Intraoperative, Post Op & Specimen Flashcards
Intraoperative Counts
. Sponges
– Placed on the kick bucket; the circulator retrieves and
counts the sponges with the STSR
– If a sponge is missing, recount
. Sharps
– Placed on the needle case at the back table
. Instruments
– Instruments added are recorded, (final counts are not necessary for every procedure)
– Broken instruments must be counted with its entirety and placed in water filled basin
– Instruments that came in contact with appendiceal stump should also be in separate basin
Intraoperative phase ends & Postoperative case management begins after what?
Dressing application
– Intraoperative phase ends with application of
the dressing.
Chemical
.25% or .5% bupivacaine (Marcaine / sensorcaine)
. 1% or 2% lidocaine (xylocaine)
. Thrombin (bovine derived): Used on arteries
. Heparin sodium: Used in vascular
. Avitene (microfibrillar
collagen): Used in neuro Sx.
. Gelfoam (purified
gelatin): Used in the
body cavity
Bair hugger
Mechanical
3 settings:
. High: 43°C/109.4°F
. Med: 38°C/100.4°F
. Low: 32°C/89.6°F
Saline (.9% NaCl)
Thermal
Preservation of the sterile field
. Remove sterile drapes, remove gown and
gloves, don a pair of utility gloves to start
cleaning
. Sharps and instruments are removed from the drapes
. Mayo stand and basins are moved away and kept sterile
. Maintaining sterility of these items is considered “best practice”
. Maintain sterile field until patient is transported
. Transport used instruments and equipment to decontamination area
. Prepare OR for next patient
. Dispose of sharps
Removal of PPE
. Drape removal
– STSR holds the dressing in place while the drape is
removed
. Gown removal
– Soiled gown should never be thrown any distance
from the waste container
. Glove removal
– should never be thrown any distance from the waste
container
. Mask are removed last
Immediate post op patient care
. Excess prep solution is removed
. Dispersive electrode is removed
. Patient may be extubated
. Monitoring devices removed
. Provide warm blanket
BREAKDOWN
. Specimen are cared for
. Sharps are placed on the container and
closed
. Instruments are removed
. Soiled instruments are placed in the basin
. Instruments not used are placed in the tray
. Linen are placed in the hamper
. Disposable items are placed in the waste
receptacle
. Suction canisters and tubes are discarded
. Case cart is taken to the decontamination
. PPE removed
. Hand wash performed
Foreign bodies:
– Bullets
. Have legal value and
turned to the police for
evidence
. Handled with a sponge to
avoid scratching
– Orthopedic implants
. Should be kept dry
General Information on
Specimen Care
. Specimen should be
passed to the
circulator in a sterile
manner
. Small specimen can
be placed on a telfa
or 4x4
General Information on
Specimen Care
. Large specimen should be placed in a sterile basin
. If the specimen cannot be passed off the sterile field immediately, it should be placed in a sterile basin with sterile water
. Most common type of
preservative used is
formalin (formaldehyde
solution)
Ex. Tonsils, appendix,
uterus
Aspiration Biopsy
– Removal of fluid using a
needle;
Ex.
– Thoracentesis (procedure
done when there’s too
much fluid in the pleural
space) and
– Arthrocentesis (procedure
of using a syringe to
collect synovial fluid from
a joint capsule)
Thoracentesis
(procedure done when there’s too much fluid in the pleural space)
Arthrocentesis
(procedure of using a syringe to collect synovial fluid from a joint capsule)
