Wednesday, August 1, 2007

O.R. Thoughts

First thing's first: HI, MOM! It's still the day before your birthday over here, but over there, it's your birthday already, so HAPPY BIRTHDAY!!!

You may have already seen this, but I want to brighten your day with a humorous video clip (my absolute favorite, actually) which never fails to put a smile on my face:



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The punch line from the video above and a post from Patty entitled "You Gotta Be Joking" on oboeinsight.com made me want to keep track of what I think of during stable cases in the O.R. Last Monday during a carotid endarterectomy I took notes on my train of thought - which, according to my husband, frequently "leaves the station" without him - and although writing about my thinking, as the act of writing always does, may have also influenced my thinking, I think the following is a fairly faithful representation of where my mind went during the case:

Gotta hook up the arterial line...is it damped? No, whew...can't even believe the a-line went in so easily...this woman had no radial pulse...what a cute, sweet lady...is this the right mask size for her?..."The anesthesia medication might sting a little bit in your I.V., Ms. B, but that will go away very soon, I promise"...No eyelid reflex...red syringe in, laryngoscope ready, watching that loose tooth...epiglottis in view...vocal cords, beautiful - we're in...let's get some tape...warming blanket on...how's the blood pressure?...not too bad, actually...let's hang a phenylephrine drip...O2 saturation 100%, but let's tweak the vent settings a little...good tidal volumes...my left heel is killing me...gotta have a seat...radio's playing the oboe part from Concierto de Aranjuez! Awesome!...We're over-ventilating a little; time to go down on the respiratory rate...surgeon going to France next week...me too...wonder if my high school French will cut it...gotta look up those recipes for tarte aux oignons and charlotte aux noisettes...hope the hubby's having a good day...BP looks good, & CO2's right where I want it now...did I draw up the heparin?...okay, all the drugs for the rest of the case drawn up and ready to go...I'm hungry...wonder if there's any chocolate in my locker...cross-clamp time - gotta make sure her pressures hold...EEG guy says things are lookin' good...what am I gonna make for dinner tonight? I am so out of ideas...maybe a simple chicken and rice with a little roasted red pepper on the side...wonder if the kids are doing okay today...movin' right along, time to back off the phenylephrine a little...I think I'll work on that E flat major scale today...and I gotta try the Swan Lake opening on this Fossati oboe!...but I'm so tired...so hard to practice when you're tired...wow, he's closing already...things are really lookin' good - O2 saturation's perfect, BP's totally stable, heart rate couldn't be better... maybe I'll try some lidocaine so she won't cough so much at extubation...forgot to bring lunch or cash today - think the recovery room pantry has anything edible?...probably won't get a real lunch break anyway...ow, there goes my heel pain again...time to shut off the gas and wake up this sweet lady...all my drugs are in, oxygen flow up, let's get ready to land this plane...

Wow, it really is either patient care or food in there...

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