A Surgeons Journal Interruption of electricity during surgery Dr. Mohamed AHMED-NASR Last week was a hard one. I had multiple episodes of interruption of electricity during surgery. Usually , there are powerful UPS generators that instantaneously start on electricity power interruption. Because of repetitive interruption, the UPS units take now between 15 and 30 seconds to assure light. These seconds may appear hours for the surgeon in action. I have done last week 5 cardiac surgeries under these circumstances. The first one was a case of four coronary artery bypass grafts. The first electricity interruption occurred during passing the stitch between the left internal Mammary artery (LIMA) used as a conduit to bypass the coronary artery lesion and the left anterior descending (LAD) coronary artery. Suddenly while passing the stitch of the angle I found myself in total darkness. Since I am an old surgeon having developed tactile sensation I passed the stitch. Light came after 15 seconds. Another two episodes of electricity interruption occurred during the same surgery but they were less critical. The stitch of the LAD angle is primordial in this surgery. The LAD is considered as the orphan or widow maker artery. If it obstructs , patient cannot come off pump to recover his own hemodynamic. The second day I was doing a double valve replacement to a 55 years old lady. I had three episodes of electricity interruption without great risk. UPS generator worked each time after 20 to 30 seconds of total obscurity. Thursday I was doing three successive mitral valve surgeries , two cases had undergone repair of their mitral valve and a third lady had mitral valve replacement. Interruption during valve repair was the most critical. Fortunately, the 5 cases are doing well with no complications. I have to thank here all members of my time for their support and dexterity . In the first cases I was assisted by Dr Ahmed ABDELSAMAD DESSOUKY surgeon of the National Heart Institute and Dr Khaled MOHSEN Assistant lecturer of the same institution. The anesthetists was Professor Abla Atef Khalil, Professor of anesthesia in The National Heart Institute. In the last three cases I was assisted by the young Dr Khale MOHSEN born in 1984 , but is actually an excellent assistant. His dexterity shows how good is the training of young surgeons in the Egyptian National heart Institute that performs 3000 open heart procedures per year in addition to another 1000 cases done y the whole team in the different Cairo and Egyptian clinics. The anesthetists in the last three cases was Dr Ahmed EL HADDA senior lecturer in Cairo University. I have also to thank Dr Nabil ETATO and his intensive care team that dealt with the patients during the post operative period safely instead of multiple episodes of electricity interruption and menace of arrest of ventilators , electric seringes and all electronic equipments. All the above events were not really critical for my team and myself. We are a well trained team having experience from the large volume. We are working in well equipped hospitals having well trained personnel. This is the usual case in the centers of excellence. The problem is in the provincial hospitasl where surgeons and personnel are still in need for more experience. They may panic during interruption of the electric current. In addition all hospitals are not well equipped with powerful units of UPS. In infantile and pediatric intensive care where fragile newborns are in incubators electricity interruption may be fatal. In fact even if the UPS works , regulation of the apparatus should be re- started. In certain ICU there may be tens of patients on ventilators or receiving perfusion by tens of electric syringes. The personnel may suddenly be obliged to re start 70 apparatus in lapse of time that should not exceed few minutes. With all my experience over the years , I was on the point to develop a heart attack, what would be the case for a less experienced surgeon or personnel. Interruption of electricity is not allowed in hospitals exactly as similar as danger of major mistakes in aircrafts In conclusion , one is wandering what happened after The revolution to let electricity problems become so accentuated. I hope that each community should try to solve the problem locally. Building a super central electricity station may need funds for transportation through electricity towers that may be exposed to terrorist acts. In addition electricity power transported over long distances loose great percentage during transport E mail : [email protected]
Posted on: Fri, 08 Aug 2014 08:31:55 +0000
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