Preparing the pt for Anaesthesia and Surgery - Anaesthetics Flashcards
Emergency surgery definition
An unplanned nature of identification of the need for surgery, and a relative urgency for surgical intervention, without which the patients health may deteriorate and risk poor clinical outcomes. Including loss of life, limb or function or reduce quality of life.
patient assessment
collection of objective (physical assessment) and subjective (history) data
Adults having elective procedure - pre-op fasting
- Solid food may be taken up to 6 hours prior to anaesthesia
- Clear fluids up to 2 hours prior to anaesthesia
Children 6 months + having elective procedure - pre-op fasting
- Breast milk/formula, limited solid food up to 6 hours prior to
- Clear fluids up to one hour prior to
Infants under 6 months having an elective procedure
- Formula up to 4 hours prior
- Breast milk 3 hours prior
- Clear fluids (no more than 3ml/kg/hr) up to 1 hour prior to
ACE inhibitors with anaesthesia
Can cause severe hypotension at induction of during maintenance of anaesthesia
Diuretics with anaesthesia
Can cause hypokalaemia which may potentiate the effects of muscle relaxants.
Lithium with anaesthesia
Potentiates non-depolarising muscle relaxants
Anticoagulants with anaesthesia
Increased risk of bleeding or surgical haemorrhage.
Oral contraceptive pill with anaesthesia
Increased risk of thromboembolic complications
Benzo’s with anaesthesia
Potentiate action of intravenous anaesthetic agents and opioids
Garlic with anaesthesia
Potential for irreversible inhibition of platelet function
Grapefruit/ cranberry with anaesthesi
Interact with warfarin
Valerian and Kava with anaesthesia
Potentiate GABA mediated systems, interfering with inhalation anaesthetics which work on GABA receptors.
St John’s Wort with anaesthesia
May potentiate or prolong anaesthetic agent effect
Ginkgo Biloba with anaesthesia
may increase bleeding
Ginger with anaesthesia
Potent inhibitor of thromboxane synthetase enzyme that can prolong bleeding time.
Echinacea with anaesthesia
Increases the risks of poor wound healing and opportunistic infections post surgery.
Negligence
Not informed about all of the risks associated with the treatment/
Trespass
Either assault/ battery and false imprisonment if pt is not informed of broad nature and effects of proposed treatment.
Nurses and consent
- Verify the consent and pt ID
- Nurses can only witness the pt signature on consent form
- Ensure a valid consent is obtained prior to all procedural/ research activities
- Identify instances when guardian relative or attorney should be consulted regarding pt consent,.
