Hemostasis management Flashcards
What are the 7 goals of hemostasis?
- decrease and control bleeding
- minimize the need for blood replacement
- optimize the surgical field view
- avoid major organ damage
- shorten the length of surgery and length of facility stay
- decrease the risk of infection
- decrease health care costs for patients and facilities
What are 8 issues associated with surgical bleeding?
- surgical site visualization
- increased surgical time
- necessity of a blood transfusion
- hypothermia
- SSI
- thrombocytopenia - decrease in platelets
- hemodilution
- lactic acidosis
What are the risks of a transfusion?
- SSI
- SIRS
- transfusion related ALI
- multiple organ failure
- increased mortality
What are 3 ways to quantify the surgical patient’s blood loss?
- inspecting
- weighing surgical sponges
- monitoring lab values
What do you want to inspect when looking for blood loss?
- suction canisters
- drapes
- sponges
Mechanical hemostasis can be achieved how?
- direct pressure
- sutures, staples, and clips
- dressings
What are 4 medications used to suppress surgical bleeding?
- epinephrine
- vitamin k
- protamine
- vasopressors
What are thermal-based energy sources used for hemostasis?
- monopolar electrosurgery devices
- bipolar electrosurgery devices
- vessel sealing devices
- ultrasonic devices
- lasers
How do you want to conduct a surgical count?
in an established sequence, with a wall-mounted count board that is visible to all team members.
The surgical count requires what?
that all team members are responsible for a correct count
who conducts the first surgical count?
scrub person and RN circulator
How do you want to count sponges?
in the packaged amounts
What does the scrub person do when doing a surgical count?
separates and points to items while counting
What does the circulator do when doing a surgical count?
records the count
Where can sponges typically found during the procedure to be counted?
- sponges on or in the patient
- mayo stand
- back table
- kick bucket
- pocketed sponge bag
Where does the scrub person put sponges during the procedure?
into a kick bucket
Where does the circulator put sponges during the procedure?
places sponges into a pocketed bag that is visible to the entire surgical team
What is kept in the OR/procedure room where the surgery is performed?
all sponges, linen, and waste
What must be done and correct before being removed from the room?
correct counts of sponges, linens, and waste
When should counts also be performed?
during any staff change
What are simple drains?
simple drains permit free flow through the drain to a dressing and use gravity to facilitate drainage
What are 2 examples of simple drains?
- Penrose drain
2. t-tube
What do close drainage systems do?
uses suction to draw fluids from the body
What are examples of a JP drain?
Jackson pratt drains
What is another example of a close-system drain that is shaped like a bellows?
hemovac drains
What are the 4 types of drains used in the surgical setting?
- simple drains
- closed suction drains
- chest drains
- negative pressure wound therapy devices.
How does negative wound therapy work?
helps remove excess fluid from the wound via suction tubes into a liquid waste collector
What do surgical sponges look like?
they are radio-opaque
