Anesthetic question (pangolin are you out there)?

Question

when the anesthesiologist gives you that shot in your IV why does it make your wrists hurt???And how do they keep track of your vital signs and keep you alive when you're under??And how long do they have to stick around after the operation...until you wake up??? Do they have to stay in the recovery room with you?? Btw how do you wake up from that sate....and I was wondering what kind of math do they use to do their job???

Answer 1

Lots of questions!

Some of the drugs we use are irritating to the veins, and they can sting or burn when injected.  Propofol is used to put most people off to sleep, and it is known to burn quite a lot.  We often add numbing medicine to the drug to reduce pain on injection.  

We keep track of vital signs with a number of monitors, and we record vital signs every 5 minutes (tho' we watch them all the time).  We keep people alive by counteracting whatever is trying to kill them - if they bleed, we give fluid or blood; if they don't breathe, we do that for them; if blood pressure goes up, we give more anesthetic, or drugs that work to lower blood pressure.  I can't really explain years of training here.

We stay with the patient from the time we assume care (usually when the patient enters the OR) until we sign the patient out to the recovery room nurse.  Recovery room is an intensive care area, with each nurse caring for only 1 or 2 patients.  We are usually responsible for most patient care issues in the recovery room, so if the blood pressure is wacky, or the patient has chest pain, we deal with those issues.  Once the patient is discharged to the floor, or is sent home, s/he is the surgeon's responsibility.

Most of the waking up is done by breathing out the gases and metabolizing drugs. We want the pain medications to stick around, though, and frequently give more of those in recovery.

We use a fair amount of math, but nothing too complicated.  We need to figure out dosages, drug concentrations, allowable blood loss, fluid requirements, and a bunch of other stuff using math.  Most of it involves plugging numbers into formulas, or simple algebra.  No calculus or trigonometry.