Tuesday, November 2, 2010

The Operating Room

The Operating Room sits between the ATLS section and the ICU.  It is equipped and staffed for two simultaneous operations, but the second bed is reserved for absolute life and/or limb threatening emergencies.  We try not to have all of our OR assets tied up in case something more urgent arrives.

LTC James, SPC Nguyen, SSG Penn, and SPC Thomas
LTC James is the OIC of the OR section.  He has 22 years of military experience and works as an operating room nurse in civilian life.  SSG Penn is a firefighter/paramedic when not activated.  He has almost 20 years of military service, and functions as a second circulating nurse when necessary.  SPC Nguyen manages a nail salon at home, as well as being a personal trainer.  SPC  Thomas works as a personal trainer.

SPC Nguyen assists 2 surgeons (LTC Koutlas and MAJ Jordan) simultaneously
Penn, Nguyen and Thomas have all received the 68D MOS, which is "Operating Room Technician."  The Army course is 16 weeks in length, at which time they are taught sterile technique, basic surgical skills, and instrument nomenclature.  They must log many hours during actual surgical cases to graduate.  Thomas just graduated last December, and was immediately activated!  These men do a remarkable job.  Unlike their civilian counterparts, they frequently first assist while providing help to another surgeon at the same time.  It is not uncommon to have an orthopedic procedure taking place simultaneously with a general surgery operation on the same patient.  These soldiers have learned to suture, insert chest tubes, perform cricothyrotomies, and apply external fixations to broken bones.  Not many civilian OR Techs can boast about having those skills!

Dental Autoclave
Big Bertha
The OR staff is responsible for sterile supplies for the FST as well as several combat outposts.  Usually, FSTs are supplied with one dental autoclave for sterilizing instruments.  We are fortunate to have a "Big Bertha" full-sized autoclave that can handle larger instrument sets.  It is an amazing machine.  We power it with electricity, but it can also use almost any fuel, including kerosene, gasoline and JP8 jet fuel!  It is not as fast as a civilian autoclave.  It takes 15-20 minutes to "flash" an instrument, depending on the ambient outside temperature.  We also have 2 water distillers for use in the autoclaves.  The surgeons who rotate to the FST must be able to operate with a minimal instrument selection.  We have major, minor, thoracotomy, craniotomy, vascular, and ortho sets, but they are very basic.  Separate instruments are "peel packed" to supplement the sets.

Not all casualties need to go to the operating room.  Sometimes, minor wounds are cared for in ATLS or the ICU.  The OR is reserved for serious injuries that cannot wait for the flight to a combat support hospital.  We basically stop bleeding, apply external fixation to broken bones, shunt vascular disruptions, and stabilize the patient for transport to a level 3 facility.

The views expressed in this blog are those of the author only, and not necessarily of the US Army or the US Government.  None of the information given is classified in nature.

1 comment:

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