January 17, 2017
Happy New Year, everyone! I can hardly believe we are two weeks into the new year, but there are already a few notable events. First, we have completed our residency applicant interview season! We have had numerous stellar applicants, and I would like to thank all of you — residents, faculty, and staff — for the energy and enthusiasm you brought to this year’s interview season.
Secondly, I want to make you aware of a major speaker coming to give combined Anesthesiology and Surgery Grand Rounds this week as the Merel H. Harmel Distinguished Lecturer, Paul Farmer, MD, PhD. He is a Duke alum and current professor at Harvard who has devoted his life to global health. Through his passion and persistence, he has changed the way international organizations view the management of global health crises and has been a voice for so many who have simply been ignored or forgotten on the world stage. As both an anthropologist and infectious disease specialist, he has leveraged his talents in medicine and public policy to develop highly successful, locally sustainable programs to combat infectious diseases in the most challenging environments. He is the recipient of numerous awards including the MacArthur Genius Grant and is the subject of the biography, Mountains Beyond Mountains, for those of you interested in learning more about his remarkable life. The lecture hall will likely be standing room only, so I encourage all of you to arrive early.
January 27-29 is our 5th annual ACES Symposium. Our ACES chiefs, Kendall and Taylor, are putting together a fantastic weekend to showcase our innovative program and its outcomes. You’ll also see some of the ACES applicants walking around speaking with some of the hospital’s researchers. Saturday is also the bowling event for residents and the Education Office has received some great raffle prizes so we’re looking forward to that! Saturday is also my daughter’s birthday so it’ll be a busy weekend for all!
The ITE is a month from now, February 18th. Jessica will be sending out information on whether you’re in the morning or afternoon session. I know you all have been doing practice questions, but my advice would be to read for depth of understanding, particularly as it relates to the complex cases you are managing. Write down two or three questions daily from your observations in the operating room, and really try to understand the evidence-based or physiologic underpinnings of the management you do every single day. You’ve got this!
Lastly, the ACGME survey period will begin this Friday January 20th for both RESIDENTS and FACULTY. Please complete the survey as soon as possible. We can track who has not completed the surveys so you’ll receive weekly reminders (we don’t receive the results until mid March so it is completely confidential). Last year, the residents got 100 percent completion and the core faculty got 97 percent completion – let’s make it 100 percent all around!
Have a great week!
Presented at ASA 2016
Awake Fiberoptic Intubation for a Patient Undergoing MVR and AVR With a Benzodiazepine Allergy and Intolerance to Opioids
Christopher S. Wahal, M.D., Ryan M. Konoske, M.D., Cory Maxwell, M.D.
Duke University Medical Center, Durham, NC, USA.
A 21 y/o female with history of PDA repair, POTS, severe MR, and moderate AI presented for AVR/MVR. Patient’s history included difficult airway (MP 4, micrognathia, 2 cm opening) requiring rescue fiberoptic intubation with 6.0 mm ETT, anaphylaxis to benzodiazepines, and opioid intolerance from intractable nausea. Small vessel size led to very difficult arterial line placement. An awake fiberoptic intubation was performed. Topical anesthesia was achieved with 4% lidocaine nebulizer and 2% lidocaine ointment. Sedation for intubation and induction included IV ketamine, dexmedetomidine, and promethazine. Hemodynamic stability was maintained in the pre-bypass period, and mechanical valves were placed without incident.
- 1/22 – 1/28
- This weekend (1/21-22): Falcinelli, Ellison
- Next weekend (1/28): Hulsey, Castro ; (1/29): Hulsey, Devinney
- This week (Sat PM 1/21 – Fri AM 1/27): Jia, Hall
- Next week (Sat PM 1/28 – Fri AM 2/3): S. Jones, Fox
Friday Night Call
- This Friday (1/20): Bluth, Devinney
- Next Friday (1/27): Reskallah, Donald
Liver Call Weekend (pager: 7320)
- This weekend (Fri PM 1/20 – Sun PM 1/22): Mangan
- Next weekend (Fri PM 1/27 – Sun PM 1/29): Brockbank
Liver Call Weekday (pager: 7320)
- Liver day (Mon AM 1/23 – Fri PM 1/27): Herbert
- Liver night (Sun PM 1/22 – Fri AM 1/27): Falcinelli
- Saturday 1/21 AM: Brockbank
- Saturday 1/21 PM: McCauley
- Sunday 1/22 AM: Anderson
- Saturday 1/28 AM: Bluth
- Saturday 1/28 PM: Pleticha
- Sunday 1/29 AM: Anderson
Simulator (4-6 p.m. — page charge CRNA *7853 to ask for relief at 3:45 p.m.)
*These are mandatory sessions*
- Mon 1/23: Crowgey, Mintz-Cole, Wang
- CA3 on call pager (970-9313) is covered by CA3 on general OR call.
- Liver call pager (970-7320) is always covered.
Have a good week!
Please stop by during the office hours listed below. Or, please feel free to contact any of our leadership to schedule a meeting outside of standard office hours.
Duke Health wants to showcase our residents as faculty are! Contact Jennifer Schwabel at firstname.lastname@example.org if you’re interested in being videoed for your profile! Check out Dr Allan Kirk’s profile for a great example. Please let Jessica know if you’re interested in this!
Want to talk with someone?
Personal Assistance Service (PAS) is the faculty/employee assistance program of Duke University, that is FREE. The staff of licensed professionals offer assessment, short-term counseling, and referrals to help resolve a range of personal, work, and family problems. PAS services are available at no charge to Duke faculty and staff, and their immediate family members. An appointment to meet with a PAS counselor may be arranged by calling the PAS office at 919-416-1PAS (919-416-1727), Monday through Friday between 8:00 A.M. and 5:00 P.M. If you need assistance outside of those hours, call the Blood and Body Houtlins (684 1115) for behavioral health concerns.
This Week in Lectures
CA1 (1/17): PONV with Dr Ashraf Habib
CA2/3 (1/18): Complex Regional Pain Syndrome with Dr Srinivas Pyati
Thursday (1/19): Resident TEE Series with Dr Sharon McCartney
Next Week in Lectures
CA1 (1/24): Drug Reactions Anaphylaxis, Anaphylactics and Anaphylactoid Reactions with Dr Jerry Levy
CA2/3 (1/25): Cancer Pain with Dr Thomas Buchheit
Thursday (1/26): Resident TEE Series with Dr Sharon McCartney
Private practice group in Lewes Beach Delaware is expanding! See Dr Jay Hutson’s email in the jobs box account for more details about the job and how to reach him.
Emory is expanding faculty – high risk OB, peds, cards, thoracic, general cases, etc. Contact Dr Bola Faloye, 2013 alumni, for more information. Contact information is in box account!