There Is Nothing Dexmedetomidine Does that Cannot Be Done Old School

Pediatric anesthesiology was mesmerizing. Watching the anesthesiologist use tools scaled down to facilitate management of airways the size of my pupil enticed me. More importantly, as a medical student, I was an observer and I was keen on understanding the intricacies of the magic performed behind that blue curtain. And so it was another day on my rotation as the anesthesiology team wheeled down a patient from the pediatric intensive care unit (PICU). The child was aged three years who was unfortunately inflicted with a relatively rare disorder known as nemaline myopathy. She lay flaccid and weak with nasal bi-level positive airway pressure (BiPAP) assisting her every breath. As I stared into the portable monitor where the pulse oximeter measured a frustrating 89 %, the attending looked at me and asked, “What are we worried about in this patient?”