Theatre Flashcards
What is the preferred Machine in theatre?
The see our mobile image intensifier
Why is the c-arm mobile image intensifier the preferred option in theatre?
It’s quick (no waiting for an image to be processed)
Offers real-time dynamic imaging
Images are easily stored and sent pacs
How do you prepare for theatre?
before leaving department
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

What clothing must you be wearing in theatre and why?
The shoes must be antistatic because of the explosion risk
Hair covered
Scrubs – Infection control
Radiation badge and ID
What steps do you take in to prepare in theatre?
regarding the equipment
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
Setting up the theatre Radiation protection + infection control?
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
What’s the procedure after setting up the equipment in theatre?
Patient details
Pre-imaging procedure
Teamwork - environment
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
What must you do when assuming everything is sterile? (theatre)
Don’t touch anything
Don’t stand close to others
Don’t touch sterile field with machine
What must you do after the examination?
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

Name orthopaedic examinations:
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
Describe manipulation under anaesthetic:
It’s a closed reduction to either realign fracture or mobilise joint
example – distal radius Colles’ fracture
What does the manipulation under anaesthetic indicate?
There is no surgery and there will be no internal fixation
What imaging is needed for manipulation Under anaesthetic?
AP and lateral Screening
What is a k-wire?
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
What is a k-wire also known as?
PRIF – per cutaneous reduction and internal fixation
What is an open reduction and internal fixation?
Involves a placement of screws, wires and plates on to the bone to stabilise injury

What is an 0RIF used for?
Use does treatment for complex fractures
Example ankle, bimalleolar fracture
 what are parallel cannulated screws?
It is a percutaneous procedure hollow screws guided by wires
What imaging is used in a ORIF and why is it used?
bi-plane screening, ap and lateral
Radiographic screening to check alignment
What are parallel cannulated screws used for?
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)
What is a dynamic hip Screw?
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)
Why is a dynamic hip screw dynamic?
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
What is a Intramedullary mail (im mail)?
Introduced through the upper end of the long bone and fix into place with locking screws at the lower end
What is an IM nail used for?
Femorotibial and Humira fractures
factors which determine if IM nail is antrograde or retro grade?
previous medical history
if they have had surgery before
depends on injury sustained
Why would shorter Im nails need to be used?
Shorter versions are used for subtrochanteric femoral fractures - proximal femoral nail - PFN
What is the difference between retrograde and antegrade federal nail?
Retrograde Nail is entered from distal end of humerus
Add to Great nail is entered by arterial end of humerus - humeral head
What is an external fixation?
A cage of support wired and screwed into affected limb
Why would a external fixation be used?
Used when a fracture is complicated and ORIF devices would be unsuitable
Used of section of bone is missing due to trauma or infection
Other theatre procedures?
(Facet) joint injections
Pacemaker insertion
Subcutaneous IV giving sets

What is a facet joint Injection?
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
What imaging is used during joint injections?
Fluoroscopy
What is a sub cutaneous IV giving set and why is it used?
Used for drug therapy
Used instead of Central line, Hickman line, grid Chung lines, pic lines etc.
Image intensifier required for guidance
