Close Calls in the Operating Room: A Few Critical Scenarios

Working in an operating room is a high-stakes environment where even the most experienced professionals must stay vigilant. As a nurse in this demanding field, I have witnessed numerous close calls that not only challenged my skills but also underscored the importance of quick thinking and teamwork. Here are a few critical scenarios that stand out in my memory.

Construction Worker Injured by Rebar

One of the most harrowing incidents I ever witnessed was with a construction worker who fell on rebar and was impaled. He had a severe abdominal wound that punctured his abdominal aorta, which required immediate attention. Three vascular surgeons had to work together to fix the aorta, and he lost a significant amount of blood, requiring multiple transfusions. Despite the severity of the injury, the patient made a miraculous recovery and even needed several abdominal surgeries to follow. Although this case was far from what one might consider an everyday occurrence, it remains a stark reminder of the potential risks involved in working with sharp materials.

Quick Thinking in a C-Section Emergency

Another scenario that comes to mind is a case where we were called to perform a C-Section as quickly as possible. While the patient initially appeared calm, it became clear that something was off during our pre-op interview. She mentioned that everything had been going great with her pregnancy until the morning when she felt something was wrong. The doctors did not disclose the urgency, but we were keenly aware of the woman's panic. The baby was delivered without complications, but during the examination of the placenta, we discovered an abnormal knot. This situation required immediate attention, and the OB/Gyn doctors handled it with precision and care, ensuring the safety of mother and child.

Watching for Signs of Shock in a Little Boy

A particularly tough experience occurred in the PACU (Post-Anesthesia Care Unit). On a particularly busy Tuesday, we had multiple tonsillectomy and ENT surgeries. I was especially attentive to a 5-year-old boy with a beautiful smile and blonde hair, as I had a similar-aged child at home. During his post-operative recovery, his nurse noticed him spitting out a significant amount of blood, and I was concerned about the amount. Thirty minutes later, he started vomiting blood, and his complexion turned ashen. Despite the anesthesiologist saying everything was fine, I insisted on calling the MD, as I was not entirely convinced with the initial assessment.

The situation rapidly deteriorated, and the child began showing signs of shock. His vital signs were falling, and I could see the panic setting in. The anesthesiologist returned to the bedside and correctly identified the child as having an active bleeding source. We had to airlift the child to a children's hospital, where he made a miraculous recovery. Unfortunately, it later emerged that the child had a family history of a clotting disorder that had been previously undiagnosed due to the absence of prior surgery.

These experiences highlight the critical role of vigilance, teamwork, and quick decision-making in the operating room. They also underscore the importance of staying informed and keeping certifications such as ACLS (Advanced Cardiac Life Support) and PALS (Pediatric Advanced Life Support) fresh in my mind, especially during hectic days.

Working in the operating room, one learns to trust their instincts and the importance of voicing concerns even when they may seem overblown. These cases serve as a constant reminder of the incredible dedication and skill required of all those involved in surgical care, and the potential for making a difference in a patient's life can be both a reward and a challenge every single day.