36 hours in the life of the anesthetist

Hello everybody! I want to talk a little bit about his profession. I Anaesthetist. "Who is it?" - You ask?
Anesthesiologists - people about whom most Russians had never heard. And if you have heard, is not seen. And if they have seen, necessarily with someone confused. This Creo about people is always in the shade. © Oleg Malskyy - Three weeks of life molded (with minor changes)
Job Anaesthetist Doctor is a hobby for adventurers, and like any hobby income brings. This is one of the commandments of Anesthesiologists, which I will continue to lead to a description of the photo. So, what is (for many patients) remains behind the scenes ...
Will ph 25, the end of the compilation tell apart

A day in the life of the common severe surgeon can be read here



After coming to work, changing clothes, the traditional morning cup of coffee, I go to the operating unit, which held eight hours of his life. The clock above the door now as ten years have stopped the run. True time 08:20 am



These patients enter on gurneys, nurses led by strong hands. Immediately close to the sanitary inspection I put on a beautiful blue hat, a mask, and go into his operating room.



General view of the operating unit. There are seven operating rooms on the other floors at the hospital 8. In another day in our hospital held 40 - 60 surgical procedures involving anesthesia service.



It's my operational. Client is still driven long corridors. I prepare the equipment to work. Today will be a relatively large operation - coronary-artery bypass grafting bifemoralnoe. Open heart surgery, we have not carried out because of the banal to Russia - there is no money for the purchase of cardiopulmonary bypass. Hands there, the desire is there, experts have ... But the hardware is not present. Surgeons will arrive just an hour.



First of all, I check the performance of my anesthesia machine - Drager Primus. Self-test runs fully automatically. If there is a critical fault - the device will not operate. Flow sensors are faulty for two years, and buy their hospital can not (guess for whatever reason). Customer service unit had not seen for five years. I bow to the Germans for their wonderful neubivaemaya equipment! Here by the way, is visible piece of this device.



The customer is already operating. I spend installing an epidural catheter for pain relief both during surgery and in the postoperative period in the intensive care unit.



The back of the stone, thick needle. Barely I pass a bunch of yellow and falling into the epidural space. It remains to have a catheter to hold aspiration test, an injection of local anesthetic and can begin operation. Operation starts under epidural anesthesia, it is not anesthetized, but the patient did not hurt.



At 09:45 am local time, the operation is already under way, although the patient is only dormant after injection of 5 mg dormicum. The body is already crammed: two intravenous catheter, one arterial, epidural, urinary. Gentleman set



It's time to go to a general balanced anesthesia (anesthesia). Anesthesia is largely not a science but an art. And, like all art, it is understandable and interesting only to know His subtlety. Nurse anesthetist introduces drugs for induction of anesthesia, I'm getting ready for mask ventilation, intubation and then.



Intubated patient. We say - do not let pride seize you - intubated again intubated two intubated once more and call the authorities, there are no bosses - call the Almighty! At this time there the first time. The tube is in place, the operation is going on.



General view of the operating "on the other side of the surgeons»



These small devices are called syringe pumps (perfusors). They allow me to accurately dose rate of administration, for example in this case dopamine introduced at a rate of 6 ml per hour naropin 5 ml per hour. You can set the value, for example 3.6 ml / h per hour and the machine enters exactly 3.6 ml of solution. Perfusors streaked yodonata in which surgeons generously share with patients, staff, and with all my equipment.



The operation comes to an end - the surgeons sew up the skin. Anesthesia is over, but, as they say, quickly, after graduating from anesthesia you still have to maybe spend a patient in the last journey.
The patient is awake and breathing oxygen. He did not hurt - works (as well as at the beginning of the operation) epidural analgesia. The patient went to sleep without pain, woke up without pain and unpleasant memories. He's already in the mind talking, but his stay in the operating room at the end of surgery, he will not remember.



The clock 15:20. Client on a gurney, equipment turned off, the end of the work in the operating room. The patient, accompanied by my surgeon and transported to the intensive care ward.
That you think that my work day came to an end? No ... I have yet to watch in the ICU.



Entrance to the department of anesthesiology and intensive care. Here we live



Our recent client lies on a bed and sleep. Periodically tries to pull out of his body all sorts of catheters and drains, so hands are tied, that did not play. After two hours of absolutely adequate guy I am surprised that he could do it all ...



And this is just beginning an intensive care unit. The department is central air conditioning, which constantly maintains the same temperature and humidity all year round.



General view of the department. Very annoying the wide-open doors in all directions. In normal resuscitation them or not, or they leave in the side. In total we have 6 chambers for 12 seats. At the time of writing, the creative on treatment were 8 people.



My work place. Right central station, which collects data from all monitors. On the wall is stuck on brain implants, there is a huge folder, and e-library, collected more than 150 books on anesthesiology and resuscitation. Well, my personal laptop, which I write in between appointments and try to finish the thesis.



The room doctor on duty. Here we rest, if possible



And this is the balcony where you can smoke a cigarette ... and look at the will



General view of the intensive care unit. Patients do not see



One of the chambers. And look, our customers, who are on mechanical ventilation. On the left is the ventilator (one of the most advanced), on top of the monitor, and hung anywhere perfusors.



Another Chamber. On the left is the patient after two clinical deaths and rendered nevovremya resuscitation (just kidding). As they say on the skillful massage is excited even a dead man!



And another. All the show does not make sense, yet many more



In the morning I'll go to five-minute duration of 25 minutes, which reports all duty shift. Then I drink some coffee, a cigarette break and go ... Home ?! No, back in the operating room, but then home.

36 hours of my life on the run is not soon ...

That's all I wanted to say. Thank you for having inspected



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