Pillows and blankets for a comfortable sleep
November 13, 2016

A pillow is a small comfort that we take for granted in Canada and we definitely need a blanket to stay warm when we sleep. Sometimes its a luxury in the OR. Well I’m sure they could find them if I asked but it might be an interesting discussion with the hospital CEO: “The visiting doctor says we have to buy pillows and blankets instead of antibiotics and pain medications”.

Why are these small creature comforts so important to have in the OR? The pillow helps position the patients head and neck for endotracheal intubation, lining up the visual axis from the mouth to the larynx. Without good positioning the junior trainee will struggle with the airway and not recognize why. Blankets keep the patients warm which is important for infection control and drug metabolism in the body. My take home message about global health: You don’t need to donate the pillows and blankets to make an impact: teach proper positioning and maneuvers for airway management and thermoregulation.

My first week at Georgetown Public Hospital Corporation is over. It has been a busy yet fulfilling week. I am at the major teaching hospital and referral centre for all of Guyana. The buck stops here for patient care. This is a country with limited resources. The population is not big, about 750,000. From an anesthesiologist’s perspective, there seem to be enough consultants, residents and trainees at the teaching hospital. The rest of the country is a different story but more of that later.

Dr. Alexandra Harvey, the anesthesia residency program director, brought forth a vision to train nurse anesthetists and anesthesiologists in 2008. The first residents will graduate this year. The training is free and the residents have a commitment to provide a number of years of service when they graduate. The residents do a 4 month rotation at McMaster University in their final year before sitting for their exams and there will be an external Canadian examiner. My role with CASIEF (Canadian Anesthesia Society International Education Foundation) is mentor and teach these residents the skills they need to provide safe anesthesia with the resources they have.

A long with clinical teaching in the OR around specific anesthesia issues, I have had the privilege of using new teaching modules developed for University of Ottawa anesthesia residents in our new competency based residency program. The modules are based around a clinical scenario. Instead of a dry talk at the end of the day, case based learning engages the residents and provides a practical context for the information the acquire and consolidate.

The concepts that they learn plus or minus the pillow will help them, for as William Shakespeare said in Hamlet: “For some must watch, while some must sleep So runs the world away”