28 January 2011


1. Standing in the OR holding a freshly amputated leg (above the knee) and putting it in the disposal bag. When you take something off the table, you have to call out. Examples include: knife down, needle back, etc. Handing off the leg, I stated "one partially used limb for pathology."

2. Putting stitches into a femoral artery graft. They have to be perfect because you don't want the patient bleeding from the graft-artery junction (anastamosis). The attending let me throw the last 4 to close the anastamosis. The needle we use is less than a millimeter thick and 1cm long. We took the clamp off and... my sutures held!

3. A patient on the thoracic service was bleeding through his dressings after having an emergent bilateral fasciotomy (two big incisions in each leg, left open) earlier that morning. The interns were busy dealing with a patient having a heart attack so they sent me down to do the consult. The fellow and attending agreed with my plan and had me present to the primary team. The nurse didn't want to touch the dressings so I redid the surgical bandages (more complicated than just some gauze), stitched his central lines in place, then answered the wife's questions. Basically, I acted as the consulting resident from vascular (quite a promotion).

4. Putting a Foley in a man with a penis that is permanently fibrosed in the erect position.

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