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Transcontinental anaesthesia: a pilot study (2013)

bja.oxfordjournals.org

21–30 of 32 posts

Re: Transcontinental anaesthesia: a pilot study (2013)

#21
post #7

Anaesthesiologist seems like one of the first doctors that could be entirely replaced with a robotic system. They are basically there to monitor and asses multiple vital factors, which seems entirely appropriate for a control system.

Pharmacist is the medical job that is already completely obsolete and could be eliminated if not for unions and inertia. Pharmacists almost never do compounding anymore. They just take pills off a shelf and hand it to you. If manufacturers and doctors could agree on standard drug regimens, counting out pills would be unnecessary as well (or could be replaced by minimum wage labor or robotic/vending machine-like devic…

That's only the aspect of the job consumers see at the walgreens counter. There is more. Go to any hospital and watch pharmacists do the job of organizing the system that delivers, evaluates and supervises drugs. They are the ones dealing with the software that checks for overdoses in prescriptions. They are the ones freeing doctors from the regulatory hurdles surrounding all manner of drugs. Ask a doctor to describe the steps to acquire a shipment of a morphine tablets.

Ask a doctor how much a specific drug costs as opposed to a different treatment. Ask which treatment better fits the lifestyle of the patient. Then ask a pharmacist. There is value in the profession.

Re: Transcontinental anaesthesia: a pilot study (2013)

#23
post #5
post #2

Holy cow, that's a confusing title. I clicked on it trying to figure out why you'd give pilots anesthesia on a transcontinental flight. In case anyone hits the comments first and has the same confusion: it's a "pilot study" in the sense that it's the first of its kind, and "transcontinental" refers to controlling the process remotely. Basically: can your anesthesiologist be off-site and do his work over the internet…

My first thoughts were on similar lines: A study on how to put economy class transcontinental-flight passengers out of their misery, pack them like sardines and resuscitate them on arrival. Wierdly enough, I might be tempted to opt for such a dystopian travel machinery than the one that exists now.

https://en.wikipedia.org/wiki/The_Jaunt

Re: Transcontinental anaesthesia: a pilot study (2013)

#24
post #7

Anaesthesiologist seems like one of the first doctors that could be entirely replaced with a robotic system. They are basically there to monitor and asses multiple vital factors, which seems entirely appropriate for a control system.

Pharmacist is the medical job that is already completely obsolete and could be eliminated if not for unions and inertia. Pharmacists almost never do compounding anymore. They just take pills off a shelf and hand it to you. If manufacturers and doctors could agree on standard drug regimens, counting out pills would be unnecessary as well (or could be replaced by minimum wage labor or robotic/vending machine-like devic…

My fiancee is a recently graduated pharmacist. I was surprised by how much of her work is just counting pills and managing insurance.

But, as with many jobs, a robot can't handle the edge cases.

Doctors can be surprisingly ignorant about the medications that they prescribe and she's the last check to make sure they aren't going to poison a patient.

She also provides advice and clarification for patients receiving drugs that could kill them if they're misused.

The vast majority of pharmacist work will likely be automated, but it will be quite difficult.

Re: Transcontinental anaesthesia: a pilot study (2013)

#25
post #7

Anaesthesiologist seems like one of the first doctors that could be entirely replaced with a robotic system. They are basically there to monitor and asses multiple vital factors, which seems entirely appropriate for a control system.

If you think about the costs and dangers of surgery as a whole, I don't think it's worth the risk trying to completely automate something like anesthesia.

The personnel really has to have a holistic understanding how the patient is doing and not just look at one number on a screen.

I would go the exactly opposite direction.

What better monitoring and tools should provide is better quality anesthesia, which is a whole big story in itself with many interesting components.

For example if you can monitor better, you don't need to give so much drugs "just to be sure". This has all kinds of benefits like faster recovery for the patient.

(Disclaimer: I've worked in a very related field.)

Re: Transcontinental anaesthesia: a pilot study (2013)

#26

Earlier quoted context omitted.

Machines already count the pills. (top search result: http://kirbylester.com/kirby-lester-products-and-technology.... ) Pharmacists are still well paid, which implies they are doing something of value (even at big chain stores they have good salaries).

Pharmacists are well paid and will continue to be well paid because they, as a profession, do things engineers don't: - Create industry groups that advocate for the profession as a whole, using their seat at the table to influence policy makers - Oversight over education institutions to ensure quality of graduates - Collectively organize to ensure fair base pay, sane work schedules, and safe work environments

Create laws to restrict competition, automation and innovation.

Monopolize education to restrict supply and prevent deskilling.

Collectively organize to extract rents from the consumer in the name of safety.

Re: Transcontinental anaesthesia: a pilot study (2013)

#27
post #7

Anaesthesiologist seems like one of the first doctors that could be entirely replaced with a robotic system. They are basically there to monitor and asses multiple vital factors, which seems entirely appropriate for a control system.

If you think about the costs and dangers of surgery as a whole, I don't think it's worth the risk trying to completely automate something like anesthesia. The personnel really has to have a holistic understanding how the patient is doing and not just look at one number on a screen. I would go the exactly opposite direction. What better monitoring and tools should provide is better quality anesthesia, which is a whole…

> What better monitoring and tools should provide is better quality anesthesia, which is a whole big story in itself with many interesting components.

To add to this, my wife is studying to be a Nurse Anesthetist and I'm always amazed that there are plenty of docs who insist on using the intubation tool that doesn't have a camera vs the one that does. I'd say around 20-50% the time they have to get the one with the camera to help out anyways. Why not just use the one with the camera if it's there.

There's a lot of value to be added in the complementarity of humans and machines, particularly in anesthesia.

Re: Transcontinental anaesthesia: a pilot study (2013)

#28
post #13
post #10

Earlier quoted context omitted.

Probably because anaesthesia has significant risks, and even if it was safe, most people would spend the first few hours on arrival puking (a very common side effect of anaesthesia).

Even at that, you have to be able to evacuate a commercial airliner in ~90 seconds. How do you fix this?

It doesn't have to be an airliner; if you get to "sleep" for the whole journey, why not stretch the trip to a few days or weeks on a train or bus or boat?

Re: Transcontinental anaesthesia: a pilot study (2013)

#29
post #13

Earlier quoted context omitted.

Even at that, you have to be able to evacuate a commercial airliner in ~90 seconds. How do you fix this?

It doesn't have to be an airliner; if you get to "sleep" for the whole journey, why not stretch the trip to a few days or weeks on a train or bus or boat?

Because we have just 10-15 days of vacation per year.

Re: Transcontinental anaesthesia: a pilot study (2013)

#30
post #13

Earlier quoted context omitted.

Even at that, you have to be able to evacuate a commercial airliner in ~90 seconds. How do you fix this?

It doesn't have to be an airliner; if you get to "sleep" for the whole journey, why not stretch the trip to a few days or weeks on a train or bus or boat?

Unfortunately, being unconscious and relatively immobile for that long would be extremely bad for your health. People in a coma require a lot of specialized nursing care -- for example to avoid developing bed sores -- and anyone immobile for a long time risks cardiovascular problems and muscle atrophy. You can get quite deconditioned from just a week or two of bed rest.

The "stasis" approach for long trips would probably have to be something higher-tech than just regular anesthesia...

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