Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCS-Critical care > Procedures > Flashcards

Procedures Flashcards

1
Q

How to prioritise lists

A

Following adds priority:

  1. Clinical priority
  2. diabetes
  3. latex allergy
  4. paeds

Following should be last:

  1. Infection (MRSA or c dif)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where are procedures under local anaesthetic prioritised

A

Varies

Either first or last to avoid the anaesthetist having to stick around

or

Middle to give anaesthetist a break

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

NCEPOD criteria

A

National clinical enquiry into patient outcome and death

1a. immediate
- life or limb threatening
- Ruptured AAA, spleen

1b. <6hrs
- life threatening but not immediate
- ischaemic bowel
- large bowel

  1. Urgent <24hrs
    - appendicitis
  2. Expedited <7d
    - deterioration of elective condition
    - acute cholecystectomy
  3. Scheduled
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Periop hyperglycaemia mx

A
  1. pt should be prioritised
  2. should not miss more than one meal
  3. sliding scale if insulin dependent or expected to miss more than one meal
  4. hourly BM monitoring 4-12
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Difference between monopolar and bipolar

A

Monopolar: current passes between electrode and plate. Heat is transferred over a large surface area

Bipolar: current is transferred between two electrode tips

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What complications are COPD patients at risk of post op

A

7 fold increase in complications such as:
- atelectasis
- pneumonia
- resp failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What to use in pt with iodine allergy

A

chlorhexadine antiseptic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Colostomy preparations

A
  1. Stoma site marked
  2. within rectus abdominis below belt line
  3. avoid skin creases, previous scars
  4. stoma nurse review
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is vicryl absorbed

A

55-70 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How long does its tensile strength last

A

2-3wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to protect tissue whilst tying at depth

A
  1. ensure lighting
  2. retraction of tissues out of the way
  3. controlled descend of the knot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

FNA procedure

A
  1. needle on syringe
  2. clean skin
  3. stab and aspirate 2-4 times
  4. add a small sample in the green part of the needle on to slide
  5. add another slide at 90 angle and smear it across
  6. air dry one slide
  7. fixing agent on another
  8. place the rest in a pot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is vicryl made off

A

polyglactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long before removing sutures from
- face
- scalp
- limb
- back

A

face: 3-5
scalp: 5-7
limb: 7-10
back: 10-14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Post op instructions for suturing wounds

A
  1. To seek medical advice if any temp, felt unwell, discharge, redness
  2. Give abx if dirty wound (if delayed presentation, multiple doses)
  3. Home on simple analgesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mech of action of xylocaine (lidocaine 1%)

A

Na channel depolarising blocker

17
Q

What to give if allergic to xylocaine

A

bupivacaine

18
Q

Removal of naevus step by step

A
  1. ensure 2mm margins either side
  2. draw lines either side and times it by 3
  3. V shaped excision either side
  4. close from the edges slowly towards the centre
19
Q

Post op instructions for naevus skin removal

A
  1. post op analgesia
  2. RFs to seek medical advice
  3. Once the histology results available, MDT, followed by clinic appointment for discussion
20
Q

What are langers lines

A

natural orientation of collagen fibres in dermis, generally parallel to muscle fibres underneath

21
Q

Catheterisation

A
  1. WIPER: check allergies to latex
  2. Non-sterile gloves, clean the penis and foreskin
  3. sterile gloves
  4. drape
  5. slowly feed through
  6. inflate balloon
  7. pull
  8. document volume
  9. send sample for MC&S
22
Q

How to insert a chest drain

A
  1. WIPER
    position: supine, hand behind head exposing axilla
  2. anaesthesia:
    - local, first superficial, then deep
  3. Incision:
    parallel to superior aspect of the rib
  4. procedure
    insert haemostat and dissect the tissue, before entering the pleural cavity
  5. insert the tube apically if pneumothorax, basally if haemothorax
  6. fogging of the drain indicates its in the right place
  7. suture in place
  8. attach to under water seal
  9. post procedure bubbling + CXR
23
Q

Thoracotomy indications

A
  1. > 1.5 l on insertion or >200ml /hr for 2hrs
  2. persistant pneumothorax despite drainage
24
Q

Rate of HIV/Hep B/Hep C transmission post needle stick

A

0.3% in HIV +

Hep B 30% (vaccine is 90-95% effective)

Hep C 1.8%

25
Q

What to do after needlestick

A
  1. wash out under water and allow to bleed
  2. inform OH and ask another doctor to approach patient to take bloods
  3. You should be tested at the time, at 6 wks, and 3 months.
26
Q

AMTS

A
  1. age
  2. time
  3. 42 west st
  4. year
  5. place
  6. person
  7. DOB
  8. WWII
  9. PM
    10 20-1
27
Q

Causes of delirium

A

PINCH ME
Pain
Infection
Nutrition
Constipation
Hypothermia
Med
Environment

MRCS-Critical care (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions