Wednesday, May 11, 2011

Paradigm Shift

Standard Monitor Used in Critical Care and the Operating Room

The monitor was the last great paradigm shift, Kevin Tremper, MD, said in the Rovenstein Lecture of 2010. He reviewed the invention of the pulse oximeter (blue line, with 100) and it's rapid acceptance and role in improved patient safety.

He also paralleled the changes in technology in aviation to the changes in technology in anesthesia. One of the newer developments in aviation is to 'fly by wire'...this means that there are no wires connected to the controls. Just a computer. And it interprets every move the pilot makes and adjusts it perfectly.  Tremper said that Sully overrided the computer in landing on the Hudson River. But a whole new age of monitoring perioperative data and using it as a resource for clinical research is the wave of the future.

I have seen this done. Intraoperative monitoring with 'Quality Assurance' turns the operating room into a place where administrators set limits on where they want vital signs to change from baseline. And without the anesthesiologist knowing it, triggers are set and the anesthesia provider can be 'counseled' about their care. The chair of the department has an app on the cell phone and can see every case's monitor data remotely. It puts the anesthesiologist in a daunting position of defensively annotating the automated record to document everything to explain variation in the hemodynamics during each case. There is a little clock in the computer, and promptness is needed.

Sometimes, in a very unstable case, we don't chart, traditionally. In a horrible trauma, we take care of the patient first, pile the used bags of blood products and i.v. fluids on the floor, and the code drugs as appropriate, and chart at the end. Sometimes it takes more than one to do anesthesia for such a case.

The next wave after that is the use of 'subtle methods' in the operating suite. Yesterday, with a slow surgeon, working on a difficult case, I had time to think. Boredom does arise in such cases, with the finger re-implant with a microscope in the middle of the night being one of the hardest cases to stay alert.

While the surgeon went on and on, and on and on, I did Deeksha, Chakra balancing, Reiki, and Karuna Reiki on the patient. The striking thing about Karuna is claircognizance. You 'just know' what is going on. This patient had female problems. I picked up who had abused her, around what age, and why the fertility problems were present--rage. When I found out the patient's religion, a very strict and conservative one at the end when I filled out the face sheet, everything fit together: super sensitive to anesthesia drugs, pressure to have a family, and anger/betrayal at the head of the family of origin. 

Instead of treating symptoms, I was able to take an energetic read on the chakras, interpret it, and offer treatment. No monitors were needed at all. One of my colleagues I did anesthesia for asked me what it was I did. Why she 'had no pain', and only took two pain pills because her husband was worried about her. I told her 'I zapped' and 'gave her the works'. She believes.

I hope others will, too.

Have a great day,

Reiki Doc