With patient safety a top priority, ReSurge has numerous strict protocols and quality measures. It even has a series of emergency scenarios each medical team practices prior to operating – in case something goes wrong, like a loss of power in the operating theater. Planning for the “what ifs” is good practice when working in the developing world. But still, the unexpected can come, like last week in Cao Lanh, Vietnam.
New Emergency Scenario #43: Snakes in the Operating Room (OR).
Have on hand: duct-tape, a blunt object, and extra isoflurane available to anesthetize the snake. Cameras to prove that it happened helpful, but not critical.
“Now I have seen it all,” said experienced volunteer anesthesiologist Mike Flynn.
“A three-foot long green snake came into the OR from a tiny gap in the window, where we were exhausting our anesthetic gases. It jumped down onto the window ledge, about six inches from the anesthesiologist’s head,” Mike reported.
“Nurse Judi Eng was the first to see the snake and alarmingly pointed to the snake by anesthesiologist Jim Anania’s head. Jim turned, the snake jumped onto the floor next to him and slithered behind our big oxygen tank at the back of the anesthesia machine. This all occurred with a patient asleep and ready for a 2-hour palate surgery, with gag in place and surgeon scrubbed.
“So we called for help,” continued Mike. “A person with an absolutely useless metal stick arrived and tried to kill it. The snake went behind supply boxes and sent everybody scrambling away when it came out and started heading for the corridor between the two ORs. It then went under the operating table – with the patient still asleep on the table. The surgeon decided to continue the surgery because no other room was available. To secure the snake, Jim duck taped all around the base of the table. I cleared the room of all boxes and we planned to send the hospital snake catcher in as soon as the case was over.”
“Two hours later, the official hospital snake catcher arrived with an even smaller stick,” said Mike. “But the snake catcher did not kill the snake. Jim did -- by poring liquid isoflurane (an anesthetic gas) into the base of the duct-tapped OR table, stunning the beast and then applying blunt trauma when it came out later in a stupor.”
“Both operations were successful,” concluded Mike very thankfully, as it turned out that the snake was a poisonous juvenile green pit viper.