Is the tourniquet supposed to be up??
One thing about being an SRNA, working with other SRNAs, is that life is hilarious because you’re trying your best to function despite both having incomplete knowledge.
For example, take the other day in an orthopedics case. Just for a little background, in orthopedics cases, an electronic tourniquet is often applied to the leg to reduce blood flow and thus blood loss during surgery.
The case had started about half an hour ago. The junior SRNA was the primary anesthetist for the case. I had helped start the case, but had been in and out of the OR a little bit since I had also been helping other rooms. Now I came back in to check on the junior.
Junior: (Pointing to the tourniquet) Um, is this supposed to be on? They’re going to let me know when to turn it on, right?
Me: (Mildly alarmed at realizing the tourniquet is not currently on) Uh… I mean, it’s usually turned on at the beginning of the case. They never asked you? Are you sure you didn’t miss them asking you?
Junior: I’m… I’m pretty sure they didn’t ask for it. I never heard anything.
Me: It’d be hard to miss. They make a big deal out of it, they ask for a certain pressure, you repeat the pressure to confirm, and the circulator marks the time the tourniqet went up and stuff. If you’re sure they didn’t ask… then… I guess they’ll let us know…?
Junior: Should… we confirm with them?
I stayed quiet for a second because I knew there were 2 outcomes to this predicament:
If we asked if the tourniquet should be up, and it turned out that it didn’t need to be up — then it revealed how little we knew about this particular surgery and it’s workflow loool
But worse, if we asked if the tourniquet should be up, and it turned out that it should have already been up — then it meant we fucked up and the ortho team would be annoyed that the tourniquet hadn’t been up this whole time. Loool.
In the end I decided to quietly ask the circulator (who confirmed that the tourniquet didn’t need to be up, and the ortho team would let us know). Lol.