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Not Quite Primed
Some days in this field are a little gray. Or is that grey? not sure really, but as we have been told, perfusion is 99% boredom and 1% terror, or sheer tragedy…
Well there is another part to that 1%- and it’s not terror, nor tragic in the typical sense, but just plain rude in how circumstance can misalign so completely, that you might as well show up to an emergency with a piece of used tubing in your hand, for all the help that the misguided fates of perfusion will give you on this particular day- or in this case, the pending weekend.
So as I am driving in, I decide to call the OR desk to get some details. The case I am told is in room 3. I figured that to be a misprint, and said – you mean 18 or 14 right ? (Our designated heart rooms.)
A virtual broom closet, which in this case held no broom. We don’t have anything set up (hardware or disposables in that room) so I realized this was going to be a mess.
On top that, the patient and team was in the room, and it was a ruptured ventricle! So that is a total curve ball. Now- the day has my attention…
From Casual to wtf… ?
The first thing that had to happen was to find a parking spot quickly, which in this case was the sidewalk just to the outside of the doctors parking lot (full), and a run across the parking lot, up a flight of stairs to arrive breathlessly to the OR. And I mean breathless, as in- I am a little out of shape (a lot) and gasping for air is not a good way to walk into a seriously messed up clinical environment. On my way in, I had already talked to someone and told them to drop a couple of cell saver lines onto the field, but where was the cell saver?
The ONLY fortunate thing about the day, was that the circulating nurse had on his own initiative, brought in the heart-lung machine from next door, and it was somehow plugged in with oxygen and room air lines already connected.
The room was full, the chest was open (as it turned out that this was a postop heart from the week before), the surgeon had his finger on a pretty serious hole in the left ventricle, and the only options that were going to get this patient on bypass- in a room not equipped for open-hearts- are myself and the HL machine.
All the rest of it- needed to arrive in one big hurry.