Setting: a level 2 trauma center in Dallas, Texas in the mid 1990s
This is a detective/western but it's taken a bit of a medical bent and I pride myself on using accurate detail where possible.
The MC is a fifteen year old female, intubated and vaguely aware (she knows something went wrong, that she's in a hospital and she seems
to comprehend she's going to have surgery but anxiety, pain, and fear have her quite distracted), about to be taken to surgery for repair of abdominal and thoracic trauma.
Here's the problem: a year ago I had emergency surgery done but I can only remember bits and pieces. I don't, for instance, remember the name of the pre-op area they took me to or what exactly they did to prepare me for sedation and surgery. I don't remember the name of the place they took me to afterward or what was done before I was put back in my room. I'd really love a site or details outlining exactly how your basic surgical procedure --- from prep to post-op. I haven't been able to find one.
Also, they're going to end up removing her spleen during the exploratory surgery for the abdomen. All of the documentation I've read say that they would normally vaccinate for several types of disease before removal in order to prevent infection. However, since the surgeons in my story won't know that the spleen is what needs to go until they open her up, I'm guessing that's not an option...or is it. Would they vaccinate her in the OR or simply remove the organ and hope for the best? The stats on sepsis complications are relatively remote (between 0.23-0.42% per year) but that assumes protocol was followed and the patient was properly vaccinated prior to the procedure. I couldn't find any data on how likely such a complication would be without vaccination. I also could not find any data on what specific antibiotics she'd have to take as a preventative measure for the following two years.
keywords used: surgery, trauma surgery, splenectomy, surgery care, your surgery, surgery procedure, surgery description, preoperative care, post operative care
These are the sites I utilized:http://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Splenectomyhttp://en.wikipedia.org/wiki/Aspleniahttp://en.wikipedia.org/wiki/Overwhelming_post-splenectomy_infectionhttp://www.trauma.org/index.php/main/article/413/http://www.yoursurgery.com/ProcedureDetails.cfm?BR=1&Proc=46
(probably has what I need but the site charges)http://www.spineuniverse.com/displayarticle.php/article1867.html
(about spinal injury, not what I need)http://www.answers.com/topic/preoperative-care
(too generalized and did not address this type of situation)http://www.spineuniverse.com/displayarticle.php/article613.html
(details spinal surgery, I'm not sure if the information applies?)http://www.nlm.nih.gov/medlineplus/ency/article/002944.htm
(spleen specific, this is the page which conflicts with the others and says that the vaccines are given AFTER removal)http://healthlibrary.epnet.com/GetContent.aspx?token=70ff5260-81bd-4de1-9998-14fc98aa9133&chunkiid=14866
(spleen removal but doesn't apply to trauma)