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How to observe In Surgery

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How to observe In Surgery

  1. 1. By : Kareem Hamimy 6th year Medical StudentKasr Al Ainy Faculty of Medicine Cairo University
  2. 2.  This ppt is designed to give a simple tips for Surgery Interns, observers, Medical students About observation in OR ( Operation Room )
  3. 3.  I would like to thank everyone who gave me he opportunity to attend and assist in Surgical operations in Kasr Al Aini (Professors, Lecturers, Residents, Nurses, Workers, patients )
  4. 4.  1st : Check The Surgery unit that you are going to attend with. 2nd : Introduce yourself to the Resident, and ask him for the permission to attend. 3rd : Know the schedule of unit .  ( when is the grand round, when are the operations ? ) 4th : The day before operation, get the List of patients who are going to OR ). 5th : Try to take a brief History and full Examination to these patients.
  5. 5.  6th : Try to read about this Disease, Management, Operative technique, the Night before the Operations, for Maximum benefit
  6. 6.  In Kasr Al Ainy, Scrubs are not provided in OR So Dont forget to pack your bag with your clean ironed scrubs.
  7. 7.  Before Exiting lockers you have to check that you didn’t miss wearing any of these :  Scrubs  Overshoes or / Surgical Clogs  Overhead  Mask
  8. 8.  In The OR, You have to be Away from Aseptic Field 50 cm  Away from the operation table  Away from The Surgical instruments table  Away from scrubbed surgeons Away from Anesthesia field Away from troubles  Dont ask a surgeon when he is nervous, or when there is complete silence as this is an indicator of a precise part of operations which needs ultimate concentration
  9. 9.  While observing, you have to be sure that you know  Diagnosis  Decision ( & why ) and try to correlate what you read before with what you are observing
  10. 10. A List of what to observe
  11. 11.  Type ( Spinal, Regional, Epidural, General) Technique Intubation ( how ? ) Cannulation ( IV cannula, Central line ) Medications used, Dosage Monitor
  12. 12.  Position of the Patient ( Supine, Prone, Hand Extended, Elevated, Lithotomy ) Exposure Antiseptic application  Borders, one way strokes Surgical Sheets ( how they are applied ? ) Light ( Direction ? )
  13. 13.  Incision  Extensions  When to extend it ? ( Observe when is this decision taken )  Layers ( what are the layers incised ? )
  14. 14.  Traction and Counter Traction Surgical Instruements used  And why this specific instruement not the other ?
  15. 15.  Important Structures ( Anatomy ? ) Dangerous Areas
  16. 16.  Drainage  Why  Type ( Suction, …)  Size  Position  How ?
  17. 17.  Layers Sutured  Muscle  Subcutaneous  Skin
  18. 18.  How? ( Simple, Subcuticular ), and ask the resident to show you how is it done Material ( proline, Vicryl, silk ) When? ( ask when to use different types, and size ? ) And why ?
  19. 19.  Betadine Dressing Plaster
  20. 20.  Waking the patient ( anaesthesia ) Postoperative care Visiting patient, the next day of operation is essential, try to follow to observe Recovery phase, and if complications occurred, and how to manage
  21. 21.  After being Familiar, with the OR, and the operations, You can ask the resident, to scrub in for assistance and better observation
  22. 22.  Prof Dr Aly Haseeb : Illustrated Operative Surgery. Browse Symptoms and Signs of Surgical diseases. Oxford Handbook of Clinical Surgery. Basic Surgical Techniques ( R M Kirk ). Essential General Surgical Operations ( R M Kirk ).
  23. 23. Thank YouFor Comments and Further info :Kareemhamimy89@yahoo.co.uk

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