or they get it already ready?
Also what do they have to do during 5/6 hours of surgery besides look the patient vital signs ?What do they actually do besides it and when the patient have no problem with heart beat, pressure, etc?
Tell me details I want to know all
ps Does somestimes when everything is ok , the patient is already put to sleep they just have to be stand there and pay atention? do you think it gets bored?
I like long answeres
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2 comments ↓
Hey! No food or drink allowed in the OR! (Not in the US, anyway) – and I’ve never seen drugs mixed to gether for a rapid sequence induction. Is that a UK thing? Yikes.
Here is a link to a rather long answer I gave to another question:http://answers.yahoo.com/question/index;…
We constantly adjust things as the case goes on. It’s true that most of the work is at the beginning and end of the case, and if we plan things right, we don’t have to work TOO hard during the case (unless the surgeon hits an artery, and then we work real hard, real fast).
As for medications, most of them are in vials, and we just have to draw them into syringes. A few are powdered,and we have to mix them (vecuronium) and some we have to dilute before we can use them (ephedrine, phenylephrine). Sometimes we have to prepare drips – put a vial or two of medication into a bag of IV fluid, put that on a pump and program it. We label all the syringes so we know what’s what.
You know how when you’re driving, you have to constantly make adjustments in your speed and direction, even if it’s a relatively straight road? And sometimes there are sharp turns, and very rarely, there’s something completely unexpected, like a tree across the road or an accident up ahead? Giving anesthesia is sort of like that. You have to constantly make minor adjustments in what you’re doing, based on what the surgeon is doing, how the patient responds to drugs, how much blood is lost and other things. You plan one thing, but sometimes things don’t go as planned, so you need to have an “alternate route” available.
When things are going smoothly, then we DO chat with the surgeon and/or nurses, some people read a bit or do a Sudoku puzzle, tidy up the mess of syringes, get things ready for the next case… always with an ear on the pulse ox and an eye on the monitors.
Some cases are truly boring. Ophthalmology tends to be that way (and if there’s going to be an oddball surgeon, it’s more likely than not it’s an ophthalmologist. No offense, if there’s any out there.) Spinal tumors being picked at under a microscope and vascular bypass surgeries can also be boring. They’re just tedious surgeries. Vascular patients tend to be sickies, though, which adds more challenge on our side.
I don’t get too bored because I am comfortable living inside my own head with my own thoughts. If all is going well and the surgeon isn’t in a foul mood, there’s usually also music and conversation. All in all, I find it a pleasant environment in which to work. (I wouldn’t likely say that after a day with an ophthalmologist or vascular surgeon, though) My favorite place to be is OB – lots of happy people, new babies, spinals for C-sections, epidurals for labor, and the occasional life or death emergency… it’s just a great place. (Not all anesthesiologists agree with this, though)
Is this long enough?
I have to go help my daughter with trigonometry. Her math teacher is worthless.
That’s an interesting question. The preparation of anesthesia has a couple of components. If you’re given a general anesthetic (you’re knocked right out), then your anesthetist will give you a sedative/hypnotic drug for that first knockout punch (a barbiturate or benzodiazepine), a muscle relaxant or neuromuscular block (to stop those pesky surgeon-swatting reflexes), and then an inhaled anesthetic to keep your lights out. The IV meds are in separate vials. They may mix them together for a rapid sequence intubation (typically in emergencies) or load them in separately. I imagine separate is preferable, because it is apparently quite jarring to have the neuromuscular block make you quiver right before you’re completely paralyzed (you can’t breathe).
The anesthetist will also:
1. Intubate you (put a lovely tube down your trachea for easier ventilation)
2. Program and monitor the venilator unit
3. Monitor your vital signs (heart rate/ECG, pulse oximetry, blood pressure, EEG (brainwaves), ETCO2 (how much carbon dioxide you’re breathing out).
4. Visually inspect/palpate your face/skin in addition to instrument monitoring
5. Adjust the operating table for the surgeons (up, down, tilting, etc)
6. Check up on pneumatic devices on your legs to keep blood flowing and prevent clots
7. Chat with curious/obnoxious students
8. Drink coffee and eat chocolate covered raisins (outside the sterile field of course.
9. Top you up on IV muscle relaxants (so you won’t jump off the table when they spill coffee on you)
10. Read the newspaper.
They seem to prefer short surgeries, because the most interesting and challenging work is at the beginning and the end. But mostly, if you’re stable, they just want to keep you breathing and… er… asleep!
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