Wow. What a crazy week. I just now realized I'll never have a first week of anesthesia ever again, thank God. Today was especially crazy. I was assigned to a big case...a Whipple Procedure. I wanted to get lots of sleep so I would feel good today, but instead my neighbor's 4 dogs barked all night, until about 4am when a big storm hit and their owners brought them inside. Great, my alarm goes off at 4:30! So I got to work way early to set up the room. I got to put in an arterial line, and I got to put in a pulmonary artery catheter and float it in for the first time. That was pretty cool. It took us an hour after the patient was in the room to get all the monitors set up before the surgery could start. About an hour into the case, my attending leaves for awhile and I settle down to start charting an hour's worth of vital signs. I heard this really weird noise come from the back of the machine and then the apnea alarm started going off. Wha??! I didn't think that could be right. I looked at the breathing tube and it was still in and connected to the circuit, but there was no fog in it, which told me the patient was not breathing. I about wet my pants. The patient's oxygen level was still fine, but I wasn't sure how long that would last. Anyway, I was very calm and told the nurse to get on the intercom and have my doc come in, then I let the surgeon know what was going on. I was just about to switch off the automatic ventilation system to the manual system when he came in. I really thought I had screwed something up and that he would be able to fix it. Well, as it turned out, it was not a Katy Malfunction this time... the machine actually failed. We had to manually ventilate the patient for awhile while the tech came in and tried to fix the machine. No one could figure out why it broke so he ended up calling some "anesthesia machine hot line" and they told him to just turn off the whole machine and then turn it back on (kinda like rebooting a computer when it quits cooperating). That actually worked. I'm glad it worked. The case went on 4 more hours and it would have been hard to manually bag the patient through the rest of it. I'm going to be leary about that machine from now on.
I'm home really late and I have to take my yearly anesthesia training exam tomorrow morning. It's the test anesthesiologists take to become board certified. As residents, we are required to take it every year to monitor how we progress. Our program requires us to score above the 50th percentile to stay off probation. It's a lot of pressure. I planned on studying tonight but I'm just absolutely exhausted. I think I'm going to do okay though. This morning our program director happily announced to our department that the new anesthesia class scored really well on our anesthesia knowledge test we took on our first day. It's a national test and we are compared with everyone nation wide. I did really well on it (not as well as I'd hoped) and scored way above the 50th% percentile (and this was after I was up all night with some weird stomach bug and showed up to the test dehydrated). One of the attendings told me I'll probably do just fine tomorrow. I'm really happy for our class. We got such a bad reputation this past year because of a lot of stuff that went on, and it's so nice to have the program director happy with us and bragging about us. She's really big on test scores, so if you have high scores, that gets you out of a lot of harassment from the attendings for an entire year. I am all about that.
Argh. I gotta go study. I get to sleep in Sunday! I haven't had a good night's sleep in 2 weeks!
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