Minor Surgery Flashcards
What is the most common complication for minor surgery?
Anxiety
Ideal age?
15-65 y.o.
Riskiest body type?
Endomorph (heal slower).
What body type heals fastest?
Ectomorph
What is does vitamin k help for?
Clotting Factor
What should you ask them?
Have they been to the dentist for numbness without complication.
What leads to bleeding?
Aspirin.
T/F: Diuretics cause a risk.
True. (not as much if under 35 y.o.)
Why are diabetics a high risk?
Infection.
What do all patients require before surgery? (blood work)
CBC, UA, and prothrombin time.
T/F: Patients have to ask you to remove a mole.
T. Can’t bring up surgery to patients.
T/F: Don’t lie to a patient about length of time for surgery.
F; Overestimate the time required.
What are 4 important logistical things regarding surgery?
Rest 2-3 hours after surgery.
Give paper about post surgery bleeding.
Don’t do surgery on Fridays.
Checkin w/in 24 hours after surgery.
What is the most common form of sterilization?
Steam autoclave. (13 min. @ 120 degrees C @14.5 PSI).
What is the most common gas used for sterilization?
Ethylene Oxide.
When is dry sterilization ok to use?
Emergencies. (1 hr. 170C)
What is the least effective sterilization?
Cold sterilization.
Dulls tools.
Iodine.
T/F: Shave patient prior to surgery.
F. Trim hair.
What is the most important step of sterilization?
Gloving.
Antiseptic
Limits multiplication.
Bactericidal:
Kills. Don’t use on patients.
Phenol Coefficient:
Every other antiseptic compared to 80% dilution of phenol carbo acid.
Name an example of a tar derivative.
Phenol
What is used in dilutions in the vagina?
Bolton’s solution.
Black tar derivative that comes in spray cans in .5%; not for patients.
Cresol.
Used for itchy skin conditions.
Resourcinal.
Used for mouth, fungal infections, and foot worm.
Thymol.
Phenol coefficient of 7x; used for burns; evaporates TNT.
Trinitrolphenol.
7x more powerful than 80% phenol and toxic
Proflaven dehydrochloride concentration
1:1000
Merthyolate concentration
1:2000.
Pre-surgical scrub after soapy iodine bath.
Halogens:
Chloride, Iodine, Silver nitrite.
Daikens solution
Chloride.
Kept in light resistant bottle.
Lasts 24 hours.
Dissolves good and bad tissue.
Creed treatment:
Antiseptic treatment in eyes of newborns (gonorrhea).
Silver nitrite.
T/F: Alcohol works well for sterilization.
F.
Used to preserve tissue.
Formaldehyde.
10% is formalin.
What is used to clean, but not disinfect, and has no antibacterial properties?
Pluronic F68
Bacteriostatic that is a teratogen?
Hexochlorophine.
What presents the biggest risk to patients?
Concentration mistakes.
Epinephrine:
anesthetic.
Vasoconstrictive.
Can’t use on fingers, toes, ears, nose, penis.
1/100,000 or 1/200,000.
2 Secondary effects of local anesthetics.
Limit bleeding.
Potentiate infections.
Minor surgery needle gauge?
25, 26, or 27
Venopuncture gauge?
21.
Skin refrigerant:
Ethyl chloride (spray).
2 surgery rules:
Only with patient laying down.
Multiple wounds or more that 35cc epi, then REFER.
Anesthetic injection steps:
Inject, withdraw plunger, and look for blood. If not pink, then proceed and distribute as you withdraw.
Cut is already open, so you don’t need to pierce the skin with the needle.
Direct infiltration.
Used in elective surgeries where you inject anesthetic around the area you are about to cut.
Field block.
Go in at base of digit with 2cc on each side to numb the finger.
Volar block.
Procaine AKA:
AKA novacaine.
Ester base.
Tetracaine AKA:
AKA pontracaine
Ester base.
Lidocaine AKA:
Zilocaine.
Amide base.
Mapiphacaine AKA:
Carbocaine.
Vasoconstrictive (same epi limitations).
Bupiphicaine AKA:
Marcaine.
Use less than 2% epi concentration.
3 part topical analgesic that is used on children:
TAC: Tetracaine, epinephrin, and cocaine.
Equal parts.
What spray is used for throat?
Rostra.
What are the 3 toxic effects of local anesthetics?
too much, too quickly
Cardiovascular (w/slurred or lethargic response).
Excitatory CNS (panic/shock).
Allergic (asthma attack or vasovagal syncope).
What is the sequence of healing?
5
Wound healing Inflammatory Epithelialization Collagenization Wound contraction
Primary union:
Sew them up
Secondary union:
Don’t sew them up.
Tertiary union:
Delayed closure (penrose drain)
Rubor:
Redness
Tumor:
Swelling
Callor
Warm
Dolor
Tenderness
What is the other sign of infection?
Redness greater than 1 cm from incision = infection
What are the cardinal infection signs?
Rubor, Calor, Tumor, Dolor.
100,000 organisms/gram of tissue.
What is the most common infection?
Staph Aureus.
What requires a tetanus shot?
Stellate (3 branches)
Crush
Muscle penetration
How often do you need a tetanus booster?
Every 5 years.
What does a 4x4 gauze help with?
Helps maintain homeostasis.
What is the relationship b/w aughts and suture size?
Increased aughts -> decreased suture size
How long do you leave sutures in for extensor surfaces and lower extremity?
2 weeks
How long do you leave sutures in on the face?
3 days.
What are the 4 occlusive wound dressing types?
Films
Foams
Hydrocolloids
hydrogels
When is 4% lidocaine ok?
Topically
T/F: Never exceed 2% of injections.
T
What is used in place of iodine with allergies?
Benaconium Chloride.
Tumors:
Hyperplasia, metaplasia, dysplasia
Benign tumors:
Grow slow, nontender.
Blunt trauma that pushes fat cell into superficial fascia?
Keloid
Lipomas
Produces sebum next to the hair follicle in skin.
Sebaceous cyst.
Excision and biopsy
Malignant tumors
Grows fast, spreads, fragile.
Basal cell carcinoma
From UV exposure.
takes one to two years to reach centimeter in size.
Less than 1/10 of 1% spread.
Where is Squamous cell found?
Ears
What should a chiropractor do if they find melanoma?
Calls a specialist.
What are warts also known as?
Verrucae vulgaris
What is a Papilloma also known as?
Skin tags.
Can be removed.
What percentage of cutaneous horns become cancerous?
12%
Are ganglion cyst within the scope of practice?
No
How do you treat for furuncles and carbuncles?
Can be drained or burnt.
Requires antibiotics.
How do you treat paronychia?
Remove the nail
How often do you suture bites closed?
Never suture bites closed
Pasteurella nutosa:
Animal bites
Echeanella corrodids
Human bites
When do human bites usually occur?
From punching someone in the face.
What can come in the lead to osteomyelitis?
Human bites
What do you do for snakebites?
Apply restrictive band, lay patient down, and have them breathe slowly.
What do you do for spider bites?
Cut them out if you get to them quickly.
What do you use for black widow bites?
Liovac
What do you use for any other insect?
Hymenoptera
How do you remove ticks?
Grasp with tissue forceps and gently pull them by the body.
What is a form of hypothermia?
Frostbite
What is conduction?
Direct contact.
What is confection?
Wind
Burns need to cover what percentage of the adult body to go to the hospital?
50%
The child must go to the hospital is what percentage of their body is covered in Burns?
33%
What is a 1st° burn?
Redness
What is a second-degree burn?
Redness and blisters
What is a third-degree burn?
Redness, blisters, and lots of tissue
Burns are most dangerous for which age groups?
The old and younger in trouble
What do you use to cure poison oak?
Baking soda
What is the cut off for minor surgery?
Superficial fascia. That which is on or just under the skin is fair game.
