I just finished the first week of clinical rotation in the OR at LAC-USC Medical Center. Oh My God! This anesthesia program at USC is better than I could ever have imagined. We were in the OR for three long days this past week and just from what I saw during these days I could discuss for a month. The only problem is there is no time to describe all of the surgical cases or the scenarios that came up. What I will relate is a few of the basics of what I learned during the first week of clinical here at Unit #1. “Just the facts, madam, just the facts.”

The basics come first. We went over the anesthesia machine check and setup thoroughly. By the end of the week I feel confident that I could set up the anesthesia machine completely and run a systems safety check. This is good. Second, is the cart set up. Every anesthesia provider has a little bit different take on how to set up their cart; the layout of the medications and where the airway equipment is kept at the ready varies from person to person. The basics are the same and this is what came through.

There are standard concentrations for the medications and established ways that are for the most part followed from OR room to room. The idea is that when a relief anesthesia provider comes in there will not be any misunderstandings about what is drawn up in the syringes since the concentrations are standard throughout the hospital operating rooms. That is another very good thing. The way some of these people label their syringes is a crack up. “Now the tape has to go this way, not that way…….” etcetera. Individuals have varying degrees of tolerance for how other providers set up their carts. The main thing is patient safety and having established concentrations from OR to OR for the drawn up medications is one way to establish safety.

Time is limited right now so I will add to the story tomorrow, promise.

This is it. The day has finally arrived to start clinical rotations at LAC-USC Medical Center in the Anesthesia department as a Student Registered Nurse Anesthetist (SRNA). After all of the academic preparation, this is the payoff.

Today was spent with the staff at the Los Angeles County Medical Center doing orientation duties, receiving lockers, pager assignments and generally getting used to the large place. Our clinical assignments were made for tomorrow and we were able to call the Certified Registered Nurse Anesthetist (CRNA) staff members that we will be working with in the morning. For me, I will be covering the Emergency OR for general surgery. Sounds exciting but from what I am told most likely the day will be slow. For the first day of our anesthesia rotation at the LAC it will be nice to be with a very experienced staff member. The physician attending staff at the LAC Hospital is a wonderful group, very experienced and used to working together with CRNA’s. The relationship that is fostered at the LAC is a strong collegial one with Dr. Philip Lumb as head of the Anesthesia department in the Keck School of Medicine at the University of Southern California.

CRNA’s are the Nations largest anesthesia providers, reportedly performing over 50% of anesthetics and in some reports up to as much as 65% of all general anesthesia. To learn more about the practice of the Certified Registered Nurse Anesthetist, the resources of the National organization, American Association of Nurse Anesthetists (AANA) may be resorted to.

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Mout Fuji
originally uploaded by David Godden.

Today we road through the San Gabriel Mountain foothills on our way to Pasadena for coffee. The skies cleared for a while today after so many weeks of rain.

I have enclosed a picture taken from a vantage point a small way up the road to Mount Fuji thinking that you would appreciate the view. Our ride today was not as spectacular as this but you get the idea anyway. Every Sunday, the Velo Monrovia bicycle group from “Stan’s” place heads out around 8:00 in the morning; summer time take off is at 07:00 give or take the stragglers showing up a little late. Today was no exception. Our trip was quicker than usual due to an overabundance of male testosterone that pops up every so often.

Picture this, several itchy racehorses couped up for three weeks due to rain. The first clear day and all of the riders gather at the old mill. No one can keep their horses in check very well and the best thing to do is let them run off their excessive energy. After ten miles or so of dead out running the horses are easier to control and everyone is happy. Such was the setting today.

Instead of horses, picture thirty or so bicycle riders with too much TV under their belts and glycogen to burn. Our ride today started out fast and speeded up until the rest stop. Unfortunately I was dropped but was able to close in at the appointed rest stop as the lead riders tired so that I was only less than thirty seconds behind. No one noticed that I was a little bit off the back, thank God. The rest of the group straggled in after five to ten minutes or so. Its always nice to stay with the lead, it makes for tall tales later.

After the rest stop the group was softened up enough to ride on together. Comrades in arms, warriors all, beat the path back to home and family. Another day full of laughs, lies and friendship.

For the past two days I have spent the majority of my time playing. That’s good you say. Yes, play is good; being productive is better. These two days were spent installing WordPress blogging software on a new server.

I wanted to find out more about WordPress and all of the stuff that goes with managing a PHP site. There has been a lot of things to learn and the going has been a little slow but I am glad to say that the new site http://metaltiger.org/blog is up with a basic layout. If you want to see what a really nice WordPress site looks like, take a look at Susan Kitchen’s 2020HindSight blog. Very clean and great content. I love her site and it’s powered by WordPress software. The WP software is open source and free too, how is that for a deal! The people that have developed WP and the support have really been terrific.

Enable Referrers

My first bit of confusion started when I tried to add a link. I received this notice that I must ‘Enable Referrers’ before the link would post. Enable Referrers? I scratched my head for a while on that one. After searching for a long time through all of the documentation in WordPress, I gave up and asked about it in one of the on line help support forums. It took a while before a kind response came that I did not know what I was doing and he supplied a link with a page on how to turn on Referrers in the browser. Great!

The trouble ended up being in my security software. Zone Alarm to the rescue. Sometimes we get locked up with security and loose the tools we need to do our work. Does this sound familiar? Eventually I opened up the security in Zone Alarm for my own site and presto changeo, the links now work. Thank you James Huff the wizard of web.

Bicycle Ride up to Claremont Ca

Other play today was conducted on the bicycle. The Velo Monrovia group did a 48 mile ride up through Claremont. All of the canyons are closed due to mud slides so we stuck to the foothills on the route. We ventured up Azusa canyon but one mile up the CHP officers had the barricades up and were turning people back. The heavy dump trucks and dirt/boulder movers were there in force. I think that it will be a while before all of these roads are open. Tomorrow is another day and I will get some more riding in. Good thing too. After three weeks of sitting on my rump watching the rain, I need a couple of good days riding just to clear away the cobwebs. Hopefully, I will be able to get some pictures of the snow on the local mountains during the ride tomorrow.