Reading, crossword puzzles, etc while administering anesthetics

[22380]

Hello,

I am new to the board and recently passed my board exam and am proud to be amongst your ranks. My post is concerning activities that I have observed from anesthesia providers (both CRNA's and MDA's). I have observed people reading and working crossword puzzles during cases. What are your views on this? I do not think it looks very professional. I am not implying that those that do these activities are not monitoring their patients. I am strictly speaking from am impression viewpoint. What kind of impression does this make on surgeons and operating room staff? What impression does this make on SRNA's? It made an impression on me as a student.

[heartICU]

I agree with some of the others - while I think that being completely inattentive to your patient isn't right, I also believe that you cannot stand at the head of the bed and watch a seven hour case with just a lunch break and a fifteen-minute morning break. It is simply mind-numbing. And yes, I am a student, so I actually do stand there and watch, because I have never seen some of these cases. However, my preceptors are often going over test questions, reading applications for next year's class, or reading the latest research articles on anesthesia, and they still pick up on subtle changes in patient condition - the pulse ox pitch drops a bit lower, suctioning by the surgeon suddenly gets more 'juicy-sounding,' etc. I think when you have been doing this long enough, you learn to use all of your senses at the same time in the OR to monitor your patient. And sorry to say, but vision isn't the keenest in the OR environment. Your patients are usually draped to the point that you can't see most of them - it is more difficult to see if they are turning blue, etc. You begin to rely on sound more than anything, using your monitors as aids.

Don't get me wrong, I am beginning my second year as an SRNA, so I am not pretending to know the ins and outs yet. I don't think anyone who is still a student should be doing these things during a case - this is our time for learning to do anesthesia, not crosswords. But as an experienced CRNA who has seen their 500th total hip...I would think they are more likely to fall asleep if they don't stimulate themselves with something.

[sway]

By the way, today, I picked up two disconnects and one CO2 line blockage, just by listening to the machine and monitor. It is hard to do that if there is a lot of ambient noice in the operating room.

YogaCRNA

This is totally off the subject, but how on earth does a CO2 line become blocked?

[skipaway]

This is totally off the subject, but how on earth does a CO2 line become blocked?

mostly from moisture in the line.

[air]

This is totally off the subject, but how on earth does a CO2 line become blocked?

Well, I have not noticed a blocked line, but the filter on the gas analyzer (spectrometer)could be blocked. Usually, I change them. It would/ should give you ample warning.When using old machines,sometimes your patient is properly ventilating but you can not see ETCO2. Then you troubleshoot from the patient up the gas sampling hose/tube to the analyzer. If everything is fine, I would check the filter. I am sure secretions may clog the intake port(baffle) of the sampling hose. When you guys do machines in class you will learn those little things. Talk about those Danemiller DVD's.

[yoga crna]

The CO2 line actually was kinked where the tubing comes off the hub. One of the surgeons was leaning on the circuit and line. The reading on the monitor was "line blocked".

yoga