The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Wednesday, October 26, 2005

Anaesthesia-- From the Latin Word for "This Rotation is Putting Me to Sleep"

Okay, I'm determined to say something positive about anesthesia. Today was a good day. Part of that might be because it was the first day I worked this week, and part because it only lasted three hours. Sigh. On Monday I went into work only to find that the ONE operating room that was doing general anaesthetics had already been claimed by a respiratory therapy student. Okay. I went around to the other rooms, but all there was going on that day were a couple of ortho rooms doing spinals and a couple of eye rooms doing neuroleptics (i.e. happy drugs that relax you but don't put you to sleep). So, I went home.

That was the second time in the space of a week that I'd gone in and ended up turning around and going home. This is getting ridiculous. After being told by a staff anaesthesiologist that 'it's expected that residents step down to let the medical students have the good rooms' I had enough. I checked the list for the next day, saw that there was a similarly small number of OR's running, and made the executive decision to stay home.

I'm being paid for this. Yes folks, this is where your health-care dollars are going. To fund a doctor with 11 years of university education to go on a hike with her visiting sister and her dog. To break up the monotony of this post, here's a picture of the dog:

So here is my effort to say something positive about anaesthesia: I may have learned something this month. Today, I did a successful nasal intubation. Pretty cool. It's a tricky thing, so I'm proud of myself. Then, I got to see an 'awake intubation'. Which, unfortunately for the patient involved, is exactly what it sounds like. If you're expecting someone to be SUCH a difficult intubation that you can't risk sedating and paralyzing them, you stick a tube down their throat while they're awake, then put them out once you've confirmed correct tube placement. Another tricky thing... I left that particular trick to the staff guy! It was unfortunate to watch, but the guy had a tumor in his throat that obscured all of his laryngeal anatomy. Calling him a difficult intubation would be an understatement.

Okay, so here's where I learned something. I'm sure this is going to be one of those stories that you really had to be there to appreciate, but I'll try it anyway. So during the last case, the anesthesiologist got called back to the recovery room to deal with the patient we had done previously. I was left alone with the patient. Suddenly, lights and alarms started going off on the big, intimidating anaesthesia machine...

That's not good. All I could figure out was that the bellows weren't filling and he wasn't breathing... this guy was a heavy smoker and didn't have much in the way of reserve, so his oxygen saturation fell pretty quickly. I panicked at first and asked the circulating nurse to call the recovery room and get the anesthesiologist back ASAP. He wasn't there. I tried manually filling the bellows, I tried increasing the flow of oxygen, I tried bagging him manually... nothing. Finally I got my head on straight enough to think the problem through. And I found the problem... the surgeon had inadvertently knocked the tube, and the circuit had come apart from the tube. Phew. Crisis averted.

So there ya go... anaesthesia isn't always boring.

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Anonymous Anonymous said...

Your dog is hot.


2:30 PM


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