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Name Kegan. For those of you, I haven't met, I'm one of the Ortho interns. Um I did undergrad in, in med school at UF. Um So I'm pretty patients in the room. Uh So be quiet, be respectful when time out's happening. Uh It's for safety purposes and people will get mad at you if you know, you're not respecting that um help get the patient from the hospital bed onto the or bed. Um You know, if you have to kind of uh observe the first time or two just to kind of see how it's done whether they use a slide board or not. Um over at the va they like to use the blow up thing. Um That's perfectly fine. Um You know, just kinda see how they do it and then try to be as helpful as you can with that. Um Once the patient's on the or bed, you can roll the hospital bed out of the room. Um put it in a spot that's not obstructive. Uh um because something that's seemly helpful uh by rolling the hospital bed out can quickly turn into, you know, more fodder for people questioning you if you put it directly to block the doors to the, or which I've seen before. Um, yeah, you'd be surprised. Uh, and then, uh you can help the nurse put the s EDS, the compression devices on the patient's legs if you're using them for the case. Um And then a lot of times the nurses and techs are really good about this. But, um, I put kind of a picture, this is what the table usually looks like and they kinda set it up with a check on top of it and they'll put a, uh, a boat of gauze and then a bottle of peroxide and a bottle of alcohol. Um, and, you know, usually wipe, use that to wipe down the patient's extremity, um, and kinda preclean it and then they use these plastic 10 tens. This is the best picture I could kinda find of what they look like. They're all folded up in the smaller squares. Um If you grab a couple of those and put them on the table, they usually use them to um, pre drape, you know, around your, your surgical site. Um, before you, you know, you put on your surgical drapes. Um, so just having all that prep can save somebody even if it's 10 seconds, um, you know, saving people time, um, is generally very much appreciated and then prep, um, you know, this is kind of a harder thing to do as a student in its area of a little more stress. Uh, people get a little anxious during this time. Um, you know, if, uh, this is more orthos specific to you, but, um, during, you know, like a hip or knee arthro, you'll have folks, uh, who, who may have bigger legs and if you grab a pair of sterile gloves, um, you can let the nurse prep the foot, an ankle and then you can offer, you put the gloves on in a sterile fashion. Um So you put the glove pack down. Um, you know, you slide one hand and one glove and then kinda grab the other one through the wrist part and slide it over here without ever touching the outside of the gloves with bare hands. Um And now you're wearing sterile gloves, you pick up the prepped foot or ankle and you just basically hold it up in the air for them while they prep, stick around you. Um They'll prep the whole leg out with the uh prep stick and then the surgeons will start to drape around you. Um And just kinda doing that. Um You know, the nurses are super appreciative cause they can go put in their stuff in the computer while you hold the leg up in the air. Um And it gives them a break. Uh You know, and you can show people how big and strong you are. Um But, uh, you know, that stuff like that can be super helpful and people are actually super appreciative. Um You'll hear like on the overhead, you know, a lot of times prep help and stuff like that. Um, you know, and instead of them having to wait for y you know, one of the, um, techs or whomever to come help, you know, you can save them a good amount of time. Um, you know, and then while they drape you go scrub and then you jump in the case and everybody's quite pleased with you. Um Otherwise at the certain level, there's not really big expectations for prepping and draping, uh just don't contaminate. That's always a big thing. Blue stuff uh is, is bad during that time. Um And then again in interop anatomy, it's, you know, this is always gonna be your biggest bang for your buck and I'll say it over and over and over again. It's gonna be the case for medical school residency, you know, all this stuff. I mean, all these questions are gonna be anatomy based for the most part. Um, orthos specific wise, we're not a huge pimping service. Uh, you know, which it doesn't mean anything good or bad if you don't get pimped during a case. Um But when it, you know, does happen, it's generally always gonna be anatomy related. Um And, you know, don't feel bad if you don't get every question right. It, nobody really cares. Uh As long as you learn from it. Um, you know, as long as you're putting in some effort. I think people notice and, you know, it's well received. Uh and then interop uh so I, you know, to me, I think the biggest thing uh is just being aware, be self-aware when you're trying to be helpful. Um You know, so little things if someone's cauterizing and, you know, they're using a Bovi that doesn't have the suction already on it, you know, grab the suction and suck up the smoke, even if you're wearing a clean air suit in a joints case. Um, you know, they've done studies that actually show it can increase your risks of lung cancer even in the clean air suits. Um Plus, you know, the smoke kinda muddies up the field and, you know, by sucking it up, you can help somebody see better. Um, you know, again, going back to being aware and self-aware, you know, just try to see if you're kind of in the way. Um, you know, kind of be cognizant of the table behind you don't back into it. Um You know, if you're moving the lights for people don't shine it on the back of somebody's head, it gets hot really fast and also accomplishes nothing. Um, you know, kind of take the second to think critically, consider where your retractors are. Um, you know, if you're helping in a shoulder arthroplasty case and um you have like the deltoid retractor and you're cranking on it really hard, uh, consider that the axillary nerve is probably somewhere under there. Um, and postoperatively they might have a pretty numb, painful arm if you crank on it too hard for too long. Uh So when somebody steps away, you know, you can let go a little bit on the retractor and take some of that tension off. Um, you know, or if somebody's moved away from, you know, the field where you're retracting, uh, you don't have to retract all the way over here when they're operating over here now. Um So just things to think about, um, you don't have to ask a ton of questions. I feel like, I don't know. And I guess the disclaimer to all of this, this is things I did in ways that, you know, I feel about these things. Um You know, I think a lot of people talk about asking a ton of questions to show interest, but I don't think you have to. Um, so, you know, feel free to ask questions, but don't feel like you have to. And I would only ask them, you know, at appropriate times if somebody's struggling in a case and you could see they're visibly frustrated, probably not a good time to ask questions during a case. Um And then, you know, lastly probably best not to grab from a text table as a student. Um You know, unless you're kind of specifically pointed to do so, um and then again, going back to like, I said, you know, going in the room introducing yourself, just be friendly to all staff all the time, regardless. Um, you know, even if people are mean to, you just kinda kill them with kindness, it'll serve you much better. Um, and then going back to the questions, uh, just a personal pet peeve of mine don't be the person to ask questions since you're so off knowledge. Um, II don't think it's generally well received. Um You know, it, I know people talk about showing interest in stuff, but II just, I think doing that eventually is picked up by people and people don't like it. Um No, and then uh cutting sutures. Uh so just a small tip, slide, the scissors down, go on top of the knot and then cut in an angle to turn your hand slightly. Um Don't cut the knot and then if you don't know the length, I know as a student, um you always cut it too long or too short. That's just part of, you know, being a student and even being an early resident. Um if they don't tell you how long just ask. Um generally speaking, um if it's deep, you know, under skin, uh go short. So it's not poking on the skin and if it's on the skin, leave a tail cause somebody's got to cut it out in clinic. Um POSTOP help clean up, obviously, uh grab the hospital bed that you moved out of the room and then help move the patient back onto the bed. Uh Between cases. Uh Everybody feels like you always have to be on all the time. All this stuff you're allowed to use the bathroom, you're allowed to have something to eat or drink between cases. It's not a sign of weakness. Um Generally speaking, turnover at the main hospital, the three towers is pretty slow. Uh So I usually have a good amount of time. Um Some folks have, you know, come in and seen consult with us with uh with us um between cases um if you're over at F se and CSE the outpatient centers is actually pretty fast, turn over. Um So sometimes you'll sit down and you'll see your next patient rolling past you. So just things to be aware of um between cases is a good time to use some of those resources I was talking about. Um usually cause you'll find the resident and the fellow are busy writing notes and putting orders in anyway. Um So sometimes it's a good, good time to be kind of self sufficient and just prepping stuff. Um you know, cause they might be busy with epic anyway. Um You know, and then something that's not mandatory um but might serve you well in, in the future, um consider making a list of kind of the types of cases you saw that day. Um Maybe some interesting findings, anatomy, um little maneuvers or tips and tricks, uh, that the attending did that. Um, you know, they've kind of picked up on with experience. Um, so, you know, that you didn't see in the videos you watched for prep, um, and then write down any questions you have, uh, it might be good fodder for discussion later. Um, you know, comparing things that do you find useful and interesting in your future career? Maybe even research ideas. Uh, we have a couple of attendings that um do uh procedures in a way that's, you know, not as broadly described in the literature. Um And you could probably make a case series from all the patients that do it and have good outcomes with. Um and then most importantly, just have fun um or is a really cool place, um don't work too much, just have some fun. Um You know, again, think pretty critically about, you know, being in the or so, you know, surgery is kind of a pretty amazing thing. Uh you know, when you take a step back and, and kind of look at it and get past all those nerves and jitters, there's this kind of per if it's really like perfect orchestra of kind of coordinated events that, you know, facilitate a surgeon going in and piecing somebody back together or taking out things that are hurting a patient. Um You know, you need this really detailed knowledge of anatomy and this practice skill set uh that, you know, kind of come together to accomplish these goals. It's really a team sport, um, you know, between the surgeon and the nurses and the techs and the patient, you know, everybody assisting in the surgery. Um, you know, and it's kind of amazing when you watch people who've done this for a long time really efficiently and, you know, kind of productively use all their tools and, and hardware at their disposal and, um, in a manner that really accomplishes, you know, what they set out to do. Um, you know, in, in a day's work. So, um, you know, just consider it, you know, how, how cool that can be. Um And then just a plug, um, you know, obviously going into surgery Ortho is the best. Um, we do some crazy stuff but in all reality, um you know, uh kinda find what you're passionate about. Um, you know, whether that's surgery or not, uh Just know that, you know, people are always welcome to come hang out with us or no or um have fun with it. Try to be helpful where you can, um, try to learn a thing or two while you're at it too. I know it's a stressful time. Uh We all go through it. Uh It's, you know, all temporary pain, it's all very survivable and, and doable. Uh You know, just think if, if I made it here, you definitely can. So, got an extra room happy to, to take any questions. What are?