I'm an operating theatre practitioner...AMA!

[wontletmelogin]

I work mainly in scrub sometimes as a surgical first assistant across a huge range of specialities in the private sector.

I also do anaesthetics. AMA

Are all patients under general anaesthetic intubated and with a ventilator controlling their breathing?

How does it feel under sedation rather than GA? How conscious is the patient?

What is the grossest thing you've seen?

What does cancer look like?

Is it weird carrying an amputated limb around ?

*Are all patients under general anaesthetic intubated and with a ventilator controlling their breathing?

How does it feel under sedation rather than GA? How conscious is the patient?*

Yes everyone is intubated. We have different means of intubating depending on the procedure being performed. The gold standard is an endotracheal tube which goes directly into your 'airway' the other are supraglottic and sit around the airway.

Sometimes we ventilate, sometimes we don't. Patients can breathe for themselves also.

It depends on the sedation given! Sometimes we just use Midazolam and a painkiller such as Fentanyl. This means you may be awake and aware but forget it afterwards. Sometimes we give a small dose of Propofol.

*What is the grossest thing you've seen?

What does cancer look like?*

The grossest was actually when I used to work in A+E (that's a whole other thread!! ) and someone impaled a bamboo stick just below their eye, luckily avoiding losing their vision!

I also love gross things like abscesses!

Cancer isn't always that obvious and luckily I don't see it very often in my line of work. We have had patients that we've opened or looked into laparoscopically and it's obvious that there is wide spread cancer. It is discoloured, usually white patchy.

This is what I wish I had trained in. I would love do train to do it his now but can't afford not to work and go back to uni! Is there any other route in ?

Is it weird carrying an amputated limb around ?

Yes! Body parts look so much bigger when they are detached As the scrub nurse we hand them out to our circulating staff very quickly. They are often weighed, sometimes photographed and put into formalin for screening.

This is what I wish I had trained in. I would love do train to do it his now but can't afford not to work and go back to uni! Is there any other route in ?

You can work as a healthcare assistant within theatre and be very much involved! You can sometimes go on to train as a scrub practitioner for minor cases. We have HCAs who are scrub trained. See if there's any jobs on the NHS jobs page or your local private hospital

Have you ever known a case of anaesthesia awareness? Is there a way of preventing this/monitoring it to know if it happens during the surgery?

Do people ever have rude or funny tattoos that everyone in theatre laughs at?
Do the surgeons sing along to music or is it always very serious?
Do the theatre staff pause long operations for toilet and food breaks?

How bad is it to have had a sip of water before a GA? One time, I was scheduled for surgery of about 3 hours and had fasted, but in the shower before heading to hospital, I accidentally forgot and drank a mouthful of water from the shower. Oops. I didn't say anything and nothing bad happened, but I wonder how big a deal it really was.

Have you ever known a case of anaesthesia awareness? Is there a way of preventing this/monitoring it to know if it happens during the surgery?

No never. We can use something called entropy which measures ‘awareness’ during anaesthesia but we don’t use it very often!

Do people ever have rude or funny tattoos that everyone in theatre laughs at?
Haven’t seen many rude ones! We get lots of Arabic or Chinese tattoos. They usually read as some sort of gibberish though (as my colleagues try to translate!)

Do the surgeons sing along to music or is it always very serious?
Sometimes we have music and other times not. It’s surgeons preference. We sometimes sing along or chat but know when to also work in silence. Like any job I suppose!

Do the theatre staff pause long operations for toilet and food breaks?
The longest surgery I’ve scrubbed was 9 hours. I know some take longer. For that one we paused for one 20 minute break so we could go to the toilet and eat quickly. The patient is covered and is with an anaesthetist and someone else to ensure sterility and safety whilst the rest of the team break.

How bad is it to have had a sip of water before a GA? One time, I was scheduled for surgery of about 3 hours and had fasted, but in the shower before heading to hospital, I accidentally forgot and drank a mouthful of water from the shower. Oops. I didn't say anything and nothing bad happened, but I wonder how big a deal it really was.

A tiny sip won’t cause too much bother. We ask you not to though as we are worried that you will aspirate. When we put you to sleep your chance of reflux is high, if there is anything in the stomach then this can regurgitate upwards and cause you to aspirate.

I always have a fear that the operation will start before I am truly under the anaesthetic. (It has never happened!), but I just wondered how you check that a person is truly 'out'.

Is it true people talk when they are anaesthetised, do they tell their secrets? If so, what was the funniest thing you’ve ever heard?

Do you get frustrated with junior doctors? When I had a c section the junior anaesthetist struggled to site the spinal (senior was ‘on the way’ but never came) and DH said the theatre tech basically talked them through it and knew far more than the doctor.

I have a fear that the operation will start before I am truly under the anaesthetic. (It has never happened!), but I just wondered how you check that a person is truly 'out'.

Clever machines

Is it true that some people swear and speak aggressively when under?

If you had to, do you think you could perform a surgery based on all you’ve seen? Would you be nervous to be operated on in the OR you work in?

What do you think of Greys Anatomy?

do people fart under anaesthesia? sorry to ask an immature question!

Is it true people talk when they are anaesthetised, do they tell their secrets? If so, what was the funniest thing you’ve ever heard?

We don’t seem to get patients like the American post op videos! I’m not entirely sure what drugs they use over there for that effect! We get the odd funny comment. The cringiest was after a male haemorriodectomy not long after waking up he shouted in the middle of recovery “my arseholes on fire!!! I’m never pestering my Mrs to use her back door ever again!”

Do you get frustrated with junior doctors? When I had a c section the junior anaesthetist struggled to site the spinal (senior was ‘on the way’ but never came) and DH said the theatre tech basically talked them through it and knew far more than the doctor.

Ahhhh! We don’t have juniors in the private sector unless they come along with their consultants for teaching. I didn’t mind them in the NHS - they were always keen to learn and I was happy to teach! Some grasped things a little slower than others but it’s like that with any career!

Is it true that some people swear and speak aggressively when under?

Nobody can speak ‘when under’ - what you’re referring to is called emergence which is where you wake up afterwards in recovery. Sometimes people swear and fight. They could be the nicest most gentle person but it’s something that overcomes some people.