Thank you. I manage construction in hospitals. It's worth pointing out that in OR construction, we strive to have more supply duct surface area in the ceiling (over the patients) so we can get those 20 air changes done with slower air speed. And we balance the supply to be the same speed across the entire face so that we create a laminar flow (of HEPA filtered air) across the patient (and sterile field) to also lower SSI. Another factor is making that air speed slow enough to reduce noise in the OR, but, fast enough so that movement around the Sterile field doesn't stir up dirty air around the patient while keeping the OR positively pressured (relative to the corridor). Thanks again, your content really helps me to understand why it's important to construct OR's the way we do.

@MaxFeinsteinMD

Жыл бұрын

Wow that is amazing! Let me know if you’d ever want to make a video together, I’d love to learn more about what you do!

@ReclusiveMountainMan

Жыл бұрын

@@MaxFeinsteinMD That would be a cool video!

@JohnVKaravitis

Жыл бұрын

tl;dr

@DamonJohnCollins

Жыл бұрын

@@MaxFeinsteinMD let me know what questions you have and I'll do my best to answer. I love your channel and I'll keep an eye out for any other topics you cover that cover the built environment. In the meantime, if you are in Orlando in the near future, I'll show you the current specialty hospital we have under construction. It includes 10 OR's and is joined to a 10 station bioskills lab and an ASC with another 12 OR's.

@cliffontheroad

Жыл бұрын

@@DamonJohnCollins If lighting is a contributor to heat, maybe an alternative to current bulbs is overdue. Whale oil excluded. LOL

Everytime I go in for surgery I have to tell everyone involved especially the anesthesiologist: "I have an upper spinal injury and can't regulate my body temperaturen so I'll need that really cool heated blanket thing, and you will need to watch me." The anesthesiologist always appreciates the heads up that I'm a lizard person and not to ever trust my body temp.

@mustang8206

Жыл бұрын

That's actually fascinating

@klyxes

Жыл бұрын

How does the injury prevent your body from self regulating?

@loverlei79

Жыл бұрын

@@klyxes ​ The doctors aren't really sure what exactly went wrong in my case. The cervical spine break was c1, c2, c4, c5 with shattered c1 and c2; c4 and c5 overlapping. the shattering caused a piercing of my spinal cord and the overlapping caused a kink in the spinal cord. There was also undiagnosed brain trauma, which left a shrunken hippocampus, affecting my long and short term memory. I was in a coma for a few weeks and spent 2 years getting my left side back. Eventually I was diagnosed with Brown Sequard Syndrome and Non Epileptic seizures of unknown origin. Its been 20 years this March and the right side and temperature regulation never came back. I once got hypothermia in 68 degree weather, and will pass out in temperatures above 80 degrees F.

@klyxes

Жыл бұрын

@@loverlei79 if u don't mind, what happened? Is hotter weather worse for you then cold? Does your body not start to sweat?

@loverlei79

Жыл бұрын

@@klyxes It was a car accident in 2003. I was sleeping in the backseat of a small car and we were hit by a drunk driver. Neither hot or cold is better, but at least in hot weather I can go outside for an hour or so before over heating. As far a sweat is concerned it took several years for my body to produce sweat. Even now though, I don't sweat much, which is why we need ice packs to cool me off when i overheat. Same thing goes for fevers. If i get a fever from illness, i will take ice cold showers until my temp goes down.

After a literal 48 surgeries, I’m finally getting an explanation. I was always flippant with my Doctors that they were taking me to the morgue instead of the operating room. Thanks for the important information.

@CJGfarm

Жыл бұрын

😅😂

@IAMZERG

Жыл бұрын

LOL. Hope I won't need to use that line any time soon, but I'm sticking that one in my back pocket.

@Finduski

Жыл бұрын

48 surgeries and you never asked? Bruh

@dulcilass

Жыл бұрын

The last time I went in for surgery I commented on how cold the room was and was told it was to help lower the germ count. We had to wait a bit to start the surgery so they kept wrapping and re-wrapping me up in warm blankets. I began to feel like a warm wrapped mummy. This video was great for getting the real reason for the chilled air.

@valariewillis6000

Жыл бұрын

48 surgeries.....Explain 🤯

I quit my surgical nursing position because I kept getting very ill from the constant cold. I constantly shivered and couldn't control my body movements. It also caused me to feel a frequent need to empty my bladder. I never questioned the cold temperature because my nursing instructors taught us it was to lower the chance of infection for patients. Wow!

@williamjones391

Жыл бұрын

I worked at Klondike in St Petersburg FL packaging those little ice cream bars ..12 hours shifts 5 days a week ..They kept that building so cold that people dressed like Eskimos in there ...I shiver so bad in there .ooh lordy ...every night when I went home it was like I had a cold everyday .i finally quit .Couldn't take the cold

@drinkwatereatmelons7048

Жыл бұрын

A person with anemia...These jobs definitely wldn't be good🥶

@safffff1000

Жыл бұрын

@@williamjones391 I just wore more layers of cloths

@somethingsomething404

Жыл бұрын

@@williamjones391 lol never move to Canada. Florida people don’t know cold

@missophelie3781

Жыл бұрын

​@@somethingsomething404You don't feel the cold in Canada! It's not wet but dry in Canada compared to Europe.

I commented that I didn't think the surgery was going to happen in a meat locker. The nurse went into the blanket heater and returned with 3 heated blankets. The doctor was wearing all the crap you were saying, the nurse even said he would overheat if it wasn't that cold. No joke, that surgeon had two helpers getting all the stuff on and when he came to visit me afterwards in recovery, he looked like he was playing basketball. He just looked hot and sweaty. He said he goes thru scrubs all day long

@morganschiller2288

Жыл бұрын

Yep! So true! Most of my guys wear cooling shirts where ice cold water is circulated under their lead and scrubs. We have some spine cases that go for 8-14 hours. It can get rough for them

@jerrym1070

Жыл бұрын

Wonder if cool suits would be practical . I am a hvac tech of 30 years . The man who brought me to the trade use to talk about his cool suit , could sit in hot attics 130⁰-140⁰ and not break a sweat he would say . Only guy I knew that ever had one

@robertheinkel6225

Жыл бұрын

Those warming blankets feel great.

@badgirlhollywood9741

Жыл бұрын

Yea they’re working you

This really opens my eyes to how hard anesthesiologists work and what they have to take into consideration.

@jewelhome1

Жыл бұрын

We don’t just put people into drug induced comas. Our job is to keep people alive and healthy while they are being dissected and repaired by the surgeons, so we take over controlling and monitoring your various bodily functions. Physiology is our game.

@williamgibb5557

Жыл бұрын

The anesthesiologist can do a better job of keeping a person alive then the doctor.

@playfulpanthress

Жыл бұрын

@@williamgibb5557 They ARE doctors, sweetie.

@bugwar5545

Жыл бұрын

Yep. Course once you look at their paychecks, it all seems not so bad. "The average salary for an anesthesiologist is $331,937. Anesthesiologists can make up to $663,000 as a top earner, or a little as $113,000 for those beginning their careers."

@XRROW_

Жыл бұрын

@@bugwar5545 they deserve every bit of it

I remember when I was going through my military nursing school roughly 18 years ago, I spent some time in a burn unit and that OR was kept quite warm (100F if I remember?) due to how extensive the burns we delt with were (often 80% and more TBSA) and I vaguely remember being told it was due to how unequipped the patients were to regulate their own body temp.

@Lew114

Жыл бұрын

That makes sense. One of our skin’s main jobs is to regulate our body temperature. If 80% of that system is damaged it makes sense that temperature regulation would suffer.

@MP-in4or

Жыл бұрын

I worked in the OR with burn patients. That is a very rough environment. As you said, we have to maintain their body temp because they cannot do it themselves. This puts a lot of stress on the OR team.

@Sasha5555

Жыл бұрын

Wow that’s interesting. Thank you for sharing. I want to be a military nurse 🙌🏽

Both surgeries I've had since 2014, they put heated blankets on me once moved to the surgery room. They automatically do this for patients with diabetes, but also patients over the age of 60 (I was in 50s at the time). If you tend to be cold when others are comfortable or hot, be sure to mention this when you are in the pre-surgery prep room.

@missblackwood

Жыл бұрын

I had two surgeries at about 30 and both times I woke up with heated blankets. I assumed everyone got one so that’s interesting. The second time I was shivering like crazy for a few minutes even with the blanket!! That OR felt absolutely frigid lol.

@amycronkright6421

Жыл бұрын

I do this for every patient.

@sally8708

Жыл бұрын

My normal body temp is 97.5 thanks to my hypothyroidism. However, I actually like being cold because I’m further away from being too warm. I’m quite hefty, so I get overheated easily when I’m active or if it’s summer. I’m happiest when my skin is a bit cool to the touch. Should I warn anesthesiologists if I go in for surgery? If they don’t know 97.5 is my baseline, it might be concerning. I won’t care if they stick heating blankets on me because I’d be out, so how would I even know until I woke up?

@pacdude11

Жыл бұрын

@@sally8708 I’m not a medical professional, but whenever myself or a loved one has been in hospital they check vitals regularly so if your temp was abnormally low they would probably be aware

@Benlucky13

Жыл бұрын

@@sally8708 never hurts to talk to them if you're worried about it. any sort of planned surgery the anesthesiologist will come in and explain the process and ask if you have any concerns or questions well before actually putting you under

You might find it interesting to visit a semi-conductor production facility. The standards for removing particulates and exchanging air are many times more rigorous than OR's. In fact, in some parts, there isn't anyone in the facility at all. It's just robots. I worked for a company that had a smoke-enders program in which the technicians participated. The production crashed. It turned out that earlier they had tweaked the process to get the yields they wanted. Now that technicians were not smoking, not exhaling or sweating out the biproducts of the habit, the tweak was now wrong. They untweaked and all was well. This demonstrates just how sensitive the chemistry is. All that was a "Sub micron" facility but now, it's 5 nanometers and - no humans allowed.

@SeekingTheLoveThatGodMeans7648

Жыл бұрын

Secondhand (thirdhand?) smoking in semiconductors, huh.

@fluffysheap

Жыл бұрын

Semiconductor manufacturing is far more sensitive than surgery. In surgery you're worried about a bacterium that is maybe a micrometer long. This is more than a hundred times the size of the features on a chip. And a lot depends on the body's ability to take care of itself, which chips don't have at all.

@tazzer9

Жыл бұрын

I work in a cleanroom that produces time critical medicine (it goes out in syringes and because it's injected it needs to be totally sterile). It amazes me how stringent the standards for us are compared to these operating rooms. If our regulator saw us producing our medicines in one of these operating rooms wearing the same gowns and masks as the surgeons our licence would be revoked on the spot.

@NZKiwi87

Жыл бұрын

@@tazzer9 that sounds like an interesting job!

@lizziebjl

Жыл бұрын

@@tazzer9 I would hope so!

I firmly believed it was to freeze out bacteria, viruses and other pathogens. I did have one warm operation, when I had my gastric Bypass at the Ohio State University in Columbus Ohio. My anestheologist actually asked if I was comfortable before I went off to LaLaLand- I knew if He was That Considerate- I was in Pefect Hands!

@playfulpanthress

Жыл бұрын

Trust me, they just wanted an excuse to warm the room. Getting you warm blankets or putting the bair hugger under the sheets before you come into the OR would have been better.

Just finished OR rotation as a nursing student. I loved how it was always cold. And yes, I agree that the surgeons love it cold. It happened to me twice where the surgeon complained that it was hot. They had to lower the thermostat.

When I was a few weeks away from turning 13, I had an accident that resulted in a skull fracture requiring a fairly intensive surgery. I think it was the nurse who said something to either myself or my parents about asking for a warm blanket for my surgery, or maybe it was someone else on the team. I don't remember a whole lot of those 2 weeks that I was in the hospital, but I do remember the discussion of a hot blanket, and when it was actually time for my surgery, the sensation of a heavy, warm something being draped over me as someone told me to start counting back from 100 (and I only remember getting as far as 98) and then I was talking to someone in the recovery room.

Okay, I watched this from beginning to end. I hope you keep an affiliation with a hospital that trains doctors and nurses. You have an enormous aptitude for keeping the material interesting and engaging. I've had three 'procedures' so far and while it was just an idle curiosity why the room was so cold now I at least understand some of the reasons why. Thank you very much!

I once got too much anesthesia when I went for a cornea transplant, that I almost died, and slept like a baby for the next week. The next time the specialist gave me less of the medicine and my surgery was more normal, like the last time I had surgery when I got my inflamed appendix removed. It made me really appreciate those who do your job, so thank you for all the hard work you do for your patients!

@drewzalo

Жыл бұрын

Hope you’re doing well now

@Dutch3DMaster

5 ай бұрын

A family member who had the same surgery mostly experienced the anesthetic administered as feeling like fire being poured into his veins. He can still remember the heart monitor sound immediately shooting up in pitch and tempo due to the stress this induced. I'm not sure if it was this response or something else, but they were ready to give him an adrenaline shot after surgery because he refused to regain consciousness in the average time to be expected. For the next 2-3 weeks he kept falling asleep at random moments for very short amounts of times, and when he woke up and he heard "Welcome back in the waking world", the response almost always was "I wasn't asleep!" :P

Matt's video series on general anethesia was a huge help for me. Had surgery shortly after watching these and I was significantly less anxious & stressd out because I knew what the anesthesiologist would be doing, in what order & why they were doing each part of the procedure. I can''t thak you enough for making this series. Great job. 👍

I just discovered your channel and can't wait to watch all the videos. My name is Ted and I retired 6 years ago from a 42 year career in nurse anesthesia. I feel so blessed to be doing something that I loved and I still miss the hustle and bustle to this day but at 73 years old the memories will do. I can remember the banter between the surgeon and OR staff complaining about the room temperature. I wore a long sleeve undershirt under my scrubs and a disposable surgical gown over top. Occasionally we could swipe an extra bair hugger from across the hall and put the nozzle under our gowns. Could you speak on the topic of loud music in the OR. Some younger surgeons insisted on blaring their tunes all the while the staff and I could barely hear the monitor alarms and the loud noise can be detrimental to the thought process. No kidding, I've had arguments when asking to turn the music down so I would just call my chief and let those two go at it. Thanks , I will subscribe . Ted in Sebastian, Florida

@Inkling777

Жыл бұрын

An interesting observation. Our society seems to be dividing between those who NEED music as a background to what they do, and those who HATE that and see it as a distraction. Apart from requiring surgery staff who want that music to wear headphones, which would raise all sorts of issues, I don't see a solution.

@xisotopex

Жыл бұрын

nothing has change LOL! CNA's still love to put the bair hugger under their lead!

For a pulmonary endarterectomy the patient`s body temperature needs to be at around 18°C. Therefore, the warming blanket is actually used to cool the patient down, the heart-lung-machine cools the patient`s blood but also the room temperature is lowered even more. In my opinion it gets really cold in the OR during this specific procedure. Thats why i like to wear scrubs with long sleeves for a PEA.

@franks2910

Жыл бұрын

How often do you do those?

@marvinmuller1085

Жыл бұрын

@@franks2910 We perform more than 150 of those each year

@mrvwbug4423

Жыл бұрын

The pressure on the surgeons with that procedure must be immense. Having to work very quickly on incredibly delicate lung tissue because the patient is in a state of clinical death, the hypothermia is how it's able to be done without brain damage or the patient just outright dying.

@Suiseisexy

Жыл бұрын

@@franks2910 He's done them like much more often since the mRNA therapies, in fact, this is probably why the question was asked with an increasing frequency such that a med youtuber would make an answer video just now: lots of ORs have been colder more often thus prompting a re-asking of the question in general. Don't feel too bad doc, not only did my gasto admit it for safety reasons (Cirr, MELD=8) but in the past I got one of the military eggheads to talk about what the army does with it's elderly enlisted, we actually played TF2 together, so I know how the sausage gets made. Still, though, it's these little off-hand confirmations of reality that help my sanity. Yeah, I bet it's been cold in that OR lately.

@xXDESTINYMBXx

Жыл бұрын

@@Suiseisexy worst bot ever

It’s freaking freezing in the OR. This is really interesting

We kept our recovery room pretty cool after I gave birth and the doc actually told us we had to turn it up cause it could’ve been contributing to our newborn daughter not gaining weight quick enough. Like her body was working to keep her warm and in turn burning calories. She never shivered or anything and the nurse turned the temp down, not us lol. It was just interesting!

@AmoreMiu

Жыл бұрын

She did not shiver because babies don’t get the capability to shiver until they’re about 6 months old.

@gendoll5006

Жыл бұрын

@@AmoreMiu well isn’t that a neat fact, no wonder she didn’t shiver! Lol.

I had spinal surgery last year. First time i'd been in hospital for an operation since i was five. I was surprised at just how cool the operating theatre was when i got there. Have to give a shout out to the Anesthesiologist i had though. He was wonderfully calm and reassuring as i was going through the process of it. Really settled any nerves i had.

We had a Bair Hugger in the infirmary at the ski hill I patrolled at to help warm up patients we brought in on cold days. It was a great addition to the kit.

Thank you for your videos, I’ll be having my 10th surgery tomorrow thanks to my autoimmune disease. No matter how many times I’ve been through it, anesthesia still makes me nervous every time. But watching your videos really humanizes it and makes it less nerve wracking. Thank you! 😊

@The_New_Abnormal_World_Order

Жыл бұрын

I hope it went smoothly for you.

@JohnDlugosz

Жыл бұрын

@@jonathanparle8429 "might even die" if they told you that the trip to the hospital by automobile was the most dangerous part, including "you might even die", it would help put things in perspective.

The lead really seals in the juices. Sometimes we come out drenched in sweat. Great for giving hugs!

Unless I missed it, one reason wasn’t mentioned. I’m a nurse and I worked outpatient surgery, we always kept the temp at around 66 degrees. One day our air conditioning was not working and temps were rising. We were notified that if it wasn’t fixed we were going to have to cancel the rest of the cases for the day. The reason being that our equipment needs those temps in the 60’s in order to function, and that is what I would tell my patients when they complained about the cold.

@Nic1Moreno

Жыл бұрын

Always wondered the same....never really made a issue over it have MS and cold is my friend plus I've realized nurses have one of the most difficult jobs there is.....very appreciative of what they do....but I've seen things work faster and are more productive if I do treat them as they want to be treated...RESPECTED...

You are truly impacting a lot of youngsters in Aneasthesia school. Thank you.

I also believed it was to reduce bacteria. I wonder where these ideas start? I’ve had 14 operations in my life and I must say the most important person in the operating room is you! When I have my pre-op chat with the anesthesiologist, I tell them so ! ❤

@Allegory_of_Wolves

Жыл бұрын

I believed this, too, and I was even told this by the nurses in the OR, when I had a surgery in 2019. Hailing from Germany. So apparently these ideas start from medical personell telling this to patients? I wonder why, because they should know better, if it's instead really like the guy in this video says.

@BioTheHuman

Жыл бұрын

At what grades do you maintain your fridge? (A practical example to easily understand what's the real cold to reduce bacteria). I'm sorry but there is no way you can regulate bacteria with cold room in a human body. Even if the body reaches hypothermia, we're talking about 35 C° or let's even say 34 C°, which is still incredibly warm (outside human body). Try to put your hand in 34 C° water and you'll understand :)

@amycronkright6421

Жыл бұрын

I’m a nurse in the OR and I was told this too. Bacteria love warm moist environments, so we keep it cool and dry. Also for the surgical team comfort; it was twofold.

Before a recent surgery I actually had one of the nurses tell me exactly this. I appreciated the honesty.

My mum had surgery on Monday of this week to remove a rare (but thankfully not aggressive) tumor from her stomach. It was planned as laparoscopic, but ended up being open surgery once they had started operating because they needed to go more hands on to find the tumor. They managed to remove the entire tumor and some tissue around it to really ensure that it was all gone and mum is now considered cured! We were also expecting her to need to be in hospital until the weekend but I actually picked her up and brought her home already yesterday, and she could have been discharged already on Wednesday from a medical point of view, the reason she came home yesterday was because I need to know about such long drives beforehand (the hospital is almost 50 miles away) as I’m disabled and deal with severe chronic pain, so longer drives and longer excursions from home is something I need to plan ahead a bit and ensure I’m well rested. The extra night in the hospital for mum also gave her a bit more time to ensure she was indeed ready to go home and also gave us a bit of peace of mind to have her heal a little bit more before getting in and out of the car and such. Mum had an absolutely amazing team caring for her both during surgery and at the ward! She didn’t mention feeling cold so I’m guessing she had plenty of cozy blankets on her before being put under. Anytime I’ve been in an operating room, I’ve always needed a ton of blankets because I’m actually shivering in there, I feel cold very easily, and I always mention to the team working on me that “it’s amazing you can work in this, it feels like we’re in Antarctica” XD

These videos were a KZread rabbit hole recommendation. And I must say, Dr. Feinstein is such a reassuring voice and I admire his temperament. And when (if) the day comes for me to have surgery, I hope that someone quite similar and just as competent is “at the controls” and safeguarding my life in the OR.

I had a major spine surgery done three weeks ago. I was told that it was 11 hours and required two units of blood. I remember being wheeled into the room but since I’m more hot natured the cool temperature didn’t bother me. The anesthesiologist was surprised that I wasn’t using the hugger blanket and more surprised when I declined the offer of warm blankets. We had met earlier in pre-op but he asked questions about me being more comfortable when cooler as that hadn’t come up previously. He said that he would keep me comfortable and safe during the procedure which was complicated by three position changes. Your videos really help me to understand how important your role is in the operation. He also assured me that he would never leave my side. I’m not sure how practical that is given the need for bathroom breaks but I appreciate the sentiment.

I have been in recovery and freezing but couldn’t tell any one because I wasn’t totally awake yet. Finally shivering violently I was able to speak and ask for a warm blanket! Thank you for discussing this very important aspect of surgery!

I wondered the same thing when I had my first surgical procedure (pacemaker). It was almost like being on a different planet. All went well, the staff was great, and the surgeon complimented me about how cooperative I was. I neglected to tell him that he was the one wielding the scalpel...

OMG after several procedures in freezing ORs, the latest one they finally gave me the heater in the recovery room. I’m really sensitive to cold & drafts & this was like heaven. Thanks for explaining.

It's interesting to hear an explanation on the human medicine side of things. I perform anesthesia in veterinary medicine. We always hear about human medicine being vastly more advanced with research/technology and whatnot but it's comforting to know most of my job is pretty similar to what's mentioned here ☺

I'm really surprised people think the cold stops infection lol. also it's fascinating how anesthesia impacts heat retention in the body. great video!

Mad respect for answering the question at the beginning, then giving more information if we are still interested.

I was in an outpatient facility yesterday for a knee replacement and the place was cold. But when the anesthesiologist did his thing, I was out and never knew the temp. Everything Max presented makes sense. Good video

@karenvonbargen4472

Жыл бұрын

Outpatient knee replacement is absolutely barbaric. There are so many things that can go wrong and pain control alone can be a huge issue. I hope you’re ok.

I work in a hospital…. A secretary… and I always believed it was because germs don’t like the cold…. Very interesting and thank you so much for sharing😊

@bettysmith4527

Жыл бұрын

Virus actually survive much better in the cold, which is why winter is prime time for colds, flu, COVID etc.

@NickzAndMikz

Жыл бұрын

@@bettysmith4527 I’m not sure that’s true, but cold weather is a contributor to a change in human behavior

@bettysmith4527

Жыл бұрын

@@NickzAndMikz It is true, it's a medical fact! "Viruses are actually protected by cold air. According to the National Institutes of Health, cold temperatures allow the virus's outer layer, it's envelope, to harden into a "rubbery gel." This protects the virus, allowing it to better transmit, or spread. Cold, dry conditions can also increase the spread of germs. "The dryer air may also allow the virus to stay airborne longer and increase the chance of another person coming in contact through inhalation," says Bilsky."

@NickzAndMikz

Жыл бұрын

@@bettysmith4527 ah thanks for sharing

@queenbunnyfoofoo6112

Жыл бұрын

Winter has a higher cold and flu rate because people tend to be inside more, in closer contact.

thank you for the explanation doc, I used to shiver during a cesarean section. my head and hands were shaking. the nurse had wrapped me in a blanket, but I was still cold. The anesthesiologist finally turned up the room temperature, but I was still shaking. The Obgyn doctor during the operation protested why the room was so hot.

Hi Max, Thanks for answering that one! I am an AV consultant and in my first business, videotaped some Orthopaedic procedures in Melbourne Australia in the 80s. A specialist in Melbourne had developed a novel, faster procedure for hip replacement and Howse Protheses, owned by Johnson and Johnson, came back afterwards and said that this was the best quality video of a procedure that they have ever commissioned. I used a high quality camera, studio lighting and the camera was positioned over the operating table the night before the procedure by a Grip from the film industry. They were so happy that they got the Surgeon and us to do two more procedures. I was fascinated by everything in the Operating Theatre. In the last few years I have had two emergency procedures (a terrible triad elbow and a quads tendon rupture) as well as two prostate biopsies. And now to my point. The Anaesthetist usually appears before the procedure, introduces themself and a bit later, either they or an Anaesthetist Nurse, put you to sleep before entering the OT and then they hold your life in their hands - sometimes literally! Generally, you never see them again. So do they/you go into this important speciality to avoid patient contact? BTW - before the last biopsy, I asked the Anaesthetist if I could stay conscious unit after I had been wheeled into Theatre so that I could see everything. He agreed! Max - keep the vids coming, I enjoy really enjoy them.

I have worked at my hospital for 22 years. Some years ago a new wing was almost finished that would create a new main entrance with the standard foyer with two sets of doors and it was very cold in between, in the foyer. I had the occasion to ask the architect about the cold air in the foyer. He explained that it was a "flying insect barrier" to help prevent disease transmission.

@tookitogo

Жыл бұрын

_Almost_ finished? Did they not finish it?

@donaldvincent

Жыл бұрын

@@tookitogo "Some years ago" was almost finished. This explains why the architect was there. They finished it a few months later.

Great video Doc! You teach us so much!

As a former pediatric OR nurse, I agree with the answer 100%. Our patients were "slept" on heating pads, and covered as much as possible with piles of blankets from the warming cabinet. All of the staff, anesthesiologists included, usually wore warm-up jackets and were then swathed in old cloth scrub gowns. We were still cold and, as the circulating nurses, we were moving around quite a bit. I actually had a disagreement once with an anesthesiologist who wanted to open the windows (Florida location), but this would be an impossibility because of contamination risk. Fortunately, the windows were sealed shut, thus putting an end to that idea!

That was the first thing I noticed at the operating room's temperature, but I was hot at the time and the coolness of the room felt great.

Enlightening. I as a CBET, I would suggest discussing with a Biomed about troubleshooting some of the common issues with OR equipment. Items like Gas Machine circuit test issues, infusion pump problems, etc.

So I'm an neuro IR tech and we were coiling an unstable cerebral aneurysm and our biplane angio table overheated and shut down WHILE THE INTERVENTIONALIST WAS ABOUT TO DEPLOY A COIL. I will never EVER forget that case. The room was unusually warm but not enough to warrant it as unusable. The scrub team wearing 12-15 lbs of lead plus surgical gowns....well we were super uncomfortable but this case was an emergency. So what happened to the patient? We kept them intubated, secured the sheath in the groin, transferred them to another room, moved all of the anesthesia equipment all the while the interventionalist was pacing back and forth (still impressed he kept his composure) Horrific situation I will never ever forget and I will never raise the temp of my room I don't care how damn cold the staff is. And for the patient there are bair huggers for a reason. The coiling went great by the way. And this was at a top ten hospital

@MaxFeinsteinMD

Жыл бұрын

Yikes that sounds like a nightmare scenario. But well-handled!

Heh. In my last surgery, I was actually kept awake, which was novel - the anesthesiologist let me have input in my level of sedation - and one of the first conversations we had was over what temperature we were going to keep me, because my body temperature is generally about a degree cooler than "standard" (I'm sure you're aware of the variability of body temperature). It was kind of funny to have a nurse bringing up my EPIC EHR to verify that yeah no, I generally run cold, so please don't make me uncomfortably warm!

@VeryRGOTI

Жыл бұрын

wow, did you not feel any pain during the surgery?

@khills

Жыл бұрын

@@VeryRGOTI Nope, no pain. I mean, she was clearly keeping an eye on things and making adjustments, but I only had to tell her twice when I felt a bit of random, distance tugging (I was having a finger debrided and partly amputated). Otherwise, we talked about her sneakerhead kid, travel, COVID, and other general stuff. I didn't actually notice when they began amputating (which wasn't a given when I went into surgery). I made an offhand comment that she should let me know if they do, and she gave me an odd look and was all "honey, they already did." Utterly pain-free experience and it meant I didn't have any violent reactions waking up from surgery and no amnesia period after. I definitely preferred it!

@LittleKitty22

Жыл бұрын

I tend to run cold too, my normal body temperature is between 34 and 35 degrees Celsius. Trouble is, I never get believed. I'm in the UK and the motto here is - according to people who train up new staff: "all patients are stupid and don't understand anything, ignore everything they say, always remember all patients are stupid". They are not aware here of the variability of body temperature.

When I was rolled into the O.R. for my first surgery ever, I wondeed why it was, so cold in there... you explained it in a most excellent way. Thank you!

Doctor F is the man. He is the person I want on my care team full stop. Thank you Doc for all these nuggets of wisdom and humor.

I would appreciate your insights on the pediatric patient experiencing hypothermia during extended procedures. I enjoy your familiar humor I witnessed as an OR tech back in my days. Blessings to you!

I've been a Theatre RN for 30yrs & am so used to being cool, theatre garb, concentration & the light keep me awake. Thanks for your video.

Thank you for answering a question I didn't know I had. Now, I'm off to check out more of your informational videos. So glad I stumbled across your content. Thanks again!

Thanks, enjoyed that more in depth explanation. I actually did know that but only because I asked an OR nurse as I was being wheeled in once! Cheers from Western Australia

It would have been an interesting addition to the video to discuss what sort of clothes you are allowed and not allowed to wear in the OR if you want to make yourself more comfortable.

@acloudshapedcloud7785

Жыл бұрын

At my hospital you can wear hospital laundered scrubs only, a new set each shift. They do provide hospital laundered jackets as well. You're not supposed to wear any "outside" clothes, so no shirts or pants under your scrubs as an extra layer. During long surgeries you'll often find the nursing and anesthesia staff wrapped in blankets from the warmer!

@amycronkright6421

Жыл бұрын

For us, no street clothes can be visible under our scrubs, but we are allowed to wear something underneath if it doesn’t show. Normally, if I’m cold, I just grab one of those wonderful warm blankets!! 😜

Retired R.N. here: This video is amazing. Well presented as is your usual.

Thanks Dr M. Feinstein for all the thorough and less mysterious explanations about Anesthesia, Meds, OR, Temperatures, etc, etc.

Hi Max, Thank You for another EXCELLENT video. I am not in the medical profession but enjoy learning about anesthesiology💖

Thank you for this explanation. In 2002, I had to have an emergency appendectomy. I noticed how cold the operating room was for the minute or 2 I was in it before I was knocked out; the table they made me move myself onto was cold, too! 🥶 But about 2 minutes later, I was waking up in my hospital bed in my room. I wish they’d used something like the Bair Hugger on me then.

This explains to me everything that transpired when I hit the cold OR table. Thanks!

Huh 😮very 🥶interesting…I love your humility, you must be very easy to work and get along with. 🤗

Once when I was assisting with LSCS as a intern in the OR and i remember the AC weren't working that day (at night 3am), the heat from the scrubs and the OR lights made me feel intensely hot and this churning sensation in the stomach and i almost fainted. That made me realise why I would never become a surgeon 😂

Haha the heated pun was amazing. In all seriousness, Thank you for all you do! Lots of love to all ❤️

Your channel is very educational but also fascinating

If you feel uncomfortably warm in an adult OR, go to a paediatric one. Those can be well above anaesthetist temperatures

@MaxFeinsteinMD

Жыл бұрын

That’s the plan. Starting peds anesthesia fellowship later this year

@amycronkright6421

Жыл бұрын

Yes, this! And burns!

Hi Max, thanks for this great video about temperatures in operating room. I imagine that while the pandemic was going on, the amount of material and protections surgeons wore was even more. I would also think that a surgeons adrenaline is quite high so that also would make them warmer as well. Your channel is so helpful to lay people, that want more information about being an Anesthesiologist and it's challenges.

@xisotopex

Жыл бұрын

no the level of protection was the same. when the patient is intubated it is a closed circuit so the patient is not respirating into the room.

Extremely informative. Thanks so much!!!

dude thank you for the info hope you get 100k soon.

Great video man! I learned a lot! Great info! I really enjoyed donating to the anesthesiologist Foundation, since it was hard for me to go to college to be a anesthesiologist after I graduated high school in 08 because of my cerebral palsy! I think it takes special people to be a anesthesiologist, and you’re one of those special people, I’m one of those special people too!! I love anesthesiology! Anesthesiology is the best

I actually had a series of major operations at Mount Sinai in 2012 and I asked the anesthesiologist right before one of them, why the ORs are always so freezing cold. I thought it might have something to do with whatever the reason is, that MRI rooms are also always freezing. But he told me the same thing that was said in this video. I forget what the reason is that MRI rooms are always so cold too, but it's completely different. I was kind of surprised he actually bothered to answer my question when he knew I was going to be out in literally another two seconds. I didn't think the reason might be to control infections, like some people think. I would think if they wanted to control infections, they'd have to actually make the room way colder, like at least the temperature of a walk in refrigerator or freezer. And that low of a temperature, you'd have frostbite to contend with. I did always wonder how to lower temperature and exposure to air to, affects a person's insides, though.

@Inkling777

Жыл бұрын

For MRIs, the reason might be to keep all the equipment and electronics cool. In the late 1960s when I was in college the rooms for mainframe computers were kept cool for much the same reason.

@notsogreen

Жыл бұрын

Have you ever heard of Listeria? It loves the cold and flourishes in freezing temperatures.

I had some foot surgery done quite a few years ago….I have neuropathy in my foot, so I never felt a piece of metal get trapped in my sandal to make its way into my heel. It required surgical intervention to remove it…it had gotten embedded pretty deep. Anyway, the OR was freezing! My surgeon kindly asked for heated blankets for me🥰. Quite a guy, my doc. He’s done all of my ortho surgeries. I kid him all the time that I’ll never let him retire.

It’s always so nice when the nurse offers you a heated blanket!

Love you caps. I can understand wanting cooler air.

@franklinstephen3268

Жыл бұрын

Hello 👋 how are you doing?

I always thought that it was to control bleeding. Thank you for another informative video Max.

@acloudshapedcloud7785

Жыл бұрын

I've been told that too about spine and neurosurgeries. That the cold helps constrict peripheral blood vessels. These patients are often getting the warmed blood products mentioned in the video so I wonder if that changes anything.

Thanks for sharing your knowledge with the public Dr. Max.

I wondered about the cold OR temperatures! That’s why the warm blanket is my favorite part when I have surgery.

I'm an anaesthesia resident in Germany and I'd always wondered about this before starting my residency. On a lighter note, the best part of the video is that you used Celsius instead of Fahrenheit. Lol

@MaxFeinsteinMD

Жыл бұрын

We actually use celcius in the OR!

@adithyakaushik8069

Жыл бұрын

@@MaxFeinsteinMD Really? That's interesting. I really like watching your videos. They're informative and at the same time provide an insight into the practice of anaesthesia in the US.

@mustang8206

Жыл бұрын

@@adithyakaushik8069 Yeah while the Imperial system is easier for Americans we use the Metric system for science, medicine, sports and other international things

@SeekingTheLoveThatGodMeans7648

Жыл бұрын

This also means "a couple of degrees colder" is almost twice that much."

@lizziebjl

Жыл бұрын

United States will never get it’s act together with metrics. We had a chance in the 1970s, but people were dead set against it.

Yes, you’re right it keeps the surgeon and surgical tech cool, but it has a more important role. It helps to keep the humidity down as well. Humidity/condensation can present a problem with maintaining a sterile field. Also, you don’t want a surgeon sweating his eyebrow over an open patient.

I had surgery this past August. When I was taken to the OR O said it feels like a meat locker in here. LOL They gave me a warm blanket and it was wonderful.

@franklinstephen3268

Жыл бұрын

Hello 👋 how are you doing?

Going unconscious from anesthesia is such a relief from feeling cold… I’ve been awake for some operations and it’s sometimes chilly.

Hi Max, thanks for your videos, they are invaluable. I’m an ICU nurse who cares for patients after very long, complex operations. I’d love to know the effects of anaesthesia/drugs on the body after hours of surgery. A recent young exenteration patient had a lot of facial oedema that took a long time to resolve for example. Would be good to know from a nursing perspective.

I had a good few orthopedic surgeries after a serious car crash because doctors couldn’t fix me at first time and they needed to break a bone to redo surgery. I am a type of woman which loves warmth and heat (cold feet and hands) and every time I woke up from general anesthesia I always shivered and was shaking uncontrollably. I love watching your videos as I like to get to know some interesting facts about medicine and biology/anatomy.

@scrumptious9673

Жыл бұрын

I was also shivering!

Awesome video! When you said the most important person in the OR, I immediately thought Surgeon, closely followed by anesthesiologist. You are so correct! It is the patient. For my last surgery(outpatient) I was wrapped in the Hair Hugger. I was still cold the entire time. They kept trying to make it warmer, but I was uncomfortably cold. By the time I hit the OR, I was too out of it to care about the temp in the OR, but I did notice it was very cold, like previous surgeries. Very cool video! Thanks.

Good vid. Really worth watching. Liked and subscribed.

As a patient who has been through many surgical procedures, I can attest to the fact that the operating room definitely feels cold to a patient

And the circulating nurse prefers 68 degrees F- we split the difference! For major abdominal surgeries with large exposure, I’ve used both upper and lower Bair huggers to warm as much of the patient as possible. Also tried to get the surgeon a cooling vest/ unit if one was available. Sweat dripping into the field is not good for infections either We also tend to have fainting med students when the room is too hot- circulator must tend to them as well.

You explained it so simply in your videos! Love your videos!

Great video and explanation - very helpful, thank you.

Even in a full surgical gown I was freezing in my surgery rotation lol

As a surgeon, I was sure when you said "The most important person in the rooms at all times is ...", the answer was going to be the anaesthesiologist!

This made a lot of sense thank you!

The OR I was in last month for heart surgery felt more like 15 C. When I mentioned it my anesthesiologist agreed and everyone laughed. Didn't get the laughter at the time but I do now. Thank you for the interesting and informative videos.

We have like 20 to 20.5°C in the German ORs I'm at and it's a happy medium where I feel pretty comfy working at the table as well as sitting around 🤷‍♂️

I love the warm blanket out of that blanket warming drawer

Thank you for the clarification. Coming out of chiropractic school, I had the opportunity to shadow some orthopaedic surgeries and found one of those surgeries to be particularly cold. The anesthesiologist must have noticed me shivering and grabbed me a heated blanket. I’ve always wondered why

Q: Why do they keep the OR so cold? A: To make those heated blankets feel so good... 😃

Great video

The cold temperature and the height of items made me not pursue theatre scrub nurse. Cold makes me unhappy and I like being happy. Thank you for your hard work.

I just stumbled upon this video, I found it interesting so I subscribed.

thank you for debunking the myths of the cold temp in the operating rooms.. now i can sympathise with how the surgeons feel while at work

I’ve only seen a few of your videos (they’re great, can’t wait to learn more!). I’m curious about why the IV meds they give right before going under actually seem to hurt in my vein. It’s happened every time I’ve had general. Surely there’s a way to reduce or eliminate it? Is it something to ask the surgeon about (if there’s no pre-op consult w the anesthesiologist )?