Page 48 - CASA Bulletin of Anesthesiology 2019 Issue 1

CASA Bulletin of Anesthesiology
delays because the other hospital had very small surgery schedule. It was a very long day for all team members. However, it was rewarding for all of us. It reminded us the true meaning of Hippocratic Oath, all about our patients: all for our patients. For our junior volunteers and PA students, they had a chance to observe and participate in the operation they learn about in school.
Day 3
The following days on the mission were very similar to our first day. The mission team first rounded on all six patients from day 1. Most of them had an uneventful night. They were given Tramadol and morphine subcutaneous injection for pain control. Only one patient had more pain than the others. After detail questioning, we found that she had recent surgery (within
6 months) and had been taking pain killer (was on Percocet) for a few months, which she conveniently forgot about. As a result, she had more tolerance to our average pain medication regiment. We reassured her that the surgery was a success and adjusted her pain medication dose to have better control of her discomfort. After the first day of warm up, our surgical team had better cooperation. We were also more adapted to the turnover and flow of this hospital. Surgeries move along very smoothly.
The local anesthesiologists were extremely interested in ultrasound-guided nerve block. They tried to observe what we do whenever possible. One of them, Carlos asked me for a favor to help him perform a block for upper extremity surgery. Timing of the surgery was perfect. It was between the start of our surgeries. I saw the surprise on the local surgeon’s face when I rolled our ultrasound into the OR. Patient was a healthy 20 year-old male and here for left arm surgery. Motorcycle accident brought him fracture of both the ulna and the radius. I helped Carlos do a quick scan on both supraclavicular and infraclavicular view, identifying nerve and other structures in the view. An infraclavicular block was performed under the ultrasound guidance. It was an unexpected case for me, but a little extra help to the patient doesn’t hurt.
Because we had better cooperation and more used to the flow, we actually finished our 6 surgeries an hour earlier than the first day. Team members were really happy about our achievement.
Day 4-5
The next two days were following the same footsteps. On day 3, five of the first six patients whom we operated on day 1 were discharged from the hospital. They recovered very well and would continue physical therapy with Dr. Juan Carlos, our local orthopedic surgeon. One of the six actually went on and had her contralateral knee replaced on day 3!
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