June 1, 2009 § Leave a comment
Filming a radio frequency ablation (RFA) for liver cancer a couple of weeks got me thinking about the hierarchy that exists in the OR. Especially between the surgeon, or in this case radiologist, and the anesthesia personnell.
It’s probably an everyday situation in the OR, and not remarkable in any way, but I found it a bit strange. Just an observation.
This percutaneous RFA was done in the OR because of the narcosis. Most of the procedure consists of the radiologist using ultrasound to locate the tumor and find the best placement for the RFA-needle.
Nothing I haven’t seen before, but every now and then the radiologist would call out “apnea” and the anesthetist nurse would immediately push a button on her anesthesia machine. At first I didn’t understand what was happening, but I soon realized she was holding the patient’s breath by pausing the ventilator. This would of course keep the liver more still, increasing the accuracy of the needle placement.
The radiologist was very fixed on his ultrasound machine, concentrating hard to get this 100% right. So much in fact, that he always forgot to order the nurse to resume the patient’s breathing. Eventually she would ask him, but to me it seemed like a lot of unnecessary apnea (image credit).