So today I spent the morning in the Plaster Room (which of course, is where they put on and take off casts and check up on broken bones) which was very exciting! There are different types of cast; Plaster of Paris (POP) and synthetic (fiberglass) casts. POP casts are heavier than synthetic casts and synthetic casts also come in many colours! (…and patterns…including heart and paw prints!) and they are also waterproof (well the synthetic outside is, the cotton padding isn’t)…which is great for children. Before putting the casts on we looked at the X-rays to see which type of cast was needed and what position it had to be placed in. I saw arm, leg and elbow casts being put on and I also observed a K-wire being removed.
K-wires are surgical wires (or pins) which are used to hold bone in a corrected position after surgery. The wires stick out of the skin so that they can be easily removed after the bone has healed.
In one case, a K-wire was being removed from a young child’s wrist. The little boy was quite scared but the nurse was great with him; he calmed him down and promised him stickers and told him when to look and not look at his arm. The removal was quite simple as he just pulled it out with no anaesthetic (although you can have it done by a surgeon under general anaesthetic) and he did it so quickly that the kid didn’t believe it was over.
The removal of the casts was also pretty cool because the saw was really loud and looked dangerous, but because it is not rotating and vibrates instead, it cuts easily through harder materials (such as casts) and it’s really difficult to cut through soft things (such as skin and flesh)…the nurse even tried it on my hand and it just felt tickly J. In some cases, because soft casts were used, you could just cut them off with scissors. After the cast was removed the fracture was checked by a doctor to see whether a new cast would need to put on or if the patient was ok to leave. In some cases the patient was also sent for an X-ray to check. Casts are usually left on for the same number of weeks as half the patient’s age.
Acute Cardiovascular Care Unit:
I then spent an hour in the Acute Cardiovascular Care Unit (ACCU), where I observed a nurse checking patient’s obs (observations). There was this really cool app which you put all the details of the obs in (heart rate, blood pressure, pain, alertness…) and it tracks the patient and then also tells you how long it should be until the next obs are taken. We also checked the blood sugar levels of a diabetic patient, which there was also an awesome machine for J ). I also sat in on a handover from the morning nurses to the afternoon shift. They went through any updates on each patient and what would need doing next for them.
Finally, I spent the rest of the afternoon in Phlebotomy and observed bloods being taken for blood tests. The phlebotomists made sure to talk to the patient (especially nervous patients) whilst they were taking blood to distract them from what was going on but even then, there were some patients who were almost too nervous to talk. For example, there was one patient who was nervous and she usually had a different phlebotomist. It was difficult to find a good vein on her and when we had a good one, it was difficult to get blood from. At this stage, the phlebotomist could’ve kept searching, but the patient was obviously panicking, so together, they decided to rebook the appointment when the other phlebotomist was back- it is important to know when to stop, even if you could keep going.
So anyway, there are different coloured tops on the blood tubes and today I found out why- the different colours represent the different anticoagulants in each vacutainer blood collection tube, so that the blood can be tested for different things.
I also got to see the labs when we took urgent samples for testing. There was lots of really cool looking equipment such as centrifuges and big microscopes…I would’ve liked to spent longer in the labs and had a proper look around, but there were more patients to see and more blood to take J.
Anyhoo, bye guys, I’ll blog tomorrow for my final day of this Hospital Work Experience…