Welcome to the Anesthesiology Unit.
In my opinion, this unit is where the real fun in the medical field lies. It’s one of the aspects of Medicine that literally leaves non-medical personnel mesmerized (Pun intended).
Yes, the Anesthesiology team is in charge of all the beeping machines you see in the Operating Theatre and the Recovery room.
Anesthesiologists are awesome. They give special effects to the drama that takes place in the operating room. I see them as the behind-the-scene characters that make surgical “productions” a reality.
I can understand if you’ve never heard of them before. Anesthesiologists aren’t the most popular among Doctors. I became aware of that field of medicine about 4 years ago, when my mom had to undergo a major surgery. I was in the room with her when a doctor came in and introduced himself as her Anesthesiologist. He explained what he was going to do during the procedure and so forth, and I casually took in the information. I obtained more knowledge about what the Anesthesiologists really do on starting my clinical rotations.
Whereas the Surgeons are admired for their courage and skillfulness in handling both the scalpel and knife, the Anesthesiologists are really the ones technically in charge of the unconscious patient lying on the operating table. Hence, I think they deserve more credit as well.
I had a memorable time in that posting. I saw and learnt a lot too. I had the opportunity to observe a wide range of lots of procedures across several specialities. My Preceptor, Dr. Mandel was a nice, elderly gentleman who preferred the more traditional approach to Medicine. He sometimes painted scenarios of what to do in a place where standard medical facilities are not available. A good grasp of Physiology and Pharmacology was required from we his students. There were two other doctors and two Nurse-Anesthetists on the team as well.
I especially liked the flexibility of our schedule (morning or afternoon shifts on alternate days, or as specified); since we had to stay in the Operating Theatre all day.
Let me briefly show you how we roll on a typical day.
It’s the day of your surgery, preferably an Elective Procedure (maybe an Epigastric Hernia repair, nothing really serious) and you would need a General Anesthesia.
You’ve been wheeled through the doors of the operating theatre and you are lying on the operating table. We now await the scrub nurses and their assistants as they setup for the procedure. The Surgeon and his Assistant are ready to scrub in as well.
The first thing we do as the Anesthesiology team is to chat with you. We want you to feel as comfortable as possible and attend to any concerns you have about your procedure.
“Ms. K, how do you feel today?”
“It’s okay to feel a bit nervous but we would like you to try and relax.”
“Hope you haven’t had anything to eat or drink since night?”
As we chat with you, we go through your medical chart. We want to ensure that you have no comorbidites (especially Hypertension or Diabetes Mellitus) that may put you at increased risk of complications during the surgical procedure.
If you are over 40 years of age, we want to see that you have the results of your Complete Blood Count (CBC), kidney function test (UCE), Chest X-ray and Electrocardiogram (EKG).
In addition, we need to ensure that you have an intravenous line running, we can’t always predict hemorrhage, so we also have to make sure a request has been sent to the Blood bank for a cross and match (in case a blood transfusion is required).
We start by placing EKG leads on your chest and connecting those to a monitor. We also put a pulse oximetry machine on one of your digits, as well as the Blood Pressure cuff on your arm. All these are done so that we can monitor your vitals (Blood Pressure, Heart rate, SP02, Heart tracing etc) as the procedure progresses.
Now that the nurses are set and the surgeon has scrubbed in. It’s time for you to go to sleep.
First we inject you with an anesthetic agent that makes you drowsy (PROPOFOL a milk-like suspension, is the most widely used); followed by a neuromuscular blocking agent (like SUCCINYLCHOLINE) to help facilitate the intubation process. After that, we cover your nose with an oxygen mask and ask you to take in some nice and gentle breaths.
In a little less than 2 minutes, you’re well sedated and unconscious. The next step is to do a Tracheal Intubation. This involves the placement of a flexible long tube through the back of your throat into your lungs to facilitate adequate ventilation during the surgery procedure.
Image: Tracheal Intubation
As soon as we are done, the surgeons can proceed. On our part, we continue to monitor your vitals and ensure you have an adequate anesthetic depth. We also give you Analgesics to ensure you don’t experience critical pain following your surgery, and Antibiotics as prophylaxis against Nosocomial Infections.
Once the surgery is over, we give another drug to reverse the effect of the anesthetic agent. We then extubate, ensure you’re awake and breathing adequately before transferring you to the recovery room. There you are monitored for a few hours to see that you’re in stable condition before you’re returned to the WARD or discharged home.
For more information, here’s a link to what Anesthesiologists do.
So would I love to practice as an Anesthesiologist? To be sincere, I’d rather not. I think the long (often unpredictable) hours of standing would be way too demanding on my body. Anyway, cheers to all who choose to go through this dynamic path.
ANALGESIC: A drug primarily used to provide relief from pain.
GENERAL ANESTHESIA: A medically induced coma and loss of protective reflexes resulting from the administration of one or more anesthetic agents; with the aim of ensuring unconsciousness, amnesia, relaxation of skeletal muscles and loss of control of the autonomic nervous system (WIKI).
NOSOCOMIAL INFECTIONS: Also known as Infections acquired in the Hospital or other Healthcare facilities.
Thank you for reading!