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

[HelloGabriel]

How far in advance would the consultant read-up about his or her patient before performing surgery? Or is it a case of turning up on the day and reading through the patient notes?

[FrankenCat]

@strawberrie I had a hysterectomy on Thursday, I was sick twice after coming round actually. I'm ginger.

[wontletmelogin]

I’ve had lots of laparoscopies for endometriosis and I’ve always assumed that the reason you have to untie your gown before you lie down is because they remove it but someone here said that’s not the case - could you confirm?

For a laparoscopy we pull the gown up so your abdomen is exposed but it still covers your chest. Your legs are put into stirrups (if it's a gynae laparoscopy) too as we put something called a uterine manipulator into your uterus so we can move your uterus about to get a better view.

[wontletmelogin]

If you have a procedure with propofol, are you aware at all or are you completely oblivious, in the same way as you would be with a GA? Are there any side effects with propofol?

You shouldn't be aware. Propofol is used for general anaesthesia and very occasionally for sedation. It can leave you sleepy, obviously it causes respiratory depression (in Michael Jacksons case!) so it needs to be administered by someone who is trained in looking after the airway.

[wontletmelogin]

How far in advance would the consultant read-up about his or her patient before performing surgery? Or is it a case of turning up on the day and reading through the patient notes?

Depends on the consultant and how busy they are. Mostly on the day of surgery. Again sometimes they might forget little things so we also refer to notes or scans during the procedure to make sure we don't miss anything.

[TheQueef]

Bugger. I thought the botox might be a perk.
Ok two more please!

I recently had a saddle block (excellent) and some mask stuff but I was awake and yammering on chatting throughout my STAPLED HAEMORROIDECTOMY (I'm shouting because it's as painful as it sounds) would my wittering on distract you?

Secondly. Would you be amazing in an emergency? Massive car pile up inferno scale. Would it all just click in to place?

Excellent thread thank you.

[Difficultcustomer]

Really interesting thread, I’ve had a number of operations and wondered what was happening while I was “out”. Im greedy so have a few questions

What is the longest and the shortest operation you’ve been involved in?

Do you get to know what happens to the patients especially longer or more serious?

I’ve had some brilliant case pre and post op and would like to send.a present (equivalent to something for ward staff) next time. What do you think would be appreciated (under NHS) and how do I get it there?

[Difficultcustomer]

Care not case

[LikeTheFruit]

As an anaesthetist I feel you're answering questions far far out with your scope of practice! A lot of your answers relating to anaesthesia are inaccurate and at times completely wrong!

[Frangipane]

Care to expand on that LikeTheFruit?

[wontletmelogin]

LikeTheFruit happy for you to please correct me where needed I'm 99.9% scrub these days and rarely dip into anaesthetics. Just answering from my experiences.

[wontletmelogin]

I recently had a saddle block (excellent) and some mask stuff but I was awake and yammering on chatting throughout my STAPLED HAEMORROIDECTOMY (I'm shouting because it's as painful as it sounds) would my wittering on distract you?

Ouch! Poor you. No definitely not. I love chatting to patients they are usually asleep so it's a welcome change. One of our consultants calls talking to the patient 'vocal anaesthetic' if it helps them then we are all for it.

Secondly. Would you be amazing in an emergency? Massive car pile up inferno scale. Would it all just click in to place?

Oh god I don't know about amazing! I spent 5 years in A+E prior to my current role so I know how to prioritise etc. I'd hope I would keep calm and get on with it until emergency services arrive.

[wontletmelogin]

What is the longest and the shortest operation you’ve been involved in?

Shortest are things like hysteroscopies (look into the uterus) that take around 10 minutes. My longest was 9 hours for a removal of bladder and creation of urostomy.

Do you get to know what happens to the patients especially longer or more serious?

I try to find out! Most of the anaesthetists will be able to find out as some also work in intensive care areas.

I’ve had some brilliant case pre and post op and would like to send.a present (equivalent to something for ward staff) next time. What do you think would be appreciated (under NHS) and how do I get it there?

Honestly it's cliche but chocolates or pastries/sweets! We very rarely get presents in the OR so aren't overrun with treats like the ward. That's very kind, thank you for thinking of them!

[Tableclothing]

In a c section, would everyone present get to see my bits? How many people would be in the room?

[Walnutwhipster]

I've had 3 seven hour ops and a few short ones. Do you need more anaesthetic when you've had lots of surgeries? I've another open operation coming up soon.

[wontletmelogin]

In a c section, would everyone present get to see my bits? How many people would be in the room?

Once you've had your spinal they will put a catheter, then you are covered with the drapes. Honestly everyone is so busy doing their prechecks that they won't be looking at your bits! Only the person putting in the catheter. They will usually swab the vagina at the end too, again everyone is busy doing checks so this is done by the surgeon or scrub nurse.

[lalafafa]

FrankencatIs it true that gingers need more anaesthetic to knock them out? proper lol

[LikeTheFruit]

@wontletmelogin great, thanks. Just some of the info on the pharmacology was a bit off regarding propofol and midazolam. And some of the technical points of anaesthesia and awareness. To be fair I wouldn't know where to start if someone asked a question about scrub and theatre instruments !

[wontletmelogin]

LikeTheFruit It's been a while since I was exclusively in anaesthetic. I dabble now and again aka when they're short but scrub and first assistant is my jam! Would love to get your views - feel free to hop on

[Difficultcustomer]

Thanks for answering about gift for theatre staff. How could I get it to theatre - could I leave it with ward staff to pass on?

Another question- I shiver when I come round, is that normal?

Can I also say a huge thank you to all the theatre staff, anaesthnetists ?spelling and porters. I usually get to see the surgeon and ward staff, cleaners for a day/when I’m awake but you lot and people like radiography are so important reassuring when I’ve had all sorts.

[rugbychick1]

Difficult customer, it is reasonably common to shivery after an anaesthetic, even if your temperature is near normal (36.9 degrees), and can be caused by the anaesthetic drugs. Like the fruit maybe able to tell you more. It does pass, and we find warning devices, like giant hairdryers help stop the shivering.

Not every single patient will have a general anaesthetic. A lot of joint replacements are done under spinal anaesthetic and a smidge of sedation (like a tiny bit of midazolam).

[Chilver]

I've had some pretty major abdominal surgery and had a horrible time in recovery and after. My experience in recovery was traumatic as I was aware but couldn't see and felt I had lots of medical staff tending me but it was brusque and painful and frenetic. I asked one of the medical staff to stop for at least tell me (couldn't see) if he was going to touch me/ inject me or adjust my tubes etc but he carried on, relentless - or at least that's how it felt. I spoke to someone in the hospital about it after and they said it couldnt have happened how I remember?

Could this be the case - was i just imagining it in my post surgical state?

Also, I was in extreme pain and 3 days later un my room (after passing out a few times when the nurses tried to get me to stand) they sent a pain specialist in and it turns out I'm 'analgesic naive' i.e. synthetic medicines dont work on me so he tried morphine instead of fentanyl and presto, blessed pain relief!!! Apparently something to do with being blonde/ red head??

Is the term analgesic naive the right phrase? I'm not sure I remember that right?

Also, when I had my unexpected csection, I was really nervous as I walked in to theatre a scrub nurse realised and told everyone to come give me a group hug!!! Very sweet and appreciated, so thanks to all the scrub nurses

[Chilver]

God, so long, sorry

[Reallybadidea]

I’ve had lots of laparoscopies for endometriosis and I’ve always assumed that the reason you have to untie your gown before you lie down is because they remove it but someone here said that’s not the case - could you confirm?

As the OP said, the only bits that are exposed are the bits that need to be accessed. But the gown is untied a) because it's difficult to pull up if the patient is lying on the back of it iyswim b) lying on the knots at the back for a long period of time could potentially cause pressure sores and c) the gown might need changing if it gets blood/antiseptic skin prep etc on and it's much easier to do this if the gown is already undone!

[wontletmelogin]

Difficultcustomer speak to PALS, they will be able to make sure it’s delivered to the correct area