MAR 06-2

Medical Anecdotal Report 06-2
Date of Medical Observation: February 16, 2006
Title: Working as One

Narration:

It was mid-afternoon, I was on duty, when I received a phone call from the OR regarding an intra-operative referral from OB-Gyne. I asked them what the referral was about and they replied that they encountered massive bleeding.

I immediately went up to assess for myself, as I hurried up the stairs, several questions ran through my mind, what vessel did they hit and what am I going to do?

After changing into a scrub suit, I went straight into the OR and asked the surgeon what happened.

The information was bleeding in the pelvic area, while doing a TAHBSO, the blood loss at the moment was at 5000 ml, the blood pressure was 70/40. I asked them to pack the pelvis and transfuse blood, as I readied the vascular instruments.

I referred the case to my chief resident and asked for help, then scrubbed in. I arranged the packing myself and held my hand on top of the packing. As I waited for blood to be transfused, two surgery senior residents scrubbed in as well.

After stabilizing the blood pressure, we removed the packing, identified the bleeders, and placed operative packing again with plans to go back after 24 or 48 hours.

INSIGHTS: (discovery, stimulus, REINFORCEMENT), (physical, PSYCHOSOCIAL, ethical)

If I was alone doing the operation, it would have taken me a longer time to achieve the goal of controlling the bleeding. Thanks to my two co-residents, we were able to move synchronously on the operating table, saving a lot of time. At the same time, it boosted my confidence that I have someone to ask help or opinion in terms of judgment, which needed to be fast.

When a member of the team is weak, the others help, the stronger ones pick up the ones in need, this is teamwork, if the group works as one, it can achieve far more than if each member working individually. Each person may be doing different things, each according to an identified strength, but as a whole the group moves toward the common goal.