1. Surgeons:
Lawrence E Ruf, MD LER
E. Daniel Deloach, MD EDD
Scott W. Vann, MD SWV
Barbara L. Davies, MD. BLD
Chris Pettigrew, MD FCP
Harvey A Zarem, MD HAZ
Call Pt for surgery the day before:
Confirm arrival time
Responsible caregiver/transportation home
Appropriate dress for post-0p
RX filled and bring with them day of surgery
Scopolamine patch and zofran may be given on arrival
Remind NPO for night before surgery
If diabetic have pt bring glucose meter or asthmatic bring inhaler
NO makeup, jewelry, contacts, piercings, dentures
Mark confirmed in book
Procedures
Local/ Sedation
Prepare pt in surgical attire with IV
An RN to circulate case
An RN to administer medications as directed by surgeon
o Monitor and document VS on anesthesia/OR record
o RN will remain at the HOB at all times
Have oral airway, ET tube, laryngoscope on standby with suction and 02
L/S Drug Preparation
Phenergan 25 mg (may give 12.5 mg pre-op)
Antibiotic- give pre-op IV
Demerol 25-50 mg
Versed- may give 1-2 mg pre-op
Ketamine- mix 1 cc in 9 cc NS use 10 cc syringe for a 10 mg/1cc concentration

2. Breast Reductions
Prepare to weigh RT @ LT breast tissue and put in separate containers
Keep surgeon aware of weight removed from each side-use grease board
Record weights in intra-op record and in lab form
Send tissue to lab
Lab Corp uses black paint buckets only
Other labs use white tubs with formalin
Nipples post-op color and sensation
Drains, record on sheet- instruct families
Determine bra size for post-op
Take photo of tissue excised
Give the following to take home-
Syringe
Fluid container
Instructions sheet and record sheet
Bam
Triple antibiotic for irrigation:
o Gentamycin 80 mg
o Ancef 1 gm
o Bacitracin 50, 000 units
o Mixed in 1000 cc NS
Valium 5 mg post -op
Pain Meds
Nubain 1-5 cc
Fentanyl 0.5 -1 cc
Morphine 1-2 mg up to 10 mg
Demerol 10-25 mg
Shivering
Demerol 12.5- 25 mg check with anesthesia

3. Nausea
Phenergan 6.25-12.5 mg ivp slow
Zofran 2 mg ivp repeat if needed
Epinephrine 10 mg slow ivp in 15 min increments if BP <20% or systolic <90
Phenergan suppository
Reglan 10 mg ivp check with anesthesia first
PO Nausea drugs
Compazine 10 mg
Zofran 8 mg
Phenergan 12.5-25 mg tab or 25 mg suppository
Room 2
Cauterize Machine- R313229S
Room 1
Cauterize Machine -