Gen Surgical; Preoperative Considrations-1.pptx
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This document discusses general surgical considerations and procedures. It covers preoperative patient evaluation including lab tests, the importance of surgical experience and judgment, and maintaining asepsis. Surgical procedures are classified as clean, clean-contaminated, contaminated, or dirty based on the wound and risk of infection. Sterile techniques like drapes, caps, gowns and gloves should be used routinely. Postoperative infections may be treated with antibiotics, drainage, and culture/sensitivity testing. The document also covers preparing the surgery site through clipping/shaving and cleaning, and ensuring proper use and sterilization of instruments.
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The document discusses the management of patients undergoing surgery. It covers the three main phases of surgical management: pre-operative, intra-operative, and post-operative management. For pre-operative management, the document outlines the physical, psychosocial, physiological preparations and assessments a patient undergoes before surgery including examinations, investigations, pre-medications. It then briefly describes the roles of the surgical team during intra-operative management. Finally, it discusses the immediate post-operative recovery phase in PACU and management of common post-operative complications.
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The care provide during surgical intervention (pre-operative, intra-operative and post-operative period) is known as Peri-operative Nursing Care.
Peri-operative Nursing Care includes :
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Post-operative Nursing Care.
Anesthesia means “loss of sensation with or without loss of consciousness” .
Medications that cause anaesthesia, are called Anesthetics.
Anesthesia is defined as a temporary state consisting of unconsciousness, loss of memory, lack of pain, and muscle relaxation.
Anesthesia is defined as a loss of feeling or awareness caused by drugs or other substances which keeps patient free from feeling pain during surgery or other procedures.
Or lect
The document outlines perioperative nursing concepts including:
1. The three phases of perioperative nursing - preoperative, intraoperative, and postoperative phases.
2. Details of the preoperative phase including preoperative teaching, assessments, and preparations.
3. Details of the intraoperative phase including the surgical environment, principles of asepsis and sterile technique, and the surgical team roles.
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The document discusses different aspects of pre-operative patient care including:
1. The pre-operative period involves evaluating and preparing the patient prior to surgery through obtaining medical history, conducting examinations, reviewing lab results, assessing physical and psychological needs, obtaining informed consent, and providing patient education.
2. Key parts of pre-operative evaluation and preparation include developing a pre-operative plan, taking a thorough medical history, conducting a focused physical exam, ordering relevant tests and labs, addressing any comorbidities, and discussing the planned surgery and post-operative expectations with the patient to obtain informed consent.
3. The goals are to optimize the patient's condition for surgery, identify any issues that could impact the procedure,
Surgical site infection-diagnosis and treatment
LETS KNOW ABOUT - SURGICAL SITE INFECTION(SSI).
Infections of the incision or organ or space, that occur after surgery.
60% of SSIs -preventable with evidence-based guidelines.
MC and costliest hospital-acquired infections, 20% of all hospital infections.
CLAClassified based on the depth and tissue layers .
Superficial incisional SSI
Primary or secondary.
Deep incisional SSI
Primary or secondary.
Organ/space SSI
SUPERFICIAL INCISIONAL SSI
Infection occurs within 30 days after the operative procedure and involves only skin and subcutaneous tissue of the incision and had at least one of the following:
a. Purulent drainage from the superficial incision.
b. Organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision.
c. At least one of the following signs or symptoms of infection: pain or tenderness, localized swelling, redness, or heat, and superficial incision is deliberately opened by surgeon and is culture positive or not cultured. A culture-negative finding does not meet this criterion.
d. Diagnosis of superficial incisional SSI by the surgeon or attending physician
DEEP INCISIONAL SSI
Infection occurs within 30 days after the operative procedure if no implant is left in place or within 3 months if implant is in place and the infection appears to be related to the operative procedure and involves deep soft tissues (e.g., fascial and muscle layers) of the incision and patient has at least one of the following:
a. Purulent drainage from the deep incision but not from organ/space component of the surgical site.
b. Deep incision spontaneously dehisces or is deliberately opened by a surgeon and is culture-positive or not cultured when the patient has at least one of the following signs or symptoms: fever (>38°C) or localized pain or tenderness. A culture-negative finding does not meet this criterion.
c. An abscess or other evidence of infection involving the deep incision is found on direct examination, during reoperation, or by histopathologic or radiologic examination.
d. Diagnosis of a deep incisional SSI by a surgeon or attending physician.Wound that has both superficial and deep incisional infection is classified as DIS
ORGAN SPACE SSI
Infection occurs within 30 days after the operative procedure if no implant is left in place or within 3 months if implant is in place and the infection appears to be related to the operative procedure and infection involves any part of the body, excluding the skin incision, fascia, or muscle layers, that is opened or manipulated during the operative procedure and patient has at least one of the following:
a. Purulent drainage from a drain that is placed through a stab wound into the organ/space.
b. Organisms isolated from an aseptically obtained culture of fluid or tissue in the organ/space.
c. An abscess or other evidence of infection involving the organ/space that is found on direct examination, during reoperation, or by histopathologic or radiologic examination.
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The document discusses surgical site infections (SSI), including reviewing the epidemiology and causes of SSI, evidence-based prevention strategies like proper antimicrobial prophylaxis and wound care, and SSI surveillance methods such as following standardized definitions and tracking post-operative infections occurring within 30 or 90 days of a procedure. Common pathogens that cause SSI include Staphylococcus aureus, coagulase-negative staphylococci, and Enterococcus species.
Management Of Patient Undergoing Surgery
The document discusses the management of patients undergoing surgery. It covers the three main phases of surgical management: pre-operative, intra-operative, and post-operative management. For pre-operative management, the document outlines the physical, psychosocial, physiological preparations and assessments a patient undergoes before surgery including examinations, investigations, pre-medications. It then briefly describes the roles of the surgical team during intra-operative management. Finally, it discusses the immediate post-operative recovery phase in PACU and management of common post-operative complications.
Peri-operative Nursing/Anesthesia/Pain Management
The care provide during surgical intervention (pre-operative, intra-operative and post-operative period) is known as Peri-operative Nursing Care.
Peri-operative Nursing Care includes :
Pre-operative Nursing Care
Intra-operative Nursing Care
Post-operative Nursing Care.
Anesthesia means “loss of sensation with or without loss of consciousness” .
Medications that cause anaesthesia, are called Anesthetics.
Anesthesia is defined as a temporary state consisting of unconsciousness, loss of memory, lack of pain, and muscle relaxation.
Anesthesia is defined as a loss of feeling or awareness caused by drugs or other substances which keeps patient free from feeling pain during surgery or other procedures.
Or lect
The document outlines perioperative nursing concepts including:
1. The three phases of perioperative nursing - preoperative, intraoperative, and postoperative phases.
2. Details of the preoperative phase including preoperative teaching, assessments, and preparations.
3. Details of the intraoperative phase including the surgical environment, principles of asepsis and sterile technique, and the surgical team roles.
Pre Intra and Post Operative Care.pptx
The document discusses different aspects of pre-operative patient care including:
1. The pre-operative period involves evaluating and preparing the patient prior to surgery through obtaining medical history, conducting examinations, reviewing lab results, assessing physical and psychological needs, obtaining informed consent, and providing patient education.
2. Key parts of pre-operative evaluation and preparation include developing a pre-operative plan, taking a thorough medical history, conducting a focused physical exam, ordering relevant tests and labs, addressing any comorbidities, and discussing the planned surgery and post-operative expectations with the patient to obtain informed consent.
3. The goals are to optimize the patient's condition for surgery, identify any issues that could impact the procedure,
Surgical site infection-diagnosis and treatment
LETS KNOW ABOUT - SURGICAL SITE INFECTION(SSI).
Infections of the incision or organ or space, that occur after surgery.
60% of SSIs -preventable with evidence-based guidelines.
MC and costliest hospital-acquired infections, 20% of all hospital infections.
CLAClassified based on the depth and tissue layers .
Superficial incisional SSI
Primary or secondary.
Deep incisional SSI
Primary or secondary.
Organ/space SSI
SUPERFICIAL INCISIONAL SSI
Infection occurs within 30 days after the operative procedure and involves only skin and subcutaneous tissue of the incision and had at least one of the following:
a. Purulent drainage from the superficial incision.
b. Organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision.
c. At least one of the following signs or symptoms of infection: pain or tenderness, localized swelling, redness, or heat, and superficial incision is deliberately opened by surgeon and is culture positive or not cultured. A culture-negative finding does not meet this criterion.
d. Diagnosis of superficial incisional SSI by the surgeon or attending physician
DEEP INCISIONAL SSI
Infection occurs within 30 days after the operative procedure if no implant is left in place or within 3 months if implant is in place and the infection appears to be related to the operative procedure and involves deep soft tissues (e.g., fascial and muscle layers) of the incision and patient has at least one of the following:
a. Purulent drainage from the deep incision but not from organ/space component of the surgical site.
b. Deep incision spontaneously dehisces or is deliberately opened by a surgeon and is culture-positive or not cultured when the patient has at least one of the following signs or symptoms: fever (>38°C) or localized pain or tenderness. A culture-negative finding does not meet this criterion.
c. An abscess or other evidence of infection involving the deep incision is found on direct examination, during reoperation, or by histopathologic or radiologic examination.
d. Diagnosis of a deep incisional SSI by a surgeon or attending physician.Wound that has both superficial and deep incisional infection is classified as DIS
ORGAN SPACE SSI
Infection occurs within 30 days after the operative procedure if no implant is left in place or within 3 months if implant is in place and the infection appears to be related to the operative procedure and infection involves any part of the body, excluding the skin incision, fascia, or muscle layers, that is opened or manipulated during the operative procedure and patient has at least one of the following:
a. Purulent drainage from a drain that is placed through a stab wound into the organ/space.
b. Organisms isolated from an aseptically obtained culture of fluid or tissue in the organ/space.
c. An abscess or other evidence of infection involving the organ/space that is found on direct examination, during reoperation, or by histopathologic or radiologic examination.
Tyu
Ppt. perioperative nursing
The document discusses perioperative nursing and provides information on various surgical topics including the definition of surgery, surgical procedures and suffixes, classification of surgery, principles of surgical asepsis, four major types of pathologic processes requiring surgery, effects of surgery on patients, surgical risk factors, and the roles of the surgical team which includes the circulating nurse, scrub role, surgeon, and anesthesiologist/anesthetist.
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Perioperative nursing involves caring for patients before, during, and after surgery. The document outlines the three phases of perioperative care: [1] preoperative, [2] intraoperative, and [3] postoperative. It describes the nursing responsibilities in each phase, including assessing patients, providing education, monitoring patients' condition, and ensuring safety. Perioperative nurses play a critical role in preparing patients for surgery, assisting in the operating room, and observing patients as they recover.
Lap Accsses technique and complications
- Inserts a Foley catheter through the 5mm port
- Inflates the balloon in the retroperitoneum
- Compresses the bleeding vessel
- Allows controlled deflation after haemostasis
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SECONDARY TROCAR INJURIES
- Bowel injury
- Vascular injury
- Bladder injury
- Ureteric injury
Risk factors:
- Poor technique
- Adhesions
- Obesity
- Previous surgery
Management:
- Laparoscopic repair
- Conversion to laparotomy
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The document discusses perioperative nursing which includes the care of surgical patients before, during, and after surgery in three phases - preoperative, intraoperative, and postoperative. It provides details on the roles and responsibilities of nurses in each phase, including assessing and preparing patients, monitoring patients during surgery, and observing patients in recovery to identify any complications. The postoperative phase focuses on caring for wounds, providing health teaching to patients, and monitoring vital signs and intake/output as patients recover from the effects of anesthesia.
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The document discusses perioperative nursing which includes the care of surgical patients before, during, and after surgery. It describes the three phases of perioperative nursing - the preoperative, intraoperative, and postoperative phases - and explains the nursing responsibilities and activities involved in caring for patients in each phase, such as assessing patients, providing education, preparing patients for surgery, monitoring patients during surgery, and observing patients in recovery.
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- Blue cannulas are used for fluids like saline or lactated ringers.
- Pink cannulas are used for medications.
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- Yellow or orange cannulas are used for blood products like packed red blood cells or platelets.
It's important for nurses to know the standard color coding so the right solutions or medications are administered through the correct IV line. Let me know if you have any other questions! Proper IV administration is important for patient safety.
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This presentation was prepared by RUTAYISIRE François Xavier and ISHIMWE Diane, Medical students in Year 4(Doctorate 2) at University of RWANDA school of medicine and Pharmacy, Department of Medicine and Surgery. we did the work under supervision of Dr Ntakiyiruta Georges,Mmed,FCSECSA
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Here are the common colors of IV cannulas and their meanings:
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- Pink cannulas are used for medications.
- Green cannulas are used for lipids or total parenteral nutrition (TPN).
- Yellow or orange cannulas are used for blood products like packed red blood cells or platelets.
It's important for nurses to know the standard color coding so the right solutions or medications are administered through the correct IV line. Let me know if you have any other questions! Proper IV administration is important for patient safety.
Day case anesthesia
1) Day case anesthesia, also known as ambulatory surgery or same-day surgery, allows patients to be admitted for a surgical procedure and investigation but return home the same day without an overnight hospital stay.
2) There has been a rapid expansion in the use of day case surgery over the last 30 years, with approximately 65% of surgeries in the United States now performed on an outpatient basis.
3) Day case anesthesia provides advantages like reduced costs, increased bed availability, and less risk of hospital-acquired infections compared to traditional inpatient surgery.
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This document provides an overview of general surgery, including definitions, types, and procedures. It discusses:
- General surgery involves performing surgical procedures to treat health problems and diseases of the abdomen and related organs.
- Surgical procedures are classified based on urgency (elective, urgent, emergency), degree of risk (major, minor), and purpose (diagnostic, ablative, palliative, reconstructive, transplantation, constructive).
- Proper patient assessment and preparation is required before any surgery to ensure safety and success, including evaluating indication and contraindications, obtaining consent, optimizing medical conditions, and preparing logistically.
Surgical safety checklist
This presentation was done by RUTAYISIRE François Xavier and ISHIMWE Diane, medical students at University of RWANDA School of Medicine and pharmacy, department of medicine and surgery. They did it while they were in Year 4 (Doctorate2), under supervision of Dr Ntakiyiruta Georges,Mmed,FCSECSA. It tell us about what a surgical safety checklist is, and why is it important in surgical field.
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This presentation was prepared by RUTAYISIRE François Xavier and ISHIMWE Diane, Medical students in Year 4(Doctorate 2) at University of RWANDA school of medicine and Pharmacy, Department of Medicine and Surgery. we did the work under supervision of Dr Ntakiyiruta Georges,Mmed,FCSECSA
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The document discusses the principles of trauma management for abdominal and pelvic injuries, including classifications of injuries, mechanisms of injury, assessment techniques, management approaches like damage control resuscitation and surgery, and guidelines for treatment of specific injuries to the liver, spleen, and other abdominal organs. Case scenarios are presented and management strategies are outlined for various injury patterns and severity.
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You can get 3 topics in a single slide. These topics are
1- CT Guided biopsy
2- CT Enterography
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This document provides guidance for surgeons on surgical practice during the COVID-19 pandemic. It recommends protecting oneself with appropriate personal protective equipment, frequent hand hygiene, and treating every patient as potentially COVID-19 positive. For surgical cases, it advises minimizing aerosol-generating procedures when possible and taking precautions such as proper ventilation and air filtration in operating rooms. Younger surgeons are encouraged to continue developing their skills during this time through online learning and teaching opportunities. The document emphasizes optimizing patient and staff safety while continuing to provide necessary surgical care during the pandemic.
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Here are the triage categories I would assign to each patient based on the information provided:
1. 30 year old male with a compound fracture of left femur, bleeding significantly. Resp. rate 24. Cap. refill less than 2 sec. Alert and oriented.
Category: DELAYED
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Category: DELAYED
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Category: MINOR
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- 3. THE PATIENT-1 1. Preoperative Evaluation PCV, TP & CBC (Elective as well as Emergency Cases) 2. Surgical Judgment Experience & mistakes Professional Honesty 3. Asepsis & Antisepsis Aseptic surgical technique Identify high risk patients Correction of Systemic Imbalances Prophylactic use of antibiotics
- 5. CLASSIFICATION DESCRIPTION PROCEDURE TYPE (EXAMPLES) Wound Classification System Clean Nontraumatic, noninflamed operative wounds in which the respiratory, gastrointestinal, urogenital, and oropharyngeal tracts are not entered Exploratory laparotomy Elective neutering Total hip replacement, PDA Bronchoscopy, Cholecystectomy, Small intestinal resection, Enterotomy Clean-contaminated Operative wounds in which the respiratory, gastrointestinal, or urogenital tract is entered under controlled conditions without unusual contamination; an otherwise clean wound in which a drain is placed 3
- 6. Contaminated Open, fresh, accidental wounds; procedures in which gastrointestinal contents or infected urine is spilled or a major break in aseptic technique occurs Bile spillage during cholecystectomy or biliary diversion procedures, Open cardiac massage, Cystotomy with spillage of infected urine, Lacerations Dirty Old traumatic wounds with purulent discharge, devitalized tissue, or foreign bodies; procedures in which a viscus is perforated or fecal contamination occurs Excision or drainage of an abscess, Peritonitis, Perforated intestinal tract, Ruptured gallbladder caused by necrotizing cholecystitis, Bullae osteotomy for otitis media 4
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- 8. POSTOPERATIVE INFECTION & ROLE OF ANTIBIOTICS-1 Antibiotics are not a substitute for asepsis However, at occasions infection may occur What to do? Decision rests with the surgeon Provision of drainage Culture & sensitivity test Antibiotics: Correct dosage, Correct time & correct period of time. Should be started preoperatively.
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