I am an anaesthetic ODP

[probablynotthesame]

Hi everyone I work in anaesthetics as an operating department practitioner (ODP) I specialise in paediatric and head and neck surgery although I do do other specialties. I have worked in district, private, cancer specialists and currently in a NHS university hospital. AMA!

My Dad is having a hip replacement under spinal next week. He has asthma, diabetes, is v overweight and has prolapsed discs in his spine. He is terrified of the anaesthetic risk. How do I reassure him?

Also, have you met a DC for whom anaesthetics don't "take" properly? DD has Ehlers Danlos Syndrome which seems to cause this. She had sedation last year but it didn't work. She didn't need it though as she was calm but the anaesthetist remarked that she was utterly alert during her biopsy and he was rather surprised. She then had a general a few weeks later and came round very suddenly whilst being stitched. She was terrified. What do I say if she ever needs surgery again. How do you deal with this?

My father had to have a general anaesthetic very recently and was worried sick about it because his sister got dementia after a general anaesthetic (she's 89) and her husband was told it was probably due to the anaesthetic. Can a general cause dementia in elderly patients?

I ask because he was very with it but since the anaesthetic has started saying some very odd things, for example he asked me if I wanted a chair that I bought for him recently and when I said no he got angry and said it was a present for his 25th wedding anniversary from a sports club.

Hi @ShowOfHands. Firstly I wish your dad the best for his upcoming op. It is very common for theatre teams to have team briefs before all operations, the anaesthetist and ODP will discuss in detail any medical issues and have a clear set plan in place. What is it exactly that he is concerned about?

Regarding your friends daughter I'm sorry to hear that she has been through what she has. As for the condition I personally myself haven't come across this. It doesn't appear to be common knowledge that anaesthetics is based on theory, the ability to explain conscious perception is still a mystery! We don't know why the body respond to anaesthetics the way that it does, notes will be taken for each anaesthetic she does have which can be referred to if she ever has another one again. There are different ways to anaesthetise the best thing to do is to find what parts work best. Getting a detailed debrief from the anaesthetist would be advisable, talking to her asking her did you feel sick? Do you hurt etc then finding what method and drugs were used. Hopefully she won't ever need another one though.

Sorry * your DD

@user546425732 I remember reading about a study a few years ago regarding the risk of anaesthesia and the link to the onset of dementia in elderly patients. There were no conclusive evidence from the studies although it suggested around a 20-30% increased chance if I remember correctly. I haven't read anything recently regarding this as I'm mainly paediatric based now.

Thank you for the info. I'll keep an eye on him and get him to the GP if it's not a one off.

I have ehlers danlos syndrome. This is how it’s dealt with with me.

No locals allowed, they usually all fail -> sedation for simple procedures (last time was 7.5mg midazolam and 100mc of fentanyl (I have a fentanyl patch too)

Anything that could be very painful requires GA and recently they said they had to give me extra, I was still completely alert until the white stuff went in despite copious amounts of pre meds lol

Epidurals are also not allowed, I’ve had a failed one

What exactly is an ODP?

ODP = Operating Department Practioner (I think)

Locals don't work on me & DB either, and we're very stretchy, which is a bit EDS. Generals do but we throw up for hours and nearly burst our stitches :) be careful.

Use something else to numb your DD at the dentist, and tell them first before she gets stuffed full of adrenaline that won't work. I get lidocaine and plenty of it.

OP - have you ever known anyone have a panic attack on coming round? I have a partic fear of this.

I had two failed epidurals during my firsts birth, the first one had no effect and the second left me me semi numb in a patch on my side but otherwise felt everything.

I then had two failed spinal, two different surgeries, was numb to begin with but wore off about 20 minutes in each time.

Local anaesthetic is very hit and miss, mostly miss.

Why would this be? I was assured after my first spinal it was a blip and the next one would be fine, but it wasn't. No one ever debriefed me as to why it didn't work.

I've never had any issues with general.

On half coming round once I reprimanded the anaesthetist for holding my hand and said ‘you’re not my husband!!!’. What’s the strangest thing you’ve heard when patients have woken up?

ODP stands for operating department practitioner, we are trained specifically for emergency and intensive care. Our role can be in theatre in anaesthetics, scrub or recovery. We can also work in A&E and intensive care although some hospitals (for some silly outdated reasons!) won't employ ODP's outside of theatre.

We are a job role that is in demand and it's such a shame more people don't know about us.

In a nut shell
Anaesthetics: we assist the anaesthetist (they have to have one of us by law to keep an eye on them ) putting lines in, checking equipment/anaesthetic machine, monitoring patients throughout surgery and responding appropriately with drugs/bloods etc.

Scrub: assisting the surgeon, handing instruments before they ask! So knowing what he/she wants before they do...it's a fine art...one I could never master! Checking instruments are fit for surgical use, doing surgical counts ensuring nothing is left behind. Keeping the surgical field sterile.

Recovery: looking after patients post operative. Measuring vitals again responding appropriately.

Plus we are acting as the patients advocate at all times.

We run theatre lists, manage the department, deal with broken equipment, get deployed to emergencies at the drop of the hat, work in a very close team but have to think on our own two feet at the same time plus be accountable for all our actions!

So is a ODP a doctor or type of nurse?

@LanaorAna2 yes I've often had patients come round from anaesthesia in a bit of a 'blind panic' they aren't fully aware of where they are etc and have had the odd ones trying to jump out of bed! We obviously don't let they happen and I try to make sure the theatre is quiet, not too many people are getting involved and allow the patient time to come round. Many people don't remember this though.

@theaveragewife the strangest thing would definitely be 'I want pizza' the man sat bolt upright and shouted it I was a bit sorry you'll have to wait a little while!

@lastnightidreamtofpotatoes we are the same band as nurses but we are not trained the same way.

I had an epidural before repair after traumatic birth (4th degree tear) and never got a full debrief. Before the epidural went in, I signed consent form etc and anaesthesist said that headaches were a common side effect after it had worn off.

On the operating table shortly after epidural, I felt as though I'd been hit by a sledgehammer on the back of the head. I told the anaesthesist but it was blurry and I think I lost consciousness. I remember hearing alarms going off and could vaguely hear someone saying "we've got to get her back" I felt very calm at that point and it ran through my head that I was probably dying (!) but it was ok

When I came round it didn't seem as though it had been much of an emergency though I was being monitored every 15mins.

In my notes it mentions something like "labutamol" ??

Any ideas what might have happened? Thanks

Lastnightidreamtofpotatoes, no, ODPs are not doctors. Anaesthetists are doctors. The ODP acts as our assistant. They’re a relatively new idea - when I first trained ad an anaesthetist after qualifying as a doctor 38 years ago, we used the theatre porter to assist us, or just worked on our own! Then we had a nurse. Nowadays the ODPs do a more specific training than general nursing.

Ooh I had a failed epidural and local anesthetic at the dentist often doesn’t work on me and am being investigated for lupus, definitely have fibromyalgia ..... I wonder if there’s a link?

@mummyhaschangedhername in my experience failed regional anaesthesia is usually down to clinical technique or inexperience. Was it difficult for them to find the space in your back to do the spinal/epidural? Some patients are difficult with no explanation why, I've seen several consultants try and fail before.

How would one become an ODP? What are the requirements, length of training etc?

@StopPOP it sounds like you could have had local toxicity? Did they not discuss with you afterwards what happened in theatre

No, it's never seemed an issue "getting it in" just bizarre why so many would be ineffective.

You need to have GCSE (or equivalent) in maths english and science and an Interest in healthcare. The course is three years, many universities run the course now and it is split between working placements and uni days.