Chapter 19 Surgical Hemostasis

Question 1

Hemostasis achieves a dry surgical field therby improving _______and reducing the risk of iatrogenic injury. Tissue healing is improved and postoperative _____and risk of infection are reduced

Answer 1

Hemostasis achieves a dry surgical field therby improving visibility and reducing the risk of iatrogenic injury. Tissue healing is improved and postoperative edema and risk of infection are reduced

Question 2

what are the three principles of hemostatic agents?

Answer 2

i. Reduction of blood flow to the affected area
ii. Topical hemostatic agents
iii. Antifibrinolytics

Question 3

_____ ____ reduction – performed to slow blood flow and encouraging and allowing clot formation and stabilization

Answer 3

b. Blood flow reduction – performed to slow blood flow and encouraging and allowing clot formation and stabilization
pressure tampondate
Topical vasoconstriction
hypotension/hypothermia/reduced perfusion

Question 4

pressure tamponade

Answer 4

apply pressure to a bleeding vessel. This apposes the torn edges of the vessel wall and allows for the platelet plug to forma and stabilize. 2. Time to coagulation is dependent upon vessel diameter, blood pressure, and coagulation ability.

Question 5

topical vasoconstriction (epinephrine/adrenaline/ephedrine)

Answer 5

1. Used for epistaxis.
2. Disadvantages include absorption of active agents that have effects on the cardiovascular system and profound vasoconstriction locally at the site of administration or systemic responses resulting in generalized peripheral vasoconstriction that may cause ischemic damage.

Question 6

hypotension/hypothermia/reduced perfusion

Answer 6

1. Result in revlex peripheral vasoconstriction and redirection of blood flow to vital organs.
   a. This reduces blood flow particularly to the periphery, thereby reducing bleeding in peripheral tissues.
   b. Bleeding may occur postoperatively as body temperature and blood pressure rises, the hemostasis achieved during surgery may not be adequate in the face of reperfusion of the periphery and normalized blood pressure.

Question 7

distant control of blood flow

Answer 7

tourniquets, topical hemostatic agents, active hemostatic agents, hemostatic sealants, antifibrolytics

Question 8

VESSEL tourniquets (bulldog or Satinsky) vascular clips, snares, or fingers
\_\_\_\_\_\_\_\_ tourniquet is used frequently in vascular and cardiothoracic and minimally invasive surgery to temporarily control blood flow through vessels during surgery.  
i.	Umbilical tape is applied around the vessel with the ends passed up through tubing and secured tightly using a clamp on the end of the tapes at the top of the tubing.

Answer 8

a. Rumel’s tourniquet is used frequently in vascular and cardiothoracic and minimally invasive surgery to temporarily control blood flow through vessels during surgery.
i. Umbilical tape is applied around the vessel with the ends passed up through tubing and secured tightly using a clamp on the end of the tapes at the top of the tubing