 So in this next video you guys are going to be going through a day in the life of my friend who is a thoracic anesthesiologist at Memorial Sloan Kettering and then you'll also see one of my colleagues and really good friends as well who's a regional anesthesiologist too and she works with me at Westchester Medical Center. This will be an interesting look into the life of a physician mom who's at home and not in the hospital currently but you can see a little bit of what her day looks like. I hope you guys enjoy. So on my last day of work I actually went into labor. I worked up until I was 38 weeks and six days pregnant and then my baby, baby Zion decided to come at that time. Here he is, right? And I wouldn't have had it any other way. I really felt comfortable working up until that point. My colleagues, they were very generous in offering me help when needed and I love the camaraderie in anesthesiology. When there is an issue everyone actually comes to your aid and it helps to create an environment where you feel comfortable asking for help and practicing medicine in a very multidisciplinary way with different people giving different input and making a better situation for the patient overall. So when I was pregnant I was still practicing regional anesthesia. I was walking around going to different operating rooms and giving patients either single shot injections or catheters to help to numb up different parts of the body and prepare them for surgery. I also help with post-operative pain and that involves me again giving single shot injections of local anesthetics or placing catheters that continuously deliver local anesthetics to help with pain management. It's very satisfying for me because you quickly see the end product of what you're doing. We have Dr. Lewis, the Rastic Anesthesiologist. Take a look. This is one of the operating rooms that I typically work in and just so you can get a sense of what it's like working in the operating room. So if you turn here you're going to see the OR table as I walk towards the anesthesia portion of the room. You're going to see this is our anesthesia machine that we use that we hook up to the patient, our computer. We've got what we call a blue bell where we keep all of our supplies and then all the way over to the right we've got our omni cell that we store all of our medications. So this is our work room. Dale say hi. Hi. Dale is awesome. He helps get all of the supplies for us for anesthesia and see we have different types of airway devices to go out in the hall. We also have echo machines, ultrasound machines, additional anesthesia machines as well, and towers. I'm here at my hospital in New York City and we are currently dealing with obviously the COVID pandemic, which is the reason why I'm actually wearing two masks at the moment. So I guess what I'm going to focus on is some airway management and the reason being as anesthesiologists we typically intubate our patients, which basically means that we put it a breathing tube into our patients. And so sometimes people are straightforward and it's very easy to get a breathing tube into their airway and the windpipe, but oftentimes we occasionally will have a patient who comes in who is challenging airway. There are many reasons why someone could potentially have a difficult airway and some of those reasons could potentially be if they have had any type of head and neck surgery that has altered the anatomy. Other reasons are if they are obese and have a lot of soft tissue in their airway that can also distort the anatomy and make it very challenging to get a breathing tube in. So there are different airway devices that we use. We typically will use what we call a laryngoscope to get into the airway. Sometimes in certain situations we can use what we call a video laryngoscope or a fiber optic. So I'm specifically going to show you what we use for fiber optic exam. So this right here is what we call a fiber optic tower. You can see there's a screen. There is a module here where you can adjust the brightness of the camera and then there's a connector and there is a port that you can put the hub of the scope in. And then in a second I'll open up this package here, which is what holds the fiber optic scope and I'll show you what that scope looks like. That is typically what we use in a patient who, like I said, has a difficult airway. And we often will prepare well in advance before the patient arrives to the operating room. And you want to set up the scope so that by the time the patient arrives into the operating room that we're good to go and we're not setting up equipment last minute. This is the scope that attaches to the fiber optic. Okay. So if you guys remember in that little hole here, the module, you'll see a hole that will connect to the fiber optic scope and I'm just going to go in and actually attach this bad boy. Okay. Perfect. So once that's attached, you'll see there is another portion here that is going to go ahead and connect and snap into place. And then you'll see that the actual scope itself, and this is actually what goes inside of the patient's airway. So typically what we do is there are two different approaches. We can either put a patient fully to sleep or we can take a look at their airway while they're still awake. Typically what we will do is we will take a breathing tube and we would pass the breathing tube over the scope until the adapter reaches the top of the scope. If I had a patient here, I would actually go ahead and show you, but you would go in and use the tip of the scope, which flexes, you can see here it flexes back and forth and it has the ability to rotate. If you rotate your arm, you can rotate the tip in the airway. And I like to think of it for me when I was learning how to do fiber optic. I like to think of it almost like a video game. You can pretty much go in and it's like you're going through different passages of the airway until you get to where you want. And then once you get into the airway, you can slide off your endotracheal tube or that breathing tube. You can slide it directly into the airway. So this is just a quick tutorial of what the scope looks like. And I'm hoping that in the future, I will be able to actually show you what this looks like when we're doing it in an actual patient. Just a couple of different things on the scope. There is a little cap here. This is a way for you to actually flush the airway. So if you need to clean up the airway because of lots of secretions, which often occurs in patients with TOPD, they often will accumulate a lot of airway secretions. So you have to flush the airway out with saline and you can do that directly with this port. There is also a side port for which you can attach on a suction. So if you're in the airway and tip of your camera here gets clogged with secretions, you can actually suction out some of the secretions directly. So that's just a little bit about Fiverr Opticscope. The great tool, this is really our backup. When things fail with us being able to put the breathing tube in with a regular laryngoscope which unfortunately I do not have with me right now. But this is the gold standard and this is what we use. So that was informative and I'm hoping that I'll be able to talk a little bit more about Fiverr Optics with you in the future. Especially since I do a lot of thoracic. I'm typically in people's airways and also their lungs fairly often. When I do my thoracic cases, we have to put in a special breathing tube. And this Fiverr Opticscope is extremely useful in positioning that tube in the correct position so that we don't have any issues with the surgeons. So hopefully that was informative. So I hope you guys enjoyed this video. Please subscribe and like and definitely comment and let me know what you guys think and are guys interested in seeing anything more like this day in a life from my friends and colleagues who also practice anesthesiology. And I will certainly continue to bring you guys that content. So until the next time, please be safe. Please be careful and I will see you take care.