Anesthesia Rotation

I honestly was a bit terrified before starting this rotation because I had weird problems that happened during sophomore and junior surgery (apnea- not breathing on their own, waking up while heading to the OR (operating room), and things of that nature).  I actually have been enjoying my time even though there are times when my heart still races.  It is not too bad of a rotation, but it does solidify the fact that I do not want to pursue this as a career for the future 🙂 It is just way too much stress and responsibility resting in your hands.

I struggled in the core anesthesia class because I could not picture the microscopic phenomenon that occurs when a drug is given or when the blood pressure decreases or when heart rate increases or when the patient stops breathing all of a sudden and so forth.  Going over all the lecture notes while taking this rotation greatly solidified some concepts that I could not grasp when just sitting in the classroom and taking notes.  Sophomore and Junior Surgery was also great kinesthetic practice for preparing for this anesthesia rotation.

I have improved tremendously with doing drug calculations after taking this rotation!  I loved that they give us a drug sheet with all the available anesthetic and analgesic drugs with their proper concentrations and drug administrations. It made the calculating process run more smoothly.

Life Saver!

You will get a lot of hands-on experience. You give the injections such as the premedication drugs, induction drugs, and even pain therapy drugs like an epidural (injecting an analgesia, usually an opioid, into one of the layers just outside the spinal cord to help numb the area being treated). You also get all of the equipment and station ready for the patient, place the catheter in the cephalic vein found on the dorsal-medial aspect of the antebrachium which is distal to the elbow of the front limbs or in the saphenous vein found in the lateral aspect of the hind limbs, and intubate the patient.  A lot of doctor–related decisions for when problems arise occurs very frequently.  Be ready and prepared for those situations by reviewing past anesthesia lectures and notes from rounds because changes within a patient (ex: apnea, tachycardia, hypotension, hypothermia, hemorrhage, etc.) can happen very fast.

On occasions, you will be monitoring alone with the patient having a procedure.  Do not panic though!  You will always have a technician pairing up with you for a case.  During the first week, they will be in the room with you and will rarely leave.  Later on, they begin to trust that you are getting used to monitoring the patient on your own and will leave for longer periods of time but always will check back with you to make sure everything is fine.  Technicians are extremely helpful and patient.  They will either be people who work here at the hospital, or they may be your classmate who took this rotation already and is now considered as the tech.  I was so surprised and encouraged for how much my classmates knew after taking this rotation for only 3 weeks!

Making the best drug protocol for a patient is still a bit of a challenge for me.  There is so much to consider before sticking with a drug.  What is the patient’s major health concerns, and will this drug make the patient worse while under anesthesia?  Once you feel comfortable that the drug’s contraindications will not affect the patient, it should be safe to administer.  Just remember that there will never be a perfect drug.

 

 Here’s what other people had to say about it!

(What was Orientation Day like?)

-Met in the prep room (huge, long room by Imaging services) at 7AM to get a quick introduction for how they operate and where supplies are located. We received a laminated drug sheet first day that is extremely helpful for the rotation and future. Try not to lose this handy tool.

(Average Daily hours on duty?)

-7:30AM-5:30/6PM (including AM and PM rounds)

-7:30AM-6/6:30PM With one doctor, morning rounds @ 8A, evening rounds @ 5PM

(What is the attire?  When do you change into scrubs?)

-scrubs and white coat (supposed to change into scrubs once in building to keep them “clean”)

-make sure to always put your white coat back on after leaving the OR area. It is easy to forget, but it is to prevent any hair or blood to land on your scrubs before going back to the OR for another procedure. Have one extra pair of scrubs in your locker.

(What do doctors/residents/techs constantly harp on?)

-Have all your stuff and be prepared. Morning rounds is exactly 8AM (some doctors hate latecomers), but you need to have your stations set up for your patients by then (so get there 7:30AM or earlier).

-Know your differential diagnosis for CBC or Chemistry abnormalities. You will some times be asked to explain what causes elevated sodium levels or decreased anion gap and so forth.

-Don’t forget to give Cefazolin (an antibiotic) via IV to your patient undergoing surgery every 90 minutes. This one takes 10 minutes to administer, so it is easy to forget to re-administer this drug and to give it very slowly also.

(What are some struggles to watch out for?)

-Inconsistent lunch breaks  (have snack bars on you at all times to eat in the changing room!). People on-call have been there up to 1-3AM, be ready to be there if you’re on-call (whether it’s primary or secondary on-call)

-You may finally be able to do an epidural without assistance, but then you notice the administration was still unsuccessful because the patient is tachycardic and hypertensive during the surgery (meaning the patient is painful). Don’t beat yourself up if it did not work. Just make sure you have other pain meds such as Hydromorphone or Fentanyl to help facilitate the problem.

-Some times, students in other services forget to write where the patient is located, so you have to walk a lot to try and find where the student or the patient is to get more information about the particular case. If you ever have to write up an anesthesia form, please write where the patient is. It will help us out greatly.

(Words of encouragement)

-It can be very overwhelming and nerve-wrecking, but really rewarding. You get the chance to do and learn a lot with direct supervision and guidance (lk epidurals, brachial plexus blocks, lots of intubation/ catheterization). The more work/ effort you put into it, the more you’ll get out of it! Also, teamwork is a must!

(Difficulty Level (1-3)? 1= It’s a breeze/ 3= really difficult workload)

2 out of 3

3- our block was constantly busy and would sometimes have up to 12 requests to work up for the next day (good news is that you never have to write up discharges or put in any requests for tests or imaging)

Through Him,

~Camille

1 Corinthians 6:19-20= “Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God?  You are not your own, for you were bought with a price.  So glorify God in your body.”

Surgery Time! (Week 6)

Week’s Itinerary = 1st surgery day and Surgery Quiz 1, Renal Pathology Exam and Bone/Muscle Pre-test, Toxicology Quiz 1, Polysystemic Case 2, and Anesthiology Final Exam and Final Draft Paper Due

I love surgeries!!  It was an exciting week for me because we finally got to do hands-on work with our cute little piglets!  Our group decided to not name our piglet because we knew we would get too attached, so we are continuing to call it Case # …… 🙂  It actually helps me to not get too attached even though I am already.  Here are some helpful advice for you before you do Lab #2 which focused primarily on anesthetizing the pig and sterilely draping as if we are preparing for a surgery:

-bring your own surgical scissors

So, we had some difficulty tearing tape for securing the catheter in the ear and taping the Doppler probe onto the medial plantar region of the forelimb.

-Remember to eat something!

The doctors told us at least one person faints during these surgery sessions, so EAT PLEASE!  That should not be a problem for me, but I’ll let you know if that happens…

-Relax

    Make sure to prepare before the labs.  The doctors provide a lot of handouts and videos that will ease the surgery experience, so take advantage of that.  If you have a question, I would advise asking your group members first before asking the doctors because your questions may have been answered in the videos and handouts.  The doctors are very patient with you, but they may sometimes not help you immediately if you have not taken the time to research material on your own.

-Weaknesses

So this week, I did struggle with placing the catheter in the ear & being the student doing anesthesia.  Fortunately, the doctors were very patient with me as I was doing the catheter (it is not easy).  They helped guide me after I failed on my first attempt.  I never felt embarrassed or looked down upon for not doing it correctly the first time.  Thank you for your kindness and patience!  Then again, our group’s surgery time is in the beginning of the week, so maybe they have not been bombarded by so many students yet 🙂

To me, having the task of being the Anesthesiologist is the most demanding.  You are the one who has to watch vital signs every 5 minutes!  It feels like the patient’s life is all in your hands and supervision.  That feeling is so crazy for me!  Remember important steps to take if you see complications such as hypotension, hypoventilation, and hypothermia and what to do with fluids that are provided.

All of this is just one thing we had to accomplish this week.  We also had 6 other things to do!

1) Monday morning, we had to do our Renal Pathology Exam and Musculoskeletal Pre-test.  This was a big day for me because I did not do as well as I should have done on my Renal Pre-test.  Guess what??  I got an A on both my Renal and Musculoskeletal exams! Trusting on your strength God!!

2) Oh man, Toxicology… that quiz #1 was brutal!  It was all multiple choice but many were very picky and specific questions within the lecture slides.  He did not put the Echo lectures up online until the day before the quiz.  The quiz is heavily weighted (20% of your grade), so study for it like you were studying for an exam.  There will be 4 quizzes total.

3&4) An Anesthesia paper and Polysystemic Case 2 were due this week.  The great thing about them is how we can be in groups as large as 4 people to share our creative minds.

5) General Surgery Quiz 1= It was short answer, and I did not have to study that much because information where I do things hands-on sticks much better to me than just reading it from a textbook or lecture slides.  Handouts were provided, so I would look over those notes real quick before the quiz

 6) The big day has finally come . . . the Anesthesiology Final Exam!!!  It was a 3 hour exam of only short answer questions.  I have to be honest with you that I was a bit nervous for this final.  Guys, the experience was very long but better than what I thought I would dread.  He did have a review session that laid out the learning objectives and what to focus on, so I thought it was beneficial to go.  Study hard for it though!!  You can do it.

This weekend, I decided to go to the Real Life Real Impact again (by Christian Veterinarian Fellowship Club).  Last year, we went to Auburn University in Alabama.  This year was at North Carolina State University.  I thought the experience this year was way better than last year, and I got to enjoy it with some of my classmates.

 

 

 

 

Through Him,

~Camille

John 10:10 “The thief comes only to steal and kill and destroy; I have come that they may have life, and have it to the full.”

Snow Day Miracle! (Week 5)

Week’s Itinerary = Ophthalmology Exam 1, Clinical Pathology Exam 1, and Anesthesiology Quiz 4 & Protocol Paper due

Happy Snow Day!!

For real????  Lord, you are such a magnificent God!  You saw my struggle with this crazy workload this week.   You saw my desperate need for help, and you greatly supplied it!  Thank you Lord for taking good care of me.  I love you so much!  So yep, we got a Snow Day when I desperately needed it before my Ophthalmology exam on Friday.  Here are the 6 things we all did this week:

1)We had an online Ophthalmology quiz due on Monday, and it was a bit challenging to be honest with you.  It was take home, and you could discuss it among your classmates.  I am just not a fan where multiple choice questions have multiple correct answers.  If you thought an answer was right and got it wrong, it deducts an answer you had correctly chosen.  It gets thought-provoking when a question is formatted like this.  I managed to do well though plus it helps prepare you!

2)Also on Monday was our Clinical Pathology Exam 1.  It was very long with a mixture of multiple choice, short answer, and analyzing test results from different species.  After taking it, I felt like I did the best I could, but my efforts were unfortunately not reflected on the grade.  When this happens, it is due to the fact that I second guessed myself with many of the questions, or I did not have enough time to fully immerse myself in the material.  The ladder has been a normal occurrence for me with this very fast-pace schedule in vet school.  Two more tests to go!  I can rebound from this Lord!!

3&4)2 Assignments had to be postponed due to the well deserved Snow Day.  The last Anesthesia quiz was postponed to Friday, and it involved the Pharmacology section.  You really have to practice differentiating between proper drugs for different species and see what are some detrimental side-effects of each drug to do well on this next quiz.  The Bone/Muscle Pre-test is postponed until Monday.  This is what the professor said the the format will be like:

The pre-test will be only 5 case based questions that are short answer, hand written (not on elc new like usual).  There will be visuals and the client’s history. With some of the cases, she will sometimes ask us to explain the issue so that an owner will understand (don’t use big words to explain in this instance). Hope this helps!

5)The last thing I had to conquer was the Ophthalmology (make sure you know how to spell this word 🙂 ).  It consisted on multiple choice and short answer, and it was challenging for me.  Make sure to look over the Lab Cases because some were reuse in the exam.  With the cases though, if you get one question wrong, it will ultimately affect the other answers regarding the same case.  Tests like these frustrate and frighten me (but that’s just me).  A classmate told me the experience of taking the exam was fun for her. Update: Did well!  (JESUS!!)

6) Remember to turn in your protocol paper for Anesthesia.  I highly recommend being in a big group and discuss each case after everyone completed their assigned case.  Also, the Lab final for Anesthesia was very much like the protocol paper.

We get to start surgery next week!!!  I am so excited, and we have our piglets now.  I am already attached!

Through Him,

~Camille

1 Corinthians 2:9 “However, as it is written: “What no eye has seen, what no ear has heard, and what no human mind has conceived”— the things God has prepared for those who love him.”

Worrying is Not an Option (Spring Week 4)

Week’s Itinerary = Principle of Surgery Exam and Practical, Anesthesiology Quiz 3 & Lab 1 Final, and Clinical Pathology Case 1, 

So yeah, this semester is rough in so many ways, but worrying about what the next few days brings to the table is pointless and a waste of time.  I must focus on what the present day reveals and thank God for each moment of the day.  I know with God’s strength, I can surmount to ANYTHING!  Praise the Lord!

So my Class finally received our 1^st Polysystemic Exam, and I received a B!  I can improve, but I am so thankful for this grade!  So again, using the handout notes for each powerpoint were very helpful!

We did begin this week with Principle of Surgery Written and Practical Exam.  This was how they went:

Written:

We were all required to go to the vet lab to take the exam.  I assumed since we were here, the exam would be an online test, but we received a scantron and hard copy tests.  I believe the main reason why we were here was due to the fact that we had to get up during the exam to identify knots, surgical tools like suture and hemostats, and other tangible objects related to surgery.  The exam was a bit tricky!  You really need to get a firm grasp on ALL the material from lecture PLUS the required textbook reading.

Practical:

Don’t stress over this at all!!  It was so laid back guys.  Don’t get me wrong, practice all the suture techniques to prepare yourself to do actual surgery, but don’t feel nervous about having the professor personally watching you do the techniques (they are very patient with you).  They had us only do 6 suturing and handling techniques for the practical, but you still need to review everything from that module.

We had our 3^rd Anesthesia quiz this week, and this was intense.  He asked us to answer so much from one question in 6 minutes!  When he shouted out “1 more minute left!” Iheard a classmate gasp b/c time was going so fast.  I am going to meet up with the professor next week to get a firmer understanding on how he wants us to approach his questions because we only have one more quiz then the exam!

Next was our Clinical Pathology Case 1 Assignment with our assigned CATME groups.  Some of those cases were BRUTAL!  Make sure to work each case together after assigning a case to each teammate.  You wouldn’t want your case to be a good grade and your partner’s section to be unacceptable.  Please talk it out and work together with these cases.  Our group managed to get a B, but now we know what the professor is looking for.

At the end of the week, we had our Anesthesia Lab Final 1 where you prepare by knowing how to do:

1)    pressure checking the anesthesia machine

2)    understanding pulse ox, ECG, and capnography machine usage and abnormalities

Capnography equipment is very essential for Anesthesia

http://cardiologyforless.com/Edan-M3B-Vital-Signs-Monitor.html

3)    finding any problems on a anesthesia machine (what is missing?  What needs to rearranged?)

Hope this helps for this week!  I have a big test tomorrow in Clinical Pathology, so I have to go guys!  Remember, don’t worry.  Speaking to me too 🙂

Through Him!

~Camille

Matthew 6:25-27=  ²⁵ “Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes? ²⁶ Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they?²⁷ Can any one of you by worrying add a single hour to your life^[a]?”

Feeling the Pressure (Week 3)

Week’s Itinerary = Anesthesiology Quiz 2, Polysystemic Case Study, Pathology Urinary System Pre-Test, Polysystemic Exam 1,  Rough Draft Paper due for Anesthesiology

What in the world!?  This week and and the following weeks to come looks gruesome!  The Spring semester of second year is more overwhelming than fall semester because not only do you have 1 or 2 exams a week, but you will have to do quizzes and separate assignments (ex. cases studies, papers, surgery and treatment with the piglets).  My advice is to make sure you look at when assignments and the exams are due each week from the syllabus from each course, write them down on the calendar, and then take each week at a time.  You will get very overwhelmed by how much you have to do every week, but you can do it!

This week, we had 5 things to conquer!  1) We first had to study for an Anesthesiology quiz that covered 2 lectures.  This time on the quiz, he cut the paper in half because so many of my classmates were writing way too much information down 🙂  He wants us to be very concise with our answers.  2) The next assignment for the week was a Polysystemic case study where a group of about 4 people looked at a patient with his history and physical exam and then had to come up with a problem list, a differential diagnoses, and a final treatment plan for the patient.  I really need to practice this type of write-ups because this is exactly what I will have to do when I become a veterinarian in the future.  3) Thirdly, we had our first pre-test covering the urinary system for Systemic Pathology.  Lets just say studying for this material was not as exciting as I remembered it from last semester.  Yes, it had the same helpful tools: web lessons (most disappointed with/ too long & didn’t feel as organized as last semester), lectures (this time, I appreciated them doing a narrated version where you just click on a microphone image and you hear the professor speak to you in each slide/ a genius idea, but the slides to me were all over the place), AQS (Class is split up into 4 huge sections, and we get to look at samples of tissue and organs that have various abnormalities/sometimes, there were no actual specimens to feels, so I personally was not feeling it/ it did last 1 hour instead of 2 hours like last semester). and notes written like an ebook with pictures (a friend told me to use this before anything else, because it was more organized, and most of the questions came from this note form/ will use this in preparation for the exam.

4) The fourth assignment for this week (I know, let this end!!) was our Polysystemic Exam.  Dr. Ward can be tricky sometimes, but her questions are straightforward for the most part!  I struggle a little bit with physiology concepts like endocrinology because it takes me a while to see it.  A friend who is an upperclassmen brought up a good idea for what he plans on doing during clinical rotations.  He said since he also struggles with physiology (“Internal Medicine”), he will sign up to do 2 rotations in Internal Med.  That way he will be able to see the symptoms and treatment plan in action!  I think this idea is genius, so I may follow suit.  5) Lastly, we had a rough draft due for a book review in Anesthesiology.  The book is called “The Invisible Gorilla”, and we had to summarize each chapter and show how they relate to Anesthesiology scenarios.  This book is very thought-provoking.  I enjoyed thinking outside the box and seeing how all of the concepts listed out in the book can be related to veterinary anesthesiology.  This book greatly solidifies the idea that one may perceive and acknowledge their surroundings to the best of their abilities, but one will always have flaws in their everyday perceptions.

http://www.theinvisiblegorilla.com/

Yeah…and next week is not getting any lighter.  I believe we have 5 or 6 things to do next week too!!  I love when people are taking just 2 minutes out of their time to pray for someone.  Can you please pray for me for this month and February??  I would greatly appreciate it.  I need to continue to focus on accomplishing my goal as God’s arms continue to embrace me and keep me safe!  Amen!!

Through Him,

~Camille

Happy Martin Luther King, Jr. Day!!

Psalm 55:22= “Cast your cares on the LORD and he will sustain you; he will never let the righteous be shaken.”

With Heavy Hearts… (Spring Week 2)

Week’s Itinerary = RIP to a sweet vet student, classmate’s birthday party, and Anesthesia Quiz 1

The whole of UGA’s vet school was so shocked to hear about the loss of a sweet young man from the freshmen class of 2017.  We got an email from the Freshmen’s President that read:

As you all heard this morning, we lost an integral member of our class.  Zachary Cowart was one of the most kind-hearted, positive, and uplifting individuals any of us have ever had the pleasure of knowing.  His passing is shocking to say the least, and we greatly appreciate all of the support we have received from everyone.  Zach will never be replaced in our class, and we will always be a “102 Man Wolf Pack”.  As we continue to deal with this loss, please keep his family and friends in your thoughts and prayers.

With heavy hearts,

The Class of 2017, “The Wolf Pack” 

This news greatly saddened me.  Even though I did not get the opportunity to meet him,  we are like a huge family here at UGA’s vet school.  Please keep his family in your prayers…

http://whitley.tributes.com/our_obituaries/Zachary-Cowart-97649903

I will continue with what went on this past week.  It was all-in-all a very relaxing week.  I am organized with the schedule, and I am feeling very comfortable with classmates.  I can’t complain right now.  Then there comes the Anesthesiology quiz… just playing!  It was not too bad guys, but of course I over-analyzed the questions.  The majority of the Class do not over-think questions as badly as I do 🙂  Basically, you only have 4 minutes to turn in your quiz.  He does not want you to write a whole page of content (wants it very concise).  You get to choose 1 from 2 questions that best suits you.

The end of the week on Saturday was fantastic!  Got to celebrate the 30th birthday of a very special friend!  Love you my sister in Christ!

 

Through Him,

~Camille

Isaiah 41:10 “fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand.”