The Diary of Anesthesia Technologist

Hey, my name is Tamara, and I'm a 27 years old Anesthesia Technology student, now you might ask, why 27? Shouldn't you be 18 or something? Well, this is my second degree, I studied linguistics and now I'm studying Anesthesia Technology.

But that's not the point, the point is that I'm here to document my adventures and experiences! So this is a diary, telling all about the insanity of my practicums and studies.

The posts on this blog will include: Dairies, funny interactions, anesthesia information, medical information and terminologies, guides, guidebooks, artwork and more!

You'd be introduced to different characters based on real people to seal their identity, I'm excited for you to meet everyone I met so far!

This is NOT a porn website, this is just a diary and a place to vent and talk about my practicum and experiences to document and genuinely express myself in a fun way. It is NOT a role-play blog so don't expect me to cater to that.

If you have any questions to ask regarding my posts or the field in general, feel free to DM me or pop into my asks, I'm always happy to help and answer your concerns.

This blog is human-ran but it uses Artificial Intelligence to organize data in a better way and to generate profile avatars.

With that being said... I'm excited to share a glimpse of my life with you guys and thank you for being here!

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Patient: *becomes hypotensive*

Anesthesia Tech: *panics and starts going through the drawers*

Anesthesia Tech: *finds Oxytocin*

Anesthesia Tech: *administers Oxytocin*

Patient: *has normal bp again*

Ventilator: *beeps about how the ECG isn't connected*

Me: *panics and waits for the anesthesia tech*

Anesthesia Tech: *returns*

Me: *panicked* THE ALARM IS READING THE ECG ISN'T CONNECTED

Anesthesia Tech: *panics for a moment* *has a moment of realization* dude, do you see any ECG machines in the room?

Me: No?

Anesthesia Tech: THE SURGERY DOESN'T NEED ECG YOU DUMBWIT THAT'S WHY WE DIDN'T CONNECT THE MACHINE TO BEGIN WITH AND WHY THE ALARM IS BEEPING!

Me:

The last month I started my internship at a private hospital, a whole different experience where the technologists literally told me to shove my information down the drain and restart with more accurate ones as they might've given my misinformation, so I've been learning a lot.

They are friendlier that's for sure, but their work hours are insane, imagine working twelve hours six days a week? I'd go crazy, considering that I did go crazy back when I was working eight hours six days a week and literally kept quitting because I needed the one week break before transitioning to another job, it was a life saver.

Anyhoo, my new scrub uniform is regal purple, the hospital came up with the weirdest color there is to distinguish us from the already existing staff, guess what happened once we started wearing the regal purple? THEY started wearing it too! So I suppose I need to change the blog's aesthetics to regal purple now, a task that I'm delaying for a while because... well, I'm too exhausted.

The reason why I'm generally exhausted is because I'm also going to uni at the same time as practicum, meaning I have exams, quizzes, and lots of assignments that I haven't even started yet!

My first day, I was assigned to observe at the gynecology department and witness the birth of children, let me tell you, the more time I spend there, the more I'm convinced that pregnancy is a scam, it's falsely advertised as this form of magical moment while it's actually a lot of pain, blood and other bodily fluids, completely disgusting.

They left me to tend to the recovery unit, my very first patient grabbed my hand and never let go, she made me promise not to leave her side and gave me the sweetest hand massage the entire time, she was still under the effect of Ketamine's hallucinations so that's why she was extremely emotional.

My second patient kept asking me what she gave birth to, I didn't know because I was more focused on her as a patient, the child is not my responsibility, she asked about it every five seconds, and kept telling me that I'm a good person, it was also adorable, I helped transport her to the room.

Then I had a male patient when I transferred to the general surgery department, he was all hallucinative and kept inviting everyone to his restaurant and told us not to let him to go to his room because his anesthesiologist cousin was planning on filming him make confessions -idiot cousin, if he tipped me earlier, I would've filmed him and sold it to him, jk loves, we have a code, don't worry- we asked him about his name, he said he was only certain about his name 90%, we were laughing just fine and had to be removed from the scene. Not cool.

I also had a patient with autism, he was kind, he was verbal but he wasn't very functional, I saw the anesthesiologist attending the case basically remove himself from the scene because he was too sympathetic with the boy, he kept telling us about how his life quality is forever altered, and how he would spend the day thinking about whether he's being taken care of appropriately at home or not. It's so rare to see a healthcare professional get emotional about a case because we do see all, it was so refreshing.

I also had a patient with lymphedema, or what's known as elephant foot, it's hereditary, she was so sweet but she started crying the moment she was left alone, I comforted her, a side of me that I never knew existed, stayed with her, she was nice, I couldn't stay to check the results of the surgery but I truly hope her life quality improved and everything went well, I'm still waiting for the hospital to post about her on social media, will keep you updated about it!

Some doctors and medical staff members need to remember that we're not in Grey's anatomy even though it feels like it.

Not every intern is your Meredith Grey or Cristina Yang, not every line you say is heroic and well thought, and most of your puns? They are lame but we don't wanna hurt your feelings.

Human body can take more than it should be taken

People get creative when they have so little resources, don't have an IV stand? Tape it to the surgical lights with a plaster

If you see two or three flies stop at a sterile surface, it's somehow still sterile

If your patient's foley bag starts leaking and drowning the operation room's floor, keep going, worry about cleanliness later

Seeing a gecko in the middle of the operation room is not the end of the world, keep going, pretend it's not there until he gets killed by a trolley by mistake

If you don't have a medicine that is relatively safer for you patient, use the dangerous one but like, treat the symptoms later

The air-conditioning leaking water all over the operation room's floor that is filled with wires and electricity is not a health hazard

You walking into the common area with your shoes is a health hazard but the dead rat in the ceiling isn't

Face masks are optional unless it's a patient with a contagious disease

Ortho bros are literally ortho bros the way we see them in the movies/tv shows and it's not just the surgeons, it's everyone in the department

Surgeons with multiple certificates are threatened and jealous of women just because they go to a fancy university and will try to undermine you and ridicule everything you do while speaking loudly and aggressively because they are truly insecure

Pens worth more than money, I saw a grown-ass man's face light up because his colleague gave him a pen, he insisted on paying and when she refused he would've given her a kidney if she asked, he was so happy that he kept writing on all surfaces in the operation room and showing it to the interns

Analgesia / Sedation

Diprivan (Propofol) – Sedation/anesthesia; CI: egg/soy allergy, hypotension; dilute in NS/D5W; best for rapid ICU sedation. Dose: Induction 1–2.5 mg/kg IV; infusion 5–50 mcg/kg/min

Piopam (likely Flunitrazepam) – Sedation/anxiolysis; CI: severe respiratory depression; usually undiluted IV push; best for pre-op sedation. Dose: 0.5–2 mg orally or IV

Diazepam (Valium) – Benzodiazepine sedative/muscle relaxant; CI: severe resp. depression, myasthenia gravis; no dilution for IV push; best for seizures/anxiety. Dose: 2–10 mg IV slowly

Midazolam (Versed) – Short-acting benzodiazepine sedative; CI: hypotension/shock; dilute in NS for infusion; best for short ICU sedation. Dose: 0.02–0.1 mg/kg IV bolus; infusion 0.02–0.1 mg/kg/h

Lorazepam (Ativan) – Benzodiazepine sedative/anxiolytic; CI: hypotension, narrow-angle glaucoma; no dilution for bolus; best for long-term sedation, seizure control. Dose: 1–4 mg IV every 2–6 h

Ketamine – Dissociative anesthetic analgesic; CI: hypertension, raised ICP; dilute in NS/D5W; best for pain and hemodynamic instability. Dose: 1–2 mg/kg IV bolus; infusion 0.1–0.5 mg/kg/h

Thiopental – Barbiturate induction agent; CI: porphyria, severe cardio/respiratory disease; dilute in NS; best for rapid anesthesia induction. Dose: 3–5 mg/kg IV bolus

Fentanyl – Potent opioid analgesic; CI: severe respiratory depression; dilute in NS; best for severe pain and anesthesia adjunct. Dose: 1–2 mcg/kg IV bolus; infusion 1–2 mcg/kg/h

Remifentanil – Ultra-short-acting opioid; CI: severe respiratory depression; dilute in NS/D5W; best for short procedures. Dose: Infusion 0.05–2 mcg/kg/min

Paracetamol (Acetaminophen) – Analgesic/antipyretic; CI: severe liver disease; dilute in NS (IV); best for mild/moderate pain, fever. Dose: 1 g IV every 6–8 h (max 4 g/day)

Acupan (Nefopam) – Non-opioid analgesic; CI: seizure disorders, angle-closure glaucoma; dilute in NS; best for moderate pain without respiratory depression. Dose: 20 mg IV slowly (max 120 mg/day)

Muscle Relaxants / NMBA

Atracurium – Non-depolarizing NMBA; CI: allergy; dilute in NS; best for short-term paralysis. Dose: 0.4–0.5 mg/kg IV bolus

Azmeron (Rocuronium) – Non-depolarizing NMBA; CI: allergy; dilute in NS; best for rapid sequence intubation. Dose: 0.6–1.2 mg/kg IV bolus

Succhyline (Succinylcholine) – Depolarizing NMBA; CI: hyperkalemia, burns, neuromuscular disease; no dilution; best for rapid intubation. Dose: 1–1.5 mg/kg IV bolus

Antidotes

Neostigmine – NMBA reversal; CI: GI/GU obstruction; dilute in NS; best for reversing paralysis. Dose: 0.03–0.07 mg/kg IV

Sugammadex – NMBA reversal for rocuronium/vecuronium; CI: severe renal impairment; no dilution; best for rapid reversal. Dose: 2–16 mg/kg IV

Antibiotics

Ceftriaxone – Broad-spectrum cephalosporin; CI: severe penicillin allergy; reconstitute with sterile water; best for sepsis/pneumonia. Dose: 1–2 g IV daily, don't use with Ringer fluids

Steroids

Dexacure (Dexamethasone) – Potent corticosteroid; CI: systemic fungal infection; no dilution for bolus; best for cerebral edema/allergy. Dose: 4–10 mg IV bolus

Hydrocortisol (Hydrocortisone) – Corticosteroid; CI: systemic fungal infection; dilute in NS; best for adrenal insufficiency/shock. Dose: 100–200 mg IV every 6–8 h

Gastrointestinal and Antiemetics

Ondansetron ( Ondagin): 5-HT3 antagonist antiemetic; CI: QT prolongation; dilute in NS; best for nausea/vomiting. Dose: 4–8 mg IV slowly

Semotidine (Famotidine) – H2 blocker; CI: allergy; dilute in NS; best for stress ulcer prophylaxis. Dose: 20 mg IV every 12 h

Metocol (Metoclopramide) – Prokinetic, antiemetic; CI: GI obstruction, Parkinson’s; dilute in NS; best for nausea/gastroparesis. Dose: 10 mg IV every 8 h

Cardiovascular

Betaloc (Metoprolol): – β-blocker; CI: bradycardia, AV block; dilute in NS; best for rate control/hypertension. Dose: 2.5–5 mg IV every 2–5 min (max 15 mg)

Adrenex (Epinephrine) – Vasopressor; CI: none in emergencies; dilute in NS/D5W; best for cardiac arrest/shock. Dose: 1 mg IV every 3–5 min (arrest)

Ephikwal (Ephedrine) – Vasopressor; CI: hypertension, tachycardia; dilute in NS; best for anesthesia-induced hypotension. Dose: 5–10 mg IV bolus

Furosemide – Loop diuretic; CI: electrolyte depletion; dilute in NS; best for fluid overload/pulmonary edema. Dose: 20–40 mg IV bolus

Angeside (likely Enoxaparin) – Anticoagulant; CI: active bleeding, HIT; no dilution; best for DVT/PE prophylaxis. Dose: 40 mg SC daily

Respiratory

Aminophylline – Bronchodilator; CI: arrhythmias, seizure; dilute in D5W/NS; best for severe asthma/COPD. Dose: Loading 5–6 mg/kg IV over 20–30 min

Me: SIR, IT'S THE FIRST TIME WE WITNESS AN AMPUTATION!

One more day before my practicum ends, and yes, I have a lot of stories to share with you guys! A lot of observations and negative stories, as well as positive ones. Hopefully I'd be able to post about them during my mini-break.

As for today, it started at the ENT department, one of my most favorite experiences, the staff was always very cooperative, the surgeries always seemed interesting and yes, I know what you'll say "Girl, you're an anesthesia technologist, stick to your lane and monitor the anesthesia cart!" but, surgeries are long, you get bored after a while, and when the patient is stable enough, you get a chance to see the extents of how fascinating the human body is and what it can endure.

The surgeons had a competition, who finishes the surgery first without any complications and with precision, they worked in two different operation rooms -obviously- and were competing with passion. Neither won though, they both finished at the same time, one due to complications, and the other took longer time double-checking everything.

Afterwards, it was announced that there were no more surgeries in the department for the day, they were preparing for a certain event in my country that might cause a sudden need of all hands on deck, they were preparing for the calm before the storm.

So naturally, we switched to my favorite departments urology and emergency surgeries! -Yes, they are both on the same floor.

For the first time ever, we were solely responsible for the recovery phase of the anesthesia, we pushed the antidote, suckered the secretions, held the masks, offed the fluids, woke the patient up, the experience was overall amazing -Don't worry, we were supervised- and our patient was alright, it was a feeling that one can't deny! Like, yes, I did this!

But then, came the case that I actually wanted to share with you! The patient was a 73 years old woman, she had no mental problems but due to age, her mental capacity was compromised, that woman sobbed with every prick of needle, she had dark spots all over her body of clotted blood, she was diabetic, and hypertensive, she was a smoker, and had diabetic foot.

If you don't know what that is; Death of foot tissue in people with diabetes, usually from poor blood flow and infection, leading to blackened, nonviable areas that may require amputation. She was scheduled for an above the knee amputation but the doctors decided a lower amputation was the best under regional anesthesia, and although seeing an amputation was something extreme but the unwelcomed gecko in the operation room sent us screaming, and the worst part, no one did anything about it.

Now if you don't know, I have a geckophobia, I hate them, I don't tolerate them, if they are somewhere, I literally run the opposite way, this was the most scary part of the surgery, not the smell, the flesh being torn apart, no, this disgusting creature sent me into a fit.

Which made me realize, I've grown cold towards people's pain, although I sympathize with their feelings and suffering, but I saw a woman's foot get cut and I felt nothing, no disgust, no sorrow, but I felt fear from a gecko of all things! When you're in the medical field, your sentiments become more optional than mandatory, eventually, you become numb towards the horrible things you see and yes, I know they are medicinal but still horrible.

This numbness is actually scary, because entering this field, you want to make a difference, be the practitioner you want your family to have instead of following the steps of everyone else and turning into a cold, numb, shell of the excited-change-thriving intern you once were.

As a person, I'm naturally an introvert, and I've been through some shit that generally made me disconnect from everyone around me, build walls, not get affected by stories in general, therefore, never in a million years I thought that I would end up connecting with patients and desperately try to comfort them.

The first time I was left alone with a patient was a screaming child, this child was terrified, I wanted nothing to do with him, why you ask? Because I generally try to avoid "Special population" which includes children, elderly and pregnant women, I never learned how to connect with them or handle them so I keep my distance. The child kept sobbing out of fear and plotted his escape every five minutes, my colleague insisted that she can handle kids, and before we knew it, five grown ass women were standing over that child, trying to keep him at bay so he doesn't hurt himself. It was that moment I decided to never be around children ever again.

The second encounter I had was different, I was at the Operation Room, waiting for the surgery to begin all by myself when a surgeon walked in and playfully asked "Ma'am, are you prepared for us to send in a patient?" I thought he was kidding, I was obviously an intern, I had my badge and hungry look of inexperience all over my face, that and the scent of fear all over me, so I said "Yes sir! Bring 'em in" little did I know, he meant business.

He brought in this 26 years old, one year younger than me woman, who was terrified, he brought her then left, it was only the two of us. And this woman looked at me and started sobbing, like I said, I'm not a people's person, I had no idea how to comfort a sobbing person, I held her hand, told her the surgery was easy, that she'll feel nothing.

She told me that she was crying because she had a son 11 months ago and today he hugged her for the first time, it was sad because she thought she wouldn't see him again (her surgery was a success so don't worry). It was also overwhelming because she suddenly found herself surrounded by 25 medical intern, told her that if she started crying that I might end up asking one of the interns to do her surgery via Youtube videos which made her giggle, I told her that if she kept her morality up I'd give her cannulas to stab people with as a revenge which she liked. I still think about that woman and hope she's generally doing well.

The third time is the most recent, a 13 years old child that I found sitting on the hospital bed, terrified and crying all by herself, I told her to hold my hand and squeeze it whenever she felt scared or in pain, I explained to her that the surgery was minor, that she had nothing to worry about, I got a few smiles out of her. Especially when I told her that she can use this opportunity to be spoiled by her parents, my friend suggested that she gets an iPad, she smiled, plotting the demise of her parents' financial state (Her surgery was a success as well).

Overall, connecting with people is something strange and kinda uncomfortable for me, but, I'm discovering a whole new side of me, a more humane side of me, someone who can relate to others and try to help them in their moment of need, comfort them even.

Taxi Driver: So... you're a doctor?

Me: No, I'm actually an intern anesthesia technologist

Taxi Driver: So... You put people to sleep?

Me: Yeah

Taxi Driver: Do you know any good doctor?

Me: Actually no, I haven't been in the hospital long and I don't interact with doctors, I mostly monitor quietly near the anesthesia cart far away.

Taxi Driver: So... My son has a rash, what treatment do you recommend?

Treating everyone equally, sharing your knowledge, your expertise and information with everyone is cool, it's a good way to build connections, it's a good way to show everyone that you're a decent person and it's totally acceptable to communicate more with a certain person because you feel a connection or simply enjoy a conversation with them or even feel curious about it.

What's not cool is; kicking every man on the interns team with petty excuses, isolating the only woman on the team just because you're curious about her or allegedly like her, and requesting her contact information for exchange of experience is not cool, it's creepy, even if the intentions were good, it feels like being trapped and suffocating kinda, it's not acceptable.

Today I arrived at the hospital I'm put to practice at, it was quite the experience, I still don't know anything about the halls and where to find whom, I had to send everything as a GPS to my buddy, if you know anything about me its that I suck at directions but I'm hell of a map navigator.

While we walking, our supervisor with urgency told us to gather around and he said "Tell us where you live so we can carpool, tell us your name, your phone number and your father's work" which I got really excited about, I legit thought he was going to offer us rides, but apparently no, he was warning us not to get too friendly with the staff - hope he doesn't figure out that I chose that specific hospital because my friend works there. It made me laugh though, all the suspense he offered.

After getting assigned to our department (I got GYN/OB, not so yay). We were directed there and everyone was like "aww go wear your scrubs" which we did, I put on my scrubs, my head cap and started to wander in the ORs.

The first surgery I attended was a baby delivery, I still didn't know what the protocol was so I observed with the medical students, one of the medical students became hypoglycemic and fell on the floor, he was spasming, they had to give him an IV fluids, his friends definitely made fun of him when he recovered.

Afterwards, I stepped out of the OR because it was overly crowded and went to observe a hysterectomy surgery where the anesthesia technologies was generally kind and gave us some notes and tips, for example, the affect of the following meds

Valium – Calms, sedates, relaxes muscles Dexacurium – Paralyzes muscles for surgery Plasil – Stops nausea and vomiting Azemeron – Induces surgical paralysis Atracurium – Short-term muscle relaxant Neostigmine – Reverses muscle relaxants Remifentanil – Fast-acting pain relief

As well as the anesthesia triangle:

Hypnosis / Unconsciousness

✦ To make the patient unaware ✦ Common drug: Ketamine, Propofol, Etomidate

Analgesia (Pain Control)

✦ To prevent pain sensation ✦ Common drug: Opioids like Fentanyl, Remifentanil, Morphine

Muscle Relaxation (Neuromuscular Blockade)

✦ To relax muscles for intubation or surgery ✦ Common drug: Atracurium, Rocuronium, Vecuronium

And most importantly the MAC of inhalation agents

Isoflurane 1.15% Sevoflurane 2.0% (sweet and favorable) Desflurane 6.0%

It would be a lie to say I understand how MAC works yet. But hopefully I will learn soon enough.

Mid hysterectomy surgery, the patient woke up and the anesthesia technologist was nowhere to be found, it was terrifying to say the least, and as it was my first day ever, I had no idea what to do, neither did the two interns next to me, so they rushed hysterically to find another one, while I stayed with the patient semi-frozen, it wasn't a good sight, but eventually the replacement arrived and the patient was well.

I took a moment to breath out of the OR and instead of returning, I went to another OR where the rest of my colleagues were, we witnessed a Exploratory Laparotomy, apparently if the the patient is obese, vaginal entry is difficult. And there might be a need to switch to rectal entry or even create abdominal incisions.

Another fun fact, Neostigmine is a tough medicine that actually goes slowly through the patient's body, so to make it work faster, they push normal saline.

A fun interaction, an old woman saw me and my colleagues - five people - and she looked at us so confused and said "you guys look like prisoners" I got bullied by an old woman - our scrubs are ceil blue.

Also we heard a "HEY YOU KNOW IT'S NOT MANDATORY TO WEAR A UNIFORM COLOR RIGHT?" we know, it's not mandatory for you but it's mandatory to us, our supervisor from college observes us. No one in their right mind would pick ceil willingly, I personally would go to darker colors.

A few weeks ago, my college nominated me to participate in an international conference that's hosted by another college at our university, this conference was supposed to take place in another country and I was one of four.

The other college, we'll call it college B for future references, requested my passport and papers 30 days beforehand, they also gave us an intensive training for two whole days, and I was in contact with them on daily basis.

Three days before the trip, they informed me that I needed to renew my passport for an issue related with the expiry date (they had it 30 days prior), the administrator who's responsible for booking the plane tickets said "I knew it was gonna happen" meaning she had prior knowledge of this problem for 27 days and withheld the information from me.

Now, I worked day and night to fix that problem, spent around 100$ in transportation and paperwork, the embassy was very cooperative and kind (Afterwards, I had to fix the problem with the embassy as well) and they were so stressed about the deadline, so College B's administrator told them "Not to worry about it, even if you get it done 3 hours before the flight, we'll get her ticket booked" so they gave me a date after the weekend to get my paperwork.

I go on Monday, pick up my passport and visa and then I tell the administrator "hey, I just got it done, are you gonna pick my ticket now?" and her reply is "um, yeah, but the college wants you to pay 600$, half the traveling expenses because your paperwork came in late" then she added "if I were you, I wouldn't pay the money because it's only for a couple of days" so, my intake was that I wasn't wanted and there was a sabotage from the very beginning.

I thanked them politely and declined, especially since I knew that the airplane ticket didn't cost 600$ at all. The total costed 500$ so I would've paid unknown extra expanses and it wouldn't be the half as she claimed.

Mind you, all of this happened straight after my finals, I had to go to college B and the embassy for a whole week, I was exhausted and holding on by a thread, I don't even remember how many breakdowns I had in the cabs.

Now! Many weeks later, they send me an email about applying for another contest for them, like??? Honey I'm petty! I'd apply, join the opposing team, win the whole thing just out of spite! Like, what made you think that this would be a good idea? The audacity of some people! You literally wasted my time and energy over something that isn't related to me directly but I was willing to help and share my expertise with you, and upon all of that you wasted money that I could've used for something else, like, saving up for transportation for next semester!

I don't understand in what world they thought I'd be alright with representing College B, after all of this!

Now, I would like to hear your thoughts, am I overreacting? Am I insane for losing all trust in College B and generally not wanting anything to do with them anymore?