pre-operation brief

[901]

Has anyone on the other side had a review discussion with the surgeon just before the anesthesiologist (sp?) puts you down? I recently attended a presentation by a by-pass patient where he described in vivid detail what goes on in the room the morning of surgery. He was given a "pile" of forms to sign that were for the patient across the hall!
In my line of work, we emphasize "pre-job briefs". This is a verbal walk through of the work that will be performed to try to make sure everyone is "on the same page" and identify the most error likely steps. Mistakes, where I work, can be very expensive and even fatal.
Does anyone discuss/"walk through" with the surgeon what the surgeon is planning to do just before he "does it"?

 

[Big-Chuck]

pre-surgery

pre-surgery

well my surgeon called me on my cell phone the day before surgery and answered all the questions that i had for him. and he kept his word on every last thing too.

 

[Phyllis]

Dick was at the hospital, two days before surgery for pre-op and that's when all was explained and all the paper work taken care of. The second day he had catherization and the male nurse who took care of him afterwards, went through the whole procedure for surgery the next day and recovery afterwards. The only thing he signed just before surgery was a release form and he was almost "out" before he even made it into the surgical suite.

 

[hensylee]

uh, no - wow, I never thought about them making sure I am me. I was checked in at the desk, signed all the forms, they put on the bracelet, got taken to the right floor, they did check my check-in bracelet to make sure who I was, tho. The nurses gave me a briefing. The anesthesiologist came in. There were a lot of other people in that room, but I don't know who they were. They got it right.

 

[Mary]

Has anyone on the other side had a review discussion with the surgeon just before the anesthesiologist (sp?) puts you down? I recently attended a presentation by a by-pass patient where he described in vivid detail what goes on in the room the morning of surgery. He was given a "pile" of forms to sign that were for the patient across the hall!
In my line of work, we emphasize "pre-job briefs". This is a verbal walk through of the work that will be performed to try to make sure everyone is "on the same page" and identify the most error likely steps. Mistakes, where I work, can be very expensive and even fatal.
Does anyone discuss/"walk through" with the surgeon what the surgeon is planning to do just before he "does it"?

You'll probably be lucky if you see your surgeon the morning that you're scheduled. I talked to mine the night before, after my heart cath, just to review the findings. We discussed my wanting a tissue valve and he reiterated that I would face another surgery somewhere down the road.

He was probably with me five minutes tops.

I wouldn't worry about a "pre-job" brief. And by the way, I only had to sign one very short document the morning of surgery.

 

[bvdr]

I was admitted ahead of time for heparin and my surgeon spent quite a bit of time with me the day before surgery. In retrospect I think I would have preferred another visit in his office to discuss some other issues in my heart but I don't know if it would have changed the course of action any. I did not know that he was planning a heartport access before I was in the hospital. He did tell me that if he found my aortic valve also need replacement, or that if I needed a couple of bypasses, he would also have to open my sternum. I ended up with only the mitral valve replaced and the other issues are still in the watch and wait areas.

I hope you get all your questions answered ahead of time but remember that some of the decisions may have to be made when you are on the table already opened up.

 

[Debbrn]

Dear Doug,

I think that you brought up an excellent point!!! I am a nurse. Where I work, an OR staff person checks the patients arm band, and consent form before the patient is taken to the OR. I am not sure what gets done in the actual OR room. When we do a procedure outside the OR the doctor and nurse are required to fill out a form immediately before the procedure with the name of the patient, procedure and indicated side if applicable, consent is the same as the planned procedure and sign that we checked the arm band.

Hospitals are putting in more checks to ensure the right patient gets the right procedure on the right side of the body.

Debbie

 

[Natanni]

Brief

Brief

As far as what happens after you leave the holding area, I can offer what we do; I assist the docs in the OR, and in our facility, we have a "time out". At the time the surgeon enters the room, and the patient is prepped and draped but before the incision is made, the circulation nurse calls for the time out, and everyone in the OR stops what they are doing and we do a confirmation, "This is Mrs Smith and we are doing a right hernia repair...." and all participants must agree and the surgery can proceed.

 

[hunniheart]

The day before my surgery, I had an angiogram to make sure all my blood vessels were okay and that there would be no surprises (like needing a bypass) during surgery (aortic valve replacement). My cardiac surgeon later spent a good 20-30 minutes with me the evening before surgery, discussing the pros and cons of the different valve choices. Then the next morning, before the actual surgery, he met with me again to review and make sure what I wanted (I chose the tissue valve). Then I was brought down to holding, where they checked my arm band and I waited. I was then brought into the OR. I remember the anesthesiologist asking if I had any questions, and I said, "yeah, when do I get the valium," and he laughed and started the IV. I was out in seconds and then woke up in ICU. I am assuming and hoping that they checked my armband again in the OR.

 

[Jamboesque]

I was scheduled for the Monday morning 0800 slot.

Not long after admission 11:00 on Sunday, I got my chest (and selective other bits) shaved, guys they always seem to forget to tell you ‘bout that.
I got shaved by an older nursing assistant who, although you wouldn’t argue with was great fun she just loved giving us guys a bit off added grief. Don’t worry it mostly all grows back ……. in time.

Can’t remember if I was allowed something for my evening meal, but I wasn’t awfully hungry, wonder why?

I was visited by the assistant Cardio Surgeon and Anaesthetic chappie who explained the why’s and wherefore’s and to get me to sign my release form so that they could do all the messy business needed to put me back together.

In the evening my partner and I (by this time I was wearing a very fashionable greeny/blue gown thing that ensured if I ran away they would spot me pretty quick, and return me under guard) was shown the ICU where I would wake up, personally I didn’t find it too off-putting, seen most of that stuff on TV.
The strange thing was, when I woke from the anaesthetic I immediately knew exactly which bed I was in.

Come night time, I was given something to aid sleep, didn’t work though.
(Interesting Note here. It was/is policy that the NHS (UK’s National Health Service) will provide whisky as aid to relaxation, of which I made full use, even to the point of bringing in my own single malt. It is only heart patients that get this special medication.)

Got woken at 6:00 at told it was a good idea to use the toilet and have a shower and shave. After all you will be ‘out’ for a minimum of 24hrs, and your next shower is going to be something else!

This is what happened to me the day before, your experience will be different I would reckon.

 

[901]

I was scheduled for the Monday morning 0800 slot.

Not long after admission 11:00 on Sunday, I got my chest (and selective other bits) shaved, guys they always seem to forget to tell you ?bout that.
I got shaved by an older nursing assistant who, although you wouldn?t argue with was great fun she just loved giving us guys a bit off added grief. Don?t worry it mostly all grows back ??. in time.

Can?t remember if I was allowed something for my evening meal, but I wasn?t awfully hungry, wonder why?

I was visited by the assistant Cardio Surgeon and Anaesthetic chappie who explained the why?s and wherefore?s and to get me to sign my release form so that they could do all the messy business needed to put me back together.

In the evening my partner and I (by this time I was wearing a very fashionable greeny/blue gown thing that ensured if I ran away they would spot me pretty quick, and return me under guard) was shown the ICU where I would wake up, personally I didn?t find it too off-putting, seen most of that stuff on TV.
The strange thing was, when I woke from the anaesthetic I immediately knew exactly which bed I was in.

Come night time, I was given something to aid sleep, didn?t work though.
(Interesting Note here. It was/is policy that the NHS (UK?s National Health Service) will provide whisky as aid to relaxation, of which I made full use, even to the point of bringing in my own single malt. It is only heart patients that get this special medication.)

Got woken at 6:00 at told it was a good idea to use the toilet and have a shower and shave. After all you will be ?out? for a minimum of 24hrs, and your next shower is going to be something else!

This is what happened to me the day before, your experience will be different I would reckon.

Actually, as it turned out there wasn't much briefing. I remember the surgeon coming in and saying hello and talking a little bit to the anesthelogosit. He told me he would be handling all the anesthisa and then I remember waking up with the tube still in and my throat on fire and getting real frustrated because I couldn't "tell" anyone that I wanted some ice in my throat. I think they thought I was thrashinng around in an anesthia stupor. Also' at least one arm and one leg were secured to the bed. So, I was left with trying to make one-handed hand signals for ice.
I remember being confused because the surgeon had told me that the work would last till about noon but when I was trying to get ice it was somewhere around 2030-2130. Where did the time go? I found out later that they had "some problems" securing all the sutures.
Glad to be home and rappelling down the other side