OMG, that’s the RV!

The case A 44-year-old male with a history of pectus excavatum status post minimally invasive pectus excavatum repair and multiple chest reconstructions presented for removal of the pectus bar due to irritation and ongoing pain. The patient and his family were anxious in the preop holding area. He had been through multiple surgeries and wanted to relay to the surgeon and anyone who was listening the irritation in his chest from the pectus bar and wires. After a smooth intravenous induction, a laryngeal mask airway (LMA) was placed with ease, and the surgeon was given the green light to remove the annoying pectus bar. Incision was made, and after 10 minutes of dissection, the surgery resident commented about a pulsatile mass that he was meticulously trying to avoid. Avoid, he did not! Gushing through the chest incision was dark, venous blood. OMG (Oh, my God), Houston, I think we hit a large venous structure! Patient care Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families. The patient and his family members had concerns and anxiety in the preoperative holding area and wanted to relay their worries to the anesthesiologist and the surgeon. You are communicating with an operating room frequent flier. It is best to spend the extra time listening to his concerns, addressing these issues, and being his advocate.