My name is Randall McKnight.
I am an Orthopedic Surgery Residency.
This is a day in my life.
It’s a Saturday morning.
it is a on-call day.
So we’re just driving to the hospital
and the goal is to see all my patients,
have all my notes written before 7:00 AM,
at which point, I will meet up with the call team
and we’ll kind of run the lists
see what patients came in overnight
what surgeries have to be done,
and then I’ll head off to the operating room and pick up our pager.
So I’ll operate throughout the day
and also see any consults that come in to the emergency department.
And then once the day is over, I stay overnight.
And I will finish my shifts tomorrow morning at 7:00 AM.
It’s about 7:30, just got done with rounding on all my patients,
writing all my notes for the day.
Now, we’re getting ready for our cases.
We’ve got a patient that had broke his femur,
so the thigh bone.
What we’re gonna do is go in,
put a long metal rod down the inside of the bone,
to just bring the bone pieces back together
and keep the bone stable
so they can start to walk on it.
But first, we need to scrub in.
So to scrub, first you’re gonna take your scrub brush,
you’re gonna get your hands,
wet all the way up to your elbows.
I typically turn the water off afterwards, just to save it.
Then you just start scrubbing.
So you want to make sure you get every part of your hand at least 10 times,
that includes both sides of your fingers.
Then you’re gonna flip it over and use the brush to actually
get your finger nails.
You know you’re doing it long enough,
if everybody else that’s scrubbing into the case is already done.
So then once I got my hands done,
I want to get my forearms,
again going a couple inches above the elbow.
So again, we’re only sterile up to our elbows.
I am going to rinse off my hands,
keeping my fingers above my elbow.
This way any germs will rip down my arm
and not towards my hands,
which I want to keep sterile.
Again at this point, I’m trying hard not to touch anything,
and I’m ready for my case.
So we finished our cases for the day.
Typically, that happens around 3, 4 o’clock on a weekend.
Just an example of the type of things that we do.
You can see that this person had broken their femur
right here and a little bit of a fracture up there as well.
So we take a long metal rod
and we actually push it in from the hip
and go down the bone after aligning
the two different ends of the bone.
And then we put these screws in, going up into the femoral neck
to keep the bones from rotating
around the rod that we put in.
And typically, when patients come in with an injury like this,
they go from not being able to walk to being able to walk on this, the next day.
For the rest of my shift, typically,
I’ll be holding the pager.
So any consults that come in to the emergency departments,
there’s people that have infections of their extremities,
have broken things, dislocated things I’ll go and see.
Just an example, if we had a patient– they called me…
比如说 来了病人 他们就呼叫我…
the ankle fracture dislocation like you can see here.
This is something that’s going to need surgery at some point.
But right now we can’t just leave them like that,because…
all their cartilage will die,
if it’s just pressing on the bone.
So I’ll go down to the emergency department and see the patient.
Reduce the fracture which means
take that ugly image and make it look
something a little bit more normal.
Here’s just an example,
so you can see there’s still a fracture here and a fracture here.
But for the most part, the bones are well aligned
and it looks more like a normal joint.
So this patient would either be sent home
to follow up for surgery in the future,
or we’d admit them to the hospital
to do surgery in the next 24 to 48 hours.
And we’ll typically get one consult
like this per hour when we’re on call.
And I think for me the big thing is that in Ortho,
you actually get to make patients better…
as opposed to other specialties where you temporize things and–
Actually, hang on one second,
we are going to have to call this page back.
That was the ED.
We have what we call a native hip dislocation.
So we need to go down, see the patient.
Get some X-rays, get him sedated
and then we’ll put the hip back in place.
This is the end of the call night or day at this point.
值班夜 现在应该叫值班日了 终于结束了
It was a pretty busy night.
Had a few distal radius fractures.
A few ankle fracture dislocations.
Bunch of long bone fractures.
A couple hip fractures.
So it was pretty busy.
Now I just need to finish up some notes
then I’m going to get out of here and go home and go to sleep.
That’s it, it’s the end of a call day.
So that was a day in the life of
an Orthopedic resident on call.
Hope you enjoyed it.
If you have any questions,
you hit me up on MedSchoolInsiders.com
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My name is Randall McKnight.