First Aid for the Orthopaedic Boards, Second Edition ebook PDF download
First Aid for the Orthopaedic Boards, Second Edition ebook PDF download Eat before you begin the case. Some cases can go on for longer than
planned and it isn’t cool to leave early because you are hungry (read
unprepared!) or, worse, to pass out from exhaustion. As a student, your
function in the OR will most likely be to hold retraction. This can be
tedious, but it is important to pay attention and do a good job. Not pull-
ing in the right direction obscures the view for your attending, and pull-
ing too hard can destroy tissue. Many students get light-headed standing
in one position for an extended period of time, especially when they are
not used to it. Make sure you shift your weight and bend your knees
once in a while so you don’t faint. If you feel you are going to faint,
then say something—ask one of the surgical techs to take over or state
discreetly that you need relief. Do not hold on to the bitter end, pass
out, and take the surgical fi eld with you (believe it or not, this has actu-
ally happened; we print this advice from real experience).
Find out about the case as much as possible beforehand. Usually, the
OR schedule is posted the night before, so you should be able to tell.
Read up on the procedure as well as the pathophysiology of the under-
lying condition. Know the important anatomic landmarks.
Find out who you are working with. If you can, do a quick bibliography
search on the surgeon you will be working with. It can never hurt to know
which papers (s)he has written, and this may help to spark conversation
and distinguish you among the many other students they will have met.
Assess the mood in the OR. The amount of conversation in the OR di-
rected to you varies by attending. Some are very into teaching and will
engage you during most of the surgery. Many others act as if you aren’t
even there. Some will interact if you make the fi rst move; others nuke
all efforts at interaction. You’ll have to fi gure it out based on the situa-
tion. Generally, if your questions and comments refl ect that you have
read about the procedure and disease, things will go well.
Keep a log of all surgeries you have attended, scrubbed on, or assisted
with (see Figure I-1). If you are planning to go into general surgery or a
surgical subspecialty, it can be useful during residency interviews for
conveying how much exposure/experience you have had. This is particularly true if your school’s strength is clinical experience. The log can also be useful if you are requesting a letter from the chairman of surgery
whom you have never worked with. It gives her/him an idea of what
you have been doing with your rotation.
Many rotations will set a mini-
mum number of surgeries you are to attend. Try to attend as many as
possible, and document them. This serves both to increase your expo-
sure, and confi rm your interest.