A Little Downtime, and Add-Ons

I apologize for the lack of updates; it's been busy. I've been getting assigned to a bunch of add-on cases after my scheduled cases finish, and it's been extraordinarily draining. Add-ons can be a little daunting because I spend a good amount of time preparing my daily cases. I do a thorough chart review, think through the anesthetic plan, review everything in my mind before going into each case. But with add-ons, we get called after our last scheduled case, and upon learning the urgency of the following surgery, I rush to prepare my room, scan over the chart, meet the patient, and talk to my attending. Often, add-on cases are sicker patients, admitted to the hospital with a pertinent medical condition. Their vital signs are abnormal, they are undergoing antibiotic therapy, their labs are off, they have less reserve. This compounds the fact that I don't have as much time to prepare.

But separately, add-on cases are also highly inefficient. I hear about a case, but it takes everyone an hour to get the room prepared. The equipment and case cart need to be brought in and opened. A team of a circulating and scrub nurse has to be identified. For cases with prosthetics, the representative from the biotech company must be available. We have to assure availability of surgery and anesthesia residents and attendings. So while scheduled cases are expected to turn over in 15 minutes, these add-ons drag on, and it's exhausting. But I'll be back to blogging regularly once my days permit.