Keep Calm, and Call an Anesthesiologist
While vacationing recently in Palm Springs, CSA member Dr. Ian Chait and his family were enjoying their hotel's pool and gardens. Dr. Chait was chatting with one of his friends, who had just finished reminiscing about how he used to be a lifeguard when he was younger. Suddenly Dr. Chait’s youngest daughter screamed for help. “Dad! Dad!!”
A blue, limp, unconscious little boy, about 3½ years old, was being pulled from the swimming pool. Dr. Chait leapt over a chaise lounge to get to the child, accompanied by his friend, the former lifeguard. The friend pointed to Dr. Chait and said: “He’s a doctor!” Dr. Chait immediately took charge with his training and skills in airway management. He opened the boy’s airway, and began rescue breathing. The unconscious child coughed, slowly started to breathe, and vomited, while Dr. Chait kept his airway clear. The more than 100 hotel guests at the pool kept deathly quiet as the struggle for life unfolded in front of them. When the little boy regained consciousness and began to cry, the crowd erupted in spontaneous applause. “That was amazing," said one hotel guest. "I have seen heroes on TV, but never in real life!”
As a fellow anesthesiologist and colleague of Dr. Chait at the Children's Hospital of Orange County, I first heard this story when he showed me a Facebook post from his teenage daughter. "I am so proud of my dad for saving that little boy's life," she wrote, "but I know he saves peoples' lives every day!"
Dr. Chait is an excellent anesthesiologist, and he is also very humble. Unless you know him well, you would never guess how skilled he is in the specialty of pediatric anesthesia, or that he volunteers to go on two-week missions, twice a year, with Operation Smile. This international charity treats thousand of children each year with cleft lip deformities, making it possible for them to do things normally that other children take for granted — eat, speak, and smile! He just returned from a mission in Nicaragua, and has also taken care of children as far away as Egypt, Morocco, Peru, China and the Philippines.
When I asked him about what he did to save the little boy who nearly drowned, he answered in his usual soft-spoken way. "I just did what we as anesthesiologists are trained to do: support the airway," he said. "And I think the one maneuver that helped the most was an aggressive jaw thrust." He added, "If there is one positive outcome from the event, other than the successful resuscitation of a near-drowning victim, it is that many people expressed an interest in learning CPR."
To my way of thinking, this story really gets to the heart of what we do as anesthesiologists: we take charge of critical events, and we save people’s lives every day. We rely on our tens of thousands of hours of training in anesthesiology to be able to respond immediately, decisively and effectively. When the chips are on the line, who do you want on hand to see you through your critical situation? Keep calm and call a physician — an anesthesiologist.
Views expressed in CSA Online First are those of the individual authors.
The Prescription Opioid Epidemic: Challenges and Opportunities for California Pain Physicians
By Ramana Naidu, MD and Mark Schumacher, MD, PhD
Depending on your practice, you may have been hoping for or fearing the day when all turn and ask, “Why are ever-increasing doses of opioids being used to treat chronic non-cancer pain?”
With the first national guidelines on opioid prescribing, that day is upon us, and many are scrambling to provide an evidence-based response to our patients, professional societies, and government regulatory services. The issue here is not simply whether or not there is sufficient evidence that long-term opioid use for non-cancer pain improves pain and quality of life. In fact, there is little if any evidence of benefit past one to three months of use, and a growing burden of morbidity and mortality.