, and in others ways, an audition.
How can you do the best you can on your surgery rotation? A thread. 𧔠... /
In some ways it resembles an endurance race, and in others ways, an audition.
How can you do the best you can on your surgery rotation? A thread. 𧔠... /
1.Pace yourself
Itâs tempting to start with an all-out sprint but this is a marathon. It is potentially the rest of your life
Find a pace that allows you to feel challenged, but also leaves you some reserve to learn, feel content, and push harder when the opportunity comes
Itâs tempting to start with an all-out sprint but this is a marathon. It is potentially the rest of your life
Find a pace that allows you to feel challenged, but also leaves you some reserve to learn, feel content, and push harder when the opportunity comes
2.Observe, pause, observe, then reach
My 1st surgical rotation reminded me of when I immigrated here.
I was entering a new community, with an open-mind.
Surgery has its own language, and culture. Observe them with all of the curiosity and respect it deserves.
My 1st surgical rotation reminded me of when I immigrated here.
I was entering a new community, with an open-mind.
Surgery has its own language, and culture. Observe them with all of the curiosity and respect it deserves.
CPB đ§”pt4. Dessert course. Circ arrest.
Yes we know itâs a lifestyle.
But what IS it actually? Why do we do that to a person - stop blood flow to their whole body. Isnât blood flow necessary? Or at least preferable?
#surged #meded #CTSurgery #CardioTwitter
Yes we know itâs a lifestyle.
But what IS it actually? Why do we do that to a person - stop blood flow to their whole body. Isnât blood flow necessary? Or at least preferable?
#surged #meded #CTSurgery #CardioTwitter
To understand why we âcirc arrestâ someone- meaning arrest or stop the circulation to the whole body- we have to return to the basics of vascular surgery (bc cardiac surgery is kind of the ultimate #vascularsurgery đ)
itâs all about proximal and distal control
itâs all about proximal and distal control
Letâs say you want to fix a psuedoanuerysm on the common femoral artery.
Well you need to get proximal and distal control with vascular clamps so that you can work on the area of interest.
Now while youâre working, the leg is a little sad đ but itâs got some collateral flow
Well you need to get proximal and distal control with vascular clamps so that you can work on the area of interest.
Now while youâre working, the leg is a little sad đ but itâs got some collateral flow
Ok letâs keep going with #cardiopulmonarybypass. Several requests for circulatory arrest, but first letâs understand how to go on and off bypass and a few flavors of cannulation and cardioplegia
đ§”primer pt 2: going on and off bypass
#CardioTwitter #surged #meded #CTsurgery
đ§”primer pt 2: going on and off bypass
#CardioTwitter #surged #meded #CTsurgery
Again, donât get overwhelmed by the surgeon shoving a large number of tubes into the heart. Think logically what each one does and why it is needed.
If you know your stuff and you canât come up with an answer, then maybe youâve identified an inefficiency in their process. đđ
If you know your stuff and you canât come up with an answer, then maybe youâve identified an inefficiency in their process. đđ
But maybe wait until youâre a PGY-10 to tell them đ
For student coming onto #cardiacsurgery: hereâs a primer on cardiopulmonary bypass I usually give between rounds and incision
You wonât pass perfusion boards from this đ§”but hopefully youâll feel more oriented at the table.
#cardiotwitter #surged #meded #CTSurgery
You wonât pass perfusion boards from this đ§”but hopefully youâll feel more oriented at the table.
#cardiotwitter #surged #meded #CTSurgery
When I was a sub-I on cardiac surgery I was totally lost on what all the different tubes did and would see a diagram like this and think I should stick to belly surgery:
But itâs not actually that complicated. Basic idea:
Bypass helps us overcome some unique challenges of operating on the heart:
đ«Itâs full of blood
đ«It moves
đ«If itâs not moving, then something else needs to perfuse the body while we interrupt it from doing that
Bypass helps us overcome some unique challenges of operating on the heart:
đ«Itâs full of blood
đ«It moves
đ«If itâs not moving, then something else needs to perfuse the body while we interrupt it from doing that
EPONYMS:
Morrisonâs pouch, sphincter of Odi,
Langerâs lines, cover the body,
Virchowâs triad, virchowâs node,
Scarpaâs fascia, should it be sewed?
1/7 #SurgEd
Morrisonâs pouch, sphincter of Odi,
Langerâs lines, cover the body,
Virchowâs triad, virchowâs node,
Scarpaâs fascia, should it be sewed?
1/7 #SurgEd
Angle of Louis, McBurneyâs point,
Foramen of Winslow, Charcotâs joint,
Auerbach's plexus, keeps the gut well,
The long thoracic nerve of Bell,
2/7
Foramen of Winslow, Charcotâs joint,
Auerbach's plexus, keeps the gut well,
The long thoracic nerve of Bell,
2/7
Meckelâs Diverticulum, Toldtâs Line,
Gerotaâs fascia, Murphyâs sign;
Pouch of Douglas and Morrisonâs Pouch,
Buergerâs test, the leg raise off the couch,
3/7
Gerotaâs fascia, Murphyâs sign;
Pouch of Douglas and Morrisonâs Pouch,
Buergerâs test, the leg raise off the couch,
3/7
The Inferior mesenteric, arteryâs course,
Starts at the aorta, the original source,
Originates at, the level of L3,
At the inferior edge, of the 3rd part of DueeeâŠ;
Starts at the aorta, the original source,
Originates at, the level of L3,
At the inferior edge, of the 3rd part of DueeeâŠ;
Supplies splenic flexure, to upper rectum,
Of the three splanchnic vessels, this is the small one,
Keeps hind-gut alive, the proctologistâs chum,
Friend of that strange bunch, who work on the bum;
Of the three splanchnic vessels, this is the small one,
Keeps hind-gut alive, the proctologistâs chum,
Friend of that strange bunch, who work on the bum;
Left colic then sigmoid, branches supply?
Errr.. Left colon and sigmoid?⊠donât be a wise guy!
Superior rectal, the terminal branch,
Over upper rectum, holds perfusion âCarte Blancheâ;
Errr.. Left colon and sigmoid?⊠donât be a wise guy!
Superior rectal, the terminal branch,
Over upper rectum, holds perfusion âCarte Blancheâ;
The makings of a surgeonâŠ
Prize if you can name all four. đ
What makes a surgeon, as good as they can be,
Technical prowess and dexterity?
A sympathetic smile, and good bedside manner?
Mechanical mind? Being good with a spanner?
1/4
Prize if you can name all four. đ
What makes a surgeon, as good as they can be,
Technical prowess and dexterity?
A sympathetic smile, and good bedside manner?
Mechanical mind? Being good with a spanner?
1/4
An eagleâs eye, at least at the start,
The handâs of a lady, a lionâs heart?
Decision making, thoughtful with care,
Acceptance of failure, hopefully rare,
2/4
The handâs of a lady, a lionâs heart?
Decision making, thoughtful with care,
Acceptance of failure, hopefully rare,
2/4
Ready to cut, to leap into action,
A strong arm, appreciation of traction?
Patience and courage, when hoping for the best,
âSitting tightâ, can be a real test,
3/4
A strong arm, appreciation of traction?
Patience and courage, when hoping for the best,
âSitting tightâ, can be a real test,
3/4
Superior Mesenteric Artery:
The SMA is the next of the splanchnic vessels,
Leaves aorta at L1, to itâs right SMV nestles,
Drops anteroinferiorly behind the neck of the pancreas,
Occlusion up here makes the whole small bowel gangrenous;
The SMA is the next of the splanchnic vessels,
Leaves aorta at L1, to itâs right SMV nestles,
Drops anteroinferiorly behind the neck of the pancreas,
Occlusion up here makes the whole small bowel gangrenous;
Itâs branches are many, weâll start from the top,
Pancreas gets a branch, acts as coeliac trunk prop,
Inferior pancreatico duodenal artery,
Adds to the pancreas and duodenal symphony;
Pancreas gets a branch, acts as coeliac trunk prop,
Inferior pancreatico duodenal artery,
Adds to the pancreas and duodenal symphony;
Then jejunal branches, and ileal next,
And our friend ileocolic, which also supplies appendix;
Right and middle colic, gives Colon its blood and,
The watershed kept alive, by the marginal of Drummond;
And our friend ileocolic, which also supplies appendix;
Right and middle colic, gives Colon its blood and,
The watershed kept alive, by the marginal of Drummond;
Recall of gut anatomy wanes and waxes,
So letâs quickly recap the coeliac axis,
The first of three vessels to supply the intestine,
The content of these vessels normally fluid and sanguine;
#SurgEd @roux_group #SoMe4Surgery @ASiTofficial
So letâs quickly recap the coeliac axis,
The first of three vessels to supply the intestine,
The content of these vessels normally fluid and sanguine;
#SurgEd @roux_group #SoMe4Surgery @ASiTofficial
Arising from the aorta, at the level of T12,
From beneath the arcuate, into the abdomen it does delve,
Enters lesser sac, then divides into three,
At the upper border of âThe Queenâ, like an inverted tree;
From beneath the arcuate, into the abdomen it does delve,
Enters lesser sac, then divides into three,
At the upper border of âThe Queenâ, like an inverted tree;
COMMON HEPATIC is first, and heads off to the Right,
Gives off GDA and RIGHT GASTRIC, when liverâs in sight,
âPROPER HEPATICSâ to the liver blood do serve,
The RIGHT GASTRIC does the same, to the stomachs lesser curve;
Gives off GDA and RIGHT GASTRIC, when liverâs in sight,
âPROPER HEPATICSâ to the liver blood do serve,
The RIGHT GASTRIC does the same, to the stomachs lesser curve;
My take on teamwork in healthcareâŠfor what itâs worth. đ#SurgEd
Ada from Lincoln, 4 score years and seven,
Had lived a good life, she was destined for heaven,
Developed a pain, down in her left groin,
Decided to fight, that it wasnât her time;
Ada from Lincoln, 4 score years and seven,
Had lived a good life, she was destined for heaven,
Developed a pain, down in her left groin,
Decided to fight, that it wasnât her time;
Called up her practice to book an appointment,
They listened intently, suggested some ointment,
Explained âif things get worse, call 999â,
They couldnât see her, just didnât have time;
They listened intently, suggested some ointment,
Explained âif things get worse, call 999â,
They couldnât see her, just didnât have time;
Later that evening, as she entered ED,
A stressed looking nurse, complained about the GP,
âThey just send you all in, donât do nowt at all,
Waste of time picking, the phone up to callâ;
A stressed looking nurse, complained about the GP,
âThey just send you all in, donât do nowt at all,
Waste of time picking, the phone up to callâ;
Re-upping the latest excellent #feedback thread from @GStetsonMD @MedEdTwagTeam, and emphasizing this point- someone is not a 'struggling trainee' or, even worse, 'the difficult trainee'. đ€š
#MedEd #SurgEd
1/6
#MedEd #SurgEd
1/6
A trainee not meeting expectations reflects on the unit as much as the trainee. Our local saying is 'not a trainee to fail until they are a *properly supported* trainee to fail'. Importantly, this does not mean the support provided to the last successful trainee is sufficient.2/6
Recall the difference between equality and equity. Teaching cannot be 'one size fits all'. Teaching must be tailored to prior knowledge, learning opportunities, learning goals, preferred ways of communicating, and much more*. 3/6
*#DiversityIceberg đđđ. Read on!
*#DiversityIceberg đđđ. Read on!
