Intro to Surgery Lecture Powerpoint

Question 1

Why operate on a patient generally? (5)

Answer 1

• Preferred treatment for condition
• only other treatment option rather than comfort care
• palliative surgical intervention
• elective treatment
• weighing out the benefits vs the risks

Question 2

Steps of the surgical process (7)

Answer 2

• Preop eval H&P
• Immediate perioperative period (pre-op holding, not sterile) prep by anesthesiologist
• transfer to operating theatre and OR table, anethesia begins
• patient prep once intubated (foley, cautery pad, chloraprep and 3 min drying period)
• scrub in and draping
• operation
• post op move patient to PACU (post anesthesia care unit) or ICU if severely ill, eventually back to holding area (write post op note and orders, complete post op check within 4 hours and record day of surgery (DOS), post op day 1, 2, etc (POD) as part of daily rounds)

Question 3

Maintenance fluid therapy 4,2,1 rule

Answer 3

• first 10 kg give 4ml/kg/hr (40ml/hr)
• second 10kg give 2ml/kg/hr (20ml/hr)
• remainder give 1ml/kg/hr (xml/hr)

-Add these 3 for total ml per hour

Question 4

IV solution type used most often in surgery

Answer 4

Lactated Ringers

Question 5

Most common type of drain to be left in a patient post op for drainage

Answer 5

Jackson Pratt and Blake drains

Question 6

A discharge note for a patient needs to include a discharge ____

Answer 6

physical exam

Question 7

Patient expectations about a surgery

Answer 7

Importance of educating patient providing accurate info before procedure regarding process, risk benefit, complications, etc and give them realistic expectations regarding pain and of course obtain consent

Question 8

General basic labs in preop eval H&P (5)

Answer 8

• CBC
• nutritional status (albumin)
• chemistry panel
• blood type
• coags

Question 9

“Toeing in”

Answer 9

Tipping the angle of the retractor more vertical or sharply to allow a surgeon to manipulate the retracted tissue and stretch it out of the way

Question 10

Procedure Note

Answer 10

Completed by operator for bedside procedure including PAs

Question 11

Operative note

Answer 11

Completed by attending surgeon for an operation they complete, NOT a PA

Question 12

Immediate post op note

Answer 12

Brief operative note done by provider such as a PA immediately in PACU including pre op diagnosis, post op diagnosis (these might differ!), procedure performed and operative findings etc,

Question 13

Preoperative note

Answer 13

Generally not done, sometimes as an addendum to H&P

Question 14

Post op soap note

Answer 14

Completed by provider such as a PA within 4 hours after surgery and during daily rounds