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[gasman]

[yogenbhatt1]

Sir,
Good list of Journals given by you.
     I am interested in some kind of Protocol for Anaesthesia in C. Section. I wish to present it  in the court of law for a case against one of our Anaesthesiologist coleague. He had a mortality following a Mendelsons' Syndrome.
     The court has asked him to present some protocol based aproach to Anaesthesia.
I found some practice guide lines in ASA journal.
      In India we have no such protocol as per my knowledge. You have some in any country?
Please let me know.

[hillpeng]

i need more link

[swatantramishra]

Dear Dr. Bhatt,


                   It is really good that you are seeking knowledge, but please do not say that Indian doctors are working without protocol, you may not have it at your institute that is a different matter. Such type of generalizations are bound to create a negative opinion about the professional std. of Indians practicing Anesthesia in India. I have got all my education from India and I was always given a protocolized approach. Try to seach some more before making such negative conclusions.

regards,

Sir,
Good list of Journals given by you.
     I am interested in some kind of Protocol for Anaesthesia in C. Section. I wish to present it  in the court of law for a case against one of our Anaesthesiologist coleague. He had a mortality following a Mendelsons' Syndrome.
     The court has asked him to present some protocol based aproach to Anaesthesia.
I found some practice guide lines in ASA journal.
      In India we have no such protocol as per my knowledge. You have some in any country?
Please let me know.

[jafo1964]

Dr. Mishra
I am teaching anaesthesia for the last 20 years
I do agree that Indian doctors or anaesthesiologists are neither inferior nor less trained than the rest.
But do you really think that we follow protocols.
No need to look far, just look at how the national family planning programme of this country works.
Have you any idea about the conditions in which we anaesthetize people . if they die they contribute to MMR. They have practically no monitoring even for laproscopic sterilization.
Also now MBBS doctors are trained for 6 months in anaesthesia and are allowed to perform anaesthesia for LSCS. It is a national programme headed by an anaesthesia chief. Soon these guys gravitate to giving anaesthesia to all cases. So are they trained enough.
Have you, me or our brethern viewed this with any seriousness. Will we permit our kith and kin to be anaesthetized by these govt certified people.

I have passed 4 degrees in anaesthesia and even now we all practice things that if said in the exams I would not have got any degrees. We dont practice it because we have no protocol in place and no rigid rules to see that we adhere to them. Why then ask questions in the exam, fail them if they dont answer but dont follow them in clinical practice
IV Ranitidine and Metoclopramide is adviced for all OB coming for LSCS. the evidence is there. Do you think all of us follow it.
Is our pre-oxygenation and intubating positions standardized. Do we use ETCO2 and temperature monitoring for all our cases. DO we have a PACU . Do we record discharge criteria and scores.
Are all of us aware the Intra-cardiac adrenaline got stopped in 1999. Do we have defibrillators at every anaesthetic spot.
Dont blame the administration, if we followed protocol the entire anaesthesia community would have risen together and made it happen.
Dr. Bhatt has stated the obvious and I am in full agreement with him.
I think we are all improving all the time but still very far away from Utopia.
Let us also stop using the untrue scenario of our country being poor. Look at our cars, our shopping malls and how rich our politicos are. So lets stop kidding ourselves.
We need protocols in place and we need accountability to these protocols and we need more original research so that the Indian anaesthesiologist can set the guidelines for the world

regs

[yogenbhatt1]

I wonder why it should hurt feelings when I say that there are no protocols. Protocols mean, that, this much pre op care, antacid, Antiemetic, evaluation, left lateral tilt, fluid preload, vaso pressors, PPH protocol,MRP drugs to relax uterus, intubation preparations, drugs and dosages, Prostodin and pitocin etc , what if spinal fails, preparation fo obst hyst, and so on.
We have text book and teachings, but no where is there a fixed printed protocol. There are recommendations and teachings, but nothing is put in black and white to adhere to the fixed line of management.
Our ppl practice what they feel right, what is available to them.
Every conference it is tought to us to have a guideline to practice, but still no protocol.
I would be really happy if any of our Indian hospital member can forward it to me. Each intitution, ( Including my own group) has the protocol, but, again not in  a print. We all say that, this is how we do our cases.

[anesthesia_samar]

useful disscusion .. thanks

http://www.fmed.bu.edu.eg/en/
http://www.fmed.bu.edu.eg/fmed/index.php/anet