Fueled by the lack of astute assistance by Sister Ples & her Horde of Hobbits, an anaesthetist in state practice develops a notable skill in projectile accuracy. To adapt to the situation, one is forced to throw things around in theatre (only have two hands, can't be in two places at once, often have finger in the proverbial hole in the dyke & can't move etc.)
Take for example, the seemingly simple and common task of ensuring reliable intravenous access - singlehandedly.
10 Steps to IV Access
(when the patient is 5m away from the bin)
- Attempt to flush existing drip with saline. Infiltrated/haematoma/thrombophlebitis/never in. From a distance, throw syringe into paper bag (PB), needle into sharps bin (SB).
- Remove existing cannula. Flick ball of sticky strapping & hurl filthy infusion set into PB, lob icky cannula into SB.
- Disinfect arm. Pitch swab into PB.
- Recannulate. Patient performs & knocks safety sheath onto floor. Discard potentially lethal (1:3 HIV) needle by tossing into SB. (Like a bushman shooting his poison-tipped arrow).
- Whilst holding cannula in place, tear off piece of strapping with other hand & teeth. Roll finished - strapping too short. Fling into PB. Stretch for new roll, strap cannula.
- Cap cannula as Sr Ples disappeared to Hobbiton whilst you thought she was preparing a new infusion set.
- Open new IV bag, toss wrapper & cap into PB. Open new infusion line, launch wrapper & caps into PB. Run fluid through.
- Stick down with dressing, screw up backing into a ball & shoot into PB.
- Clean up bloody spills with gauze, fire into PB. (Red splotch marks target like in a game of paintball).
- Catapult gloves into PB.
That's 14ppm (projections per minute) with median accuracy of over 93% (p<0.05)! There is no more satisfying sound than that "thwack!", as the projectile meets its mark. Until this week, that is!
Having transgressed the Draconian Constitution in one of my recent posts, my retribution has been public humiliation. The big gavel in the sky has clapped down & deemed my post inappropriately critical & the punitive verdict has been passed. As attested to by the litter-strewn area around the SB & PB, my projectile accuracy has dropped out the bottom. Es ist die Strafe Gottes.
I have lost my mojo!