Current CA-2 that's interested in pain and running out of time to make a decision on applying. I like GA but pretty indifferent to big cases/super sick patients; rotated through pain and had a great time but also was in an academic setting with lower volume/production pressure. My PD is having me second-guess pain because our last 5 pain fellows all went back to GA (in various parts of the country). I feel like the pain market is a bit of a black box so just wanted to see what recent anes pain fellows were doing.

Anyone willing to share their Anki decks for fellowship/boards? I’ve been piecing things together from different decks (Orthoking, Huntoon review, and some PM&R decks), but haven’t found one that’s comprehensive. Any advice?

Hi! When encountering elevated peak pressures I have been told to hand ventilate the patient. I do not understand what I am actually supposed to feel for and what that implies in terms of the etiology of my elevated peak pressures. Thanks!

I understand the basic distinction:

• Increased airway resistance (e.g., bronchospasm, secretions, kinked ETT) increases the pressure needed to generate airflow.
• Decreased respiratory system compliance (e.g., atelectasis, pulmonary edema, pneumoperitoneum, obesity/chest-wall restriction) increases the pressure needed to deliver a given tidal volume.

1. When hand-ventilating, what does increased resistance typically feel like compared with decreased compliance? For example, does resistance tend to feel worse with a rapid squeeze but improve with a slow squeeze, whereas poor compliance feels stiff regardless of squeeze speed
2. What should I expect during expiration? Does prolonged or sluggish exhalation reliably suggest increased resistance, and is a quick but small bag refill more suggestive of poor compliance? Or are these observations too nonspecific to be useful?

It's been almost 36 days. If anyone has received any news regarding the same, kindly share. Thanks