Hemostasis management

Question 1

What are the 7 goals of hemostasis?

Answer 1

1. decrease and control bleeding
2. minimize the need for blood replacement
3. optimize the surgical field view
4. avoid major organ damage
5. shorten the length of surgery and length of facility stay
6. decrease the risk of infection
7. decrease health care costs for patients and facilities

Question 2

What are 8 issues associated with surgical bleeding?

Answer 2

1. surgical site visualization
2. increased surgical time
3. necessity of a blood transfusion
4. hypothermia
5. SSI
6. thrombocytopenia - decrease in platelets
7. hemodilution
8. lactic acidosis

Question 3

What are the risks of a transfusion?

Answer 3

1. SSI
2. SIRS
3. transfusion related ALI
4. multiple organ failure
5. increased mortality

Question 4

What are 3 ways to quantify the surgical patient’s blood loss?

Answer 4

1. inspecting
2. weighing surgical sponges
3. monitoring lab values

Question 5

What do you want to inspect when looking for blood loss?

Answer 5

1. suction canisters
2. drapes
3. sponges

Question 6

Mechanical hemostasis can be achieved how?

Answer 6

1. direct pressure
2. sutures, staples, and clips
3. dressings

Question 7

What are 4 medications used to suppress surgical bleeding?

Answer 7

1. epinephrine
2. vitamin k
3. protamine
4. vasopressors

Question 8

What are thermal-based energy sources used for hemostasis?

Answer 8

1. monopolar electrosurgery devices
2. bipolar electrosurgery devices
3. vessel sealing devices
4. ultrasonic devices
5. lasers

Question 9

How do you want to conduct a surgical count?

Answer 9

in an established sequence, with a wall-mounted count board that is visible to all team members.

Question 10

The surgical count requires what?

Answer 10

that all team members are responsible for a correct count

Question 11

who conducts the first surgical count?

Answer 11

scrub person and RN circulator

Question 12

How do you want to count sponges?

Answer 12

in the packaged amounts

Question 13

What does the scrub person do when doing a surgical count?

Answer 13

separates and points to items while counting

Question 14

What does the circulator do when doing a surgical count?

Answer 14

records the count

Question 15

Where can sponges typically found during the procedure to be counted?

Answer 15

1. sponges on or in the patient
2. mayo stand
3. back table
4. kick bucket
5. pocketed sponge bag

Question 16

Where does the scrub person put sponges during the procedure?

Answer 16

into a kick bucket

Question 17

Where does the circulator put sponges during the procedure?

Answer 17

places sponges into a pocketed bag that is visible to the entire surgical team

Question 18

What is kept in the OR/procedure room where the surgery is performed?

Answer 18

all sponges, linen, and waste

Question 19

What must be done and correct before being removed from the room?

Answer 19

correct counts of sponges, linens, and waste

Question 20

When should counts also be performed?

Answer 20

during any staff change

Question 21

What are simple drains?

Answer 21

simple drains permit free flow through the drain to a dressing and use gravity to facilitate drainage

Question 22

What are 2 examples of simple drains?

Answer 22

1. Penrose drain

2. t-tube

Question 23

What do close drainage systems do?

Answer 23

uses suction to draw fluids from the body

Question 24

What are examples of a JP drain?

Answer 24

Jackson pratt drains

Question 25

What is another example of a close-system drain that is shaped like a bellows?

Answer 25

hemovac drains

Question 26

What are the 4 types of drains used in the surgical setting?

Answer 26

1. simple drains
2. closed suction drains
3. chest drains
4. negative pressure wound therapy devices.

Question 27

How does negative wound therapy work?

Answer 27

helps remove excess fluid from the wound via suction tubes into a liquid waste collector

Question 28

What do surgical sponges look like?

Answer 28

they are radio-opaque