Intraoperative Flashcards
What is the learning outcome for ultrasound in surgical vascular procedures?
Explain the use of ultrasound in surgical vascular procedures.
What are the objectives related to ultrasound in surgical procedures?
- List operative procedures that may require assistance from the vascular technologist.
- Describe the procedure for sterile draping of ultrasound equipment in the operating room.
- Describe the benefit of the ultrasound examination for each operative procedure.
What was the first application of ultrasound in the operating room?
The first application of ultrasound in the OR was with A mode in 1961, initially used for renal stone localization and then for biliary stones.
What are the advantages of using ultrasound in the OR?
Higher resolution transducers can be used, real-time localization of pathology is possible, it reduces risk of complication/damage during surgery, and information is instantaneous which can reduce surgery time.
What are some applications of intraoperative ultrasound?
- Neurosurgical (brain/spinal tumors)
- General vascular surgery
- Parathyroid adenoma location
- Intraperitoneal
- Retroperitoneal
What is the role of technologists in the operating room during ultrasound procedures?
Technologists are responsible for the operation of the equipment, reviewing other tests that help with position and appearance of lesions, while a radiologist interprets the results for the surgeon.
What is required for a Sonographer to be in the operating room?
The Sonographer must wear surgical scrubs, have hair and shoe coverings, wear masks, and remove all rings on hands.
What must be done to ensure the sterile field during ultrasound procedures?
The transducer and cord must be covered with a sterile probe cover, and aseptic technique must be used to ensure the sterile field is not contaminated.
What is Transcranial Doppler (TCD) ultrasound used for?
TCD uses a small transducer to insonate the middle cerebral artery (MCA) through the temporal bone of the skull, allowing for constant monitoring during procedures such as carotid endarterectomy and open heart surgery.
What is the significance of TCD during carotid endarterectomy?
TCD evaluates the velocity in the MCA while clamping the ICA. If the MCA velocity is 10 cm/s or greater, it is adequate to proceed without bypass.
How does TCD assist in open heart surgery?
TCD monitors cerebral blood flow disturbances, detects air micro emboli, and assesses the loss of cerebral autoregulation.
What is the role of ultrasound in intensive care patients?
Ultrasound can monitor patients with increased intracranial pressure, severe cerebrovascular disease, and detect alterations in the hemodynamics of the brain.
What is the failure rate for PTA and infra-inguinal bypass?
There is a 9-47% failure rate for PTA in the first 30 days and 5-15% failure for infra-inguinal bypass.
What complications can ultrasound assess during bypass grafting?
Ultrasound can assess stenosis, vein webs, retained valve cusps, plaque dissection, and focal platelet aggregation.
What is the major concern during intraoperative scanning of renal and mesenteric arteries?
The major concern is the hemodynamic success of the procedure to ensure organ preservation.
