Dr Sandra de Izquierdo – #BeBoldForChange

Sandra_IWD (2) Name: Dr Sandra de Izquierdo 

Role: Anaesthetist

Location: Guatemala 

#IWDSurgery

When you were growing up what did you want to be?

I wanted to be a medical doctor.

What motivated you to become an anaesthetist?

When I was a medical student in 5th grade I started to go to the OR, and in every procedure I always wondered what the anaesthetist was doing with the patient. I thought it was wonderful how they managed the patient and how they could go along with the procedure with an unconscious person.

What do you do during a typical day at the hospital?

I usually have 2 or 3 procedures per day. I always introduce myself first, to know the patient who is going to the OR. It takes me more or less 45 minutes to pre-medicate the patient, to explain the procedure, and how I am going to make them feel secure during the surgery. I try to answer all their questions and after that I get the patient’s consent to proceed with the procedure.

At the OR, a group of nurses and I arrive first, we receive the patient ask him/her a couple of questions (the Checklist). After the surgery I stay with the patient and I send them to the recovery room until they are stable, after two hours I send them to their room.

When I finish my procedures I get together with a couple of students (that are from the university and are going through 6th grade of medicine), and I teach them some classes about anaesthesia.

What is the most memorable incident (a patient, or a challenge) that happened to you at the hospital this week?

I had a female patient of 68 years old, with controlled hypertension, that had a history of syncope due to obstruction of the  left internal carotid (96%) and right internal carotid (66%), and she was scheduled for an endarterectomy. So, my main challenge was what type of anaesthesia would be more suitable for this patient. After I investigated it, I decided to go for the general anaesthesia. The procedure went really well, and I was satisfied.

The theme for IWD this year is ‘Be Bold For Change’, how have you been bold for safer surgery/anaesthesia?

I consider myself as a person that is bold for a change in safer surgery because I have been trying to promote OR teamwork in emergency cases (like heart attacks), to solve the problem. We have been doing a lot of simulations regarding this problem, and we have succeeded in a rapid response and good communication.

Another thing is that I have talked about is the importance of using a pulse oximeter to control the patient during the anaesthesia, not just at my hospital, but at the public ones too. And not just the pulse oximeter but the use of compression stockings during the procedure. As you see I like to teach, and I always have a group of medical students during the day.

Why is surgery and anaesthesia important for women’s health?

Regarding women, they go to the OR more due to pregnancy emergencies or gynaecological procedures. In these type of cases the amount of bleeding may be massive or minimum, but you always have to individualise each one of them and try to make anaesthesia safe for them.