Monday 18 February 2008

Monday

Another good day on Placement.

Today, amongst other useful things, I removed my first drain.

For people unaware of medical terminology, a drain is a tube inserted, during surgery, used to drain (surprisingly) blood or other undesirable fluids from a wound or abdominal cavity. Once the drain is no longer needed, it is removed.

Removal is a simple, but by no means easy, procedure. The drain works by a negative pressure principle. It is later secured by a stitch through the skin of the abdomen.

To remove a drain (and this is not a guide of any sort) you have to firstly calm the patient and let them know what's going to happen. After that, you need to instruct them to take three deep breaths - which in itself is not a small task, as the drain can often cause breathlessness. On the third, you let them know, you will remove the drain.

Before this, of course, you have to use a scalpel or surgical blade to sever the stitch. Then test the drain will move out with a bit of give.

After that, all that's left to do is ask the patient to take the three breathes and pull. In a perfect world, one I was privy to today, the drain will slide out with a sort of 'plop'. There may be fluid discharge, there may not be. From then, like a bottle of coke that's been shaken up too much, you have to slam some gauze over the wound in case it leaks.

Hold it for a while, maybe swapping the gauze. Clean the wound, dress it and you're done.

Although later check ups may be necessary.

I was amused. My mentor literally showed me it once and then asked me to do it. I was confident, and it went well. That, in my book, is an excellent way to learn. There's no accounting for taste, of course.

I almost got a chance to remove my second set of surgical staples, but time ran out. There'll be plenty of time for that in the future, though. I fear the day I get bored of such interesting procedures.

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