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by bookofjoe
2012 days ago
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Back when I was still practicing as an anesthesiologist (1977-2015) I had a pack of 3x5 cards I carried in my scrubs pocket on each of which was an exhaustively detailed list I'd made of EVERYTHING I needed at hand to perform specialized procedures such as inserting an arterial line (putting a #20g plastic catheter through the skin on the inside of the wrist into the radial artery for direct beat-to-beat monitoring of arterial blood pressure, a measurement employed for seriously ill or unstable patients). I would assemble a tray with the following items in the OR before going to ICUs or the ER because invariably one or more of the items I would need would not be present and would take time to procure. For example: ARTERIAL LINE • several sterile alcohol skin wipes
• 3cc syringe with 25g needle [for skin infiltration of local
anesthetic at puncture site]
• bottle of 2% lidocaine with epinephrine 1/1000
• 2x2 cotton gauze pads to use for pressure on failed
puncture sites
• 3 #20 gauge plastic catheters (22 gauge for small children)
• 2 surgical towels to drape over hand and lower arm to
absorb blood that accompanied successful arterial puncture
• size 7.5 sterile surgical gloves for me to wear while
performing procedure
• specialized 1" waterproof plastic skin tape to secure and
protect catheter in situ I was constantly amazed by how my colleagues would have to stop and wait for something not present in the unit they were called to.
Conversely, when I was called because of an inability to insert an A-line, as they were referred to, and wasn't in a place where I could assemble my desired materials, I'd proceed with the materials at hand, all the while thinking "this could have been done a lot better...." |
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