Target Practice

I have to wonder what goes on once you're asleep in the OR. Do they truck the new anesthesia residents in to practice on sleeping people? Here is why I ask that question.

I was wheeled into OR 22 with three fresh puncture marks. One was from the IV in my left hand. Must give the anesthesia resident a big "atta boy" for getting it on the first try and for using a little local novocaine-like stuff to keep it painless. The next puncture mark was for the continuous sciatic nerve block. That's a story for another blog. The third and last puncture was for a short-acting femoral nerve block on the medial knee.

Once I was on the stiff and unyielding OR table, I was positioned in the usual fashion with arms out on extensions. Leads were attached and I had the O2 mask in place, doing the deep breath thing. Someone behind me dropped a bunch of IV needles and tubing onto my chest and I thought I heard someone say that they wanted a second line with a larger needle. Then came the burning in my left hands as I was anesthtized into la la land.

Skip forward to Wednesday evening, about 15 hours later. I still had the left hand IV and nerve block catheter and had not yet remembered about the second IV. The nerve block cath developed a kink and required the STAT presence of the Acute Pain Service resident who was on call. While he was doing his thing I was all the way over on my right side, clutching the side rail with my right hand. That's when I got my first good look at "Target Practice Arm."

The back of my hand was a massive purple bruise. I counted 5 puncture marks along the main vein. The inside of my right wrist is also bruised with one puncture mark. And lastly, halfway up my inner right arm was a deep blue bruise with a central puncture.

I'm glad I was asleep for all of that. Apparently the resident who put in the original IV noted that I had skinny, rolling veins amd that it might be difficult to start with a large bore needle, so he opted to start with a 22G and wait until the OR to insert the 18G which is larger in width and allows for more rapid fluid administration. Can I say amen and thank you? If I had been awake for seven failed attempts I might have lost my mind!!!!!!

Stay tuned for the story of Dr. Orzo, pain doc extraordinaire. I think I might call that one the Twitch Test.