#Isoflurane

[secretofresearch]

Anesthesia Gases Market is Estimated to Witness High Growth Owing to Increasing Applications in Medical Procedures

Anesthesia gases are used extensively during surgeries to induce and maintain anesthesia in patients undergoing surgical procedures. Some common anesthesia gases used are nitrous oxide, sevoflurane, desflurane and isoflurane. They help relax patients and block the transmission of pain signals from the surgical site to the brain. The increasing prevalence of chronic diseases and number of surgeries being performed globally is fueling the demand for anesthesia gases.

The Global Anesthesia Gases Market is estimated to be valued at US$ 2182.32 Bn in 2024 and is expected to exhibit a CAGR of 11% over the forecast period 2024 To 2031. Key Takeaways Key players operating in the Anesthesia Gases are Dirt Road Data, Inc., AgJunction LLC, Iteris, Inc., Site-Specific Technology Development Group, Inc., CropMetrics LLC, Trimble Navigation Ltd., Agribotix LLC, AgEagle Aerial Systems Inc., Granular, Inc., AgriSight, Inc., and SemiosBio Technologies Inc. The Anesthesia Gases Market Size is expected to witness lucrative opportunities due to the rising geriatric population and increasing number of surgeries. Furthermore, innovations focused on developing less expensive anesthesia gases with improved efficacy are likely to open new avenues for market players. Technological advancements have enabled the development of advanced anesthesia gas delivery systems with features such as optimized gas flow control, real-time respiratory monitoring and leak compensation. This has further enhanced patient safety and experience during surgical procedures. Market drivers Growing geriatric population - The risk of various chronic diseases and need for surgery rises with age. With an increasing elderly demographic globally, the demand for anesthesia gases is projected to surge considerably over the coming years. Increasing healthcare expenditure - Rising disposable incomes and growing awareness about the importance of medical care have led to higher spending on healthcare services. This has provided a fillip to the number of surgeries being conducted worldwide.

Current challenges in Anesthesia Gases Market: The anesthesia gases market faces challenges in terms of ensuring adequate and continuous supply of medical gases amidst the rising demand from healthcare facilities. Strict government regulations regarding the production, transportation and storage of medical gases also add to the compliance challenges for manufacturers. Moreover, growing shift towards green alternatives and eco-friendly technologies for reducing carbon footprint could impact the sales of certain anesthesia gases in the coming years. SWOT Analysis Strength: Used extensively for induction and maintenance of general anesthesia during surgical procedures. Wide application areas include cardiology, neurology, orthopedics among others. Weakness: High infrastructure and logistics costs associated with production and supply of medical-grade gases. Stringent regulatory norms increase compliance burden. Opportunity: Growing number of surgeries globally due to rising non-communicable diseases. Increasing healthcare expenditures in developing nations to boost demand. Threats: Ongoing R&D into novel anesthesia techniques may pose competition in future. Potential supply chain disruptions and trade barriers can impact procurement. Geographical regions of concentration: North America captures over 35% share of total anesthesia gases market revenue due to well-established healthcare infrastructure and high surgical procedure rate. Asia Pacific is emerging as the fastest growing regional market with strong GDP growth in countries like India, China and Indonesia supporting healthcare investments. Fastest growing region: Asia Pacific anesthesia gases market is projected to witness over 13% CAGR during the forecast period on back of rapidly expanding medical tourism industry, growing disease incidence and increasing focus on bolstering healthcare access through government initiatives in several countries. Rising affluence of middle class populations will further propel the regional market expansion through 2031.

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Priya Pandey is a dynamic and passionate editor with over three years of expertise in content editing and proofreading. Holding a bachelor's degree in biotechnology, Priya has a knack for making the content engaging. Her diverse portfolio includes editing documents across different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. Priya's meticulous attention to detail and commitment to excellence make her an invaluable asset in the world of content creation and refinement.

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[pilcare-nce]

Isoflurane Usp Liquid For Inhalation -Isoflurane - Baxter India Pvt Ltd - Pilcare

Isoflurane Usp Liquid For Inhalation is a general anesthetic. It is used in major surgical procedures. It allows the procedures to be carried out without pain and distress. This medicine is used in a hospital setting only.

[peaceblank]

Shaved and naired 15 rats, all in a day's work.

[woso-dreamzzz]

Injured VIII

Alexia Putellas x Child!Reader

Jenni Hermoso x Child!Reader

Summary: There's an emergency

"Alexia...Alexia...Alexia!"

Alexia comes back into consciousness slowly. It's still dark out and her alarm clock proclaims it to be nearly two in the morning.

Olga is standing over the bed and even in the dim light, Alexia can tell something is wrong. Olga is saying something but Alexia is still waking up and only tunes in at the very end.

"-Already called Jenni. She's going to meet us there."

Alexia sits up, rubbing her eyes. "Meet us there? Jenni? What's going on?"

She flicks on the bedside light. Olga is still in her pyjamas but she's wearing her coat over the top and a pair of shoes. She's got Jaume on her hip.

He's got old little red pinpricks all over his neck and arms.

"Is that chickenpox?"

"No," Olga says, babbling at rapid speed as she shoves the sheets off Alexia's body," I thought it was but I saw some article on my feed about how to make sure it's not anything else and-"

"Olga? What is going on?"

"I think it's meningitis," Olga finally says," And we need to take him to the hospital."

Alexia's up like a shot, hopping around on one foot as she grabs the first set of shoes she can find. "It can't be," She denies," We got him vaccinated. I remember it!"

"That's what I thought!" Olga says back," But the rash doesn't go away when I press a glass to it and you know how he's been lately!"

Alexia nods, pulling on a Barca issued jacket. She pauses as she moves. "Bambi," She murmurs before raising her voice," Shit, Bambi! She was running a bit hot after her ballet class. But I just assumed it was all the movement. My phone...Where's my phone? I need to-"

"I used it to call Jenni," Olga says as they both go running out the door," She's going to meet us there."

She and Olga get there well before you and Jenni do.

Jaume is taken to get a spinal tap but the doctor is confident that it's meningitis so puts him on antibiotics as soon as the procedure is done.

"I don't understand," Alexia says," My kids are vaccinated! Both of them! They're up to date. I took Bambi to all of her boosters! Jaume's scheduled for another one when he hits a year!"

"Sometimes vaccines aren't one hundred percent effective," The doctor says, clearly used to calming enrage parents," What matters is that you saw it and you got him in tonight. The spinal tap should confirm the diagnosis but we've already got him on an IV." The doctor turns to leave before stopping. "You've got another child?"

Alexia's head frantically nods. "Yes. A girl. She's four. She's being brought in now."

The doctor nods, scribbling something on his clipboard. "As soon as she's here, have someone page me. Older children find it harder to stay still for the spinal tap. I'll contact anaesthesia and get someone to bring a mask."

Alexia's head changes from nodding to shaking furiously. "No!" She says it a bit louder than she meant to that even Olga looks shocked.

"It'll be better," Olga tries to explain," If they put her to sleep-"

"No, I mean..." Alexia shakes her head, the words spilling out of her mouth naturally. "She's allergic! To Isoflurane! That's the gas anaesthesia, right? Right?"

She looks around wildly as the doctor's face turns grim.

"I'll get some local," The doctor says," I know we made you wait outside for Jaume but it would be best if you came in for your daughter, if we're only using local, to keep her calm."

It's a waiting game until Jenni arrives with you and Alexia finds herself doom scrolling. She's dived into whatever article she can find on meningitis in children and the more she reads, the worse she feels.

They're yet to be allowed into see Jaume as the staff work to get him a bit more comfortable but Alexia can see him through the window and he's completely passed out asleep.

"I didn't know y/n was allergic to anything," Olga says softly.

Alexia laughs. It's more a nervous chuckle than anything else. "I don't even think Jenni does. My father was allergic. It skipped me and Alba but I wanted to check for Bambi, just in case."

"It's a good thing you did," Olga says.

Alexia looks down at her phone. "Where are they? They should be here by now."

"They'll be here soon. It's going to be okay."

It takes another ten minutes for you and Jenni to arrive.

You look infinitely worse than Jaume. The rash is completely obvious, taking over your whole body and Jenni looks just as distressed.

It takes another ten for the doctor to return.

You don't understand what's going on. Your Ma-Jenni woke you up super early before the sun has come up. She didn't get you dressed or brush your hair how you like it.

She didn't explain much at all...or, anything really. She just put you in the car and didn't say anything.

You'd tried to ask but your throat felt all scratchy and your tummy hurt.

All you know now is that you're at the hospital with Ma-Jenni, Mami and Miss Olga. There's a strange man with cold fingers that takes your shirt from you and makes you curl up on your side.

"Ma-Jenni?" You ask, trembling," What's going on?"

"Ssh, Bambi," Ma-Jenni says. Her tone is harsh, harsher than you've ever heard her speak to you and your tummy ties itself in a knot at her words.

You can hear the strange man talking nonsense to the adults and your eyes go wide at the tray of tools that's wheeled in. They look pointy and sharp, like the tools from that silly doctor show that Tia Alba likes.

You suck in a harsh breath when you feel a pinch at your back. You yelp and instantly try to wiggle away.

"No!" You cry," No! Off! Stop it! I don't want to! I don't want to!"

You force yourself to uncurl. You don't want this strange man touching your back. He makes it hurt and you got want any more of his sharp tools in your skin.

There's a grip on your legs though, forcing them back into position. You turn your head to look at who's got you against your will.

It's Ma-Jenni.

Her grip is firm and hard as she forces your kicking legs still. One of her arms has clamped them together, forcing them to stop moving while her other hand is on your hip, forcing your down onto the table until you're immobile.

You want her hands off you. Ma-Jenni has big hands that are perfect to hold you but not like this, never like this. You don't want her touching you like this.

"Ma-Jenni," You sob," Stop it! Stop it, please! Please!"

She doesn't stop though, merely readjusts her grip and pushes you down further until you well and truly can't move your bottom half.

"Stop it!" You continue to say," Stop it, Mama! Mama, stop!"

Hands curve around your shoulders and these are familiar hands too.

Mami's hands are perfect to hold in yours. They're always warm and they always hold you so gently. But now they've got your arms pinned to your chest and are forcing your shoulders firmly into the examination bed.

"Mami," You cry," Please stop. Mami, please. I'm sorry! I'm sorry, Mami! Stop!"

Mami's lips ghost your hairline. "I'm sorry, Bambi," She says, her voice a whisper that you can barely hear over your panic," I'm so sorry. It's going to be okay. You just need to be still. I'm sorry."

You can't move and the strange man is doing things to your back. You can't feel any pain but you can feel pressure and you can feel when he sticks something beneath your skin where things aren't supposed to go.

The only thing you can do is move your eyes and they focus on Miss Olga, the only adult in the room that's not actively hurting you.

"Miss Olga," You sob," Make them stop."

Her eyes nervously dart to the door like she wants to run away but she doesn't. She steps closer to where the adults are holding you, crouching down until your heads are almost the same height.

"I'm so sorry," She says to you," It's going to be okay, I promise. They're just making sure you're healthy."

"Miss Olga, please," You reply. You try to kick out your legs but Ma-Jenni just grips them more tightly," I'm sorry. I can be good. I can be better!"

"Hey," She says softly when your eyes dart towards your Mami," You are being so good. There's no one being better. Do you know what's going on?"

"No."

"You're very sick," Miss Olga speaks gently to you and brushes away a portion of hair that's covering your eyes," And we need to know what's wrong. Do you remember a few months ago when we came here and they put a needle in my arm?"

You do remember that. It was on one of hospital visits that you went on to see baby Jaume in Miss Olga's belly. They took some of her blood that appointment.

"They takin' my blood?" You ask shakily.

"They're taking a little bit of fluid from your back," Miss Olga explains," And they're going to test that for the illness they think you have. Like how they took my blood to make sure I was healthy."

You sniffle.

Mami and Ma-Jenni's hands are like shackles around your limbs, wrapped around your flesh and unwilling to even give you an inch.

"I'm scared," You whisper.

"That's okay," Olga whispers back," It's always okay to be a little scared. But you're doing so well. You're being such a brave girl. I'm sure it won't be much longer now."

You can feel the thing in your back moving and you try to shift with it but Ma-Jenni's hand clamps down on your hip and anchors you to it so you can't move again, not even a little rock back and forth.

"Hey," Olga says, pulling your attention away from what's happening at your back," Your Mami told me that you've moved up in ballet. I'm sure it's so much fun."

"It is."

"That's great! Do you want to tell me about it?"

Actually, you find that you do what to tell Olga about your ballet. Your words come out stilted and stuttered but you force them out of your mouth.

Olga smiles at you. She's got a pretty smile, you think. Mami must really love girls with pretty smiles.

"That sounds so cool," Olga says to you," You must be so talented." She leans a bit closer to you and you don't even feel the man taking the pointy thing out of your back. "Hey, maybe when you're all better, you can show me some moves. Only if you'd like to."

You duck your head down as the hands slowly leave your body. "Yes, please."

You're rolled onto your back but you keep your head tilted to look at Olga.

You don't know much about her apart from the fact that she's marrying your Mami and they had baby Jaume together.

Mami and Ma-Jenni are still talking to the doctor so you can fully focus on Olga.

She and baby Jaume look alike, you think. They've got the same eyes and nose and face shape. You think that baby Jaume might get her pretty smile when he's older too.

Her hand is gently resting on the side of your bed and you very gently move your own until your fingers are touching.

She hasn't got big hands like how Mami and Ma-Jenni's are big but they're still bigger than yours. They're safe too. You know this because she's never once dropped baby Jaume, even when she once tripped over and fell on her butt. She didn't drop Jaume once.

She smiles her pretty smile and you smile too, not even noticing when the nurse hooks you up to an IV.

"Hey, Bambi," Mami says," Everything's going to be okay now. I'm so-"

You stubbornly don't look at her and she frowns.

"Bambi?" Ma-Jenni asks," How's your back?"

You don't even deign her with an answer. It's still early and you're very tired. You don't want to talk to them, not when they pinned you down like that.

"I'm sorry," The nurse says," But I'm going to have ask you all to leave. The legal guardians can sleep over but that's all."

You don't know what legal guardians means but you do know that Ma-Jenni isn't one. She lives in Mexico for most of the year so she can't be your guardian because you don't live there with her.

She looks like she's going to argue but she doesn't. She reaches to give you a kiss on the forehead but you flinch away and she stops before her lips can press against your skin.

"I love you, Bambi," She says," And I'll be back to see you as early as I can."

You don't answer her.

It's just Olga and Mami left.

"I'm going to go sit with Jaume," Olga says and you frown.

"Jaume's sick too? Did I get him sick?" Your bottom lip wobbles.

"No, of course not." Olga says firmly," You and Jaume just got sick at the same time. It's very sad but it does happen."

"Really?"

"Yes." She heads to the door. "I hope you feel much better later. Maybe, if you feel up to it, you can tell me about your trains? Your Mami says that you love them a lot."

You nod. "Yes."

Then, it's just you and Mami left.

The nurse has set up a little bed next to yours for Mami to sleep on.

Mami seems a little nervous with you, pulling at the sleeves of her pyjama shirt. She looks at you.

You look at her.

You only saw her a few days again, when you painted pottery together and you asked her if you were wanted.

Mami doesn't sit in her bed, she pulls up a chair next to yours. She tries to reach for your hand but you pull it away before she can touch you, cradling it against your chest as you stare.

"Bambi," She begins before shaking her head and stopping. She takes a few moments before opening her mouth again. "I'm very, very sorry."

Those weren't the words that you were expecting.

You still don't answer though. If you blink, you can still feel her phantom hands over your body and the iron grip she had on your limbs.

She scoots the chair closer.

"I love you so much and I'm so sorry that you're sick."

She looks like she wants to say more but you don't really want her to keep talking.

"Bambi, I...I have not been a very good Mami to you," Alexia has to force the words out of her throat even if you give no indication that you can hear her," And I'm very, very sorry."

You still don't say anything. You just lie on your back with your eyes wide open.

"I'm sorry for what happened at home and I'm sorry for what a few-"

"I'm tired, Mami," You say, your voice quiet and exhausted.

"Right," Alexia says, scolding herself inwardly at keeping you up. It's still the middle of the night. "You go to sleep, Bambi. I'll be right here if you need me."

The stress of everything tonight seems to knock you out quickly but Alexia doesn't move to her own bed. She doesn't move. She doesn't sleep. She just stays in that seat even as a nurse pops their head in to confirm that both you and Jaume have bacterial meningitis.

A week hospital visit and IV's full of antibiotics is what awaits you both, baring any complications.

Jenni returns as soon as visiting hours begin again, pulling Alba and Eli in tow.

Eli diverts briefly to check on Olga and Jaume while Jenni and Alba come straight to you. You're still asleep when they arrive, lying on your back with a cannula in your hand to administer your medication.

"You look exhausted," Alba says in greeting, handing off a cup of to-go coffee to her sister," Did you sleep at all?"

"No." Alexia continues to stare at you, focussed on the soft rise and fall of your chest as you sleep.

"I'm surprised you're still here," Alba continues and, for once, her tone isn't biting. She seems genuinely surprised. "Haven't you got training?"

"I called off for the week," Alexia replies," And next week. It's more than enough time for them both to recover."

"You're taking time off?" Alba looks even more surprised than before. "Like, actually?"

Alexia doesn't know why that's so confusing. "Of course. My kids are sick. They need to be looked after."

Alba's mouth opens and closes a few times before she settles on something to say," How is Jaume?"

"Good, better. The doctors said that it's good we caught it when we did. The longer the rash is there for, the worse he could have gotten. It came up last night. We caught here as quick as we could."

Alexia's glad for that. She has no idea what could have happened, how much worse Jaume could have gotten if they had left it a few hours, let alone a few days.

Jenni is strangely silent at her words, reaching out to gently brush some of your hair out of your face.

"How long of a hospital stay?" Alba asks.

"About a week for both of them. The doctors said that they're going to do a hearing test with Bambi in a few days and then four weeks after she's recovered."

"And Jaume?"

"The same," Alexia confirms," Olga is with him now."

"Mama's with her," Alba says," We picked her up on the way."

There's a rustle of sheets as you blink awake. A yawn takes over your whole face as you wake up.

Mami, Ma-Jenni and Tia Alba are all looking at you and you pull your blankets up until they're over your nose.

You don't like the fact that Mami and Ma-Jenni are in the same room together. You can still feel their weights on you, pinning you to the bed as you struggled to get free.

You don't want them here. Not within arms length of you, in case they take your top away again and pin you down.

"Tia," You croak out and Alba pushes past Ma-Jenni to take your hand.

"You're not looking too good there, Bambi," Tia Alba says," How are you feeling?"

"Is Jaume still sick too?"

"He's getting a lot better. Your Abuela and Olga are with him now."

"Is Abuela and Olga going to get sick too?"

"No, don't be silly. Adults don't get sick like that." Tia Alba's teasing you. She's putting on a silly voice and it shocks a little giggle out of you. "I'm sure once your Abuela is done with baby Jaume then she'll be right in to see you."

"And Olga too?"

Alexia goes rigid in her seat. "Olga doesn't have to come in if you don't want her to."

You don't even acknowledge she's talking to you.

"No one has to come in that you don't want to," Jenni promises you but you don't give any indication that you heard her either.

"Olga thinks that I'm talented," You say to Tia Alba," She asked me about my ballet and my trains. She wanted to know more. Did you bring any of my trains?"

The bag on Jenni's shoulder is passed off to Alba. She digs through it, pulling out a spare change of clothes as well as a few model trains that had been shoved in there this morning.

"I want to show Olga my trains," You say," When she's done with baby Jaume." You run your trains over the bed, making little chugging noises with your mouth.

"I think that's a great idea, Bambi," Alexia says but you don't answer.

You haven't acknowledged her or Jenni since you woke up and it's put her on edge. Even when you were scared a few days ago, you still acknowledged her.

But your focus is purely on Alba but even that is hit and miss.

Whenever Alba reaches out to play trains with you, you flinch away. You look up at her in shock each time before glancing back down at your arms as if you can't believe you flinched.

"How are you feeling, Bambi?" Eli asks as she comes in.

You shrug and raise your hand. "They put a thing in my hand."

"They put one in your brother's too," Eli says," It's to give you your medicine."

"Did they put the thing in Jaume's back too?"

Eli nods. "They did."

Your eyes are haunted as you stare at her. "Did they pin him down too?"

Whatever bubble that the room was in bursts and Eli notices the way Alexia and Jenni both exchange a wide eyed look, like two little children caught red handed.

Eli has to think over her words carefully. "You're both very sick," She settles on eventually," Do you know why they had to put something in your back?"

You parrot back the words Olga told you and Abuela nods.

"That's right," She says.

"Olga says I was very brave even though I was crying."

"I'm sure you were the bravest little girl in the world," Abuela kisses your forehead but her lips feel too much like Mami and Ma-Jenni's and suddenly you can feel their hands on you again.

You kick your legs out and move your arms to shake the phantom hands off and they're gone as quickly as they appeared.

"Alexia, Jenni," Abuela says," Can I talk to you out in the hall?"

As they all leave, you look through the windows of your room.

Olga is lingering outside, looking into your room every so often before looking away.

"Tia Alba," You say," Can I still show Olga my trains?"

"Should I bring her in here?"

"Yes, please."

Ma-Jenni and Mami stay outside with Abeula for a long time but you don't even notice.

You've never talked with Olga like this before, not really. There had been a few moments when she was pregnant with baby Jaume where you watched things together and you helped her cook but you had never been like this with her before.

You hand her one of your trains and smile when she plays with you, gently moving the trains around your bed together.

"Is Jaume going to be okay?" You ask her because she's Jaume's mami and she knows things like that.

"He's going to be just fine," She promises you," And so are you. Just a few more days."

"I'm going to miss ballet," You say," That's bad. Mami never misses her training so I shouldn't miss mine."

"Your Mami's missing training now," Olga says," And she's missing it until you get healthy again. That's what you should focus on. Getting healthy again so you can go back to ballet."

"Mami is missing training? Why?"

"Because she wants to make sure you're okay," Olga says," Because she loves you."

You don't believe her but Olga looks very serious so you think that she must think that's true.

"Olga," You say," I'm hungry. When's lunch?"

She laughs a little bit about your blatant change of subject. "A few hours still," She says," How about I go to the shop and get you a snack?"

Olga slips out into the hallway where Eli is still lecturing Jenni and Alexia about their treatment of you. Your sobs and begging still rung in Olga's ears, the way that you cried and cried and begged and begged.

"She's hungry," She says, interrupting the lecture," I'm going to get her a snack."

"I'll come with you," Jenni says," I need a coffee."

The trip to the little shop was awkward, made even more awkward when Olga selected a plain chocolate bar only to have it plucked from her hand and replaced with one with caramel.

"She thinks the plain ones are too hard," Jenni says, almost carelessly," She doesn't like how they feel on her teeth. She prefers caramel."

Olga stares down at the chocolate in her hand, noting down another new thing in the column dedicated to you in her mind. It's painfully bare with only a few things - trains, ballet, the allergy she found out yesterday and now your favourite kind of chocolate.

She had told Alexia she wasn't threatened by Jenni and that's still true but that doesn't mean that Olga isn't intimidated.

Jenni just looks a bit intimidating with her tattoos and her height and the stern look on her face when it comes to you.

"Thanks."

It's silent for a moment as they both wander through the winding hallways back up to the peds wing.

"No," Jenni says eventually, shaking her head like she had been fighting with herself," I'm sorry, Olga. But I have to know...How could you let this happen? With Bambi, I mean? Stuff like this doesn't happen overnight."

Olga wants to bolt, to run and escape this but she holds herself firm as she scrambles to find something to say, knowing exactly what Jenni is talking about. "I didn't notice," She settles on eventually," It is wrong to say but it is true."

Jenni can't seem to understand though. "But how? Bambi is...How could you just not notice?"

"I just didn't," Olga says," And that was wrong of me. It was wrong of Alexia. We've talked about it...a lot...We're trying to move forward, for y/n."

Jenni looks at her, long and hard and Olga suddenly understands what rival players feel when they see Jenni come onto the pitch.

"Don't let it happen again," Jenni says firmly before taking off again, leaving Olga to scramble to keep up.

You're exactly as they left you, sitting in the middle of your bed. You're making chugging noises with your mouth as you run a train over Eli's arm.

Alexia is back in her seat next to your bed but you've scooched away from her as far as you can get.

"Caramel!" You cheer when Olga presents your food," That's my favourite! Thank you!"

"You're welcome."

You munch happily on your food a little but before you stop to scratch at your rash.

Automatically, like she did a few days ago when she first noticed it, Jenni takes your hand to stop you scratching.

You violently flinch away, tearing your hand away from hers. You scrunch your eyes closed firmly as you suck in air.

You can feel the hands on your legs again, forcing you to go immobile as the strange man pokes and prods at your back.

"No!" You cry out, turning away and curling up under your blanket," Stop it! Stop it, Mama! No bad touches! No more bad touches!" You kick your legs out. "No! Stop it!"

"Out," You can hear your Abuela say.

Eli-"

"Out, Jenni! Alexia, you too! Olga-"

"I'll go and see Jaume. He should be up from his nap by now."

"No! No! No!" You continue to chant as the blanket is pealed back.

It's not Ma-Jenni though. It's Abuela with Tia Alba hovering over her shoulder.

You sniffle if you sit up again.

"What happened, huh, Bambi?" Abuela asks," What was that about?"

"Mama hurt me," You say," When the strange man touched my back. I asked her not to! I asked her to stop!"

"I know," Abuela says," I know, Bambi."

"I didn't know what was happening," You say," It was scary and Mama wouldn't tell me what was going on."

It was very scary. You didn't think Ma-Jenni would do that to you, would pin you down and not explain what was happening. Mami could be harsh sometimes and you know she can be rough on the pitch too. She even said she was sorry while doing it but Ma-Jenni didn't.

Ma-Jenni told you to shh and pinned you down and didn't say sorry. You can still feel her hands on you, constantly pinning your legs down and pushing you further into bed.

She didn't say sorry at all and that's what scares you.

"I'm sorry that scared you," Abuela says," I'm sure Jenni didn't mean to."

"She didn't say sorry," You say," And she hurt me."

"Bambi-"

"She did! I'm not lying!"

"No one says' you're lying," Tia Alba assures you," I think you're telling the truth but, Bambi, you needed to have that done, so you can get better."

Ma-Jenni comes back when it's dark. There's no lights coming through your windows and the moon is out so you know it's night time.

Mami is meant to be sleeping on the bed next to you but she's not there.

The door to your room opens though and Ma-Jenni steps in.

But she doesn't look like Ma-Jenni though. There's something different about her. Maybe it's her too sharp features or her too pointed teeth. Maybe it's the curve of her nails or the way she's looming over you.

You can't move and Monster-Jenni's sharp claws dig into your legs easily.

You shriek but she's pressing her whole weight down onto the hand that's got your legs while her other one pins you down by your chest. You can't move. You can't stop her no matter how much you plead and beg and sob.

She's still holding you with bad touches and the strange man appears again. He's got too sharp teeth too and a massive needle that looks even scarier than before.

"Mami!" You cry as you jolt awake, gripping your bedsheets and screaming.

Mami's up like a shot, looking around like she thinks someone's hiding in the shadows. You're scared that Monster-Jenni is there too.

"Mami!" You sob, reaching desperately for her, your mind recycling her apologies as she held you down.

This time though, you crawl into her arms and sob, burying your face in her shirt as you cry.

For a moment, Alexia is in shock at your willingness to touch her. Whatever you had dreamt about must have been bad because you've curled your body around hers and Alexia very carefully curls her arms around you.

"It's okay, Bambi," She whispers," It's okay. It wasn't real. None of it was real. I've got you. Mami's got you."

"Mami," You whimper," Mami, it hurts."

"What hurts?"

"Everything!"

"I'm so sorry, Bambi," Alexia says and she knows that you know what she means, just like how you know she knows what you mean by everything," It's all going to be okay. I promise, this is all going to be okay. No matter what happens."

"I'm scared, Mami."

"I know, Bambi. I'm going to help make it better."

[knockedoutcops]

Spy dressed in stolen nurses uniform knocks out two policemen in elevator using isoflurane gas.

[whumpy-daydreams]

Drugs!

Masterlist

Everyone loves drugs, right? And boy are there some juicy ones in surgery. There are more, especially of emergency drugs, but these are some common ones

Anaesthetic drugs

Propofol - the main sleepy juice. It looks like milk, hence the name 'milk of amnesia' (also called jackson juice because it's what killed MJ)

Ketamine - horse tranquiliser. But also used for humans! Very fast acting, and gives good pain relief too (you only need a small amount)

Isoflurane, sevoflurane - anaesthetic gases (bye desflurane, you've polluted the atmosphere for too long)

Atracurium, rocuronium - reversible muscle relaxants, they take a few minutes to fully kick in

Neostigmine, sugammadex - muscle relaxant reversal, sugammadex (nicknamed sugar) is more powerful

Suxamethonium - nonreversible muscle relaxant. It wears off after 2-6 minutes unless you have a rare genetic condition. Also works really quickly (30 seconds)

Lidocaine, bupivacaine - local anaesthetic, injected into the area you want to numb, or used in a spinal anaesthetic

Benzodiazepines (midazolam, diazepam etc.) - sedatives, not enough to fully conk you out, but will make you a bit sleepy and more relaxed

Pain relief

Paracetamol (tylenol) - mild pain relief, can be given through IV for better results

Morphine - the simplest opioid, usually IV or given orally (apparently tastes a bit like liquorice?)

Fentanyl and alfentanyl - much stronger pain relief, used rarely except during induction of anaesthesia

Antibiotics

Not always given, used more in orthopaedics or where there's a risk of infection. The type given is usually up to the anaesthetist's preference unless there's an existing infection that's been cultured

Common ones: amoxicillin, vancomycin, gentamicin, clindamycin, flucloxacillin, doxycycline

Emergency drugs

Tranexamic acid - sometimes given at the start if there's a risk of bleeding. Helps to prevent blood loss

Atropine - increases heart rate

Glycopyrronium - increases heart rate, also reduces saliva production

Ephedrine - increases blood pressure

Metaraminol - increases blood pressure

Adrenaline - increases heart rate and blood pressure, used for cardiac arrests and anaphylaxis

Intralipid - treats local anaesthetic toxicity

Dantrolene - treats malignant hyperthermia (a life threatening condition where the body temperature raises really high)

Adenosine, amiodarone - treats arrhythmias

Digoxin - slows heart rate

[regexkind]

"your proposal to add isoflurane cannulas to airplane seats has been REJECTED by our investment firm" well if I can't have that what's the point in being a law-abiding citizen

[thatstormygeek]

Starbuck's Christmas List

Eye Lubricant ($4.00) Endotracheal Intubation ($10.50) Clipping/Surgical Prep ($12.50) Anesthetic Biohazard Waste Fee ($17.50) Vital Sign Monitoring ($19.50) Drape Pack ($22.00) CONE OF SHAME ($23.00) Major Surgery Pack ($30.50) Anesthetic Induction ($33.50) EZ Lift Sling ($36.50) INJ: Pain medication ($44.50) Suture Material ($45.50) DISP: Tramadol pain meds ($48.00) DISP: Additional pain meds for dogs over 50 lbs ($56.50) Anesthesia : Isoflurane Additional 30 minutes ($65.00) INJ: Antibiotic ($67.50) IV Catheter and Fluids with Anesthesia ($71.50) DISP: Pain medication ($82.00) Skin Staples/Suture Material ($83.50) DISP: Antibiotics ($89.00) Meniscus Surgery ($126.50) Laser Surgery ($129.50) Epidural ($132.00) Exam Recheck x2 ($138.00) Radiograph (digital xrays) postop/Recheck x2 ($150.00) Pre-Anesthetic Blood Screen ($169.00) Hospitalization - Day of Discharge ($176.50) General Gas Anesthesia ($190.00) Hospitalization Level 0 - Post Op ($384.00) Bone Plates And Screws Hardware Fee ($618.00) TPLO Surgery ($671.50) Bone Plating Surgical Fee ($1,061.00)

[audible-smiles]

assisted with two emergency surgeries yesterday as part of a training initiative to get more staff comfortable in the OR, and by far the worst part was being told that the anesthetist gets to pick the music we put on. I am constitutionally incapable of making that decision, because I KNOW it is a secret test and people will judge me, because that’s what always happens. and I can’t ever turn the offer to pick music down by saying I don’t care! people will insist they want me to choose right up until I, mind blank and incredibly anxious, pick something basically at random, and then they’ll object anyway and put on whatever they wanted to listen to in the first place. genuinely my nightmare scenario. running a fentanyl CRI so we can get away with using less isoflurane in a hypotensive dog while a surgeon yanks on his intestines is chill by comparison.

[allthingsvetmed]

WEEK FOUR

This week, I am going to be breaking down the ECG shown above from our patient from week three.

To jog your memory, we have a young small breed dog with no prior medical history presenting for a bilateral deciduous canine removal, as well as a bilateral maxillary third incisor removal. 

This patient was pre-medicated with Buprenorphine at a 0.02mg/kg IM dose, Dexmedetomidine 5mcg/kg IM and Meloxicam 0.95mg SQ. After we placed the intravenous catheter, she was induced with 4mg/kg of Propofol and maintained under general anesthesia at 1.5% Isoflurane inhalant. 

The deciduous canines were extracted with no issues, but once we began working on extracting the maxillary incisors we noticed that she was developing a heart block. 

A heart block, otherwise known as an “AV Block”, means that the impulse normally generated from the atria to the ventricles is being disrupted somehow. There can be many cause of AV block from ischemia to mitral valve insufficiency, excessive vagal tone, and drugs with parasympathomimetic effects. 

There are many different kinds of heart block, all requiring different methods of treatment. First degree AV block is seen by prolonged p-r intervals with a normal QRS complex. There are many things that are associated with first degree av block. Normally, we do not always have to treat first degree av block, it is best to find the underlying cause of the block to appropriately treat the issue. 

There are two types of second degree AV block. First is, 2nd degree AV block Mobitz type 1. This is classified on an ECG by progressive prolongation of P to QRS waves, then a dropped QRS complex. Some causes of 2nd degree av block mobitz type 1 is AV node disorders or increased vagal tone. Treatment of mobitz type 1 would be done only if the patient is hemodynamically unstable (decreased blood pressure and heart rate). The increased vagal tone is possibly caused by general anesthesia, so it may be helpful to lower the patient’s anesthetic depth if you are seeing this dysrhythmia. 

For second degree AV block mobitz type two, you will see many P waves with no corresponding QRS complexes. This can be a more serious dysthymia, because it has the possibility of becoming third degree AV block. The cause of this dysthymia is an abnormality within the bundle of HIS. Treatment is warranted, especially is the QRS complexes are becoming wider. We would treat with anticholinergics, isoproterenol, or a pacemaker. Sometimes this can also be due to increased vagal tone, which can be arising from many different issues.  

Finally for third degree AV block, on the ECG we would see P waves with escape QRS beats from ectopic foci. All the P and QRS waves are uncoordinated and random. This can be caused by a congenital deformity within the heart, an abnormality within the heart itself or an electrolyte imbalance. This rhythm should be treated as soon as possible with either isoproterenol, a pacemaker, or epinephrine if cardiac arrest is impending. 

In our patient, we took into account that we were in the middle of extracting her maxillary incisors and that she was under general anesthesia. We deemed that the patient was showing signs of seconds degree AV block mobitz type 1. After finding this block, we took into account that her blood pressure, mucous membranes and capillary refill time and heart rate were stable and that this block was most likely due to increased vagal tone. The vagal tone may have been increased from the increased ocular pressure that was occurring from the doctor while the maxillary teeth were being extracted. 

The vagus nerve is cranial nerve 10 and it originates in the medulla. It innervates many parts of the body and is mostly apart of the parasympathetic nervous system. The parasympathetic nervous system is the part of the autonomic nervous system which tells the body to “rest and digest”.  It innervates the heart, lungs, stomach, spleen, kidneys, small and large intestines. When the vagus nerve is stimulated, this induces the parasympathetic nervous system to kick on and bradycardia, increased gut motility, miosis, decreased blood pressure, increased secretions and more can be seen.

After identifying this arrhythmia, we chose to monitor for any decline in her hemodynamics. The procedure was smooth from here on out and her blocks resolved when the teeth were extracted. 

[schlauemaus]

Anästhetika

Injektionsanästhetika

=wirken über Bindung an GABA-Rezeptor (außer Ketamin: NMDA-Rez. -> wirkt deswegen als einziges auch analgetisch)

je nach Dosierung: Sedation, Hypnose od. Anästhesie

Barbiturate

Thiopental: gutes Hypnotikum und Muskelrelaxanz; keine Analgesie; stark atemdepressiv, arrythmogen, Hypothermie; kontrainduziert bei Leberinsuffizienz und Windhunden; stark gewebereizend -> nur i.v.; schneller Wirkungseintritt; kumuliert bei Nachdosierung (NICHT zur Erhaltung) -> langer Nachschlaf (bis 24 Std!) Pentobarbital: heutzutage nur mehr bei Euthanasie oder für Epilepsietherapie verwendet

Steroidanästhetika

Alfaxalon: für Kleintiere; keine Analgesie; kann i.v. zur Einleitung verwendet werden (kann zu Beginn zu Apnoephase/ Atemdepression kommen), akkumuliert nicht -> kann der Erhaltung dienen; Aufwachphase nach Monoanästhesie sehr unruhig (meist Kombi mit Alpha2-Agonist)

dissoziative Anästhetika

Ketamin: gute Analgesie, Bronchodilatation (Asthmatiere!), schlechte Hypnose (Reflexe bleiben erhalten); Nebenwirkungen: Tachykardie -> erhöhter Blutdruck, Katalepsie (=Muskelstarre) -> Gabe IMMER mit einem Sedativum zur Vorbeugung

Andere

Etomidat: nur zur Einleitung bei kardiovaskulär geschädigten Patienten; Gabe IMMER mit einem Benzodiazepin (Vorbeugung Myoklonien (=Zuckungen)) Propofol: gute Hypnose, rel. gute Muskelrelaxation; kurzzeitig nach Injektion: blutdrucksenkend/ neg. ionotrop/ atemdepressiv -> langsame Gabe

Inhalationsanästhetika

Nebenwirkungen

Vasodilatation -> Blutdruckabfall und Hypothermie

Atemdepression

Senken der Kontraktilität (?)

Desfluran: bei Patienten, die schnell aufwachen müssen (weil Blutlöslichkeit geringer); Maskeneinleitung möglich (aber etwas schleimhautreizend) Isofluran: Verwendung bei Jungtieren, Leber-/ Niereninsuffizienzen, herzkranken Patienten; beste Blutlöslichkeit (langsame Einleitungs-/ Aufwachphase) kann maligne Hyperthermie hervorrufen; schleimhautreizend -> "Luftanhalten" möglich Sevofluran: nur für Kleintiere zugelassen; Verwendung bei Jungtieren, herzkranken Patienten, Schädel-Hirn-Trauma; gut für Maskeneinleitung (geruchsneutral, keine Schleimhautreizung); kann maligne Hyperthermie hervorrufen

[woso-dreamzzz]

are alexia’s girls allergic to anything? if so how would she react if they had a reaction

Bambi's allergic to Isoflurane, which is an anaesthetic

Alexia is very careful when it comes to Bambi's medical needs so she'd never let something like that happen to her

[pilcare-nce]

Isotroy Solution for inhalation - Isoflurane -Troikaa Pharmaceuticals Ltd - Pilcare

Isotroy Solution for inhalation is a general anesthetic. It is used in major surgical procedures. It allows the procedures to be carried out without pain and distress.

[infocrazebyrepwoop]

Bangladesh Implements Ban on Halothane in Anesthesia After Tragic Incidents

Following recent fatalities, the Ministry of Health and Family Welfare has issued a directive prohibiting the use of halothane in anesthesia across all hospitals in Bangladesh. In an official order, the ministry instructed the Directorate General of Health Services to enforce the utilization of isoflurane or sevoflurane as viable alternatives to halothane. Additionally, the Directorate General of…

[lalsingh228-blog]

Anesthesia Devices Market To Witness Huge Growth By 2029

Advance Market Analytics added research publication document on Worldwide Anesthesia Devices Market breaking major business segments and highlighting wider level geographies to get deep dive analysis on market data. The study is a perfect balance bridging both qualitative and quantitative information of Worldwide Anesthesia Devices market. The study provides valuable market size data for historical (Volume** & Value) from 2018 to 2022 which is estimated and forecasted till 2028*. Some are the key & emerging players that are part of coverage and have being profiled are GE Healthcare (United States), Becton Dickinson and Company (United States), Smiths Group plc (United Kingdom), Ambu S/A (Denmark), Teleflex Incorporated (United States), Drägerwerk AG & Co. KGaA (Germany), SunMed (United States), Airsep Corporation (United States), Koninklijke Philips N.V. (Netherlands), Verathon Inc. (United States), Karl Storz GmbH & Co. KG (Germany), Pentax (Japan). Get free access to Sample Report in PDF Version along with Graphs and Figures @ https://www.advancemarketanalytics.com/sample-report/56542-global-anesthesia-devices-market Anesthesia devices or anesthesia respiratory devices include a dosing unit, a respiratory device and the monitors both the device as well as the patient. Inhalation anesthesia administers a combination of air, oxygen, nitrous oxide and anesthetic e.g. isoflurane, sevoflurane or desflurane to the patient. The volatile anesthetics are added to the respiratory air in exactly defined concentrations through a vaporizer in the anesthetic device. Pressure and flow sensors monitor the line pressures in the anesthetic device along with the inspiratory and expiratory volume flows and confirm that the patient is administered the gas mixtures designated by the anesthetist in the right concentration and with the set pressure and volume.

Keep yourself up-to-date with latest market trends and changing dynamics due to COVID Impact and Economic Slowdown globally. Maintain a competitive edge by sizing up with available business opportunity in Anesthesia Devices Market various segments and emerging territory. Influencing Market Trend

Integration of Anesthesia Machines with Hospital Information Management Systems

Augmentation of Advanced Product to Deliver Accurate and Controlled Anesthesia during Surgical Procedures

Market Drivers

Increasing Number of the Geriatric Population Preoperative Monitoring

Increasing Use of Anesthesia Devices in the Freestanding Surgery Centers

Opportunities:

Rising Government Investment to Use These Devices

Rapid R &D in Medical Health care Sector

Have Any Questions Regarding Global Anesthesia Devices Market Report, Ask Our Experts@ https://www.advancemarketanalytics.com/enquiry-before-buy/56542-global-anesthesia-devices-market Analysis by Type (Anesthesia Delivery Machines, Anesthesia Delivery Machines, Disposables & Accessories, Anesthesia Monitors, Anesthesia Information Management Systems), Application (Cardiology, Neurology, Dental, Ophthalmology, Urology, Orthopedics, Others), Sales Channel (Online, Offline), End-Use (Hospitals, Clinics, Ambulatory Centers)

Competitive landscape highlighting important parameters that players are gaining along with the Market Development/evolution

• % Market Share, Segment Revenue, Swot Analysis for each profiled company [GE Healthcare (United States), Becton Dickinson and Company (United States), Smiths Group plc (United Kingdom), Ambu S/A (Denmark), Teleflex Incorporated (United States), Drägerwerk AG & Co. KGaA (Germany), SunMed (United States), Airsep Corporation (United States), Koninklijke Philips N.V. (Netherlands), Verathon Inc. (United States), Karl Storz GmbH & Co. KG (Germany), Pentax (Japan)]

• Business overview and Product/Service classification

• Product/Service Matrix [Players by Product/Service comparative analysis]

• Recent Developments (Technology advancement, Product Launch or Expansion plan, Manufacturing and R&D etc)

• Consumption, Capacity & Production by Players The regional analysis of Global Anesthesia Devices Market is considered for the key regions such as Asia Pacific, North America, Europe, Latin America and Rest of the World. North America is the leading region across the world. Whereas, owing to rising no. of research activities in countries such as China, India, and Japan, Asia Pacific region is also expected to exhibit higher growth rate the forecast period 2023-2028.

Table of Content Chapter One: Industry Overview Chapter Two: Major Segmentation (Classification, Application and etc.) Analysis Chapter Three: Production Market Analysis Chapter Four: Sales Market Analysis Chapter Five: Consumption Market Analysis Chapter Six: Production, Sales and Consumption Market Comparison Analysis Chapter Seven: Major Manufacturers Production and Sales Market Comparison Analysis Chapter Eight: Competition Analysis by Players Chapter Nine: Marketing Channel Analysis Chapter Ten: New Project Investment Feasibility Analysis Chapter Eleven: Manufacturing Cost Analysis Chapter Twelve: Industrial Chain, Sourcing Strategy and Downstream Buyers Read Executive Summary and Detailed Index of full Research Study @ https://www.advancemarketanalytics.com/reports/56542-global-anesthesia-devices-market Highlights of the Report • The future prospects of the global Anesthesia Devices market during the forecast period 2023-2028 are given in the report. • The major developmental strategies integrated by the leading players to sustain a competitive market position in the market are included in the report. • The emerging technologies that are driving the growth of the market are highlighted in the report. • The market value of the segments that are leading the market and the sub-segments are mentioned in the report. • The report studies the leading manufacturers and other players entering the global Anesthesia Devices market. Thanks for reading this article; you can also get individual chapter wise section or region wise report version like North America, Middle East, Africa, Europe or LATAM, Southeast Asia. Contact US : Craig Francis (PR & Marketing Manager) AMA Research & Media LLP Unit No. 429, Parsonage Road Edison, NJ New Jersey USA – 08837 Phone: +1 201 565 3262, +44 161 818 8166 sales@advancemarketanalytics.com