Friday, September 16, 2016

A Picture Story

Pictures really are worth a thousand words. This story is circa 1967 and from the golden days of big open surgeries to remove a tiny piece of pathology.  Just about every case on the schedule was for an -ectomy or removal of something. We used to carefully time the incision to  specimen in the bucket interval and the surgeons used to treasure the bragging rights of being the quickest.  It was very crude compared to the repair and replace laproscopic culture of today.

My favorite photo is #6 with that gamine looking  circulating nurse eyeballing the scrub nurse. I used to get that look from my favorite supervisor, Alice, all the time. I was always tempted to "accidently" toss a loaded, used, sponge ring forceps in her direction. "OOPS.. so sorry about that Alice.

The cloth gowns and drapes, compete lack of eye protection, glass IV bottles, and huge soda lime canister on the anesthesia machine all look very familiar to an OldfoolRN.

6 comments:

  1. In the UK they don't actually wear masks anymore like they do in the US. If you watch any A&E shows (accident and emergency, our ER or ED equivalent) where they go into surgery, no face masks. Some wear it, but most don't. Go to YouTube and look up something like 24 Hours in A&E, it's a decent show and you can spot the differences easily.

    ReplyDelete
  2. I think there have been studies here that question the effectiveness of masks in filtering out microorganisms, but they do work to prevent nasal fallout consisting of hairs and dried mucous. Some people also produce aerosolized saliva when they talk and at least masks can put a halt to this. The aspect of masks that I treasured was the attenuation of inhaled Bovie smoke for the wearer. Along with terrazzo floors and green ceramic tiled walls, masks are a part of operating room history and tradition. When I had surgery it was nice to see all those masked faces as it conveyed a message of caring.

    I have also viewed various veterinary surgeries on TV. They often forgo the mask, but could certainly use a good scrub nurse. Seeing their surgical instruments cast aside without any order made me nuts. I wanted to jump in there and line up the hemostats and load needle holders. Thanks so much for your comment.

    ReplyDelete
    Replies
    1. Veterinary surgery is like the frontier compared to human surgery sometimes! Your average vet doesn't wear a mask probably because they can't get anything from the animal they are operating on. Your average vet surgery room is a heckuva lot less sterile than a human surgery room. Only in large practices or surgical specialists do you have anything like human surgery. I was a vet tech, and a couple places I worked (that is, all of them) don't even have doors separating the surgery room from anything else. You keep a sterile field around where you're operating and that's as good as it gets. Most of the vets I worked with, when they tossed down the instruments, they were done with them, no need for order.

      I had spoken with a surgeon about the mask thing and he said there has never been a single reported complication in surgery from hair falling or dried skin landing in an incision. He said the mask's function is really to prevent the people wearing them from contamination, it's a barrier for blood or other stuff that might shoot out of a human body. It also helps if the person wearing it has a cold or something infectious. I had been so surprised to not see them wearing masks during surgery in the UK I had to ask about it and that's the answer I was given.

      Delete
    2. Veterinary surgery is like the frontier compared to human surgery sometimes! Your average vet doesn't wear a mask probably because they can't get anything from the animal they are operating on. Your average vet surgery room is a heckuva lot less sterile than a human surgery room. Only in large practices or surgical specialists do you have anything like human surgery. I was a vet tech, and a couple places I worked (that is, all of them) don't even have doors separating the surgery room from anything else. You keep a sterile field around where you're operating and that's as good as it gets. Most of the vets I worked with, when they tossed down the instruments, they were done with them, no need for order.

      I had spoken with a surgeon about the mask thing and he said there has never been a single reported complication in surgery from hair falling or dried skin landing in an incision. He said the mask's function is really to prevent the people wearing them from contamination, it's a barrier for blood or other stuff that might shoot out of a human body. It also helps if the person wearing it has a cold or something infectious. I had been so surprised to not see them wearing masks during surgery in the UK I had to ask about it and that's the answer I was given.

      Delete
    3. Thanks for the interesting information, moontoad. I watched one veterinary surgery on a turtle with impacted eggs. I was really surprised when they incised a rectangular piece of turtle shell to access the eggs. In human surgery you never see that because there is uneven pressure at the corners of a square. Craniotomies and such are always done via a round or oval opening into the skull. You have spurred my interest in vet surgery and I think I'ii try to learn more about it.

      Delete
    4. Turtle shells are incredibly hard. You can run over many of them with a car and they are just fine. You can't do that with a human head.

      https://www.youtube.com/watch?v=2TaouvmS19M

      Another eggbound turtle. They used a Stryker saw? in a square on the bottom shell (doesn't make sense to go through the top for this). That shell was really thick and that's just a red eared slider.

      As thick as turtle/tortoise shells are, they are sensitive! Many chelonians (turtle, tortoise) enjoy a butt scratch with toothbrushes. https://www.youtube.com/watch?v=cJdJyn75VxU

      Delete