SNAPSHOT of an Anesthesiologist’s Day in the COVID era
(some of the details have been modified to protect patient and colleague privacy)
“LEVEL 1! O.R. 25! Motor vehicle accident”
The call overhead rushes the call team members to operating room 25 to prepare for the arriving patient.
“Does anyone know if this patient is COVID positive?” a nurse shouts to the room as she enters. No one does. Not enough information yet and the patient just got to the emergency department. Three anesthesia personnel (a 44 year old attending anesthesiologist with a history of high cholesterol and a heart stent, a 25 year old anesthesia resident with two young kids at home, a 29 year old anesthesia resident in the 5th month of pregnancy) get the head of the bed ready and draw up medication and airway equipment. An anesthesia tech (a 59 year old woman with a history of kidney failure) prepares a Belmont rapid blood infusion device in the corner. Three circulating nurses (24 year old recent graduate recently married, a 55 year old man with history of back trouble, and a 45 year old woman with diabetes) are bringing trays of surgical equipment in the room and checking them for holes or missing pieces. A scrub nurse (a 42 year old former army medic) is putting on a surgical gown and preparing the back table.
Eight to 10 people are rapidly preparing for this incoming patient. In their head, they each wonder if this patient is sick with COVID. Maybe the patient doesn’t even know. Did the emergency room have time to get a swab to check? Will it come back in time to even make a difference? Will I have to quarantine from my family after this? Where’s my N95 mask? Is it tight? Face shield? Has anyone grabbed the gowns?
“Does the patient have any medical problems?” I ask my anesthesia resident as they start searching the electronic medical chart to prepare for the incoming patient. “Where’s your eye protection? Go get your eye protection before you do anything else.” I worry about my trainees as they are rapidly preparing to care for the incoming patient but sometimes forgetting to protect themselves from COVID.
“Do we have any gowns, yet?” I ask the circulating nurse. “Where’s the isolation cart?”
It’s been 4 minutes since the call overhead. The patient could arrive any minute. Still no update on a COVID test.
Gowns come to the room. Everyone puts one on, N95 on, secondary mask on, eye protection on. The room temperature is increased to 75 degrees to make sure the trauma patient doesn’t get cold when they arrive. It get’s a little hard to breath with two masks, but we wait calmly for the patient.
Surgeons open the door wheeling the patient in the room. There’s blood on the sheets. The patient is moaning and writhing in pain. Coughing.
