Dr. Bohlen's Blog: June 27, 2010 - "TIME OUT"

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by Julie Tork

Story Created: Jul 21, 2010 at 7:08 PM CDT

Story Updated: Jul 21, 2010 at 7:08 PM CDT

Today's blog is about two things. I situation in the operating room and an ancillary discussion of the Navy medivac team. The weekend here was centered on the operating room with taking care of the soldier who got hurt by the IED, poker, and watching the USA soccer game. Let's talk about soccer. I may have before but I just want to point out the field they play on looks humungous. Wow do they have to be in shape to play that game. I feel bad that they lost b/c it would of been cool to watch them play another game or two. I have always found the World Cup to be fascinating especially the global affect it has. If you are not a soccer fan you should try to watch the next 2 weeks of this tournament. It is as good as it is going to get. This is why. There are no ties. It is win or go home. In the first round there is even this style of play not to lose b/c you can get points to advance from ties. It changes in the these final rounds. You will see some amazing athletes perform at a tremendous level. Appreciate it even though you may not like soccer. It only happens once every 4 years. Life is experiences.

Lets talk a little about how an operating room works. This is the background on our topic for today. There have a fair amount of operations performed on the wrong side. That is the facts. Most of the cases came from orthopaedic surgical cases. Since this has occurred there has been a significant push for measures in the operating room to prevent these from happening. It obviously starts with the consent form. That has been the norm for a long time. Well rightfully so it progressed to measures including signing the site. The nurses confirm with the patient and put as yes or there initials on the extremity or the side. There are some places where the patient does it also. The other way is the doctor then does it again after the patient or the nurse does it. I understand all of this. We then implemented a part of the procedure in which the nurse reads the consent and everybody agrees to the side to on top of all of the things we have done before. I gave the nurses a lot of grief about that before I left. I think we do so much medical treatment to prevent from getting sued it is remarkable. People have to do their job and they do. It just seems like a bit much sometimes and on top of that it is hard to teach an old dog new tricks. In a way I am becoming an old dog and don't like change very much. The picture I am including today will solve all of our problems.



I think this is awesome. Everybody that I work with in the OR at Mary Lanning will appreciate this. We do the basic things like we discussed above when it comes to the surgery. Major Anderson has a time out and I am getting used to that. This though is a solution to everyone's problem. This is a towel that is included in the pack for the operating case. When we do surgery we often open up a package of blue thicker towels that we use for draping and soaking up fluid and other things. This orange towel that says TIME OUT on it comes in that package of towels therefore it reminds you to do that at the beginning of the case. I handed this towel off before it got near the surgery and am bringing it home. This is what I am going to do with it. I am going to hang it in my operating room back at home. That way when they read the consent and say for everybody to agree in unison I will just point to the towel and mumble yes. It will be a reminder to me to not be such a pain in the butt and to everyone to remember to do it.


The other pictures I want to share with you is of my excursion on sunday. Me and two other doctors that work as primary care physicians here went over to meet with the medivac team. This is a picture of the blackhawk Navy medivac helicopter.



I wanted to go meet and see this helicopter close up after the mass casuality drill that we had last weekend. It is important for me to now our capabilities for immediate transfer of the injured and the amount and timing of this at Camp Basrah. The reason is that our operating room is functional but not well equipped to handle large surgeries and multiple surgical patients. That may sound scary but really it makes sense. Look at the number of cases that I have done so far. Few and I can't even fix a regular fracture like I would at home because I don't have plate and screws not an electric drill to put them in. It therefore is imperative to know my evacuation protocol. We have had increased attacks not only from rockets but on the outside with IED. We have to be ready.


This picture is of the Navy insignia for there group.



I think it is interesting that the Navy is here doing this. This is how it is set up. The Navy works the very southern part of the country. Starting here and into Kuwait. Makes sense b/c we are close to the ocean. They function as both sea and land medivac teams and therefore this is as much north as they go. They can piggyback patients to Bagdad where we have a much larger Army hospital but halfway from here to there it switches to an Army medivac team. These guys are awesome. I guess if I were to do a job and somebody said to me you have to pick a job in whatever service and the job this would be it. The reason why isn't b/c I can tread water very well but because the Navy has bases in the best places. Compared to the middle of Louisiana or Missouri the Navy has places like San Diego, Virginia, Tampa, Naples, and Spain. Nice weather and scenery. It would be my luck I would be stationed somewhere in Michigan. I think they have a base there on the water. The second is this job is really cool. They train these guys so well and I think its exciting to fly around on these things and help take care of people. I got to take a ride on an Army medivac helicopter when I worked in Louisiana. You sit in a rumble seat with the door open and your legs in the breeze. Felt like you were floating.


Getting closer to the end. Learning the most that I can both in the OR and on the base. We have to be ready. I hope in a lot of ways it stays quiet for the true heroes of this war. I don't want to see them hurt.




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