This surgical handbook provides guidance for house officers in their surgical duties. It outlines that house officers should complete an AM review before 0800, do ward rounds with the MO/surgeon, attend various clinics and procedures to clerk cases, prepare patients for operations, and always discuss cases with the MO. It provides tips on bringing a notebook for reference and revising basic surgical knowledge. It describes how to prepare patients for the OT or scopes, including obtaining consent, ordering relevant tests and imaging, optimizing medical conditions, starting IV access, marking sites, reviewing anaesthesia plans, and ensuring fasting status and COVID test results. It also outlines the clinic SOP for a specific MO, including expectations for discussion with the MO, filling forms

1. SURGICAL
HANDBOOK
DR FARRAHIN SAZALE

2. Orientation Week
Role as House Officer :
1. Complete AM review before 0800 AM
2. TDS round with MO/surgeon
3. Attend clinics/OTs/Scopes/Breast Clinic to clerk cases
4. Preparing patient for operation
5. Must always inform and discuss every case with MO
TIPS :
- Bring pocket notebook for reference
- Memorize the common medications dosage and frequency prescribed
in surgical wards
- Revise basic surgical knowledge from time to time

3. Preparing patient to OT
 Getting informed and written consent
 Bloods – FBC, RP, LFT, Coag, GSH/GXM
 Imagings – CXR, ECG
 Comorbids patient (ie BP/GM optimisation)
• Sliding scale once NBM for DM patients
• Withhold antiplatelets/anticoagulants
 At least one large bore branula
 Marking the operation site
 Carry out Anaesthetic plan (read the blue sheet)
 Keep patient NBM for at least 6H with IVD maintenance)
 Covid-19 PCR/RTK result available

4. Clinic SOPD (KP4)
MO Incharge Clinic : __________________
Alternate Sunday, Monday and Thursday morning (8.30AM)
1. Clinic HO must be in SOPD by 8.30AM together with card
2. Help to review patients and must discuss with MO in regards with
management
3. Must remember to state name of MO/surgeon in the entry
4. To fill up imaging/scope form and get consent on the spot
5. Must have basic knowledge of common clinic cases :
• BPH, Urinary Obstruction (stones, malignancy, etc)
• Breast cancer – imagings, follow up surveillance
• Colon cancer – scopes, follow up surveillance
• Upper GI disease – varices, gastritis, PUD, PGU…
• Hepatobiliary – cholelithiasis, choledocholithiasis, HCC
• Vascular – PVD, limb ischaemia, varicose veins, venous/arterial ulcer,
AVF fistula
• Lumps/bumps – lipoma, sebaceous cyst, abscess, ..
• Hernia – congenital / acquired
• Paediatric cases

5. Preparing patients for SCOPE
Get consent from patients
Insert branula (if indicated – ie colonoscopy requiring intervention)
Preparing sedation :
 Midazolam (1 ampoule = 1cc = 1mg) add 4cc water for injection = Total 5mg in a 5cc syringe
 Reversal : Flumazenil – give 1cc at a time and monitor patient
 Pethidine (1 ampoule = 1cc = 10mg) add 4cc water for injection = Total 50mg in a 5cc syringe
 Reversal : Naloxone – give 1cc at a time and monitor patient