I arrive at work for 7:30am, and get changed into theatre scrubs, shoes and hat. After turning on some vital equipment, I check which procedures we have for the day. Today is a busy day and we have a number of surgeries scheduled for our 4 referral theatres. I set up for the first procedures of the day: a superficial keratectomy (eye surgery) in theatre 3, a key-hole liver biopsy surgery in theatre 4 and a fracture repair of a hind limb in theatre 5. Each theatre needs slightly different equipment and instruments. I check that the instruments are sterile in their packets and that the equipment needed in theatre is all working correctly. For the fracture repair, I load up the x-rays of the fracture onto the monitor, which were taken the day before.
By now, the first patient (a very sweet and waggy dog with a broken hind leg!) is ready to be anaesthetised in the 'prep room'. The veterinary anaesthetist and another theatre nurse place an i/v cannula and start the general anaesthetic. Once the dog is asleep, they pass a tube into his trachea and connect it to the breathing system, delivering the anaesthetic gas that will keep the dog asleep. They attach the monitoring equipment they need to assess his vital signs. Once they are happy that he is stable, that theatre nurse will monitor his vital signs, delivering any other drugs he needs and reporting any abnormalities to the vet.
In the meantime, a theatre assistant and I use clippers to shave the fur off his hind leg so that we can scrub the skin clean ready for surgery. We do this in the prep room to make sure no loose fluff and hair follows us into theatre. Once we have scrubbed the skin clean, the anaesthetist performs a nerve block, which involves injecting local anaesthetic around the nerves supplying the leg. This will help with pain relief during the operation and for some hours afterwards.
The dog is then moved into theatre on a trolley and positioned on the operating table. For this surgery, the surgeon needs the fractured leg suspended so that he can put the sterile drapes around it to create a “sterile field”. These are the blue drapes covering the patient that you see on the TV! I give the patient’s leg a final skin scrub whilst the surgeons scrub their hands and put on a sterile gown and gloves.
Now that the surgeons are scrubbed, it is my responsibility to be their un-scrubbed hands – opening packets of sterile instruments for them to take and assisting with equipment. I watch closely to make sure that the sterile field is not contaminated by anything.
The fracture repair goes smoothly and the surgeon begins to suture up. I go and check that we have a suitable slot booked for some post-op x-rays, making sure that the equipment needed to keep the patient anaesthetised is ready.
Once the surgeon is happy with the x-rays, the patient is moved back to the prep room to recover and eventually taken back to wards. The anaesthesia team make a plan for recovery and post-op pain relief. As this sweet young dog is fairly bouncy, they will have some drugs ready to lightly sedate him at first so that he doesn’t over do it on his newly repaired leg!
In the meantime, I clean down theatre 5 and get it set up just in time for the next procedure – a little dog needs urgent surgery for a slipped disc!