Just another day at the office
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Tried to get you off your duff and back in the saddle. Teaching would be fun and you could terrorize the residents. Or re-hone some long unused skills in some other setting...Knew a retired pathologist who worked part-time at a state institution, doing some light general practitioner work...If he thought it was something over his head, he referred it.
Help me to help you.
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I assume this is heart surgery...
Going clockwise from the bottom left.
That looks like an trans-esophageal echo.
In the upper left is a series of infusion pumps.
- Fentanyl
- Dexmetomidine (sedative)
- Lidocaine (anti-arrhythmic)
- Cisatracurium (muscle relaxant)
I can't make out the bottom two.
Center right:
Blood transfusion
Below that, more infusion pumps. I can't read the labels, but if I had to guess, those pumps are for vasoactive drug infusions - norepinephrine (I think I can read that), dobutamine, etc.
Top right: Basic Monitor. Heart rate, BP (79/39!) measured by intra-arterial catheter (I was good at putting those in!), 02 sat.
Below that monitor is something I've not seen, but it looks like it's monitoring the ventilation. On the left side of that screen are two vertical bars that I assume show you the L/min gas flow from the anesthesia machine. I don't see flowmeters on the anesthesia machine itself, so it's probably what that is.
To the right of that: Cute gal.
Behind her is the anesthesia machine. This looks like a newer model I'm not familiar with, but there are two vaporizers on it: Yellow for sevoflurane and black for desflurane.
Sitting on top of the anesthesia machine, is something I don't recognize. Perhaps some kind of EEG device, like a BIS monitor equivalent.
This is a similar model of the anesthesia machine she's using:
This is similar to what I was using.
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That's quite interesting, thanks.
What is that thing on the bed that looks like a multi-plug connector? I assume that thing wrapped in white stuff behind it is the head of the patient?
Is that thing the gal is holding just her cell phone or is that some kind of medical device?
The clothes she has on look somewhat non-ER-like. Is that normal?
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@klaus said in Just another day at the office:
What is that thing on the bed that looks like a multi-plug connector?
It's a manifold in the IV line. It's a way of plugging a host of other IVs into the tubing.
I assume that thing wrapped in white stuff behind it is the head of the patient?
Yup.
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Found some pictures from my day.
This is my handiwork - an IV in the right internal jugular vein. These days, everyone uses ultrasound to find the vein. I was taught to use landmarks on the skin and bony prominences. I was good at these too...
The black snake coming out of this victim's patient's mouth is the transesophageal echocardiogram (TEE) probe. If you recall that "scary blood clot video" I posted, it was captured using this type of device.
Here's an overview of the scene:
You can see the pump ("heart/lung machine") with all the blood-filled tubing. To the right of it is the TEE I mentioned before.
This is where I spent hours and hours ... and hours.
You can see the monitor in the top/center of the screen. Below it is the "dock" which attached all the monitoring cables to the monitor, and below that, and to the left, a bit, is the defibrillator.
At the bottom, you can see the IV manifold that @Klaus asked about.
Another view, and you can see the four infusion pumps (the rectangles with dials on them) we routinely used.
And the anesthesia machine close up:
From bottom to top:
Three flowmeters for gas, oxygen (green), air (yellow), and nitrous oxide (blue). To the right of the flowmeters and knobs are the two vaporizers for volatile gas I mentioned earlier. The two dials below the vaporizers show the line pressure of O2 and N2O.
Atop the shelf is the capnograph, measuring exhaled CO2, and above that is the cardiac output monitor, which we used to measure how much blood the heart is pumping per minute.
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Very interesting!!! Thanks for sharing your knowledge
