Or really anyone.
So in clinicals during a robotic case the surgeon proceeded to staple the sterile drapes...TO THE PATIENT!! He said this way he can be sure the drapes don't move. The patient did not consent to this and when the procedure was finished he popped them all out and just put hystocril over the puncture marks. I was in shock but, no one else was because it's common with this surgeon.
*****?!!? How can this even be right? That would just increase the risk of infection added all the extra skin punctures. I talked to my instructor about it and she said that he was allowed to that. My head is just spinning from this. I would be so angry if I woke up with puncture marks all over me.
I really wish this was some sort of bad joke but I assure you it's not!
Jan 17, '12
by Rose_Queen, MSN, RN
It's really not all that uncommon to see drapes stapled to the patient, especially on types of surgery where the drapes just aren't going to stick. Pretty much all of our surgeons will staple the drapes for crani patients, just because it's an odd area to drape out without leaving gaps. The heart surgeons don't actually staple the drapes, but they uses sterile stockinette as a soft tissue retractor by stapling it to the edge of the incision and then stapling it to the drape. These staples are usually quite superficial, and maintain the sterility of the field by not allowing gaps or sliding of drapes to expose unprepped parts of the patient or unsterile items such as monitors/cables, bed linens, or positioning equipment.
There is even some positioning equipment where puncturing skin is an automatic occurrence. One example that comes to mind is the mayfield crani positioner. The one we have involves a clamp where "points" are screwed into the clamps and then the clamp is tightened on the patient's head. I've seen some pretty wicked bleeding from those that actually required staples to close.
I get that you're upset about the patient not consenting about the drape stapling, but that's typically not something included in the consent. No surgeon I've heard getting consent mentions anything about how they drape (stapled or not) or even that the patient's incision will be closed with staples. Most patients don't want the play-by-play, they just want the basics to understand the surgery.
As for the craziest thing I've seen a surgeon do, it would probably be this one cardiac surgeon's method of keeping a patient's chest open. He would cut off the ends of two syringes, protect the incision edges and sternum with esmark bandages, then somehow secure the syringe pieces between the sternum pieces, then covered the whole mess with ioban. Usually left this in for about 24 hours until the patient stabilized enough to tolerate coming back to the OR for closure.
Last edit by Rose_Queen on Jan 17, '12
Jan 17, '12
I worked as a Vet Tech for years before switching to human nursing. One of the Vets I worked with would always staple the drapes to the animals. It seemed to do the trick. I didn't know they did that with people too.
I don't work in the OR yet, but it is where I want to work.
While working as a Vet Tech the craziest thing I ever saw in (veterinary) surgery was during a leg amputation. The assistant accidentally handed the surgeon the wrong instrument, so the surgeon got mad and threw the freshly amputated leg at his assistant!
Last edit by sillywilly on Jan 17, '12
Jan 17, '12
Staples huh? I assure you, my friend, those staple punctures are the LEAST of that patient's worries.
I assure you, consent for the procedure covers such things as staples, central line starts, ART line starts, etc etc etc. In most consents there is a piece of verbiage that translates to something alone the lines of "We have permission to do XYZ and anything else that catches our eye and needs immediate correction during the process....Oh! And anything necessary to get the job done." Handy bit, that.
Besides, patients are given an antibiotic prior to the start of the case in 99% of cases to prevent operative infection.
Also, staples are nothing. As Poet pointed out, the mayfield pins. mmhm. Delicious bit of crumpet, that is. But again, the pins are the least of the patient's concerns considering that their brain is being poked at, drained, skull flap removed, etc etc etc. I know a few surgeons whom use an instrument called a perforating towel clip to clip the drapes to the patient.
::curses and flails:: I have struggeld in vain to get my picture to post and now that I have opened a bottle of wine and calmed down...just...just google the instrument. I surrender. My archnemisis, the internet, has won once more.
If it makes you feel any better, as someone who has been stapled without anesthesia or local, it's really not that bad. Getting my ears pierced hurt worse.
I'm sitting here going through all the crazy crap I've seen in the OR and the scary thing is that it all seems perfectly normal to me. LOL. I guess I forget how shocking some of it can be to one who has not born witness before. I'll keep trying to consider it, but off hand, the only thing that comes to mind is the gratuitous air guitar solo which took place in the middle of an open appy.
::sigh:: I love my docs. Strange little birds.
Last edit by CheesePotato on Jan 17, '12
: Reason: Blasted picture ::grumbles::