Hemostasis

This post is a quick post to all my blog readers in the medical field. In the operating room (OR) in the US, medical students often have the role of assisting the surgery by ensuring that the visual field isn’t obstructed by tissue or blood. I hate to brag, but I consider myself pretty darn skilled when it comes to suctioning or using sterile mini “towels” (or laps) to keep the visual field clear of blood. ;)

Imagine my initial shock here when I realized that there is no suction in the operating rooms at my hospital here in the DR! For those of you who have seen a Cesarean section before, the average blood loss is between 1-1.5 L of blood with at least another liter or so of amniotic fluid. And for those of you who have seen a surgery with any sort of complication, you can appreciate how difficult it is to visualize anything when there is that much fluid around. Surgeons that I have worked with here have 5 sterile laps to work with. They use these towels to hold pressure on a bleeding vessel and to soak up accumulated blood or amniotic fluid. Once the towels are saturated, the laps are rung out over a trash can so that they can be used more. The surgeons here for the most part never really have a clear visual field when they are suturing, at least not a clear field that I was used to seeing.

My surgical experiences here have challenged me to be less picky about having a clear visual field. I had to learn how to suture and repair without seeing things as well as I am used to seeing. I think that this experience has challenged me to understand the procedure and the anatomy behind what I will do much more. I also think that I have become a lot more comfortable with having a less than perfect visual field. It’s a little scary at first to not be able to see things well! How do I know that my suture is in the right place? How will I know if the tissues are coming together well if I can’t see everything?!

I think this lesson will help me once I start my residency back in the US. Don’t get me wrong, I’m not going to give up on having a suction in the OR or having a clean visual field, but when things go wrong and I won’t necessarily have a picture perfect visual field I will have the confidence to know that I can still figure out how to make things work.