Getting ready for induction. We did 32 procedures during the trip. Many shunts for hydrocephalus, a number of meningomyelocoele (spina bifida) repairs and a couple of tethered spinal cords.
This child was having a shunt placed.
This intubation was relatively easy, some of the children with hydrocephalus had very large heads which were difficult to position.
This child, prepped for surgery, had marked hydrocephalus which improved dramatically after the shunt placement.
This CT of a different child shows pronounced hydrocephalus.
For two ORs we had 3 anesthesiologists, one in each room and one to float, assist with inductions and do the set-up for the next case. Just like an ODA really (operating department assistant in the UK). We took turns at being the ODA.
Nearly all our inductions were inhalational with halothane and IVs were
placed once the child was asleep.
Some of the IVs proved difficult to place but we managed. We only had
to resort to scalp veins a couple of times.
Jackie and Judy inducing one of the younger children with myelomeningocoele. Our youngest this year was a few days old and 2kg in weight. Not very extreme but small enough when you consider we could not ventilate intra-op or post-op.
The ORs were not air conditioned and had no windows or fresh air. As the day progressed the rooms would get hotter and hotter, by the evenings it was very uncomfortable, even with the battery of fans we had brought this year.