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March 29, 2019

Pre-positioning is not just for doomsday preppers

Back when I was an anesthesiology resident, I got into the habit of preparing my next day's anesthesia cart setup at the end of every working day, then securing it by placing an "X" made of tape across the top so the anesthesia techs in the workroom didn't mess with it.

[The videos above and below demonstrate my system. Note that Part 1 has over 111,000 views and Part 2 over 47,000.]

The next morning. when I entered the setup area where us anesthesiology residents prepared our carts, I was way ahead of the crowd as a result, and could proceed with the remainder of my preparations — drawing up drugs, pre-bending my intubation stylets to the perfect angle, etc. — in a leisurely fashion while bantering with my colleagues.

One thing I got into the habit of doing was having an emergency endotracheal tube — much smaller in diameter than the ones I'd be routinely using — with a pre-bent stylet molded into a "hockey stick" configuration.

In the event something happened in the OR during a case, I wouldn't have to scramble to assemble a tube and stylet and cuff syringe but rather could simply open the fourth drawer down in the cart and grab my pre-prepped tube, ready to intubate.

I was always struck by how almost all the other residents thought I was a catastrophizer and a "little old lady" with my fussing over things that most likely I'd never need — but that's how I'm wired.

I find now that I'm retired from the OR, I still use practices such as prepositioning that served me well over the decades in the OR.

Example: just now I noticed that my Citrus Magic powder — which I sprinkle over my cat's litter box after each tidying up — was almost empty. 

Rather than wait until it really is empty before preparing another container, instead I got a new one out, opened it, removed the styrofoam safety shield at the top, and prepositioned it behind the old one, ready to use when the current one is done.

And I always have spare light bulbs of every possible wattage: there is nothing* more annoying than having a bulb burn out and having to leave the lamp/room/fixture dark because you don't have the proper replacement bulb. 

You can see how I could be an annoying person to be around, much less live with....

Tell you what: my cat's down with it.

*OK, OK: few things

March 29, 2019 at 02:01 PM | Permalink


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