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Flashcards in REVISION Deck (19)
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1

DESIGN

  • RACETRACK STYLE
  • SINGLE CORRIDORS
  • SMALL CLUSTERS

2

LAYOUT

4 ZONES

1. TRANSITION EG. CHANGEROOMS

2. UNRESTRICTED EG. PREOP AND RECOVERY ROOM (STREET CLOTHES PERMITTED)

3. SEMI-RESTRICTED EG. PERIPHERAL SUPPORT AREA (TRAFFIC IS LIMITED, APPROPRIATE ATTIRE WORN)

4. RESTRICTED EG. SCRUB AREAS AND OPERATING ROOM

3

PERIOPERATIVE PHASES

  • DAY SURGERY/ WARD
  • PREOP BAY / HOLDING BAY
  • ANAESTHETIC ROOM
  • OPERATING THEATRE
  • RECOVERY ROOM / PACU

4

PERIOPERATIVE TEAM

1. ANAESTHETIST

2. ANAESTHETIC TECHNICIAN

3. SURGEONS
4. PERFUSIONIST

5. ORDERLY

6. ORTHOPAEDIC TECHNICIANS

7. RADIOGRAPHERS

8. CSSD STAFF

9. SUPPORT STAFF

10. PRODUCTIVE REPRESENTATIVE

5

CIRUCLATING NURSE (SCOUT)

  • Checks and prepares the operating theatre and required equipment
  • Assists the instrument nurse and surgical team to gown
  • Opens and dispenses items to create a sterile field (checking integrity)
  • Records the surgical count
  • Checks the patient prior to the commencement of anaesthetic
  • Assists with patient positioning
  • Applies the diathermy plate
  • Arranges theatre equipment
  • Turns on the operating lights
  • Assists the surgeons to gown
  • Receives the skin preparation dish
  • Assists with positioning of surgical drapes PRN
  • Attaches the diathermy plate and active electrode to the diathermy machine
  • Attaches the suction tubing to the suction canister
  • Records intraoperative events
  • Monitors blood loss
  • Anticipates surgical events and acts accordingly
  • Sends for the next patient
  • Documents the surgical count
  • Assists with removal of the drapes
  • Assists with the attachment of wound drainage systems
  • Assists with the patient transfer
  • Transports the patient to the recovery room and provides a handover
  • Assists with the end of case cleanup.

6

THE INSTRUMENT NURSE (SCRUB)

  • Checks and prepares equipment
  • Surgical scrub
  • Gowning and gloving
  • Create and maintain a sterile field
  • Completes surgical count
  • Prepares/applies skin preparation
  • Provides patient drapes
  • Provides instrumentation
  • Anticipates intraoperative events and acts accordingly
  • Monitors sterile field
  • Initiates the 2nd/3rd surgical count
  • Assists with dressing the wound
  • Assists with removal of the drapes
  • Assists with the attachment of wound drainage systems
  • Signs the count sheet
  • Prepares instrument trolley for decontamination
  • Disposes of sharps
  • Disposes of waste.

7

THE 8 P'S WHEN CONSIDERING SURGICAL PROCEDURE

  • PROPER PLACEMENT
  • PROPER FUNCTION
  • PLACE IT ONCE
  • POINT OF CONTACT
  • POSITION OF FUNCTION
  • POINT OF USE
  • PROTECTED PARTS
  • PERFECT PICTURE

8

ASEPTIC TECHNIQUE

  • “The methods by which microbial contamination is prevented in the environment”
  • Also called Sterile technique

  • And, To reduce service providers' risk of exposure to potentially infectious blood and tissue during clinical procedures. 

9

COMPONENTS OF ASEPETIC TECHNIQUE

  • Handwashing/Surgical scrub
  • Using barriers
  • Client prep
  • Maintaining a sterile field
  • Using safe operative technique
  • Maintaining a safer environment in the surgical/procedure area

10

NURSING ROLE IN OPERATING SUITE

  • THE NURSE MANAGER
  • THE FLOOR COORDINATOR
  • THE STAFF DEVELOPMENT NURSE
  • THE PRE-OP NURSE
  • ANAESTHETIC NURSE
  • THE INSTRUMENT (SCRUB) NURSE
  • THE CIRCULATING (SCOUT) NURSE
  • THE RECOVERY ROOM NURSE

11

PRE-OP CHECKLIST

  • Pre-op nurse verifies information (i.d., consent, right patient, right procedure on the list
  • Mandatory examination results
  • Allergies
  • Patient property/ personal effects
  • Dietary and fluid restrictions
  • Any meds administered as ordered

 

 

12

TYPE OF ANAESTHESIA

  • GA Definition: reversible, unconcious state. Characterized by: Amnesia (sleep), Analgesia (freedom from pain), Depression of reflexes, Muscle relaxation “put to sleep”
  • Regional Anesthesia Definition:a reversible loss of sensation in a specific area or region of the body when a local anaesthetic is injected to purposefully block or anesthetize nerve fibres in and around the operative site.
    e.g. spinal, epidural, and major peripheral blocks.
  • Local Anesthesia Definition: administration of an anesthetic agent to one part of the body by local infiltration or topical application.Nurse monitors.

13

PRE-MEDICATION

  • Sedatives/tranquilizers
  • Narcotics
  • Anticholinergics
  • Antiemetics
    • Desired Effects

    • decrease anxiety

    • reduce bronchial secretions

    • analgesia

    • amnesia

14

PROCESS OF GA

  • Induction – begins with administering of anaesthetic agents until pt ready for positioning or surgical prepping INTUBATION
  • Maintenance – from this point until near completion of the procedure

  • Emergence – starts as the pt begins to “emerge” and ends when pt ready to leave the OR. EXTUBATION
  • Recovery from anaesthesia can be considered a 4th phase of GA.

15

INHALATIONAL AGENTS

  • NITROUS OXIDE (GAS)
  • HALOTHANE (VAPORISER)
  • ENFLURANE (VAPORISER)
  • ISOFLURANE (VAPORISER)

16

INTRAVENOUS AGENTS

  • THIOPENTONE
  • PROPOFOL
  • DEPOLARISING
  • NON-DEPOLARISING

17

CARE OF PATIENT DURING A GA

  • EQUIPMENT CHECK
  • AIRWAY EQUIP SIZE GUIDE
  • PATIENT CHECK AND PREPARATION 
  • INTUBATION
  • POST INDUCTION
  • CARE OF UNCONSCIOUS PT
    • MONITORING
    • PROTECTION
    • HYDRATION
    • SKIN INTEGRITY
    • TEMP CONTROL

18

CATEGORIES

  • Cutting and Dissecting Instruments
  • Clamps
  • Grasping Forceps
  • Retractors
  • Suction
  • OTHER
    • Specialty
      Drills, Saws – Orthopaedics
      Joint replacement-implants
      Fibreoptic scopes
      Robotic Surgery

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