Cases during 11pm to 7am

Transected aorta - yeah, I take heart call. :wink2:

just finished a food impaction:barf02:. We seem to get a fair amount of foreign bodies.....everywhere...

tons of open fractures-ex fix., im nails

i'm trying to make a list of cases performed during graveyard shift. what am i leaving out?......

laparotomy

appendectomy

craniotomy

aaa

d&c

i've been called back to do emergency open gall bladder removal at 2 in the morning because the patient let his gallstones go so long they eroded through the sac and fell all into his abdominal cavity along with bile and the rest - evil case of peritonitis going on by the time we got there - even the patient was green. had to spend hours fishing out all the little stones, and washing out with antibiotic solutions.

also - a lap appy at 11 one saturday night that went horribly wrong with the first trocar placement - (nameless brand) trocar was supposed to retract the self-contained blade once it was through peritoneum - well it didn't and we ended up in a vascular nightmare in a small county hospital 40 miles from the nearest metro-area hospital or vascular surgeon -through-and-through in the left internal iliac, and a nick in the vena cava. to make it short, the surgeon panicked, i had to get him back on track, the circulator met herself coming and going fetching me more instruments and supplies, the anesthesiologist more fluids and drugs, calling for blood, paperwork, etc etc - and the patient was the husband of one of our or nurses who was sitting out in the waiting room waiting for the case to be over in the predicted 30-45 minutes! by the time it came time to load the castros with vascular suture, my hands were shaking, and the vascular doc (bless his heart) stopped, took my hand and told me it was all gonna be fine, i was doing fine, and to relax! i was not panicked so much as i was just worn out from stress. i walked out of there at 6:40 the next morning thoroughly exhausted and in a daze, thankful for the help that had been called in (especially the tech who was not on call that night coming in at 3 am to give me a break and then start sorting and washing up instruments that had been thrown off the field), that the vascular surgeon made it to the or in record time, all the while giving instructions over his cell phone as he drove madly through the night, that the patient survived, waking up in icu 4 days later. after that experience - everything else was cake!

oh - and the tech i worked with at one hospital got called in in the middle of the night to do an emergency lumbar laminectomy - he thought it was some kind of weird joke, but it was confirmed by the or supervisor. the patient had hit the "cauda equina" stage and time was of the essence.

and then.........oh never mind - suffice it to say, no matter how much you prepare, there's always gonna be something coming along you never in your wildest imagination considered happening!

Hmmm...what about laparoscopy for eptopic pregnancy? Did we get that one?

Removal of a foreign body - esophagus or rectum or other orfices

removal of a foreign body - esophagus or rectum or other orfices

how could i have forgotten this one...........well, let's just say this about it - one roman meal bread bag, and an aerosol can of that foam "crack filler" insulation stuff (aptly named in this case)............weekend night callback - general anesthetic, stirrups, and ring forceps.............'nuff said.............

Don't forget about the "knife and gun clubs" as we call them. A number of years ago, the circulator picked up the pants that had been cut off of a patient and a loaded pistol fell out on the floor.

We do a lot of I & D's at my hospital during the off shifts. Butt puss is a really popular procedure. I think a lot of the I & D's can wait until the morning, but it is a learning facility so they get done overnight.