Saturday, July 28, 2012

The Anesthesia Technician

Yesterday the tech called in sick. There is only one. The practice of anesthesia uses a lot of supplies. So when your technician is away, things run out.

After I give an anesthetic, I put the machine on standby, turn off the blood pressure cuff, and deactivate a monitoring alarm because its beeping drives the team that is cleaning the room crazy.

I take care to keep my monitoring cords back up on the i.v. poles, and I leave as little mess as possible. Technicians are not allowed to touch syringes. They used to be able to bring a drug you were low on on your cart, but now they are not. Only a nurse can touch a drug, or a physician. But we get around that impracticality by the loophole where a technician can bring you an entire drug tray for the cart as long as it is wrapped in protective plastic.

Once I take the patient out of the room, the tech refills the inhalational agent (anesthetic gas), takes off the old suction and breathing circuit, and sets up new clean ones for the next patient. If I used a MAC 3 blade to intubate my patient, the tech puts in a new one to keep two of each size in supply. If I used an LMA, he would replace the size in the bottom of the cart.

My storage is two drawers on the anesthesia machine, and a five-drawer locked cart. Our tech is so good he tears off the strips of paper left behind when we take a label off the roll to label our syringes. Labeling is important because it decreases the risk of administering the wrong drug.

When I anticipate a dangerous intubation, I ask the tech to bring the Glide Scope and be present. Sometimes we have to upgrade and use the fiberoptic scope instead. If I do a Double Lumen Endotracheal Tube to allow one-lung ventilation during thoracic surgery, I will have the special tubes and the fiberoptic scope so I can visually verify that placement is correct. It must be at the carina and a little crescent of a blue balloon must be seen.

If I anticipate blood pressure changes, my tech will set up an arterial line for me, and has a little cart that he brings with all of the equipment for inserting it laid out on top. If I need to monitor more invasively, he will bring the central line, a double lumen or cordis, and gown up to assist me as I place the big line in the neck. We have special tubing and a warmer to heat up blood for transfusion (it is frozen), a monitor to measure depth of consciousness (BIS), special nerve monitor for placing regional blocks (he helps on that too).

Patients do not understand the level of care that is given to their anesthesiologist can be Four Seasons or Motel Six depending on the quality of the person who is working behind the scenes for the anesthesia care.

At my old work, all of the technicians got demoted to 'Hall Support', and no one in management even made plans for anyone to order all the equipment to enable us to be restocked. The old lead tech kept on doing it. But then certificate Techs were needed, and thankfully, they came back. Tech know the work, but in a different capacity than us. They find new improved equipment, bring it to our attention, and are a wealth of knowledgeable support.

I save the newspaper for my tech every morning, keeping it all neat and folded after I read it. I also make cartoon balloons over the faces of the models, telling the tech how much they adore him so. Sometimes they talk in Spanish, other times in English, but always the message is the same--you are the best and I appreciate you.

The point of this article, is that a job well done increases the healing of the patient, even if you are not on the front lines like me. Your attitude, organization, and support are critical to a well-functioning team.

Adding Reiki to the mix makes is all the more effective.


Reiki Doc