Second Brain Surgery podcast is up!

[Dr. Joshua]

I've now published two brain surgery video podcasts. The latest is of a neurosurgical emergency.

See the videos here:
http://askdoctorjoshua.com/category/blog/

[Purple98Lady]

wowwwww!!!!

I really enjoyed the podcast. Bravo. I have seen people expire with subdural hematoma while in transport unfortunately to a trauma center. One other I remember was in a car accident, signed himself ama and returned 3 days later
in full arrest. Lucky for patients in your hospital they have on-call neurosurgeons.

Keep em coming:smile:

Thank you
Purple98Lady

[Purple98Lady]

I had a question regarding the brain surgery podcast. What is injected into the skin prior to the incision to lift the skin. Saline????

Purple98Lady

[Dr. Joshua]

It's a combination of anaesthetics and epinephrine (adrenaline).

The purpose is twofold: the anaesthetics (lidocaine, bupivacaine) eliminate the pain stimulus from the incision, reducing the need for increased i.v. analgesics and also anaesthetics, and reduce the potential for a blood pressure spike upon incision. Blood pressure spike during incision might elevate the intracranial pressure of the patient, which in a neurosurgery patient could be dangerous.

The purpose of epinephrine (adrenaline) is to contract the blood vessels in the skin, reducing bleeding upon incision. Scalp is very vascular; without the epinephrine it would bleed a lot.

[Purple98Lady]

Thanks for the answer:smile: