Leavenworth VA

4101 4th St. Trafficway, Leavenworth, Kansas 66048
Update:
Guys locker is the first one on the bottom left. It will be labeled with sticky notes
Girls Locker is #26, labeled with Dr. Rays name. Its in the bottom row, immediately to the right when you enter the locker room.

OR 601 machine check should work most of the time. If there is a problem, let the CRNA, Joe, or the anesthesiologists know and they will help you with it.

In the GI lab, Dr. Lozenski likes to use the propofol infusion pump and Dr. Harder likes to bolus.

Its pretty cool to work with Joe because he will literally just sit back and let you run the case. Most of the time, he isnt paying attention but will help you if you need it. Dave, the other CRNA, doesnt take AA students.

If I can think of any other tips, I will write them down here! 



Here is a copy of all of the information emailed to me: (THANK YOU GINA, BILLY, JESSIRAE, MATT and ALEX)

"Before OR:

Should get an email from Loyd Tovar Loyd.Tovar@va.gov outlining what to do before starting your rotation. If you don’t hear from him, I would email him

Directions to the OR:

            Park in the main parking lot and go in the front entrance. Once inside turn left and go to the elevators at the end of the hallway. The OR will be on the 6^th floor. The passcode to get into the OR is 7874

Once in the OR:

            There will be a set of double doors on your right. Go down to the other set of double doors but not through them and the women’s locker room will be on the left.

            Anesthesia office: go left once in the OR and it will be on your left

Staff:

            There are four main anesthesia people at LVA are Dr. Harder, Dr. Lowsenski, Dr. Ray and Joe (CRNA). Mostly I worked with Dr. Harder and Dr. Lowsenski. Dr. Ray does pain management so you may get a chance to do blocks with her

Dr. Harder does a great job of texting you cases the night before her number is (913)406-0145. Just shoot her a text before your first day there

There are a lot of other OR staff, they are very friendly and love having students.

Schedule:

            Cases start at 8:30 everyday. I arrived at 7 to set up the rooms at stock up because they don’t have an anesthesia tech. Mostly you will be working out of OR 0601 and 0602 (the two at the end of the hall). 0603, second to last on the right side, was used mostly for eye cases

            You can find a schedule in the break room and the preops are in the anesthesia closet

Door Codes:

            Main OR: 7874

            Anesthesia Closet: 45

            Most other door codes: 251—break room, supply rooms, etc.

Setup:

Machine: Pretty much sets itself up for you, similar to heart institute. Just follow directions on the screen. Be sure to check positive pressure afterwards (like on regular anesthesia machines) and CO2

Equipment:

            Have one of every blade (MAC 3 or 4 and Miller 2)

            Extra Suction catheters

            Suction tubing

            Yankauers

            2 of every size of LMA

            3 or 4 non rebreathers

            3 or 4 nasal cannulas

            2 or 3 of every ETT

            nasal/oral airways

            OG Tubes (all of the above are in the drawers in the anesthesia machine)

            Syringes—all sizes

            Needles

            ECG pads for nerve stimulator

            TB syringes (these are on the pyxis)

            Esophageal temp probe

            stylets (these on the RIGHT side of the pixis)

Drugs: In the pyxis, which the instructor will have to sign in for you to get drugs out. I would check your drug counts in the morning to make sure that they aren’t off. Sometimes the Pyxis thinks there are 2 or 3 of a drug left and there are none.

Begin forwarded message:

From: "Babcock, William E. (UMKC-Student)" <webm8d@mail.umkc.edu>

Date: November 25, 2012 8:33:37 PM CST

To: "Yarbrough, Regina Denise (UMKC-Student)" <rdyy96@mail.umkc.edu>

Subject: Fwd: Leavenworth VA

Begin forwarded message:

Hey Gina. Here is the info that Matt forwarded to me. Dr. Harder's cell phone # is 1(913)406-0145..Just give her a text and let her know who you are. She knows that you will be coming, so just give her a buzz and she will tell you what cases you will have. She usually will text you the cases for the next day from this point forward. If you have any questions just let me know.

-Billy 

From: Matthew Vlach <vlachmatthew@gmail.com>

Subject: Fwd: Leavenworth VA

Date: October 29, 2012 5:43:03 AM CDT

To: "William E. Babcock" <webm8d@mail.umkc.edu>

This is what Jessirae sent me and it helped. The newest anesthesiologist is dr. Lozenski. She is awesome. Let me know if you have any questions. Good luck

Matt

Begin forwarded message:

From: "Frerichs, Jessirae N. (UMKC-Student)" <jnffm5@mail.umkc.edu>
Date: September 29, 2012, 4:32:31 PM CDT
To: "Vlach, Matthew D (UMKC-Student)" <mdvq48@mail.umkc.edu>
Subject: Fwd: Leavenworth VA

Matt,

I'm forwarding you the info that Alex sent me that was so so helpful. I have a few things to add as well:

Locker room is to your right through the first set of double doors. It's down the hall to the left. If you reach the second set of double doors you have gone too far

Anesthesia office code is 45. You won't need this the first day but you will to drop off anesthesia records on Dr. Harder's desk

Anesthesia supply closet code is 251.

Employees break lounge is 251 also. They have extra copies of the schedule in here on the table. After I got dressed I'd go straight there to see which OR I was in.

Pyxis: make sure when you do draw up all your drugs in the morning that your Pyxis still has an extra propofol in it and an extra glyco. We had a few instances where the Pyxis failed us and we had to go running out of the room to get more drugs during an emergency. From then on I just made sure we had extra of an emergency drugs available to draw up on top of what I prepared for the case that morning.

The staff loves students! All were very friendly except the CRNA Dave that you will never have to work with.

Continue to make UMKC look good! Dr. Harder thinks very highly of our program and the students from our school. I gave Dr. Harder your cell phone number but she may ask you for it again on your first day so she can text you your cases the night before.

Hope this helps!

Jessirae
Sent from my iPad

Begin forwarded message:

From: "Treat, Alexander J. (UMKC-Student)" <alexandertreat@mail.umkc.edu>
Date: September 3, 2012 8:53:21 PM CDT
To: "Frerichs, Jessirae N. (UMKC-Student)" <jnffm5@mail.umkc.edu>
Subject: Leavenworth VA

Yo,

So here’s a little rundown on the Leavenworth VA that I gathered in my 3 weeks there…

The staff:

Dr. Harder is the OR anesthesiologist you will usually be working with each day.  She’s fresh out of residency, but worked in the military as an airborne surgeon previously.  She really seems to like teaching and she’ll let you do a lot. 

She told me to give you her phone # and said that if you have any questions tomorrow (or whenever) to call her:

(913) 406-0145

Dr. Ray Works with pain management and usually isn’t in the OR/anesthesia office, but she knows how things work up there and really likes students so don’t hesitate to ask her questions.

Joe is a CRNA.  You might work with him if he has some good cases.  He’ll probably let you do the most out of anyone.  He’s really laid back.

Frank?  Albi is the other CRNA.  He’s retired mostly and comes in like 1 day a week and won’t teach AA students.  It’s a political thing, but he’s still really nice and helps out a ton.

Schedule:

I usually came in around 7am every day and got set up.  The OR is on the 6^th floor of the hospital at the far left end (if you walk in through the main entrance).  The passcode to get into the OR is 7874.  If you don’t know the schedule you can hang out in the anesthesia office until Dr. Harder or Joe arrive. 

Most of the time you only have 1 or 2 cases and you’re done by 1pm.  So even though you’re there every day, it’s not too bad.

Setup:

Leavenworth doesn’t have a Robman, so basically you have to stock the room every day.  I almost got burned a couple times by this so just do a double check on some of these things. 

Esophageal Stethoscopes (far right side of the pyxis) – She likes these over nasal temp probes basically whenever you have a tube.

Suction catheters

Yankeurs

OG Tubes

(above 3 are in the bottom of the anesthesia machine)

ECG Pads for the nerve stimulator

The machine is baller and checks itself—I think you guys had these or something like them at MAHI—so just do your thing, and make sure to check positive pressure and CO2 (Dr. Harder will ask)

Drugs (dr harder will have to open the pyxis before you can draw drugs):

Propofol 20ml syringe

Lidocaine 10ml syringe (1%)

Zem 5ml

Sux (if indicated) 10ml

Neosynephrine 40mcg/ml (10mg into a 250ml bag of N/S, then draw up 10ml syringe from the bag.  She likes to use clean syringes so you can use the same bag throughout the day)

If you need ephedrine she likes 5mg/ml

Versed 2mg – in pyxis

Fentanyl 50mcg/ml – 2ml – in pyxis

As far as idiosyncrasies or pet peeves, Dr harder is pretty cool.  She likes having people she can teach.  Leavenworth was really different from Liberty.  The staff actually seems to like students and are pretty awesome.  If you have any questions text me tonight or tomorrow morning and I’ll try to help out.

-Alex"

This rotation has been pretty fun and like a vacation. I get out around 1:30 at the latest, no weekends, and the machine checks itself out! Pretty awesome. There has been an email going around for some information on the VA. I can either post it here or I can email it to whoever needs it.  Some things not on the email is that the machine in OR 601 will say there is a leak. The only way to override it is to remove the adapter between the machine and the circuit, then attach the circuit directly to the machine. This will make more sense when you see it. Dr. L gave me a book to read over regional anesthesia. Its pretty awesome and straight to the point. The book is called, "Ultrasound Guided Regional Anesthesia" by Grant and Auyong. I tried to look for the book through the library website, but did not come up with this exact book. They did have others though. If I think of anything else, I will add it to the blog.