Where is one place cautery should not be used intraoperatively?
When close to the bowel, the thermal spread may lead to damage of the intestines and
possible rupture
Figure of 8 Stick tie?
Method for closing off a vein or artery.
Procedure: Pass suture through center of vessel. Wrap both ends around the vessel and
tie it down.
A knot, when it is ideal, has ____ number of throws in order for the tensile strength and
the untying rate to be maximized.
5 throws is ideal!
At the time of cauterizing, how would you remove excess fluid?
With blotting
Reason: Avoid suction since suction may take the clot along with it.
What are the 3 major phases which occur in recovery following a major surgery?
1. Immediate phase: This starts from post anesthesia
2. Intermediate phase: This starts with the recovery of anesthesia and lasts throughout
the rest of the time spent in the hospital.
,3. Convalescent phase: Transition period from hospital discharge to full recovery --
Want to be quick!
What are 3 major areas of concern in the immediate post-op period?
1. Acute pulmonary derangement's
2. Cardiovascular derangement's
3. Fluid derangement's
While in PACU, the patient's cardiopulmonary functions are under the responsibility of
who?
The anesthesiologist!
Afterwords, it's the surgeons responsibility
and the Surgeon is responsible for the site of surgery-wound management
How often should pt's be turned while they're unconcous?
Turn unconscious patients every 30 minutes, then hourly for the first 8-12 hours once
awake
,What are the signs of respiratory failure in the post-op setting?
1. Tachypnea (>25 BPM)
2. Low tidal volume (<4 mL/kg)
3. pO2 <60 mmHg
4. pCO2 >45 mmHg
5. Low cardiac output
What are the causes for the following post op complications:
1. Early respiratory failure (1-2 hrs)
2. Last respiratory failure (>48 hrs)
1. Early: -Major abdominal/chest operation
-Severe chest trauma
-Pre-existing lung disease
, -Too much anesthesia
2. Late: -Cardiac failure
-Pulmonary edema
-Pulmonary Embolism
-Abdominal distention
-Narcotic overdosetiveness of a drug
What is the most common post-op pulmonary complication?
Atelectasis!
Commonly seen with a feverity of an axis
What is the most common post-op Cardiac complication?
Arrhythmias! PVCs are the most common
MIs are most common DURING the operationiagnosis such as systemic or local
What are the causes of PVCs in the post-op patient?
-Hypoxia
-Hypokalemia
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