Operating Theater!

Today I spent the day in to OT. We call it the OR. They call it the OT.

But before all the gruesome details. Here is a shot of Kingston at night.
Kinda blurry. Sorry.

Made my way to the operating theater. Remember, all the different "floors" in our hospitals are separate buildings in theirs. The OT opens to the outside.
Walking in I grab whatever scrubs are available. They also have cute dresses too. Perhaps I will wear one some day.
Locating what room I am in
The hallway is really much much dimmer then this. Not sure why it looks so glow-y.
My room!
Where we scrub and glove and gown. We gown and glove ourselves! No scrub nurse for this part!
Also, nothing disposable. The gowns are the old OR green linen gowns.
Old-school soap.
Handles on the sinks! We have to use our elbows to turn off the water after we scrub.
In the OR waiting for our first patient. Those are windows to the outside world. Directly behind me is the scrub room and to the left of the picture is the holding room/anesthesia room. It is a small personal holding area for the patient for that OT. There is no centralized holding area.
I got to scrub in for this surgery. Below is the outcome. It was pretty great as it was the first TAH I have seen and it was only the residents on the case. Dr. Chand is the chief resident and Dr. Reeves is the junior. I, of course, got to manage the bladder blade and the scissors.

A shot of the suction used in the case.

Close upIntubation cart.
No sharps containers, even in the OT.
They sterilize the instruments to be used between cases. They first wash them and then autoclave them. The two rooms where this takes place is attached to the OT 4.
Getting ready for the second case. Another resident showed up so I observed this one. Hence all the photographs.
Two-for-one deal! She also needed an excisional biopsy. So she got it done while she was getting a hysterectomy. Of note! There was NO GENERAL ANESTHESIA! The whole operation was done with regional anesthesia (epidural) for both cases. The second case started to feel the pain right at the end. That was the first time one: I saw regional used for major surgery and 2.) Saw a patient wince in pain while still being operated on.
Draping and discussing the case
Opening
Dr. Chand. (Something about the OR light makes me want to quit being a doctor and become a national geographic photographer. Not that below is an amazing shot but I like the light.)
Operating. Last case I was the one on the right of Dr. Chand.

Closing.
Removed: one uterus and cervix.
After the OT I had about an hour to kill until Alicia came and picked me up. (We had to go drive somewhere to sign up for a hiking trip through the Blue Mountains next Saturday). Anyway, there was about an hour left before her class finish so I made my way up to L&D and see what was going on there. There were no laboring patients (at the moment, one came in though) and the students were reviewing all sorts of labor stuff.
They were surprised to learn how much we Americans rely on continuous fetal monitoring and I was surprised to learn that they did not use any! They palpate with their hands to determine the strength, frequency, and duration of the contraction. If a woman is started on pitocin some one sits next to her with their hand on the fundus of the uterus until she delivers, the pitocin is stopped or the person is relieved. Talk about continuous fetal monitoring! One student stayed recording contractions for his entire shift! Yikes!

Our discussion on comparing and contrasting American medicine and their medicine was interrupted by some quick yells of pain coming from a woman who just walked in. Everyone quickly rushed into action and then Alicia called me. So I left. It looks pretty official that I will be going to the public hospital in downtown (read: rough neighborhood) Kingston for L&D next week. I am super excited and a bit apprehensive based on what people have been telling me. Hopefully, lots of hands on experience! Not monitoring contractions though! : )

Good night! Tomorrow I have Gyn clinic and then perhaps to a small beach in Kingston called Hillshire.