“So you want to study theatre?” Those words used to have a very different meaning to me, but here they just mean the operating theatre, AKA, the OR. Talk about a different experience.
Here are just a few of the differences that might stand out:
- Shoes are considered dirty in India. So, in the pre-op area everyone is barefoot. No shoes allowed. They have separate flip-flops for you to wear when you go into the OR. Yes, I wore flip-flops while watching surgery, and yes, it was amazing.
- My surgical scrubs/attire was actually a dress.
- They have a sterilization room, with an autoclave, where they sterilize almost everything. There is very little that gets thrown away. I’m pretty sure that even the sterile gloves that they use in surgery get cleaned and passed down to the floor nurses for dressing changes.
- They rarely use general anesthesia. More often than not they do spinal anesthesia, and the patient is still awake. The inguinal hernia repair, the skin grafting, and the appendectomy were all awake. We covered their eyes, of course.
- The monitoring system during surgery? A pulse ox. Occasionally we would use the BP cuff, except it is only available in an adult size… So the pediatric tonsillectomy went without BP monitoring.
Watching surgery here is so completely different from in the USA. But despite all of these differences, it works. Their goal here is to help as many people, the best they can, while making it free or low-cost for the patient, and I think it works.
For those of you medical maniacs, and trauma junkies, here is a more detailed description of what I have done and seen so far.
Warning: if you are allergic to reading, hearing, or generally thinking about blood, or any type of bodily fluids, do not continue. I take no responsibility for any nausea, general discomfort, or other illness that comes from reading this posting.
Skin grafting: an adult had suffered some bad burns on the major anterior part of his right foot stretching from the top of the ankle to the base of the toes, and a smaller burn on his left. We harvested a rather large portion of skin from his left thigh, which we immediately placed in a container of normal saline (NS) so it wouldn’t dry out. This harvested skin was then stretched over the burned skin and trimmed so the edges lined up. Stitches were then placed along the edges to keep the graft in place. The entire time the newly grafted skin had to be kept moist with NS.
Appendectomy: acute appendicitis. Spinal anesthesia was used. A small incision was made in the right lower quadrant. Only really interesting thing about this was when the surgeon went to remove the appendix, this purulent pus shot out everywhere. Needless to say I jumped backwards so I wouldn’t get hit. He then had to go in and make sure that he got all of the pus out so it wouldn’t cause peritonitis.
Wound care: this was a teenage boy who had blown up his hand using fireworks. He had lost one finger and half of another. The skin on his palm was quite mangled, and swollen. A chunk of his hand was missing between his index and thumb. There were probably 20 stitches on the back of his hand where they had to go in and fix the bone structure. We washed the wound with iodine solution, hydrogen peroxide, and NS. Then placed iodine soaked gauze on the wound and then wrapped it up. These people don’t usually get a lot of pain medications either…