I’m an ODP in Operating Theatres - AMA!

[ODPintheNHS]

Ive seen a couple of people before wonder what happens when they are under a general anaesthetic.

I’m an ODP in a DGH, so I’ll answer anything that’s not cardiothoracic or neurology (just because I’ve not seen it!)

[GinIronic]

What happens during abdominal surgery?

[GingerFigs]

No specific question but fascinating. Thanks for starting the thread.

[ODPintheNHS]

@SleepyTraveller We are careful with all patients anyway; but if someone was prone to dislocations it would be bought up at the team brief, and we would all be aware, and be careful (obviously we are always careful, but in that situation we’d be even more careful!) We operated on patient recently with an abscess in the armpit. Usually we would position the patients arm onto an arm board or behind their head to give the surgeon the best access. It just wasn’t happening with this particular patient, so in the end a scrub nurse carefully held the arm in a position that wouldn’t hurt the patient, and we draped the nurse as well to keep the sterile field sterile. Not ideal, but the operation needed doing, and there wasn’t a safe position for the patient.,

there isn’t a “one way fits all” with any surgery, we adapt to the needs of the patient to keep it safe for everyone.

[ODPintheNHS]

@GinIronic Laparoscopic or Open abdominal surgery?

[GinIronic]

Open abdominal - total hysterectomy for example.

[SleepyTraveller]

Good to know that sort of thing is taken into account - thank you!

[MargotChateau]

I’m having a c section in December (all going well 🤞). What should I expect from the procedure. I actually met with the anaesthetist today and requested a walk through of the procedure but they were too busy.

Im very nervous of the anaesthesia wearing off, or having a panic attack, can they give the patient some kind of sedative/anti anxiety medication?

[MarmiteCoriander]

Thanks for the thread. What job progression is available to you? Is there a lead ODP/manager ODP for example or some other role you could get to if you wanted? What AFC banding do you start at and could end up at?

[henryhoover3]

I had a hysterectomy two years ago. I was extremely nervous. They put the needle in the back of my hand whilst saying it was something yo calm me down. It was obviously the anaesthetic but they did not tell me what it was. Is this normal

[Crumpleton]

Where can I buy some of the stuff they knock you out with please 😜...
Best sleep I've ever had.

[Babdoc]

OP, your comment that anaesthetists have to have a trained assistant with them is a relatively modern development.
It made me smile, as for the first ten years of my career as an anaesthetist, the theatre porters were my only “assistants”!
I used to draw a felt pen mark on the patient’s neck to mark the cricoid, and tell them when to press, for rapid sequence intubations.
In those days there was no bureaucracy and far fewer checklists, so we got through over 20 patients in an 8 hour theatre session.

[5zeds]

I had an epidural when I gave birth in theatre (twins). I’m between babies I had a very odd moment (faint/seizure?) and when they moved me afterwards they the anaesthetist checked the epidural and said “well that explains a lot”. What did it explain and what was wrong with it? It was a terrifyingly busy time afterwards and I had flashes of headaches that were very difficult but they didn’t really understand or have time to help so I was discharged a few days later. It was a long time ago but I’ve always wondered what he meant.

[FairyBatman]

This is a little embarrassing but the last two times I’ve had a GA, as soon as they’ve started the drip I start crying. I don’t feel sad or emotional it’s more like a physiological response, have you seen this and do you know what causes it.

Also and equally embarrassing, during the last op, which was quite long, it’s was 4pm in the anaesthetic room and 7:15 the first time I remember being in recovery I peed (apparently twice) which I didn’t think was possible under anaesthesia?

[Penguintears]

I had surgery recently and had two complications which I'd be grateful for your thoughts on.

The main is that when they put the drugs in through the canula it was excruciatingly painful through to the inside of my wrist. I've had loads odf surgeries before and never had this happen. It felt like they had pushed the liquid through too quickly for my veins to cope. After the surgery I had phlebitis on the back of the canula hand, wrist and arm up to my elbow. The veins are still lumpy, hard and bruised. I have shown it to the surgeon, a nurse and my GP and they all seem really surprised like they had never seen it happen before and just said it should away and its nothing to worry about. But it's been 8 or 9 weeks now.

The other thing is that when I woke up from surgery one side of my tongue was covered in blisters and really sore. I then got thrush in the same place. I assume this is something to do with how the breathing tube was placed? The anaesthetist was a very large man and I'm wondering if somehow his large fingers didn't have the dexterity to put it in carefully?

[ODPintheNHS]

the questions are coming in quicker than I can type 🤣 I’ll get to them all, bare with me!

@MarmiteCoriander We start on band 5 AFC. There is a lot of progression into band 6, and then there are a few band 7s within the department. There are also band 7 ODPs within the resuscitation team (that oversee resus around the whole hospital) and we’ve also got ODPs that are surgical first assistants, some within A&E, and also on the ITU Outreach team.

@Crumpleton that would be propafol…. or as Michael Jackson called it “his milk”

[MissMarplesNiece]

Propafol is good stuff (lol), worth having a GA for (lol again). I assume that because anyone under GA is given paralysing drugs , they can't talk and give away secrets while on the operating table.

[GinIronic]

Has the OP lost interest?

[InTheShadeOfTheFigTree]

Waves to OP. I was an ODP too - before they actually called them that, and before the career structure was standardised Great job isn't it, no 2 days were ever the same, and loved being at the cutting edge of so many medical advances (big teaching hospital).

[marblemad]

Bit tmi but I had a m/c and as a result a d&c, ever since my hip has hurt and I've been on pain killers (3 years now) why might this be and should I raise it with my GP?

[InTheShadeOfTheFigTree]

@Babdoc

OP, your comment that anaesthetists have to have a trained assistant with them is a relatively modern development.
It made me smile, as for the first ten years of my career as an anaesthetist, the theatre porters were my only “assistants”!
I used to draw a felt pen mark on the patient’s neck to mark the cricoid, and tell them when to press, for rapid sequence intubations.
In those days there was no bureaucracy and far fewer checklists, so we got through over 20 patients in an 8 hour theatre session.

Sometimes wonder if we ever worked together babdoc There were a few 'anaesthetic assistants' who were porters who'd developed their skills when I started my training.

[Name99]

Is the milky white stuff that's put in the cannula the anaesthetic?
I recently had surgery and couldn't remember when the anaesthetic was actually given.

[RaininginDarling]

Thanks for the thread OP! I'd like to know more about open abdominal surgery too. This time last year, I had emergency surgery to remove a massive growth on an ovary. The surgeon told me they might need to open me up completely (they didnt) but had to get under my stomach to remove it. It was crushing my bowel and other vitals.(I came out a stone and a half lighter! It took a very long time to recover including acid reflux for 6 mths after. What happens in an operation like that? Is it common? Also: would the lovely, kind woman who held my hand as I went under doing the same role as you, do you think? I was so scared but so, so grateful for her kindness.

[MarshaBradyo]

Because I’ve just started watching something called Bodies and near mistake made me gasp

What is the most realistic medical film / series you’ve seen?

[Carpetfluffy]

@Name99 that's propofol the anaesthetic

[Carpetfluffy]

@RaininginDarling I'm an odp too and yes the lady holding your hand would have been one.

In your surgery (sounds like it was intense! I hope you're recovering well) the surgeon will make 3/4 small incisions in your tummy, fill it with carbon dioxide to give them space to work and then inset ports eo the equipment isn't just Sitting on the skin directly. One of the ports will have a camera on the end of flexible cable essentially inserted and controlled by the surgeons assistants the surgeon will have 2 tools in 2 ports one for grasping and one for cutting or burning away the tissue. It can take hours because of how fiddly it is, especially if the patient has had previous surgery and had scar tissue.

The surgeon is watching what his instruments are doing it on a tv screen and there are usually 2/3 in my theatres so the surgeons and theatre staff can anticipate any issues. In my trust we also have a special laparoscopic light in the theatre that turns off the main lights and turns them a bright blue so the tv picture is more enhanced.

In some hospitals (like mine) we'll have a robot doing the actual cutting and the surgeon is sat in the corner of the room at a console, no where near the patient controlling the robot. Surgeons like this because it gives 360 degree dexterity.

Then when the specimen is ready to be removed they'll make a small incision to get it out i(usually in a bag) and then the scrub nurse will hand it to the circulating practitioner and they will put it in a pot/ bucket depending on size, and it will go to the lab to be looked at by pathology.

We'll put local anaesthetic into the skin so you have less pain, stitch up the incisions, and put dressings on. Usually a new gown because of a bit of blood and then we'll transfer you with the anaesthetist to recovery and then hand you over to the recovery team

Laparoscopic surgery has better outcomes and enhanced recovery for patients so it's preferred to open surgery but we have every single piece of equipment the surgeon would need to go to open, and we can convert to open in 5 mins

During the whole process we're counting equipment constantly, counting swabs and stitches and keeping track of everything in the room.