Monday, July 8, 2013

Walk With Me: Supporting The Community With The O.R.

There is a fountain in the courtyard at the hospital I enjoy very much

When a surgeon 'takes call', all of the diseases and emergencies that present to the hospital through the Emergency Room are the 'on call surgeon's' responsibility. For example, a trauma surgeon would get any and all accidents that happen and are sent to the hospital by the ambulance and first response system. Any car accident (even an elderly wife  backing up over her husband), any penetrating trauma (gun and knife club), any major burn that requires hospitalization.

A vascular surgeon would get 'cold feet' that have 'limb threat' because there is no blood supply going to the leg (or sometimes arm), and emergency surgery is required to find some way to re-route the blood flow before the leg or arm 'dies' and 'gets gangrene'.

A urologist has several emergencies--priapism (look it up) and Fournier's Gangrene (overwhelming, 'flesh eating' bacterial infection of the 'saddle area'--typically seen in diabetics).

An orthopedic surgeon gets called in for serious broken bones that cannot wait. Open fracture (bone sticking out) has only six hours before infection sets in and has poor prognosis.

As you can imagine, there is work to keep neurosurgeons, general surgeons, otolaryngologists, urologists, and even sometimes plastic surgeons (ischemic or bleeding surgical sites) busy.

A surgeon who is on call never knows what they are going to get, what is going to walk in that door, and who is going to need their skills to 'take care of it'.

Neither does anesthesia or the Operating Room staff.

We take care of everyone who has surgery.

Let me repeat--anything that walks through that ER, rolls in on a gurney, or gets carried there by loved ones, who needs surgery, is the work of whoever is 'on call' for the O.R.

That means surgical technicians (scrub techs), nurses, and anesthesia.

We Know What To Do.

There is NOBODY else to help us when we are on call.

For example, when I am the anesthesiologist 'on call' for the main O.R. , when it comes to anesthesia needs, 'the buck stops here'. 

I do it all.

(The childbirth anesthesia is in a different part with a different person in charge of it. That one is 'the buck stops here' for all c-sections, epidurals, spinal headaches, and 'emergency intubations anywhere in the hospital'.)

The last time I took call I did ten cases in fifteen hours. One patient I did twice, once in GI lab, the other  time in the main O.R. I did two ninety-year-olds (one is enough to take years off your life in stress).
I did spinals and general anesthesia. I did patients laying on their back, their side, and their stomach while the surgeon worked.

I did the anesthetic for every kind of surgery we do.  I also had my phone on at home, just in case anything else came in through the night after I came home.

And I gave Reiki. In addition to everything else.

Just to let you know what it is like to 'walk with me'.


Reiki Doc

my new shoes have the night sky on them