When things go wrong

Depends on how wrong and what is wrong, lots of red stuff you will see a flurry of activity with silence3 on the operative side of the curtain for a minuite or two then a lot of talking, possible iscemia or somthing on my side of the curtain, me telling the surgeon so he will hurry up banter and me getting whatever drug will help or whatever else I have to do.

I'm not an OR nurse but I did a week in the OR as part of my Med-Surg rotation last year. I watched a total of eight surgeries and only two had any complications (though they weren't codes). Both were caused by the patients lack of sedation during the start of the procedure (knee replacements). The patients both tried to get off the table during the opening cuts and in the first replacement the patient was able to feel pain the entire procedure (which was evident when her vitals spiked during every single cut).

I was actually really concerned when the anesthesiologist told me not to worry because the Versed he pushed would make sure they didn't remember a thing.

Not sure if this is what you were looking for, but hopefully it gives you a vague idea. I had classmates that were in the OR as well and none of them witnessed anything like this with any other anesthesiologist nor did they see any problems.

Things do not go wrong very often at all. We do not get paid the big bucks to sit and do eventless anesthesia.. we get paid the big bucks to handle those emergencies. the airway, bp, tempurature, hct, heart rate are all under your control for the most part. Surgical complications are not.

No disrespect to the last poster... but this is a CRNA forum, where people come to ask CRNAs questions OR other CRNAs seek information from other CRNAs. 2 weeks in an OR as a nursing student,does not qualify you to answer this question. You do not know enough about anesthesia to have a valid opinnion on this subject.

I'm not an OR nurse but I did a week in the OR as part of my Med-Surg rotation last year. I watched a total of eight surgeries and only two had any complications (though they weren't codes). Both were caused by the patients lack of sedation during the start of the procedure (knee replacements). The patients both tried to get off the table during the opening cuts and in the first replacement the patient was able to feel pain the entire procedure (which was evident when her vitals spiked during every single cut).

I was actually really concerned when the anesthesiologist told me not to worry because the Versed he pushed would make sure they didn't remember a thing.

Not sure if this is what you were looking for, but hopefully it gives you a vague idea. I had classmates that were in the OR as well and none of them witnessed anything like this with any other anesthesiologist nor did they see any problems.

Not every patient gets amnesia from versed. It should not be relied upon as an amnesic. I know, because I have had versed a number of times and remember everything. We even set up a trick question to see if I would remember, prior to my last surgery. Everyone was shocked when I remembered it.

Note to moderators: I agree with another poster. If you want to get any relevant clinical information on this site, you may want to suggest that non-CRNAs be careful about posting on clinical anesthesia issues. Unless they have special knowledge or have done research on the topic, their comments are not useful to CRNAs and leads to cynical, if not hostile posts. I want to learn and share information.

We want this forum to be a place where ALL nurses and students can learn something about being a CRNA

If that is true then people who are not CRNAs should not "confront" CRNA posters who try and give their experience and information.

The plural of anecdote does not equal data. How in the world can someone who does not administer anesthesia give their "take" on it. Questions are appropriate, but IMHO only practicing CRNAs should counter other CRNAs when there is a question on clinical information.

I would not comment on pediatric nursing, oncology nursing, etc. I would only comment on that if asked an opinion about anesthetic concerns.

Again, falling short here...............................

Thanks Cerebral. I totally agree with your post. There is a lot of wonderful information available regarding the clinical practice and profession of nurse anesthesia. I was hoping this forum would allow me the opportunity to learn from other CRNAs, SRNAs and to be able to mentor others interested in the profession. For some reason, the CRNA thread of all-nurses in heavily moderated and not to the advantage of the profession. I will look elsewhere on the net for places to fulfill my needs. AANA.com has a listing of other nurse anesthesia boards, one of which is excellent. I'll see you there.

i don't have any experience with pediatrics.....but.......can i moderate the NICU forum?

So, I am working on setting up some shadowing experiences with a CRNA (or a few of them), but wanted to see if any of you out there can answer a few questions I have. First, I would imagine that the OR is typically a very controlled environment. But, how often does something go wrong, and what does that situation typically look like? What is the anesthetist's role in these situations? I guess I'm looking for some stories. Would anyone like to share? Thanks.

As an expert in anesthesia, I will offer a few answers. First, it depends on what goes wrong and who has control of the situation. There are times when there is massive hemorrhage at the surgical site. The surgeons try to control it surgically, the CRNA pumps in blood and fluid, monitors vital signs and makes necessary adjustments in the anesthetic agents to help stabilize the patient. Then there could be a fire in a surgical site that was prepped with alcohol and the cautery used. All of the members of the team would put out the fire, maintain oxygenation of the patient, make a decision about to proceed with the surgery. Then there is fetal distress and the need for a stat c-section where everyone in the team has a role to save the baby and the mother.

All of this points to the incredible team that is present in every operating room. We all have our role and the patient depends on us to know what we are doing and then do it.

What we do as CRNAs is make second to second decisions, that include a very quick assessment of the situation and being able to multitask and to keep focused and calm. That is why (1) you have to be very bright to qualify for anesthesia school--good grades, lots of critical care experience, (2) we get paid well and (3) anesthesia is not for everyone.

A recent example, last week I had a leak in my anesthesia system and while I could ventilate the patient, there was clearly something wrong. within 30 seconds I had to make a quick check of the anesthesia machine, connections, gases, ventilator, and tubings. When they were all normal, I checked the nasal endotracheal tube and determined the leak was there. I had to extubate the patient and reintubate without a muscle relaxant while trying not to contaminate the surgical field. Leak solved, patient did fine and all went well. It doesn't sound like a big deal...but I had to be an biomed engineer, a respiratory physiologist, make quick observations, identify and solve the problem.

I hope these examples helped answer your questions.

AE

Not every patient gets amnesia from versed. It should not be relied upon as an amnesic. I know, because I have had versed a number of times and remember everything.

Yeah, the CRNA gave me 3 of Versed prior to my ankle surgery, and I definitely remember it. I know that's not a large dose by any means, but I remember getting my nerve block like it was yesterday. That being said, once I got my propofol, it was all over :)