In August of my CA-1 year I showed up to to set up my room thinking I am going to do an elective VP shunt. Instead, I see the call team moving an ICU patient into my room for an emergency case. The patient was a 50-ish male with a history of renal CA. Apparently, the cancer had previously spread to his sternum and he had a sternectomy with a skin graft. Just like sevo said, you could see his heart pulsating. The emergency case was a laminectomy/fusion for cord compression due to spinal mets. The call team tubed him supine on the bed, lined him up with an a-line and CVP, then very carefully flipped him prone on a Jackson table where the heart wasn't compressed. The case went all day long. About 11 am, the surgeons calmly informed me that they were about 45 minutes to the part where they would lose about 10-15 units of blood and that I should get the blood ready. I got the blood ready, wondering how they could ever lose so much blood. But sure enough, they lost about 10-15 units and I was hanging blood and FFP. We finally dropped the patient off around 1800 in the unit. What a day that was as a fairly new CA-1.
