Monday, October 01, 2007

Tips for Medical Students: Scrubbing in Theatre

Milk & Two Sugars from Tea at Ten recently made a post about being uncomfortable when scrubbed in theatre. I gave her some suggestions in the comments, and she suggested that I post my tips to my own blog, so here goes.

Ten Things to Make Scrubbing Up Easier

  1. Make sure you have a piss before you start. Or get a pair of those NASA astronaut undies.

  2. Do calf pumps and change your stance regularly, or else you will get venous stasis and pass out more easily.

  3. Whenever you can, rest your hands and or forearms on the operating table. Preferably not the patient, as they can get pressure areas from you leaning on them for too long. Don't wave your hands around (especially over the wound) unless you want to get stuck with a needle. And remember to maintain sterility.

  4. Always let the surgeon know when you are uncomfortable. They will understand. Better a moment to change position than a medical student unconscious on the floor (or in the wound).

  5. Try to engage in banter (where appropriate). You are not the only person who is bored and can't see much - the primary surgeon is the only one who is actually doing something interesting. Mind you, as soon as you have something to do, like a wound to sew up - you will wake up immediately. Also don't feel that you have to talk medicine all the time. It may be hard to believe, but even surgeons have outside interests, and sometimes we are actually interested in you as a person, not just a student.

  6. Tie your mask a little loosely, and tape the top edge to your nose. That way it won't ride up and you can breathe air in from around the edges of the mask when necessary. Make sure you have eye protection - find some goggles if you don't like the full-face masks. Often hospitals will stock very cheap disposable ones, or buy one between several of you.

  7. Don't stick your head in the light. The surgeon loses their lightsource, and you get very, very hot. And then your head explodes, which makes a big mess.

  8. Don't inhale diathermy fumes on a full stomach and don't wave the laparoscope around (both in the patient or outside). The smell of vomit tends to hang around the scrub sink for a few hours, and there is nothing like a laparoscope shining in your eye to make you go blind for a few minutes.

  9. Check out what step sizes are available beforehand - it is more important that you are at a comfortable height than whether you have the best view. You don't want a sore neck, back or shoulders for the rest of your life.

  10. If you are not too keen on getting your hands inside the patient, then sometimes the best vantage point comes from not being scrubbed. Crossing the blood-brain barrier can sometimes give an excellent view. As long as you can see, there is no need to scrub - you can just join in at the end when there is a wound to suture.


Milk & Two Sugars said...

Hey, you made it more sugeon-ish! I like it a lot! The public-access post is here, so anyone can read it:

The Gasboy said...

Thanks for the post sheepish - much appreciated.

To those medical students contemplating crossing the blood brain barrier... contemplate crossing it permanently, perhaps you'll get good at sudoku and the stock market, and occasionally look at the patient! :P

If you do choose to come this way though to have a look, ask nicely (and we'll usually say yes since we're too busy completing the crossword) and don't touch anything round, especially the transparent plastic one with numbers printed on it, or anything connected to it!

Prudence said...

However, crossing the BBB isn't that easy. :-) Maybe next time you could write tips about that, too.

Chris said...

Sheepish, Enjoyed this a lot after finding it on Grand Rounds. I'd add the one obvious suggestion: Get scrubbed in, it is much less boring than settling for looking over a shoulder! Pardon the expression, but surgery is a bit like sex: Interesting to read about, fun to watch, but nothing beats doing it!

Ta, -C

Jeffrey said...

submitted this on your behalf to the Surgery blog carnival: SurgeXperiences.
its at:

10th edition will be hosted at dr alice's blog.

Sheepish said...

Thanks Jeffrey - now I have one more blog carnival to keep track of. I'm rapidly running out of time to read blogs... ;-)

Medic said...
This comment has been removed by a blog administrator.
Sheepish said...

Dear Medic:

I do not like my blog being hijacked for drug advertising, therefore your comment has been deleted.