Oh. And raise the transducer to get the number they want.

Same for me with PEARS with teenagers. surgeons keep asking for lower and lower BP as time goes on. Can get into uncomfortable territory with numbers I prefer to keep to myself! Keep CO2 up and watch NIRS closely too. Excellent recovery each time.

Even small dose ketamine will markedly drop the BP if the patient is truly at the limit of symp drive. The obtunded are already anaesthetised and sometimes the ketamine is to treat the anaesthetist since ‘deep pancuronium’ seems so wrong when the sternal saw starts. (But it isn’t!)

I find ketamine more forgiving than other agents and use it in critically unwell (mostly heart failure or septic children) TITRATED to effect. Ie nystagmus and sedated enough for arterial and or central venous access. Then vecuronium or panc.

What a resource! Mask drop chloroform demonstration is excellent and the Mae West videos I will now use for talking to trainees about circuits so they believe me.
Also, weren’t the ‘volunteer’ subjects all anaesthesia trainees? Whom returned for more once the pneumonia had passed?