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Chicken ittle 'n Surgery BOWMANVILLE, ONTARIO, WEDNESDAY, MARCH 24, 1976 SECTION TWO Wins Afghan at Community Fair Raffle Dr. Anfossi prepares to set a leg fracture, but gets the patient ready to receive anesthetic first. O.R. nurses Mrs. Armitage and Mrs. Bonner assist him during the procedure. Many of the minor operations at Memorial, ncluding dental surgery and cystectomies, are done on an out-patient basis which enables the patient to go home a few hours after his operation is completed. hy Liz Armstrong Mind over matter is a useful philosophy in most circum- stances, but when it comes to copingwith the siglit of blood, it's not always 100 per cent effective. Believe me. Several weeks ago, I visited the operating room at Mem- orial Hospital to see the surgeons and nurses perform- -7their skills first-hand. En route to that early óirtrningsession, Itriedato pbych' myself into believing that only the faint-of-heart would reel back in horror at the sight of an abdominal lî incision. In fact, I used to laugh at My Sister The Nurse who. would efficiently dress a minor (but bloody) wound, and then keel over on the floor after succumbing to a dizzy spell. At least, she had the propriety to finish her duty before letting personal interests intrude. Never again will I laugh when the subject is mentioned. Like A Sentry - On arrival at the lhospital at 7:30Oa.m. I was quickly briefed about operating room pro- cedure and then given a gown, mask, cap and boots to wear into the inner sanctum. (Note: the cloth boots don't look very stylish over high heels.) As a soon found out, there are two main operating theatres at Memorial, and a third smaller one which is infrequently used. That day there was a series of minor dominal operations being rformed in the first one, and m1ajor intestinal surgery was scheduled for 9 a.m. in the second one across the hall- way. Already feeling slightly, weak-kneed, I chose what I though would be the least devastating experience -- Operating Room No. 1. Dr. Anfossi had already 'scrubbed' and been gowned by one of his assisting nurses, and he obligingly began to give a step-by-step description of surgical methods. The patient was wheeled into the room on a stretcher, transferred to the table and anesthetized. Meanwhile, I stood by the door, frozen like a sentrv on duty. (I should add that my close proximity to the exit was not mere co-incidence. ..) By the time the doctor started applying the bactero- static iodine solution to the patient's abdomen, matter was beginning to get the upper hand over my mind. 1 Watching the reddish-brown detergent dripping down the patient's mid-section some- how reminded me of what I was trying my best not tt thinkabout. A moment later, just as the scalpel made contact with the skin, I made a hasty exit. I never even saw one speck of blood. If At First You Don't Succeed ... tWhen you faîl off a bicycle, the best thing you can do is to climb right back on and try again, so I applied this simple theory to the situation at hand. Back I went to the scene of my demise, though it took 30 minutes to talk my legs into taking me there. I reclaimed my positioit-at. the door and managed to survive several minutes Of-he intestinal surgery. Major credit for the achievement should go to the surgeon, who effectively blocked my view of the patient for three-quarters of that time, bless his soul. T.V. Surgery Through television pro- grams like Marcus Welby, Medical Centre and Doctors Hospital, most of us have been exposed to a close-up view of the operating theatre. The magic of the 'tube' can give us an abridged version of six hour brain surgery in a mere seven minutes (including commercials). Nonetheless, have you ever noticed that between dramatic shots of the beeping electro- cardiograph, and quick glimpses of the perspiration standing on Dr. Gannon's brow, you never get even a glimpse of the supposed in- cision? Perhaps the producers know when they're well off -- the ratings might plummet if the programs were too realis- tic. In real life there is none of the tense, hushed drama that you'd expect if you took your television viewing too literal- ly. In fact, the atmosphere at Memorial is almost casual in comparison. Thorough know ledge of procedures and a experienced staff reduce much of what takes place i surgery.there to the plateau 'routine.' Certainly, all the precau. tions are taken, and the wor casual is not to be interprete as indifferent or careless Written procedures ar stringently followed to guai antee a very high standard o care. The masks, gowns and cap (which all but conceal th identity of the medical person nel) present a frightening spectre to the patient about t undergo surgery, but the friendly, encouraging voices behind the face and liead gear reduce the negative impac considerably. Humbug to Germs In all parts of the hospita] but especially in surgery absolute cleanliness is essen tial. Besides the instruments sponges and the operating table itself, the staff on duty i -the,0,R, attempnts 1' be as bacteria-free as possible dur ing the course of surgery especially those who are in direct contact with the patient For most minor operations there are four medical per- sonnel on duty and eacl member of the team hasa distinct role to perform. The surgeon plays the key part, of course, and his cleanliness is a top priority Before he enters the O.R. for the first operation of the day he scruþs his forearms and hands in a detergent solution for 10 minutes. , Meanwhile the 'scrub' nurse has performed the same duty and has donned her sterile gown, which Is folded outside to prevent germs from getting on the outer surface. She then gowns and gloves the doctor while he awaits the arrival of the patient. During the oper- ation, the surgeon can only touch areas from his should- ers to his waist and the area directly over the operating table. The scrub nurse is respon- sible for handing up instru- ments, sponges and sutures to him while surgery is in session. A third party, the 'cir- The Central Supply Room at Memorial is located across the hall from the operatng theatres, and it's here that all of tþe stainless steel instruments, towels and gowns used in surgery are sterilized by pressurized steam for 30-45 minutes in the autoclaves. C.SR. technician Mrs. G. Avery and hospital porter Mrs. D. Ogden are shown in the photo packing thermometers. N- 1 n Cs n of u- d e Sf s e r- g o ie n- ig n s r t n n h 1 ai s Gone are the days of chloroform and éther; sodium pentothal is a quick, efficient anesthetic which causes a minimum of adverse side-effects. It is administered intravenously by a doctor and maintained by the anesthetic machine shown above. As part of her duty in the operating room. Mrs. Bryn-Jones, one of six registered nurses assigned to surgery, cleans and washes the equipment with a detergent solution between operations. Strict rules are followed to ensure that the operating room meets high standards of cleanliness at all times. 3-Mon th Pilot Proiect On Use of Video TaDe To Start Here in April It's been called the "Sen- discussion, particularly in The library will h suous Technology" or the library circles. Should li- playback unit and a r "Catherine Deneuve of Com- braries be "getting into video as well as a variety o munications'. It's used extensively as a teaching and learning device in boardrooms, schools, sales offices, universities and - most recently - in libraries. It comes in living color and its lines are sleek and modern. In fact, video tape and its technology (cassettes, tapes, recorders, receivers, play- back units and all the rest) is presently the most popularly- known audio visual device that can be used by the "man on the street". As such, it has been a subject for much culating' nurse, is charged with the duty of counting the instruments and sponges, and assisting the anesthetist. The do-ctor who administers the anesthetic is not required to perform such a rigorous 'scrub' as, the surgeon because he will not be touching the area of the patient's body near the incision. He administers the initial dose of sodium f penothal through a vein in the hand and maintains the state of unconsciousness by inhal- ation through an anesthetic machine. Minimizing Fear If the medical staff appears to be relaxed and confident, the patient about to have surgery is not quite so buoyant about the prospect. When anesthetic is involved, there is always some degree of fearon the patient's parte thougli many will not readily admit it. In order to minimize his feelings of apprehension, the medical staff at Memorial take care to explain exactly what will happen to him while he is i surgery -- well before the day of the operation arrives. Pre-surgery work-up on a patient is thorough and pre- cise. Details about his past and present state of health are checkeçl, double-checked and re-checked to ensure that surgery can take place under the safest possible conditions. Drug allergies, medications and a history of childhood diseases are all duly noted on his chart for ready reference. Extra precautions are taken if the patient is a diabetic or an epileptic. If he has had hepatitis, the regular an- esthetic is substituted for another, known not to create adverse side-effects. In cases where back injuries have been recorded, the O.R. staff will take greater care in turning the patient while he is on the table. And patients with false teeth must remove them before surgery, for obvious reasons. Precaution Reduces Risk Though the list seems end- less, precaution is not only necessary -- it's sensible. Reducing risk can only ensure that the patient emerges from the operating room in pre- dictable shape. Vital signs are dhecked too. The patient's pulse, blood pressure and temperature are taken prior to leaving the tape'? How should video tape be used? How can it benefit the public? How much does it cost?". Above all, the question of whether or not video tape can be a useful information storaeand-rr ol for patrons has dominated dis- cussion of this topic for some time. It is to answer some of these questions that Newcastle Pub- lic Library, part of the Central Ontario Regional Library Sys- tem (CORL) will start a three-month pilot project on the use of video tape in April. ward room for the O.R. and again shortly before going into surgery. Following the operation, the patient is wheeled into the recovery room to regain consciousness, and lie re- mains there until his condition stabilizes -- usually about an hour. While the first patient re- covers, the nursing staff prepares the operating room for the next case. Any tissue that has been removed during the course of an operation is packed, labelled and sent for examination in the pathology laboratory. The stainless steel instru- ments are counted a total of three times during and after surgery and the sponges are counted four times. If a sponge is accidentally left in a patient's body, it can be detected by X-ray, though the count is rarely wrong. The nurses on duty do the initial decontamination of the used instruments before tliey are sent to the Central Supply Room for sterilization. The operating room is washed down and the sheets on the table are replaced with fresh ones. All anesthetic equipment is cleaned, washed and soaked in germ-killing detergent before the next patient arrives. Surgical Staff Head Nurse Cathy Dilling co-ordinates the surgery schedule, and lier staff of six R.N.'s, two, Central Supply technicians and a porter, who accompanies the patients to and from the operating room. 12 Memorial Hospital doc- tors and Dr. Singal, a special- ist in surgery, have operating room privileges in Bowman- ville. In addition, seven con- sulting doctors from Oshawa may also use the O.R. here if the need arises. Though a large percentage of the operations performed at Memorial are classified as minor ones, the number of major cases has increased since Dr. Singal joined the medical team. Whether major or minor, however, the same high stan- dards apply, and the staff takes great pride in their work. Needless to say, though I appreciated the opportunity to visit the Memorial O.R. while surgery was in session, I'm in no great rush to make a return visit. Move over, Chicken Little. have a eceiver of video At the fifth annual Community Fair held at Bowmanville High;School on Saturday, March 13th, the Bowmanville Lionettes held a draw on this beautiful afghan. Anna Strike, centre, was the lucky winner of the hand-crocheted work, which is being presented to her by Marie Moses, President of the Bowmanville Lionettes, left, and Diane Zinn, a director of the club and creator of the afghan. The Lionettes were able to raise $166 on the raffle. -Photo by Liz Armstrong cassettes on many subjects, suppliedsby CORL.ysj , "We want to see if patrons find video tape useful - if they'll watch it to learn more about certain subjects if, in fact, it's a helpful way to get information," said chef librarian Ms. Diane Dineen. The tapes, many of which run from 15 - 60 minutes, focus on aspects of informai educa- tion - macrame, art appreci- ation, wild life, and so on. "we'Ill lave about 25 tapes"; said Ms. Dineen "and will be keeping a close eye on how well they're used." In fact, the Bowmanville Public Library will have tapes about the World Crafts Exhi- bition, health care, print- making, hockey skills, con- sumer protection and even one tape of a play presented at the Shaw festival., Ail of themn have been prepared by Ontario Educa- tional Communications Authority and are loaned to the library from CORL. Video tape has many ad- vantages. It's easy to handie and to use - just like a regular tape recordier. The equipment is transportable and needs no projectionist to operate it. It can be watched under normal light conditions and its tapes offer a flexibility of subject area. The video cassette system is as personal and intimate as television; but the viewer can choose the programs, There's no guarantee, how- ever, that patrons will use video tape and the initial financial investment required to provide the equipment and programs can be a costly one. "That's why we're taking on this pilot project," said Ms. Dineen. "We need to find out how valuable video tape can he, what type of information peopledneed, what the cost lay is, and so on." Tigers Win Top Honors for C.H.S. Play Two weeks ago, Cartwright High School presented its annual one-act play competition at the Blackstock Community Centre. In last week's edition of the Statesman there was a photo of the winning entry called "A Cue For Cleopatra" which was presented by the Tigers, but space did not permit pictures of the runners-up. In the photo above, the Alicats perform "Mr. Snoop Is Murdered" and the actors are, from left to right, Anne Marlow, Ray Porrill, Eric Post and Lois Van Camp. Barry Van Camp, playing the role of Oliver Sax, is slumped over the desk. Judges were Miss Marion Dennis, Mrs. Judy Steeves and Mr. Bruce Brandon. A lowly bank clerk proves his manhood in this play called "The Thompsons", presented by the Ookpiks. From left to right in the photo are Mark Vince, Janet Parsons, Joanne Wolters, Harold Wright ana Anita DeJong. As well as choosing the best play, the judges selected three actors and actresses who gave outstanding performances. The best actresses were Sue Catty, Janet Parsons and Louise Van Camp, and best actors were Harold Wright, Jack Gunter and Paul Larmer. 1