RODEO ANESTHESIA |
July 09, 2007
Name: RN Clara Hart
Posting date: 7/9/07
Stationed in: a military hospital in the U.S.
Fisticuffs was the name of the game today, or, as one anesthesia provider put it, "Rodeo Anesthesia." Today was the day I ducked flailing fists, kicking feet attached to powerful legs, and tried not to be head-butted by 6' 4" 230-lb soldiers. Twice! Twice I dodged punches, kicks and brain-rattling smacks.
I was looking forward to an "easy" day when I saw that my first patient was a ruptured eardrum repair. Most of the time we see these surgeries in our wounded who have experienced some type of blast: IED, RPG, or mortar. But as anesthesia rolled the stretcher into the bay and we put the oxygen mask on the patient, he began to flail. Fixing the anesthesiologist with a glare as I tried to hold his arm still so he wouldn't pull out his IV, I asked, "Is he OIF?"
"No," came the response.
Reinforcements arrived in the form of several other nurses and tech, and we each attached ourselves to a limb in an attempt to keep him from further hurting himself and undoing his fresh surgical repair -- or taking one of us out.
Over and over we crooned to him, "You're in the recovery room, your surgery is all finished, you're OK." After continuing to fight us for several more minutes he slowly -- very, very slowly -- settled down.
The rest of the recovery went without incident, and when he was finally coherent and able to answer questions I asked him if he was OIF. "No," he responded, "I'm OEF, been home 2 months." Uh huh, I thought to myself, that explains it.
As he was transported down the hall I went in search of his wife. Once I found her and assured her he was doing well, I asked her about his deployment. She responded she didn't know much as he never spoke about it to her. I questioned her on her knowledge of PTSD, and referred her to websites where she could find additional information. As I walked her along in the direction her husband had gone, I gently reminded her that for any and all future surgical procedures she needed to tell the staff about his deployments. She told me she would, and thanked me for my help.
I no sooner returned to the recovery room than my next patient rolled out of the OR. Striding to the bay, I grabbed the monitor cords only to notice this patient was also auditioning for rodeo anesthesia. I grabbed hold of his arm -- the one with the big cast on it, the one they had just completed surgery on, the same one he was trying to behead me with, yeah that one -- and all of us, anesthesia providers, pacu nurses and techs, again attached ourselves to various appendages. I looked at one of my coworkers and asked,"Is it a full moon?"
Another responded, "No Clara it's just you! They knew you hadn't been to the gym today and needed your workout." We all cracked up at that and continued to hold on.
One of the techs managed to get a pulse ox on him so we could monitor his breathing and his heart rate. He too, took some time to reorient. Once he was awake and alert he was a wonderful patient with a wicked sense of humor. I asked the key question: "Have you been deployed?"
"Yeah," came the response, "finished my three tour seven months ago."
I simply nodded my head. I asked him if he'd had surgery before, and when he responded in the affirmative he asked "Why? Did I get a little rowdy?" After apologizing for fighting with us he seemed pleased to hear it took six of us to keep him from hurting himself or any one of us. I reminded him to tell the anesthesia providers of this anytime he had surgery. He agreed, apologizing some more.
Over and over I have witnessed the OIF/OEF population emerge from anesthesia combative enough to do great damage to themselves or the staff. Again and again I have listened to their appalled lamentations once they fully awaken. Whether it is PTSD-related or just the disorientation that may come with emergence from anesthesia, very few really know.
Too few people have a good understanding of PTSD (Post Traumatic Stress Disorder). With that in mind I would like to share this very short, very simple definition: PTSD is a normal reaction to extremely abnormal events. PTSD does not, repeating not mean you are crazy! Even though it may seem like it, you are not losing your mind.
The following websites offer information and resources for helping to understand and overcome Post Traumatic Stress Disorder.