Non-surgical, Intra-operative components of care

Question 1

A 65 year old man is on the operative theatre table for a liver resection for metastases from colorectal cancer. Outline the non-surgical intra-operative components of this patients care.

Answer 1

Intra-operative, non-surgical components of care can be broken down into;

1) Communication methods
2) Hospital protocols
2) Anaesthesia? Induction, maintenance, etc
3) Patient homeostasis; temperature, electrolytes

Question 2

intra-op care - communication

Answer 2

Communication

• closed loop comms
• names on white-board

Question 3

intra-op care - hospital protocols

Answer 3

Hospital protocols

• mechanical VTE prophylaxis
• time-out procedure as part of performing correct procedure - utilise 3 pieces of information, patient name, dob, man. signed and dated.
• equipment counts: during and at the completion of the procedure: scrub and scout nurse usually
• team safety huddle: discuss patients, positioning, plan, etc

Question 4

intra-op care - anaesthetic monitoring

Answer 4

anaesthetic monitoring

• vitals: BP. HR, EEG, VBG, etc
• fluids as appropriate
• intra-op infusion (insulin-dextrose)
• continuous titration of anaesthesia according to type, duration, progress of the surgery
• prophylactic ABX as required
• appropriate hand-over to post-op recovery team.

Question 5

intra-operative care - patient homeostasis

Answer 5

patient care/homeostasis

• gel padding for pressure points
• hair net, prepping, draping
• heating
• IDC for post-op