So I am shadowing a Trauma Surgeon this week....

[Bojangles85]

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any advice, or mistakes that I need to watch out for?

I know to take it in small steps. Seeing "whatever" can be a shock to my body (not to mention the patient). Step away when needed, don't lock my legs or faint.

Anything else?

 

[CoolWhipp]

Don't ask stupid questions.

 

[GrantN]

look up the term shadow, and then try it while near a doctor.

 

[fahimaz7]

Should be interesting. I wonder how he's going to get you into the OR (no badge, access, paperwork, asepsis, etc). It's not like it's some general surgeon, sneaking you in under his wing...

Have fun though. Stay about 15 feet away from the table, and the scrub nurse won't have to kick your ass.

 

[Barcu]

any advice, or mistakes that I need to watch out for?

I know to take it in small steps. Seeing "whatever" can be a shock to my body (not to mention the patient). Step away when needed, don't lock my legs or faint.

Anything else?

Don't be afraid to leave the room, quickly if needed.

And, DON'T TOUCH ANYTHING!

 

[ucsfstudents]

- Be mentally prepared to see the worst, sometimes people die as a result of traumas
- You might or might not get a chance to go to the OR depending on whether the patients who come in that night have a problem that can be fixed by a general surgeon; a lot of trauma cases are non-operative, or go to the neurosurgeons or orthopedic surgeons.
- When a trauma comes in to the trauma bay, stand in an area where you can still see, but where you are not in the way (i.e. don't stand in the doorway or next to the patient's head)
- put on gloves when a trauma comes in (should be inside the trauma room)
- If they are about to take an xray (a chest xray and pelvic xray is commonly taken when someone presents with a trauma), either step out of the room, or put make sure you have a protective vest on
- Expect to just observe, as anything actions you take is not covered by malpractice
- If you speak another language like Spanish, Cantonese, etc. you will also be helpful as an interpreter (edit: to interpret simple tasks, like lift this, move that, lie still, etc. Not for explaining a diagnosis or for discharge instructions; do not volunteer to interpret, it's just that sometimes you will be asked to help out)
- Look and act interested and thankful to be there
- Youtube primary survey and secondary survey. This protocol is what the trauma team or ER team will follow for most, if not all, traumas.
- Not an exhaustive list by any means, but just a start. Hope it helps a little.
- And EAT and drink before going for your shadowing opportunity. Sometimes surgeons forget about that.
- good luck!

 

[Myuu]

- Be mentally prepared to see the worst, sometimes people die as a result of traumas
- You might or might not get a chance to go to the OR depending on whether the patients who come in that night have a problem that can be fixed by a general surgeon; a lot of trauma cases are non-operative, or go to the neurosurgeons or orthopedic surgeons.
- When a trauma comes in to the trauma bay, stand in an area where you can still see, but where you are not in the way (i.e. don't stand in the doorway or next to the patient's head)
- put on gloves when a trauma comes in (should be inside the trauma room)
- If they are about to take an xray (a chest xray and pelvic xray is commonly taken when someone presents with a trauma), either step out of the room, or put make sure you have a protective vest on
- Expect to just observe, as anything actions you take is not covered by malpractice
- If you speak another language like Spanish, Cantonese, etc. you will also be helpful as an interpreter
- Look and act interested and thankful to be there
- Youtube primary survey and secondary survey. This protocol is what the trauma team or ER team will follow for most, if not all, traumas.
- Not an exhaustive list by any means, but just a start. Hope it helps a little.
- And EAT and drink before going for your shadowing opportunity. Sometimes surgeons forget about that.
- good luck!

I would definitely echo the eating thing as it is quite helpful! However, do not volunteer to serve as a translator unless you have some sort of professional training as a medical translator.

 

[45408]

Should be interesting. I wonder how he's going to get you into the OR (no badge, access, paperwork, asepsis, etc). It's not like it's some general surgeon, sneaking you in under his wing...

Um, walk behind him as he swipes in and out of restricted areas?

 

[juliedi]

Get plenty of sleep, eat a good breakfast, and drink plenty of water. And during surgery don't lock your knees.

 

[rhesuspieces]

don't underestimate the power of the littlest things to make you faint. I once almost passed out watching an anesthesiologist insert a central line. I was fine seeing a guy get his chest sawed apart and cranked open for a valve replacement, but I couldn't stand watching them thread that tube into his jugular.

 

[Bojangles85]

Should be interesting. I wonder how he's going to get you into the OR (no badge, access, paperwork, asepsis, etc). It's not like it's some general surgeon, sneaking you in under his wing...

Have fun though. Stay about 15 feet away from the table, and the scrub nurse won't have to kick your ass.

I already volunteer at the hospital, so I already been taught many of the legal stuff. The surgeon said I'll only need to sign a HIPPA form and I'll be good to go.


But yeh, I'll eat/drink and turn into a fly on the wall.

This isn't like following a family medicine doc where there is time to ask questions.

Thanks for the replies, I'll let everyone know how it goes.

 

[Mithril]

Wear a Naruto headband.

 

[TrojanGopher]

If you are allowed to scrub in, make sure you ask someone (scrub nurse) how to properly scrub and gown up. Also, if you wear a mask that has a plastic shield attached to it, make sure before you start scrubbing in that you bend the shield forward so that you are not rebreathing your own air. I didn't do that my first time and nearly passed out (not to mention my mask was completely fogged up and I couldn't see anything).

 

[Electronegative]

I don't understand how people get sick or faint when watching a surgery, I and couple of other volunteers at my hospital watch surgery every week and none of us ever felt bad and some of those guys are still in high school.

 

[Morzh]

I don't know how big the hospital you'll be at is, so this may not be an issue, but what do you do if it's a slow night and you just sit around in a break room for 5 hours straight until something interesting happens?

 

[Bojangles85]

I don't understand how people get sick or faint when watching a surgery, I and couple of other volunteers at my hospital watch surgery every week and none of us ever felt bad and some of those guys are still in high school.

Wow, you all get stars, congrats

 

[Bojangles85]

I don't know how big the hospital you'll be at is, so this may not be an issue, but what do you do if it's a slow night and you just sit around in a break room for 5 hours straight until something interesting happens?

It is a level 1 AMC, so I assume there will be some action. But that would suck. At least you would have a captive audience to discuss things

 

[PremedGunner]

what is "Whatever?"

dont lock your legs, is that to reduce injuries?

definately dont bother him or ask stupid questions or let your personality leak out, and do say arrogant things, like ask him advice on whether to be an oral maxillo facial surgeon or a cardio thoracic sugeon. you are a premed. you are nothing. if anything, say you are trying really hard to get into medical school. dont assume that you can be anything. thats arrogant.

 

[Astarael]

Don't lock your legs is to avoid fainting. Standing around in a several hour long surgery with your knees locked because you are trying to look over someone's shoulder is a fantastic recipe for fainting. It doesn't matter if you are freaked out by what you are seeing or not, if you lock your knees you could still faint or become lightheaded.

Electronegative, that could be the answer to your question, as well. I have never been grossed out by anything surgical but I almost fainted during a hip replacement I was watching. The circulating nurse had given me a block to stand on so that I could see, and I stupidly spent a lot of time standing up straight so I could see better. Then I almost fainted, because my knees had been locked for half an hour. I'm sure there are people who are just freaked out by it, as well.

 

[ASU2013]

good luck

 

[orthomyxo]

I don't understand how people get sick or faint when watching a surgery, I and couple of other volunteers at my hospital watch surgery every week and none of us ever felt bad and some of those guys are still in high school.

I can't really understand how someone can get physically ill, like vomiting and stuff, but lots of people get faint at the sight of blood. Other things are just off-putting to some people, like needles, usually anything to do with eyes, broken bones, etc.

 

[Morzh]

I can't really understand how someone can get physically ill, like vomiting and stuff, but lots of people get faint at the sight of blood. Other things are just off-putting to some people, like needles, usually anything to do with eyes, broken bones, etc.

Sudden lowering of blood pressure resulting from the sight of blood is an autonomic visceral response that increases the risk of vasovagal syncope. (Wikipedia citation)

I was once told that this is actually, in part, an evolutionary defensive mechanism. The theory goes that when your association cortex recognizes excessive blood it correlates that with danger/fear to self and sends a signal through the vagus nerve to decrease cardiac output. The body plays it "better safe than sorry" and just assumes the blood is somehow coming from you or that whatever caused the blood loss in the guy next to you is about to happen to you too. Decreasing cardiac output is very advantageous when there is a potential gaping leak in your circulatory system!

Of course many people are able to override this response using a top-down mechanism, but I still think it is an interesting theory.

 

[muhali3]

I think to prevent yourself from fainting you have to kind of emotionally detach yourself from the person they are operating on. Once you start humanizing the patient you begin to think about how their family is feeling about it, how this might affect their lives, etc. I fainted at an autopsy once because of this type of thinking, but not having enough sleep or a good breakfast that day may have also contributed.

 

[NickNaylor]

I think to prevent yourself from fainting you have to kind of emotionally detach yourself from the person they are operating on. Once you start humanizing the patient you begin to think about how their family is feeling about it, how this might affect their lives, etc. I fainted at an autopsy once because of this type of thinking, but not having enough sleep or a good breakfast that day may have also contributed.

Agree 100%. When I see someone getting operated on, I have to focus on the area being dealt with to "forget" they're a person. Otherwise I tend to get the woogies.

 

[Electronegative]

Wow, you all get stars, congrats

wikipedia

 

[CaptainDrew]

I think to prevent yourself from fainting you have to kind of emotionally detach yourself from the person they are operating on. Once you start humanizing the patient you begin to think about how their family is feeling about it, how this might affect their lives, etc. I fainted at an autopsy once because of this type of thinking, but not having enough sleep or a good breakfast that day may have also contributed.

+1

The only time I've almost passed out during a surgery was during a hand surgery on a woman who was not fully under general anesthesia. I totally started thinking "this guy is HACKING into this woman's arm!!!" Needless to say I had to sit my ass down right there and then.

Btw, get enough to eat and drink. I had some food and an applejuice after said story and was fine for the rest of the day.

 

[hoot504]

Those blue drapes that they use to form the foundation of the sterile field really mitigate the drama of the entire procedure, at least for every operation I've ever seen. Certainly if it weren't for those, it would have taken much longer to become comfortable watching.

 

[45408]

I don't understand how people get sick or faint when watching a surgery, I and couple of other volunteers at my hospital watch surgery every week and none of us ever felt bad and some of those guys are still in high school.

WHOA, THAT'S SO COOL, DUDE.

For me, the light-headed aspect comes in with wearing a heavy gown in a hot OR with bright lights on an empty stomach.

 

[Electronegative]

WHOA, THAT'S SO COOL, DUDE.

For me, the light-headed aspect comes in with wearing a heavy gown in a hot OR with bright lights on an empty stomach.

I get it, I sounded like a douche, but I was referring to just watching, not performing surgeries after being in a hospital 100hrs a week without any rest.

I don't understand how people get sick or faint when watching a surgery, I and couple of other volunteers at my hospital watch surgery every week and none of us ever felt bad and some of those guys are still in high school.

 

[Long Dong]

Stroke the surgeons ego, they love it. And if he asks you to stroke anything else do it without delay.

 

[littlealex]

To OP:
It depends on quite a few things. Is it a level 1 trauma center? Does he stay in the hospital or just comes in when trauma cases roll in? Will you be shadowing the trauma team who receives the patient in the trauma bay or will you just be coming in when it's a confirmed surgical case? Does he do acute general surgery cases during the day when there are no trauma coming in?

What ever you do, try to scrub in. He may not allow it, but at least ask. Standing in the back can get boring pretty fast. If you're scrubbed in and retracting, it'll be way more fun. Also if it's a level 1 trauma center, you can ask to help receive the patient in the trauma bay. Cat1 cases rolling into the bay can be pretty dramatic and a good experience for premeds.

I don't understand how people get sick or faint when watching a surgery, I and couple of other volunteers at my hospital watch surgery every week and none of us ever felt bad and some of those guys are still in high school.

It's rarely the blood or gore that makes people faint. It's usually the fact that sometimes you get hypoglycemic, the room is hot, you're standing for the last 8 hours slowly the light headedness creeps up on you. I've never fainted before, but I've seen a top notch surgery resident pass out, and he's a much more awesome man than I am.

 

[45408]

I get it, I sounded like a douche, but I was referring to just watching, not performing surgeries after being in a hospital 100hrs a week without any rest.

The bright lights, smell of cautery, and a general uncontrollable vasovagal response can make people feel light. My first half dozen surgeries went fine when shadowing, but I felt light-headed during a subsequent one. I hadn't eaten much at all, and I'd been standing for a long time. It's usually not an issue of being grossed out.

 

[Myuu]

The not-eating will really get you, it's true.😳

 

[Bojangles85]

The deed is done. The first part will be about what I saw, the second part are my tips

So I find where the surgeon is and ask/get a OR nurse to help me scrub in. Walk into a patient with a broken back. The surgeon is cleaning the soft tissue around the back so the neurosurgeon can do their work. Very cool stuff.

After the neurosurgeon comes in, I am wisked to another surgery. The patient has Diverticulitis so they were preforming a partial colectomy. This ended up being the "meat" of my day.

The last thing I saw was a tracheotomy and feeding tube procedure. All in all it was pretty cool.

Now for my "tips"

*Eat/drink beforehand.
*Wear gym shorts, so when you put on the scrubs, you have somewhere to put your phone/wallet. There are pockets in the scrubs, but it felt weird to have them out during a surgery.
*Don't ask any questions, just respond to whatever they say.
*Be "hyper-aware of your surroundings. There could be a tube or plug or whatever near you. Hitting it would be bad.
*Fainting is ok, fainting on the patient isn't.
*Spend 25-30% of you time NOT looking at the procedure. I found myself focusing in for a while, then when I "came out of it", my legs hurt etc. Helps ya keep your mind right.
*Burning flesh smells like burning hair. You will have that smell in your nose for the next 12-24hrs.
*Thank everyone.
*Try to take up as little room as possible, think fly on the wall.
*Wear comfy shoes, you're going to be standing for 2-3hours without moving.

I guess that is it.

I didn't faint!!! WOOO!!

 

[45408]

Comfy shoes is clutch. I've got a $100 pair of Brooks walking shoes that are worth every penny.

 

[Bojangles85]

Comfy shoes is clutch. I've got a $100 pair of Brooks walking shoes that are worth every penny.

I could just see someone wanting to be "impressive" walking in with dress shoes. Oh that would suck.

 

[AsianPersuasion]

Wow, that sounds awesome 🙂 thanks for sharing. I'm in the paper work process right now before I can start to shadow the trauma surgeon in the near by teaching hospital.
I'm really excited because its a Level I ceter, hopefully something goes on ( not that I enjoy watching people get hurt or anything).

How long did you shadowed him/her for? I was thinking of doing the whole shift if they let me...or would that be too much?

 

[ESzczesniak]

- Be mentally prepared to see the worst, sometimes people die as a result of traumas

Sometimes? I'm heading downhill in my intern year where we do two months of trauma. If you're in a busy level I trauma center, MANY people die and those that don't often end up as vegetables. Trauma is an ugly beast. It's one of the few places you can routinely expect see healthy 20 something year old patients pronounced dead with essentially no warning.

It's also a heck of a rush. What does happen in the trauma bay happens fast and with a different set of rules. No where else can you walk up to a stretching essentially in a hallway and slice open the chest from side to side...and have them live (once in a while at least).

I'm not advocating trauma or saying that I want it to happen. Regardless of how often we all say that though, it does happen and it happens a lot...And when it does happen I definitely want to be the one in the trauma bay when it shows up!

 

[fizzgig]

Agree 100%. When I see someone getting operated on, I have to focus on the area being dealt with to "forget" they're a person. Otherwise I tend to get the woogies.

lol at the "woogies" 🙂

 

[Silverman780]

Yeah volunteer to go out and help sanitize the ambulance especially with after bleeders or patients with heavy vomiting and/or diarrhea.

Sincerely
- A third party with absolutely nothing to gain.

 

[psipsina]

The bright lights, smell of cautery, and a general uncontrollable vasovagal response can make people feel light. My first half dozen surgeries went fine when shadowing, but I felt light-headed during a subsequent one. I hadn't eaten much at all, and I'd been standing for a long time. It's usually not an issue of being grossed out.

Yep! I had to walk/stumble out of an OR once before anesthesia even had the patient knocked out. I was sick, it was the middle of the night, I hadn't had enough fluids or carbs in recent hours . . . and I got light headed over absolutely nothing. This is after taking many trauma calls and doing CT and vascular surg (which are arguably the bloodiest). I now know that when I'm sick I have to pay extra attention to my own hydration status. I was mortified at the time, as someone who is hoping to match into gensurg in two weeks, but the attending was very kind and told me his "I fainted in the OR as a medstud" story 🙂

The best thing you can do if you start feeling light headed is to speak up and back away from the table or anything that you could mess up by fainting on it. You won't be the first or the last to scrub out/leave the OR. Hitting the floor (or god forbid more important things) as you pass out because you didn't speak up is what you're trying to avoid.