Favorite Type of Case

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    Here is one that I don't think has been looked at for awhile.

    What is your favorite type of case to scrub?

    You know there are types of cases that everybody wants to do, from the simple OB/GYN to the more complicated vascular. I know there are OB/GYN cases that aren't easy but that is why I am asking. What makes them difficult, challenging or easy for you.
    To start off my favorite types of cases are, naturally Ortho. I love power tools, I have been making things out of wood for many years. It all seems to make sense to me when doing any type of Ortho case. Plates, screws, wires whatever, it all fits. Once I get use to the equipment the procedure just seems to fall into place. After many years in the OR there some cases I do not really want to do because after doing so many, they are just boring. I really don't like doing OB/GYN cases just because they are so repititous. I have done so many hysters, C/sections, D&C, etc......
    But being a guy it seems natual that I would like Ortho. I also like to do vascular because of thedelicate matter, even though my eyesite is a bit less than what it use to be. So let's hear about your favorite. Mike
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  3. 10 Comments so far...

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    Ortho is my favorite as well, my most favorite is total hips--I enjoy the instrumentation, seeing how everything fits together, and on those cases I stay busy. I also like total shoulders, I don't like knees as well. I enjoy the transitions, it's not the same stuff throughout the case- opening, then the acetabulum, than the femur etc--seems more interesting than one cases focusing on the same thing.

    I have done mostly spines (big surprise, huh?) for so long that I now the basic cases, microdiscectomies and lumbar fusions pretty boring, but I do antherior throracic fusions for fractures, scoliosis, etc.

    Ortho is really the only thing that interests me, don't much cre to do any other type of case.
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    I am just like you two (shodobe and spineCNOR--) my favorites are ortho and neuro--I love IM roddings, IMHSs, etc.--especially ortho trauma cases. I am thinking of taking a travel assignement in Steamboat Springs so that I can do just that, during ski season (plus ski myself in my off time!)

    I like cranis and big spines with instrumentation. You're right; everything just seems to fall in place; everything with big spines just makes SENSE.

    I HATE laparoscopic procedures--hate 'em. So boring. Also, I hate eyes; same reason. Vascular, I am the same as you, Shodobe--getting hard to see the little needles as well as I used to. Most are pretty boring, too.

    I do love big thoracotomies, as well.
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    love neuro, vascular and hernias!. Hate general, yucch!. Hate cardiac, and detest GU.
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    i love the fast paced quick gynae cases, small laparoscopies etc etc, in fact I like all lapararoscopic work even those really long ??boring ones...... love emerg theatre, basic trauma & whatever walks in off the street ... will always love the old c sections, maybe its a girl thing .... get a tear in my eye every time!! (You have to be insane to be a nurse! especially a good OR one)
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    Hot AAA's give me a buzz, total chaos getting the person in , asleep, and then its our turn to open up, suction and clamp and then calm. Brilliant. I had one particular case and I'd used 140+ of 18" x 18" packs, bloodloss 12 litres in suction and still alive.In fact once the graft went in and haemostasis was checked we de- scrubbed and went for a cuppa for half an hour. We left him with the anaesthetic team of course! The human body is incredible!!!

    On a more sedate level I enjoy opthalamic's, C-Sections are okay as I suppose the rest of the specialities. Trauma you can fly by the seat of your pants, not my cup of tea but I do it (well I hope).
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    Originally posted by sukisocks
    Hot AAA's give me a buzz, total chaos getting the person in , asleep, and then its our turn to open up, suction and clamp and then calm. Brilliant. I had one particular case and I'd used 140+ of 18" x 18" packs, bloodloss 12 litres in suction and still alive.

    Just curious, suki--in the UK, do you not set up the Cell Saver or some other form of autotransfusion so that that blood can be reinfused, not lost to suction?
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    No, cell savers are only used for cold orthopaedics and only used in knee replacement surgery. All whole blood products and ffp's come directly from transfusion, one heck of a cost considering we could use 60+ units and 10 of ffp's during one case.
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    I like so many services it's hard to pick a favorite. For many years I was a private scrub for neuro; I loved crani's. For many years I was part of an emergancy weekend team; at the time we got a fair amount of trauma for a community hospital. I loved the 'rush' experienced trying to juggle multiple procedures on ONE patient at the same time.
    I love big juicy bowel cases. I love urology, especially radical nephrectomies and radical retopubic prostatectomies.
    If I had to pick a few I could live without, Fess' would be at the top of my list along with Phaco's.

    Paula
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    Originally posted by sukisocks
    No, cell savers are only used for cold orthopaedics and only used in knee replacement surgery. All whole blood products and ffp's come directly from transfusion, one heck of a cost considering we could use 60+ units and 10 of ffp's during one case.
    Yeah, no kidding; what a waste of money!!! Everywhere I have worked, we usually, unasked (I mean, to me, it's a nursing decision; some may disagree) we usually set up and retrieve, and usually reinfuse, blood via cell saver for AAAs, lacerated spleens or livers--anywhere there is a potential for blood loss that COULD be replaced with the patient's own blood. Also for spinal instrumentation cases--to me, that's a given, but not everyone agrees.

    I can't see why you would do it for total knees--after all, there is a tourniquet on--but I wish more docs would do it for total hip revisions and IM rodiings. I have gone head to head with a couple of them over this over the years--but they always insist they won't lose blood (jinxing themselves; they always do!!!)


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