Personal Reflection on Intermediate Anaesthetic Practice

I am a student anaesthetic practitioner with a clinical placement in an acute hospital. I will be reflecting on my personal experience with a 20 year old patient who underwent a Myringotomy and Bilateral Ear Grommets Insertion procedure wherein a local anaesthetic was used and had failed, and prompting the case to be done under general anaesthesia. The operation was deemed necessary by the consultant as the patient was diagnosed with recurrent Otitis Media with Effusion (OME), ‘see Appendix A [on page 23]’, because it will eventually help to correct his hearing loss and prevent further deterioration as stated by Woolfson and McCafferty 1993.

Following the NMC Code of Conduct (2008) on Confidentiality of patient’s information, I will refer to patient as Mr. B. I will be using the Gibb’s Reflective Cycle which is shown in Appendix B as the framework of my reflection Jasper (2003). It will highlight how researching further led to a better understanding of surgery and anaesthetics and to know how to respond if the same situation happens again.

Mr. B. had been admitted in the ward at noontime of the surgery. He was seen by the anaesthetist to carry out a preoperative assessment. According to the anaesthetist, he is generally fit for surgery and does not pose as an anaesthetic risk. The anaesthetist discussed with him about her plan to give him a general anaesthesia, but he asked the anaesthetist if the operation can be done without having a general anaesthetic because he prefers to remain awake. The consultant surgeon also came in and explained the surgery. He was allowed to undertake a local anaesthetic provided that he cooperate well and if the local anaesthetic is unsuccessful, an alternative anaesthetics will be used, that is a general anaesthesia. The surgeon and anaesthetist explained what he will experience with local anaesthetics like a burning sensation in his ears, including possibly a degree of pain. Any anaesthetic may arise complications and that other types of anaesthetic is not sufficient for the surgery and therefore needs to be changed to a general anaesthetic at any time (Box Hill Hosp. Dept. of Anaesthesia, 2001). A written consent was obtained by the surgeon from Mr. B. The Department of Health Guidelines (2007) on Consent states that Informed Consent ensures the patient has full knowledge of the procedure because it is fully explained to the patient by the surgeon. The patient is also given the time to ask any questions he may have and voice any concerns and honest answers must be provided.

I was assigned in the ENT theatre for the afternoon session which has three booked cases. The operating department practitioner (ODP) and I did the necessary checks in the anaesthetic room and safely prepared the anaesthetic materials and equipment in preparation of the list (AAGBI 2004)

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