When The Power Goes Out In The OR

I´m in Honduras with International Relief Teams as part of a Head and Neck surgical team. Here in Honduras, or in any developing country, the power supply can be unpredictable. With the violent lightning storms we´ve been having, the lights have gone off several times in the last few days.

Usually the hospital generator starts immediately, but this morning there was a delay in getting the power back on. As fate would have it, the power went out right after extubating a patient from general anesthesia and just as the patient began to vomit.

While power failures in hospitals in the United States are thankfully rare, they do happen. I was in one surgicenter in San Diego quit a few years ago when the power went out during a storm, and then lightning hit our emergency backup generator. Total blackout in the ORs. So one always needs to be prepared.

Power Considerations When Volunteering in The Developing World:

  • Know your room set up, so if the lights go out you are oriented
  • Carry a small flashlight in your pocket or make sure you have one easily accessible in the room. Don´t forget your laryngoscope can serve as a flashlight in a pinch.
  • Know your monitors. Older electronic monitors may not have battery backup.
  • Be prepared for lack of monitors by having manual BP cuff, manometer, and stethoscope. Don´t forget you tell a lot about the blood pressure and rhythm from taking your patient´s pulse.
  • Consider alternatives to electronic suction

Alternatives to Electronic Suction

So there we were in the dark without suction and our patient was vomiting. What could we do. There we were in the dark with no suction. We immediately turned the patient lateral and used a surgical bulb syringe to quickly suction the mouth out. Thankfully, patient did fine without any aspiration or harm. Other alternatives to power suction that we could have used include:

  • bulb syringes come in many shapes and sizes
  • large syringe attached to extension tubing
  • toomey syringe
  • a manual hand powered suction apparatus

Think about having one of these alternatives near your work station to be ready for when the lights go out. Oh, and sometimes surgery will be continuing. Many times during volunteer trips abroad I have had to use my flashlight to light the surgical field until the generator came on or the power was restored. Always prepare yourself for the unexpected.

May The Force Be With You

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