is this description of a CABG clear and correct?
- 0I am writing as essay for "why I want to work in the OR." there is a paragraph about the first surgery I saw, a CABG. I just want some feedback on it, please! Is it clear, well paced, correct, etc?
"The event that made me want to work OR was the first CABG surgery that I saw in clinical, I realized the complexity and elegance of surgery and knew it was something I wished to be involved in. The patient was a 51-year-old male who required a triple bypass. The surgeon performed a medial sternotomy and opened the thoracic cavity with a sternal retractor. After the pericardium was incised, the beating heart was visualized. The surgeon proceeded to dissect the Left Inferior Thoracic Artery free from the retresternal bed, so it (along with the Great Saphenous Vein) could later serve as the new bypass. The Cardiopulmonary Bypass (CPB) machine was circuited to the patientís inferior vena cavae and aorta to keep the heart still and also to induce mild hypothermia during the surgery. After, the surgeon anastmosed the damaged coronary arteries to the harvested conduits, using the parachute suturing technique. After it was confirmed that the new grafts were secured and patent, the body was re-warmed, and the CBP was weaned from the patient. The cross clamp was removed from the aorta and the heart spontaneously converted to sinus rhythm. No defibrillation or epicardial pacing wires were necessary. The surgery was a success."
- 0i just wanted to paint a very general picture for the procedure, which I think i did a good job of. But the last part, where I say "The cross clamp was removed from the aorta and the heart spontaneously converted to sinus rhythm" may be inaccurate. Should I reverse it and say that the heart converted to sinus rhythm and then the aortic cross clamp was removed?
- 2Jun 23, '13 by springchick1Quote from silkystephI still don't think it is necessary to describe the procedure step by step. It looks like it is just being used to take up space in the essay.this is just one paragraph from my essay that I'm concerned about. I certainly talk about why I want to work in the OR.
- 0Jun 24, '13 by heartloverYour terminology is slightly different that what I am used to for the last 8 years I've been doing open heart surgery as a nurse but it is still accurate. I would change medial to "median sternotomy" but everything else seems ok, just different like I said.
The heart will not return to a sinus rhythm until after the aortic cross clamp is removed because it will not be recirculating blood until the clamp is off so do not reverse that sequence.
I too do not entirely see the reason behind describing the surgery you observed in such detail in your essay of why you want to be an OR nurse. It does show you paid attention and asked questions and had a genuine interest in what you were observing but you could say that in another way.
But good luck to you! And know that if the heart team sees you seeming so interested in heart surgery they may try to recruit you after your preceptorship!