*Trigger warning for anyone involved in infection control*
A bit of a competition between team anaesthesia and the surgeons on Thursday’s acute list. As is strangely typical, acutes that day had a certain flavour, which was very much general surgery. The day before had been vascular, with two amputations in a row, and Tuesday was a neurosurgery day, but for me, it was bowels. The competition was exposure to disgusting body fluids. I know that many people find the mouth and nose, and their liquid contents particularly offensive: saliva, snot, mucous, phlegm (or felgum as my daughter used to pronounce it) – all equally repellent. We had a couple of American orthopaedic registrars who used to call us Goober Doctors (Goober can mean peanut in America but here it’s referring to snot). So, yes, I’m afraid dealing with the upper airway and it’s secretions is all part of the job for us. In addition, our second patient of the day also managed to produce some gastric secretions that came up as a bright yellow fountain through the side port of her breathing tube. This is generally considered a bad thing – a bit of harmless regurgitation is no big deal but if it gets aspirated into the lungs, then it can cause damage. She hadn’t eaten for days so this was a bit of bad luck really. We dealt with it well and promptly but I did end up with a bit of stomach content on my hands. However, thirty minutes later, I considered myself lucky when I looked at the scrub trousers of the surgeon who had been down the bottom end of the table. “Oh you’ve got blood clots on you!” I said. “It’s not just blood” he said, grimly. It was leavened with a mix of mucous and poo, that had managed to slide down past the bottom of his gown. Our next case only escalated the situation, for the surgical team at least. It was a five hour extravaganza that added urine and pus into the mix, due to a rather unfortunate connection between the bowel and the bladder in that patient. At one point, we watched with incredulity from the top end of the table as the surgeons cable tied a plastic lavage/vacuum kit to an opened up section of bowel. The poo that was flushed out mostly ended up in a special plastic container but the surgical registrar ended up wearing some of it.
So, I’m thinking team anaesthesia were the winners on the day.