Theatre Flashcards

1
Q

What is the preferred Machine in theatre?

A

The see our mobile image intensifier

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2
Q

Why is the c-arm mobile image intensifier the preferred option in theatre?

A

It’s quick (no waiting for an image to be processed)

Offers real-time dynamic imaging

Images are easily stored and sent pacs

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3
Q

How do you prepare for theatre?
before leaving department

A

The request form

LMP form

The keys for the image intensifier

Don’t forget to bring your lead coat

Change into theatre clothes – scrubs/shoes/hat/mask

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4
Q

What clothing must you be wearing in theatre and why?

A

The shoes must be antistatic because of the explosion risk

Hair covered

Scrubs – Infection control

Radiation badge and ID

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5
Q

What steps do you take in to prepare in theatre?

regarding the equipment

A

Locate the image intensifier – Sterile cover on C-arm

Ensure that it is clean

Check which theatre

Position in theatre – Ask surgeon (ideally set up before Surgery starts)

Set up and switch on

Familiarise yourself with the equipment – the close of the affected parts to the x-ray tube the greater the radiation dose and magnification

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6
Q

Setting up the theatre Radiation protection + infection control?

A

Ensure signs are placed outside theatre
Ensure everyone in the area is aware that you’re exposing
Insure lead rubber aprons are worn – ownership and responsibility is
Do not touch anything green
Apply sterile covers Dash on tube/intensifier/C-arm

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7
Q

What’s the procedure after setting up the equipment in theatre?

Patient details
Pre-imaging procedure
Teamwork - environment

A

Radiation protection/LMP - form

Liaise with theatre staff and surgeon

Enter patient details – ensure they are correct

Pre-imaging set up:
Select appropriate body program
Use pulse - 50% Dose reduction
Collimation

Record screen time and DAP

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8
Q

What must you do when assuming everything is sterile? (theatre)

A

Don’t touch anything

Don’t stand close to others

Don’t touch sterile field with machine

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9
Q

What must you do after the examination?

A

Dispose of sterile covers appropriately

Remove and clean the II

Park c-arm safely

Remember images to packs, II key, request form – don’t forget about your radiation badge when getting changed

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10
Q

Name orthopaedic examinations:

A

MUA – manipulation under anaesthetic
Krischner wires – K–wires - aka percutaneous reduction and internal fixation (PRIF)
ORIF – open reduction and internal fixation
Parallel cannulated screws
Herbert screw
DHS – Dynamic hip screw
IM nail - Intramedullary nail -AKA kuntscher nail (K–nail)
External fixation devices
Spinal fusions

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11
Q

Describe manipulation under anaesthetic:

A

It’s a closed reduction to either realign fracture or mobilise joint

example – distal radius Colles’ fracture

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12
Q

What does the manipulation under anaesthetic indicate?

A

There is no surgery and there will be no internal fixation

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13
Q

What imaging is needed for manipulation Under anaesthetic?

A

AP and lateral Screening

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14
Q

What is a k-wire?

A

Sharp find wires inserted as locking pins at fracture site

Can be put in prior to our with other internal fixation devices

Example – supracondylar fracture

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15
Q

What is a k-wire also known as?

A

PRIF – per cutaneous reduction and internal fixation

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16
Q

What is an open reduction and internal fixation?

A

Involves a placement of screws, wires and plates on to the bone to stabilise injury

17
Q

What is an 0RIF used for?

A

Use does treatment for complex fractures

Example ankle, bimalleolar fracture

18
Q

 what are parallel cannulated screws?

A

It is a percutaneous procedure hollow screws guided by wires

19
Q

What imaging is used in a ORIF and why is it used?

A

bi-plane screening, ap and lateral

Radiographic screening to check alignment

20
Q

What are parallel cannulated screws used for?

A

Screws are inserted into hip usually to fix:
subcapital in fracture of neck of femur (NOF) – High failure rate once a patient WB; further surgery
example hemiarthrplasty
Slipped up a femoral epiphysis (SUFE)

21
Q

What is a dynamic hip Screw?

A

Screwing sorted from the lateral side of the femur through the neck
Screw is attached to a plate which has a secondary screws placed throughout the shaft of the femur
Used for fixation of fractured neck of femur (NOF)

22
Q

Why is a dynamic hip screw dynamic?

A

Dynamic – because screw is in two parts which side into each other, patient mobilised after op to allow compression of fracture fragments and to promote Healing at fracture site

23
Q

What is a Intramedullary mail (im mail)?

A

Introduced through the upper end of the long bone and fix into place with locking screws at the lower end

24
Q

What is an IM nail used for?

A

Femorotibial and Humira fractures

25
Q

factors which determine if IM nail is antrograde or retro grade?

A

previous medical history
if they have had surgery before
depends on injury sustained

26
Q

Why would shorter Im nails need to be used?

A

Shorter versions are used for subtrochanteric femoral fractures - proximal femoral nail - PFN

27
Q

What is the difference between retrograde and antegrade federal nail?

A

Retrograde Nail is entered from distal end of humerus

Add to Great nail is entered by arterial end of humerus - humeral head

28
Q

What is an external fixation?

A

A cage of support wired and screwed into affected limb

29
Q

Why would a external fixation be used?

A

Used when a fracture is complicated and ORIF devices would be unsuitable

Used of section of bone is missing due to trauma or infection

30
Q

Other theatre procedures?

A

(Facet) joint injections
Pacemaker insertion
Subcutaneous IV giving sets

31
Q

What is a facet joint Injection?

A

Injection of actually local anaesthetic (help with short-term pain relief)
Injection of steroid (reduces inflammation)

Injections can last up to 6 months pain-free

After the six month period an orthopaedic surgeon assessed a patient to see if this is the best way to proceed

32
Q

What imaging is used during joint injections?

A

Fluoroscopy

33
Q

What is a sub cutaneous IV giving set and why is it used?

A

Used for drug therapy

Used instead of Central line, Hickman line, grid Chung lines, pic lines etc.

Image intensifier required for guidance