Solo Surgical Basics

Job Thread 1: Surgical techniques, sterilization techniques, When it is necessary, The dangers of surgery

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Not found on any map, Endrykas is a large migrating tent city wherein the horseclans of Cyphrus gather to trade and exchange information. [Lore]

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Surgical Basics

Postby Amunet on May 30th, 2016, 9:06 pm

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53rd, Spring, 516 AV
7th Bell
River Fower


It didn’t take her long to get back into the groove of River Flower duties once she had returned. Nehrar fussed over her till he had begrudgingly confirmed she hadn’t suffered too much from her ordeals away from Endrykas. Not that Azmere and Nehrar didn’t believe her, the circumstances of the ordeal was quickly hushed for the sake of the balance of the community. Amunet was not too happy with this decision, but politics were what they were. Much to Pratal’s chagrin, the thorn in his side waltzed back into Endrykas as if she never left. Amunet wouldn’t have traded the look on his face for anything. The girl could find some solace in providing him with that bit of unease. Unfortunately the circumstances of being two days tied to a tree were a case of his word against hers. It went nowhere and it left her sour and uneasy. The Healer knew the truth. They had a snake amongst them and that cold hearted snake was Pratal.

Back to work she fell into as she applied her gift and her growing expertise. The girl was proving her potential in medicine despite being graced by Rak’keli. The red head took Nehrar and Sadara’s words to heart that the more knowledge she had, the more she could heal. The gifts of the land and the hearty nature of the people of the Drykas leant itself to healing in more ways than she ever fathomed. The threads of possibilities swam in her head and it drove her to want to know more. Nehrar Tenderbloom dreadfully wished the Stardancer pavilion would show back up into Endrykas but till then Him and his wife would keep an eye on this young lady along with her little brother. The passionate free spirited girl needed more than what he could teach her. Not today though, the doctor felt that it was time to get the healer into more advanced medicine techniques.

Amunet entered the tent with a lightened heart. She was handed a cup of tea by one of the assistants there as the red head nodded her thanks. The Healer’s hair was back away from her face the sides of her hair lightly braided and then pulled back behind the back of her head so that it would hang down loosely but have her hair out of her face. The lush long red hair hung to her behind like a cascading waterfall of blood and firey colors. The young doctor and healer moved about the various tents of the River Flower checking on any that had spent the night over speaking calmly and gently to those infirmed. Those gentle small hands offering comfort with just a touch. Amunet didn’t mind and did it gladly. It would speed up healing and get these persons back into their pavilions and homes. Nehrar met her in the middle as she was headed to the next one.

“Blessed Morn, Nehrar.” The girl said looking up to the tall doctor with a smile.

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Surgical Basics

Postby Amunet on July 31st, 2016, 5:54 pm

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Nehrar couldn’t help but smile at the infectious little lady stepping into the curtained off room of next patient. The Head Doctor of the Riverflower sighed at this patient who was feverish and only strong pain medication was keeping him comfortable. Even that is starting to not be effective. “Amunet see what you can do to ease this one, he has been here for a few days.

Amunet nodded as the pull to this one was stronger than the others. ‘this one must be really sick.’ She thought. The girl sat on the edge as her hand went to his forehead. The man was burning up. Nehrar positioned himself on the other side. Amunet closed her eyes as the gift left her at the touch almost instantly. The relief on the man’s face was obvious but there was still pain there and the fever didn’t reduce at all. It helped . The ‘urge’ had her looking at his abdomen.

“Whats wrong with him?” The girl asked as the man in his drugged stupor groaned in discomfort.

“I thought it was some kind of intestinal infection or even the stomach, but that doesn’t seem the case. Now that you have eased him some, let us take another look. Have you ever palpated an abdomen?” He looked at her seriously.

“Unless they had a baby, no.” The girl looked up at him matching his serious expression with a whimsical smile. That smile melted away at his expression.

“Alright, time to learn. You are feeling for the organs in the abdomen. “ The man brought her hands with his to feel the various areas of the abdomens in detail by pushing gently and prodding at the contents within. “That is the stomach over here center left and to the far left here is the spleen. “

Amunet followed her hands as she looked up and felt where he had pointed out. The girl was focused and nodded as she placed this knowledge carefuly in her head. Clincally feeling an abdomen was a far cry different then smoothing one’s hands over just to feel the skin. “I don’t feel anything funny.”

“Yes, this all appears normal. Over to the right of the stomach is the liver. Above the liver is the diaphragm which helps a person’s lungs fill with air think of it as a bellows at a smithy. “ The Doctor continued his instruction.

Those nimble fingers and gentle hands of the young lady trailed over to feel the organs and get a fair assessment of what should be about the right shape and feel. The man didn’t respond and slept relatively peacefully. “There seems to be more than one liver? “ This sounded absurd as it came out of her mouth as her brow furrowed.

Nehrar chuckled at this “well the liver has different sections called lobes. Let me see” His hands ran over the right side of the upper abdomen. “Yes you are feeling the different lobes. “ He guided her hand to the lobes.

“Oh. I see. It’s a large organ then.” Those hands felt the side with the liver as it felt firm and ‘normal’ in as much as she knew what normal was considered in a human. “It doesn’t feel funny. Its firm . “

Nehrar nodded. “good and correct. The liver does feel normal. Now come down a little bit. The small and large intestines are below the liver and stomach. I start at around the umbilica area and circle out. Check for signs of discomfort. Could be trapped gas, a foreign object even a deformity in the intestinal wall integrity.” The head doctor’s eyes furrowed as he looked off to the side to listen more to his fingers than anything else. He moved his fingers to let Amunet feel.

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Surgical Basics

Postby Amunet on July 31st, 2016, 5:57 pm

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Amunet’s small fingers went to the belly button which the kind doctor had said was the umbilica area. It made sense as that was where the umbilical cord had been attached. The girl looked up as her fingers pressed in and kind of kneaded the area gently pushing up and then to the side. There seemed to be nothing abnormal that she could tell as she moved down to the lower right. The man moaned in his sedated state. One more inch lower right as she pressed down the patient’s eyes popped open and gave a growl with gritted teeth. “Oops.”

“Here let me see that. “ Nehrar’s eyes came a lite as those nimble little fingers of his student found a sore spot. The Doctor’s head turned to the patient. As his fingers moved closer and closer to that bottom right location and the man came ‘alive’ again. ”Sorry, looks like the healing you did reduced the swelling enough to feel it. The large intestines have a little piece of extra called the appendix. When it gets irritated and infected it can cause a lot of pain. If left untreated it can cause death.”

“How does it cause death, cant we give him medicine?” The red head asked gently as her hand attempted to sooth the warrior’s discomfort.

“Afraid medicine is not enough. If the infection bursts inside of him, it spreads more of the infection into the intestines and infects the rest of the abdomen. It is a most long and painful death after that. “ The medicine man moved to the curtain and opened it. “Get the surgical tools, antiseptic, hot water and the strongest sedative we got. “ The list of orders went out as two strong helpers moved the man to a white curtained off chamber that had strict clean rules.

“Amunet now you get to learn one of the deeper crafts of medicine. Surgery. Sometimes it is necessary. Foreign objects as I said, blockages, and in this case removal of an infected part. The gift you have will help him heal faster, but we need to get this part out of him before that will have any effect. “ The man motioned for the red head to follow as he started scrubbing his hands vigorously with a nail brush soap and as hot water as he could stand. “Get your hands and fore arms as clean as possible. Scrub everything.

The girl nodded though she knows that the gift helps with fevers and things that caused the body to feel unwell, but not entirely sure what those things were. Infections seem to come in more than a few flavors. The act of scrubbing was not an unfamiliar one and she went about sterilizing her hands and short cropped nails vigorously. The soap was well suds up on the brush as she brushed it over the bar firmly with water. The skin was next to be scrubbed as she winced a little as she passed it over the fair skin of hers. The other hand was given the same treatment. He red head scrubbed to her elbows before rinsing in hot water. Attendants were there to give her clean linen to dry her hands before the linen over robe was passed over and tied to the back. The girl stepped into the curtained off ‘white’ chamber. Sadara was there to administer the heavy sedative lifting the man’s head and easing the strong extract diluted in warm water into the man’s mouth. Her hand soothed the throat as she urged the swallow to occur.

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Surgical Basics

Postby Amunet on July 31st, 2016, 6:00 pm

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She nodded and the herbal preparation needed time to work. Nehrar took time to show Amunet the tools of surgery. These were marvels of steel and engineering. These were treasured items and expensive for the Opal clan and the Endrykas clinics both human and animal sides. They were always kept sterile and kept in a secured safe place. “if you want a set for yourself, we may need to make a trip to Riverfall come next spring for your own set. This is a scalpel. “ He hefted up the elegant instrument with the surgical sharp thin blade at the end. “This is sharper than most weapons. With a delicate hand, you can cause less injury and efficiently get to or open up places of the flesh. This is a forceps.” He pointed out. “long pincers and various sizes help reach for items to pick out obstructions and foreign matter. That is a hemostat. It can clamp off and secure a ruptured blood vessel. Very handy in open deep leg wounds. Various scissors that are always kept very sharp.” The forceps and hemostats seem to come in various sizes. The red head took this all in as she looked the items over and secured descriptions and uses in that complicated filing system of hers. “This is a suture set, though you are already familiar with stitches. Stitches inside the body are often called sutures. We use a thinner gut twine as fine as we can get to use for internal sutures. “Outside stitches clinically are called sutures also but most people know them as stitches.” The man chuckled a laugh at this child like term, but it was terms like this that lessened the pain of what they actually did.

Amunet smiled “I can get behind that.” The girl had a knack with her patients. A bedside manner that often took some people years to develop as this young healer seemed to have acquired by natural skill not just because she was gifted by the grace of a Goddess.

Nehrar looked over to his wife as she gently pulled the eyelids up to see if their patient was good and out. The woman smiled at her husband as she nodded. The nod was that they can begin. The smile was watching him teach. The man thrived with teaching what he knew of medicine. Amunet lapped it up like a sponge. Nehrar was more than a little fond of his herbalist wife. The red head watched how those two looked at each other and put a note in the back of her mind to ask about that later. “How do we start, Sir.” The girl asked gently.

The Doctor nodded and had linen above and below the line he wished to make his first incision. The mask was put on as Amunet copied and followed suit as they tied clothes to their nose and mouth. “We must be as clean as possible as once we start our incision, we invite a lot of different infections. Even with the precautions we have taken, infection is still possible. I'm hoping your gift will help with that. “ He said to the healer.

The diminutive beginning surgeon nodded as she paid attention. The young lady found the scalpel in her hand and Nehrar guiding her hand as he instructed her. Amunet swallowed hard. “Sure and Steady. "

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Surgical Basics

Postby Amunet on July 31st, 2016, 6:03 pm

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"Make the incision three to four inches. “ She took a deep breath and with his guiding hand and words the scalpel met skin as she did as instructed. It was like striking a chisel. You had to commit yourself to the strike. In her other hand was linen as she used that to keep the work area clean of blood. The next layer was the muscle layer. The man didn’t have much of a fat layer. The girl took a deep breath and with a steady hand made a similar incision through the muscle later.

“Alright, this tool is used to retract the opening. What we are looking for is an angry red little appendix. “ The steel flat ‘hooked’ opject was placed at the edge of the incision and pulled slightly. Amunet got a forcep out as so did Nehrar.

“Its pretty dark pinkish here. Red even.” The little woman noticed as she looked at the color go from a healthy pinky to a more irritated color.

Nehrar nodded. “We are close. Lets see.” His forceps went half a more inch to the right and there it was. “There it is. See it?”

It was angry alright. It had become bright dark red angry and swollen three times the size it should be. “Oh my goodness. “ The girl by Nehrar’s direction got her forceps around the bases and pulled it up slightly. With a pair of sharp surgical scissors, the appendix was removed.

“Nicely done now we put a couple of sutures there at the end and it should heal up nicely. We cant leave it open as it leaves a hole where intestinal fluids would get into the cavity. It would create a larger problem if we left it open like this. “The suture needle was a metal curved number. It was almost delicate in the way it curved to its point. Nehrar pointed at where the best spot was. Amunet was adept at suturing tears after birth and stitching up cuts from a variety of circumstances. She did this with a little confidence. Two sutures closed up the small hole. The natural gut twine used would meld with the body in time as the patient healed.

Under Nehrar’s guidance, The red headed healer stitched up the muscle wall carefully with the skin layer. Making sure that muscle wall was meeting and skin was meeting skin so they could heal. Sadara slathered the suture site with one of her ointments and helped Amunet bandage up the wound. Very carefully, the patient was placed to rest back on the cot. “We will keep him here for three days and make sure the surgical site has a chance to mend, with your help and Rak’keli’s grace, he will heal well. “ The Head Doctor patted the girl on the shoulder as Amunet prepared to plan for the next few days of checking up on this patient.

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Surgical Basics

Postby Rufio on September 8th, 2016, 9:12 pm

  
g r a d e s


xp

Rhetoric +2
Deduction +3
Invesitgation +2
Medicine +2
Intelligence +2
Logic +1
Sewing +1
Planning +1


lores

Pratal: A cold-hearted snake
Amunet: The larger the island of knowledge, the longer the shoreline of wonder.
Human Anatomy: The liver is a large, firm feeling organ sectioned into 'lobes'
Human Anatomy: The appendix
Medicine: An irritated & infected appendix causes agony & potential death
Medicine: Scrubbing into surgery
Surgical Tools: Scalpel, forceps, hemostat, scissors & gut twine sutures
Surgery: Removing an appendix


If you feel I've missed anything in this grade feel free to shoot me a PM! Don't forget to go back & edit your grade request here~

  
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