I work in the Operating Theatre. AMA

[1AnotherOne]

I’m an Operating Department Practitioner working in the private sector.

I work the majority the time in a senior speciality role as a scrub practitioner or surgical first assistant.

Sometimes I work alongside the anaesthetist.

ask me anything!

You won’t have to ask. It will all be part of your pre op/fit for surgery appts.

Are all patients intubated? Or can they be kept under using injections?

When I was having my knee done recently by epidural and light sedation I came round twice when the surgeon was hammering my knee into place. Actually the first time it was hammering that woke me up and the second time it sounded more like a chisel was being used on me. I could see through a haze and before I knew it I as sleeping again. Afterwards I thought I’d been dreaming and said to the surgeon, “ did you use a hammer on me at any stage” and he replied, “ah, you woke up”. It wasn’t scary at all and I felt no pain whatsoever.

Do you ever feel grossed out at the blood and guts or is it all perfectly normal to you?

What would cause a blood spurt that landed on my face during a caesarean? Was it serious?
I heard them saying before I had it done that it was the 4th in a row with no break and it was early hours of the morning.
Could it have caused the chronic nerve pain I’ve had in that area?

I have a resting heart rate of 38 would it be dangerous for me to have a GA? The local hospital were reluctant to give me one for a non urgent foot operation a year or so ago.

@BenCoopersSupportWren Yes! I do have EDS. Would that really cause anaesthetic to not work as well? Wow EDS really is the gift that keeps giving!

How much do you get paid ?. I’m a grade 8 in ICU in central London and it would be interest to compare remuneration.

🤣🤣🤣 loved this!

Have you ever been involved in an op removing a weird object? Sometimes like a cucumber up they're bum?🤣🤣🤣

Sorry to be so crude but can people fart when under? 😂
With my first surgery, I was so nervous beforehand that I was really windy and I've always wondered if I was on the operating table, blowing them all away 😅🤣🙈

This is fascinating and so helpful!

I am diue to have a hysterectomy on Sunday and a private practice due to them picking up nhs waiting lists. Northern town if there's any chance you work in the North!

I haven't had surgery since I was about 8, and while I'm fine about having the hysterectomy, as you can see from me posting at 3.30am the thought of going into theatre and having surgery is starting to panic me!

Can I ask a couple of questions?

1. I've been told it will be an abdominal hysterectomy - will there be any chance someone could change their mind and perform a vaginally one? A colleague had a terrible time with this and I terrified it won't be done abdominally.

2. Since I haven't been for surgery for 35 years 😂 what generally will happen, will I go to sleep in the theatre or be knocked out before I am taken in?

I think I'm starting to panic and I don't know why!

Thanks op, this is a great thread!

Thanks for the thread OP. I have some questions.

1. my hearing is always super sensitive after a GA, straight afterwards, and then tapering off over a few days. I cannot bear noise of any sort and it seems really amplified. Is this common?
2. when I had my mastectomy they discovered more affected lymph nodes than the pre op scans had shown. The surgeon said my surgery was therefore much longer than planned because he'd sent the affected nodes down to the laboratory to see if they were cancerous before deciding whether to do a full node clearance. That took a couple of hours apparently. What would have happened to me during those two hours? Would I have stayed in the operating room with a tube in my throat and unconscious? Would the surgeon have gone to another OR to do someone else's mastectomy so he didn't have the twiddle his thumbs? And someone else like the anaesthetist looked after me? Or would the breast surgeon have to stay in the room with me?

I too wondered if you had EDS when reading your description of it!
I can’t remember the why/the mechanism, but ‘anaesthetic resistance’ is definitely a thing with Ehler-Danloss. Well known for patients to need more local anaesthetic at the dentist and for it to wear off faster.

it really is a gift isn’t it? 🤨 Fellow EDS-er here..

Not unless it’s a super long case. I’ve only ever broke for lunch with the team during one case. We keep the field sterile and obviously people stay with the patient.

Hey OP. is it possible to request no students during operations in teaching hospitals? And would that be listened to?

I was raped while semi conscious and had some other bad things happen and cannot cope with the idea of being touched when I'm not awake. I had appendicitis and needed the surgery but went into full flight mode and tried to escape the hospital. For my next operation I was given a sedative to take before arriving and then once there they had to sedate me more strongly and two nurses got me into the gown. It's like I had a personality transplant through the fear of being touched and refused to get the gown in (surgeon knew what had happened before so think they were prepared). So if I requested no students, would I really be listened to? Btw the other two ops were abroad so system maybe different - in case it sounds strange.

Asking this in separate post so not too long.

Is it possible to have local anaesthetic (or anything that's not GA) for most operations? I love human biology and am not bothered by blood and guts, especially my own. In fact I'd be curious to see what was happening during surgery if there was a screen. I know not everybody is like that, but there we go.

So is there a possibility of not having GA for operations and being awake, albeit immobile and with full analgesia? Or is it simply not possible for many types of surgery?

The propofol stings going up the arm, that’s normal (different Ph). It’s a bit sore, but it’s not there when you wake up. In a normal environment, it would feel a tad uncomfortable, but because you’re already nervous and starved/dehydrated, you’re in a cold room and you’re about to have surgery, your poor veins already shrunk a bit, it’ll sting a bit. It won’t last long.
Fentanyl shouldn’t sting, but again, if your circulation was poor at that moment, cold hands etc, I would say what you feel is your vein being dilated. It happens, it’s normal.
Hope you’re making a good recovery:)

Agitation is usually a thing in recovery, can be common with teens from what I’ve seen. It wouldn’t be during the actual op. The anaesthetist would’ve been there in recovery to witness this.

Some patients wake up very fast and can be quite mobile. We have cot sides on our trolleys to prevent rolling off but some patients try to CLIMB off. It takes a team to reason with them.

Cancer work is hard. Accidentally finding cancer when the patient came for something else is harder.

Speak to the pre admission team

Plastic surgery, ENT, dental, gynae, urology, general mostly

Not for everything but certainly peripheral surgery and below the waist and anything superficial

I had TIVA recently because I"m always sick after a GA - I think I was sicker after the TIVA than after any others ! :( :(. Are there any other options or are some people just always going to be sick - what is it that makes you nauseous and sick?

This is a fascinating thread, thank you !

Another question for you if that's ok - during a surgery if there's a bleed that can't be got under control, and the surgeons have tried and tried, it's being mopped up, fluids (presumably?) being put into the patient, what happens? Do you just stop putting fluids in and trying to stop it and the patient just bleeds to death whilst on the table? That must be an awful decision to have to make.