User talk:Cmineovb3

Chris Mineo B2

“Start counting backwards from ten” I said as I placed the breathing mask over my patient’s mouth and nose. “10…9…8.........” The patient said as he slipped into unconsciousness. “He’s out, doctors,” I announced to the surgeons. “Begin the surgery.” The patient was undergoing many surgeries and needed to be without pain and without consciousness and that is where I come in. I usually administer medication for surgery patients about twice a week. That day the operating room was quite crowded because of the risk of the patient waking up during the surgery, and because of the amount of people who wanted to observe such a complicated procedure. It was a simple room though a metal table with a surgery lights overhead, and a metal stand adjacent to the table with the saws, knives, and other utensils the doctor needed. Observers were seated or standing in rooms with windows that overlooked the operating room. The patient on the table was in a pernicious car accident and needed a lot of work done including surgery on his heart. Because the surgery was being performed on his heart I administered a general anesthetic in an exiguous dose so as not to suppress the heart, which gave way for the more likely possibility of him waking up. His unstable condition from the accident also contributed the chances of him waking up. “Doctor Wood!” called the attending surgeon “Yes Doctor Wilson?” I yell back. “The patient is starting to react to pain.” “Let me check his IV.” I say walking over to the bag hung on the metal pole with a tube leading to a needle inserted into one of the patient’s veins. “I can’t use too much more but I can push a little more of the general anesthetic.” I say as I opened the valve to allow more of the drip to be delivered to the patient. “That’s all the more he can have to do this successfully.” “It seems to be working.” Said the attending getting back to the surgery. The surgery was finished without any further problem. The patient was a nineteen year old who was texting while driving; he ran a red light and was hit by a semi and a hummer causing a hug pile-up. He suffered many injuries both internal and external. After this patients surgery I was the one in charge of his medications for his recovery. Since he was out of surgery I cold give him the plethora of admixtures for post-op pain. I also had to monitor his vital signs until the patient woke up. The day after the surgery I had a few high school kids come in to shadow me and see what my job was like. Well they got a good scare in them over a common occurrence. I was showing them how to monitor a post-op surgery patient, and I administered the patient with his medication to assuage any pain he would be having. Well a minute or so after I gave him the medications one of the girls let out a yell of terror that sounded like it reverberated throughout the entire hospital. I quickly turned to see all the students staring at the patient’s oxygen sats, which read zero and were flat lined. The girl who yelled said in complete shock “he… he’s dead!” I replied somewhat humorously. “Give it a second,” and after a good five or ten seconds everything was back to normal. “Sometimes the medication given will make a patient so comfortable that he will forget to breathe.” “Does that happen a lot,” the one boy who was trying to act like he was in no way scared asked. I responded with “just on occasion but it isn’t rare.” The day after I was in my patients going through the routines of checking to make sure the patient made it through the night. I had finished all I needed to do and was about to get a nurse to give the patient his meds when I heard a muffled voice come from behind me. “Wha… What happened?” he asked This was the first response of consciousness I had seen from him since just before surgery. “You were in a horrible car accident, and you had to go through surgery. You’ve been out for a couple days now.” I said as I checked his blood pressure and pulse. “Do you remember anything?” I asked He responded somewhat dazed nauseas “No I remember stuff before the accident, and being in some room breathing in some stuff, but that’s it.” “Then I did my job correctly.” I said rather proud. I had done my job, and was done with the patient. I had to go to a seminar the next week to talk to other anesthesiologists about the changes and how far the field has come. I prepared for hors for it and I was the lucky one who got to head up the seminar. The other doctors would ask me any questions they had about how the field got started. I started the conference off by introducing to those who weren’t so experienced in the field explaining the three types of anesthetics. “The main classifications of anesthetics are: general, regional, and local, and all of them bring about a different state of anesthesia.” I said as I scanned the crowd seeing both doctors with jaded looks because they were hearing this same thing that they have practiced for years, and I also saw people already confounded at what I was saying. It was easy to spot those who were new to the field. “Starting with the general anesthetics, general anesthetics bring about complete loss of pain and consciousness. Regional is the next class. Regional eliminates any and all pain and feeling, but only partial loss of awareness. Local anesthetic is similar to regional because it also eliminates all pain, but only partial elimination of awareness. There are six classifications of regional anesthetics: topical, local and field blocks, intravenous (IV), neural blocks, spinal, and intercostal.” As I said this I saw a student eagerly raise his hand, surprised and not knowing what to say I simply just pointed at the young man who stood up and started asking a question. “I’m sorry to interrupt, but why would you want to only eliminate partial awareness? Why would you want a patient to be aware during a surgery?” he said “That is a very good question actually,” I said to the young man. “The main reason is so that we can tell if a patient starts to feel pain.” Well I think we have made some major progress, but let’s take a little break and when we return I will answer some more questions.” After the short break people got back into their seats to return to the lecture. “Anyone have any questions for me?” I asked. One man stood up and asked, “Are there different ways of taking anesthetics?” This question had a relatively simple answer; however I did not want to make the man feel simple-minded so I took an extra few seconds to ponder the question. “Well yes there are a couple different methods of taking anesthetics, and what you need to know is that there are six classifications of regional anesthetics: topical, local and field blocks, intravenous (IV), neural blocks, spinal, and intercostal, all of which involve different administer techniques which include inhalation, injection, and some are sprayed or dropped on directly to skin. Next question.” “When were the first uses of three different anesthetics?” A woman asked. “Well the first legitimate use of successful general anesthetic was in 1864 by William T.G. Morton who used ether on a twenty year old who was getting neck surgery. The first regional and local was cocaine by Albert Niemann and Carl Koller in 1884. Another anesthetic is Nitrous Oxide which was discovered by Joseph Priestly in 1772. I will take one or two more questions,” I said when I realized how much time I had taken. “Yes, Doctor Wood are there side effects to anesthetics?” I heard from a congenial elderly man in the back. “There are, and the most common side-effect is nausea and vomiting which occurs in about thirty percent of patients, but although uncommon heart attacks, strokes, brain damage, and death are also possibilities. Also a rare occurrence is a patient waking up during surgery. Like I said it is very rare but it is more common during pregnancies, so as not to harm the baby, in heart surgeries, because too much anesthetic can suppress the heart and patients who have lost a lot of blood and have trauma. These are all the questions I am going to take today I hope I have give you some good information thank you all for listenening to my rant.” I got a few chuckles and some scattered applause, but I was done.