Wang Jianyu, Anesthesia Center, Beijing Anzhen Hospital, Capital Medical University
Today's article is inspired by the front desk sister of the operating room janitor, and I want to write a popular science article.
The front desk sister has several things to do every day: to distribute brushing gloves, masks, hats and other protective materials to the staff entering the operating room area; to contact the field staff by telephone to pick up and drop off surgical patients; to verify the identity of the personnel entering the operating room area and the review of nucleic acid test results. Of course, these are the main work contents, and we can also see that the eldest sister has to explain to the patient's family in her spare time, and acts as a volunteer science explainer.
The few words we hear most often are:
1. After receiving the operation, the doctor informed us to sign at two o'clock, how to advance or after the measure?
2, the patient entered the operating room at 12 o'clock, how come it is 12:40, the operation has not been completed?
3. Our patients have all gone in for surgery, can I, as a family member, leave?
4. What can I do if I stay at the door of the operating room? Hit the king, send Weibo, brush the circle of friends?
5. Before the operation, where can we see the patient? After the operation, will the family still see the patient?
Today I will explain to you one by one.
Question 1: After receiving the stage operation, the doctor informed us to sign at two o'clock, how to do it in advance or after the decision?
Answer: Let's first clearly explain some concepts, main stage surgery, refers to the day of the operation, the first operation in the operating room, usually on time, according to the working habits of each hospital, from 7 a.m. to 8 a.m., sign-off. The second one, commonly known as "pick up 2", the third one, commonly known as "pick up 3", and so on, pick up 2, 3, 4, 5... n。 When the family signs, some will ask about the operation time, what time to wait for the hospital to wait appropriately, etc., about the time of the operation, it is often the time range that the surgeon will tell the family according to the time obtained by calculating the previous operation progress based on experience. This time frame can only be said to be approximate, and there will be many variables, such as the previous surgical process is simpler than planned, the time is earlier; for example, due to special reasons, the previous operation was suspended; and there are some unexpected possibilities in the operation, resulting in the original planned operation time being extended, which may cause the operation to be taken in advance or after the intervention. This is like a train, in the previous station is delayed, the next stop is bound to be affected, resulting in a shortened stop time, the estimated time is taken later.
Question 2, the patient entered the operating room at 12 o'clock, how come it is 12:40 o'clock, and the operation is not finished?
Answer: The patient's entry into the operating room area does not mean that the operation is performed immediately, and it takes time to prepare for the operation during this period. Taking the unit where the author works as an example, usually half an hour in advance to sign for the next patient, the patient arrives at the surgical area, first check the patient's basic information, such as name, age, past medical history, allergy history, the content of the operation performed today, etc., and then take the patient into the preparation room, monitoring, preoperative preparation, open venous access, invasive blood pressure monitoring, some patients need local anesthesia to complete the central venous catheterization, as well as catheterization. This period is also interspersed with perioperative education for patients, communication with patients, gaining patient trust, and getting patient cooperation. Therefore, does not mean that the operation time is calculated from entering the surgical area, now some large hospitals, the patient's family waiting area, you can see the electronic surgical progress prompter, which will have the patient's surgical progress information, for the protection of patient privacy considerations, such as the patient's name information will not leave the full name, there will only be a surname and a certain word, the patient's age, gender will be prompted, so that the waiting family will be able to see the patient's surgical progress at a glance.
Question 3: We patients have all gone in for surgery, can I, as a family member, leave?
Answer: Of course you can't go. The patient enters the operating room to complete the operation, and as a family member, needs to wait in the waiting area all the time. Because, the situation of surgery, sometimes will not be completely in accordance with the planned design of the program to complete, sometimes there will be some unplanned events, such as a tumor patient, originally planned to perform tumor resection, the results of the investigation found that there may be a large-scale tumor metastasis in the patient, the tumor staging is late, there may be no opportunity for surgery, this time need to communicate, explain the condition to the family, get the understanding of the family. For another example, the intraoperative probe was originally planned to be problem A, and as a result, the B problem was accidentally found during the probe, which also needs to be truthfully told to the family. There are also some cases, when the patient's condition may have a variety of choices, it is also necessary to communicate with the family in time to seek the opinions of the family. Therefore, during the operation, the family, especially the family members who can sign the main signature, must not leave the operation waiting area for a long time.
Q4: Can I stay at the door of the operating room? Hit the king, send Weibo, brush the circle of friends?
Answer: Family members can patiently wait for news in the waiting area of the operating room, it is important to maintain a calm state of mind, do not let yourself be very excited, of course, excessive sad and depressed negative emotions, as a doctor do not want to see, because only a normal mind, such as when there is a need to ask for advice, can play a calm state, choose a relatively reliable and correct direction. Because the hospital wants to protect the privacy of other patients, it is usually not allowed to take photos and videos, so it is not recommended to send Microblogs and circles of friends. The author's relatives once performed surgery in this hospital as a patient, when the immediate family members were patiently waiting for the result news at the door, remembering that it seems that non-immediate relatives really have sent a circle of friends, the details are enough to see the mentality, the key is that it really does not make sense. Friendly reminder, when waiting, be sure to pay attention to whether the mobile phone has a signal, and it is best to prepare a charging treasure in advance.
Question 5: Where can we see the patient before surgery? After the operation, will the family still see the patient?
Answer: Because of the need to prevent and control the epidemic, now in the top three hospitals in Beijing, the vast majority of the situation does not allow family members to accompany, on the day of surgery, family members can see patients in the designated waiting area, it is recommended to maintain emotional stability, can be simply encouraged, do not get excited, because the emotions of either side of the patient and the family are unstable, it is likely to pass on to the other party, resulting in emotional loss of control, which is not conducive to surgery. After the operation, if the patient undergoes surgery similar to extracardiac, extra-divine, etc., and needs to be directly transferred back to the intensive care unit area, the patient's family will not be able to see the patient at the end of the operation. If the surgery requires a transfer back to the ward, the family can usually still see the postoperative patient in person within the prescribed waiting area.
As a medical worker, I also understand the huge pressure that the family needs to face and bear in all aspects, and I hope that readers who are the patient's family members can cooperate more with the hospital to complete the operation after seeing the article, and believe in our medical staff. I also wish all patients all the best.
【Warm tips】Point to pay attention, here is a lot of professional medical science, for you to reveal the secret of surgical anesthesia those things ~ ~