Page 20 - CASA Bulletin of Anesthesiology 2019 Issue 1

CASA Bulletin of Anesthesiology
3. Chatting in the operating room
Talking about common interests is helpful for improving relationships and relieving the stress from the surgery in non-critical times. However, chatting unrelated topics can be distraction as some surgeons do not like any discussion. Finding something to make him/her interested can be helpful.
4. Play music in the operating room
Music in the operating room is helpful, but some music can be annoying to some people. It will be helpful to play the music that most people can enjoy.
5. Cases cancellations
It is one of the common conflicts between surgeons and anesthesiologists. Although there are a lot of good reasons to cancel a case, it has to be a jointed decision between anesthesiologists and surgeons. Cancelling a case does cause a lot of logistic problems for the surgeon’s office with a busy schedule. Reasons could be that some of the pre-op tests may have to be repeated, or that a patient’s family just travelled thousands of miles for his/her mom or dad’s surgery.
6. Attention to the surgery
With the increasing use of electronic medical records, we all have to spend a lot of time to fill the space in the computer. Sometimes cell phones can be distractive too. So, it is important not to miss significant events that can change the patient’s outcome. It can be annoying if someone is distracted or no one is paying attention when a patient is crashing.
7. Problem readings from instrument
It is not uncommon that instruments give us warnings such as low blood pressure or low saturation. Simply assuming instrument error can lead to tragic events. Over treating can also be detrimental. After all, it is not difficult to just ask a surgeon to feel the aorta (yes, we can tell the blood pressure with fingers on the aorta) or just place another femoral line to verify.
8. Supervising residents to understand the surgery
An understanding of the surgery can be very helpful. For example, we usually ask to stop the ventilation while cutting the sternum. It should be resumed once the sternum is open but many times the surgeons are busy dealing with the massive bleeding from sternotomy and the resident does not know that ventilation should be resumed once the sternum is open. It would be helpful to let the anesthesia resident or CRNA know what to anticipate before you come back.
9. Compromise if there are differences
Many things can be done in different ways, so pick the battles. Try to standardize the anesthesia protocol and inotrope based on physiology and pharmacology as well as the surgeon’s preference. Communicate with the team when you start any significant inotropes such
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