Role guide · OR pre-op · 6 hours · 47 patients · May 2026
Maple Hospital Anesthesiologist Guide — 6 Hours at the OR Pre-Op Station
I spent 6 hours working as Anesthesiologist in Maple Hospital in May 2026 and processed 47 patients through the OR pre-op station. This guide documents the dosing mechanic, the vital signs monitoring pattern I figured out, and the 6 failures that taught me the most about how the role actually works.
What the Anesthesiologist actually does
The Anesthesiologist is stationed at the pre-operative area adjacent to the Operating Room. Before each surgery, a patient is transferred from the treatment chain (post-Doctor diagnosis, post-Radiologist imaging if needed) to the pre-op station. The Anesthesiologist reads the patient chart, calculates and administers the correct anesthesia dose, monitors the induction vital signs, and signals the Surgeon when the patient is ready.
What makes this role different from Nurse or Doctor: it is a bottleneck position. Only one patient can be in pre-op at a time, and the surgery cannot proceed until the Anesthesiologist completes their step. A well-executed pre-op keeps the OR running at full throughput. Errors return the patient to queue and add 3-4 minutes to the treatment cycle.
Total patients: 47 | Successful (ready for surgery): 41 (87%) | Failed (vital spike or wrong dose): 6 (13%)
Average induction time: 18.4 seconds | Longest induction: 28s (cardiac patient) | Fastest: 12s (healthy adult, standard procedure)
The dosing mechanic — how it actually works
The primary anesthesia slider operates across a 0-100 scale. Patient weight determines the target range:
Target dosage range: approximately 20-35 on the slider scale. Indicator turns green when positioned correctly. Overdosing into the 40+ range triggers the vital spike failure sequence.
Target range: approximately 40-60. This is the most common bracket — about 60% of patients in my session fell here. The widest green zone of the three brackets, making it the easiest to hit.
Target range: approximately 65-80. Narrow green zone requiring precise positioning. I made all 5 of my dosing errors (vs 1 timing error) in this bracket until I learned to slow down on the slider adjustment.
Important note: the patient weight display on the chart uses estimated ranges, not exact values. Do not try to calculate an exact dose — position the slider in the center of the corresponding green zone and confirm when the indicator is solid green.
Vital signs monitoring during induction
After dose administration, the induction timer starts and the vital signs monitor becomes active. During this window (12-28 seconds depending on patient condition), the vital display must stay within the green zone.
| Patient condition | Induction time | Vital monitoring difficulty | Common issue |
|---|---|---|---|
| Standard / healthy | 14-18s | Low | None in my data |
| Respiratory condition | 20-24s | Medium | Late-timer spike requiring upward correction |
| Cardiac condition | 22-28s | High | Early spike at ~4s requiring fast downward correction |
| Anaphylaxis history | 18-22s | Medium-high | Unpredictable secondary spike mid-timer |
My 6 failures and what they taught me
All 6 failures came from two distinct patterns:
- Heavy bracket overdose (5 failures, first 15 patients): I consistently positioned the slider too high in the heavy bracket before I identified the exact green zone boundaries. Slowing down slider movement in the 65-80 range and watching for the green indicator rather than estimating by position solved this.
- Cardiac patient spike non-response (1 failure, patient 32): I was reading the chart when the 4-second spike began and missed the adjustment window. Now I complete chart reading before confirming dose and keep focus on the vital monitor from confirmation onward.
OR-chain illnesses the Anesthesiologist handles
Not every illness reaches the Anesthesiologist. Only surgical cases — those routed through the Operating Room — go through pre-op preparation. Here are the confirmed OR-requiring cases with their XP payouts and key Anesthesiologist considerations:
| Illness | Severity | XP | Anesthesia consideration | Treatment time (full chain) |
|---|---|---|---|---|
| Appendicitis | 4 (Critical) | 28 XP (Surgeon) | Standard induction; abdominal scan routes patient to OR. Most common high-XP case. | ~120s |
| Broken Bone | 4 (Critical) | 24 XP (Doctor + Nurse joint) | X-ray first (Imaging Room), then pre-op if cast step requires OR support. | ~105s |
| Amputee (Prosthetics) | 2 (Moderate) | 14 XP (Surgeon) | Shorter induction, simpler vitals — good practice case for dosing accuracy. | ~60s |
| Emergency Thoracotomy | 4-5 | 26 XP (Surgeon) | Requires active OR Nurse coordination. Cardiac condition vitals common in this case. | ~130s |
Pre-op checklist — what I verify before each patient
After 47 patients and 6 failures, I developed a consistent 4-point mental checklist before confirming each patient's readiness for surgery. These are the steps I now run through automatically within the first 8 seconds of each pre-op:
- Read the weight bracket on the chart (3 seconds). Light / Standard / Heavy maps directly to the three dosage zones. Do not estimate — confirm the label before touching the slider.
- Check condition flags in intake notes (2 seconds). Cardiac condition flag = expect the 4-second spike. Respiratory flag = expect a late-timer spike. Anaphylaxis history = unpredictable mid-timer event. No flag = standard induction.
- Position slider to center of weight-bracket zone. Do not rush to the exact midpoint — let the green indicator confirm position before releasing. Heavy bracket (>90kg) requires the slowest slider movement.
- Keep focus on vitals from confirmation until timer completes. Once you confirm dose, chart reading stops. Watch the vital monitor exclusively. The correction window for a cardiac spike is 3-4 seconds — there is no margin for distraction.
The Radiologist guide documents a similar 3-step scan-reading discipline. Both OR-chain specialist roles reward the same habit: develop a repeatable procedure and execute it consistently rather than improvising per patient. For the full picture of which roles interact upstream and downstream of the Anesthesiologist, see the illnesses database.