Nitrous is cool stuff

I had my first experience intubating a kid yesterday. He was only 3 years old and way too cute. I wasn't quite sure I had heard right when the anesthesiologist handed me the laryngoscope and said go ahead. I was seriously worried I might break the poor kid. Turns out everything is exactly the same, just smaller. I had no trouble and all went well. I think that set the tone for the rest of the day as I went 9/9 for the entire day.

Usually when we induce anesthesia we inject a couple of drugs into an IV. A narcotic pain med, a medicine to numb the vein, and medication to send them off to sleep - this medication burns a bit, hence the numbing, and finally a med to paralyze them. We do it slightly different for kids and young adults. For the 12 year old we induced we used nitrous oxide, commonly known as laughing gas. I had never experienced an induction with this gas before, so I wasn't exactly prepared for what happened. I was holding the mask and he had been breathing the nitrous for about 30 seconds or so. All of a sudden he began laughing uncontrollably. From what I could discern, there was no appropriate stimulus for this attack of hysteria. All I can say is wow. It was a good thing that everyone in the room was also laughing at the fact this kid was laughing, I'm not sure I would have succeeded in keeping it together.

I also attempted to work on my IV skills today. I did learn how to start an IV during the second year of medical school, but hadn't done another until last week when I learned again. I worked with two amazing nurses who helped me with my technique. I was on a roll, I had successfully started 5 out of the last 5. Today I got my first three and then I choked on the last one of the day. Damn, what a way to finish. There is always tomorrow to attempt to redeem myself.

This has been an amazing rotation in so many ways. It's too bad it has to end tomorrow.