Undergraduate level presentation on Prevention of Surgical infection covering the topics of:
History
Definition
Classification
Risk factors
Surgical Site Infection (SSI)
Tetanus
Gas gangrene
Discover evidence-based practices to prevent sharps injuries and to reduce blood borne pathogen exposure to perioperative patients and personnel. This presentation is from a recent AORN webinar. Listen to the replay for free at http://bit.ly/1asAKXx. When registering for the replay, you can also earn one contact hour through June 27, 2014.
Undergraduate level presentation on Prevention of Surgical infection covering the topics of:
History
Definition
Classification
Risk factors
Surgical Site Infection (SSI)
Tetanus
Gas gangrene
Discover evidence-based practices to prevent sharps injuries and to reduce blood borne pathogen exposure to perioperative patients and personnel. This presentation is from a recent AORN webinar. Listen to the replay for free at http://bit.ly/1asAKXx. When registering for the replay, you can also earn one contact hour through June 27, 2014.
Learn about the principles behind the surgical checklist and the evidence for adopting the checklist and how one NHS Board has applied the checklist to their surgical theatres and how another has expanded the checklist principle to other areas.
Experience with the implementation of the WHO checklist and briefing in the operating theatre. Krishna Moorthy. IV Internacional Conference on Patient Safety. (Madrid, Ministry of Health and Consumer Affairs, 2008)
Discover what it takes to be a Perioperative Clinical Nurse Specialist. This presentation is from AORN's webinar which describes the role of the perioperative CNS, RN. Receive 0.5 contact hours by registering for the webinar replay and successfully completing the evaluation. The webinar is available at http://bit.ly/1aROqKI.
Interested in obtaining the new CNS-CP nursing credential? Learn valuable test-taking strategies and more through a CNS-CP Certification Exam Preparation Course: http://bit.ly/GQ5Yy0.
Purpose of the call:
•Review current data and state of the SSCL
•Discuss the role of communications and team work in patient safety
•Discuss and define how we can measure the effectiveness of the SSCL.
Read more and watch the webinar recording: http://bit.ly/1sXDqaZ
Learn about AORN's recommended practices for surgical attire in the perioperative setting. This presentation is from a webinar on August 8, 2012. Listen to the webinar for free to learn more, and you can also earn 1.0 contact hour: www.aorn.org/PreviouslyRecordedWebinars
This presentation is from an AORN webinar that helps guide perioperative team members through the evidence appraisal and rating process using the AORN appraisal tools and evidence-rating model. The webinar replay is available for free at http://bit.ly/1i9r4En. Get the 2014 edition of Perioperative Standards and Recommended Practices at http://bit.ly/1bJmXAT.
Cleaning: It’s everyone’s responsibility. Review environmental cleaning procedures for all perioperative patient care areas (preoperative, OR, postoperative, and sterile processing). This information was originally shared in an AORN webinar, which is also available for free on demand at http://bit.ly/IHTNnp. One contact hour is available for the webinar through November 13, 2014. Learn more about AORN educational events at www.aorn.org/Events.
Contents :
Anesthesiology instruments
General features of anesthetic instruments
Anesthetic cylinders
Pin index
Anesthetic gases
Anesthetic machines and circuits
Mapleson system
Oxygen control devices
Devices for co2 absorption
Dead space
Endotracheal tube
Laryngoscopy and endotracheal intubation
Nasotracheal intubation
Laryngeal mask airway
Trendelenberg position
General features of monitoring during anesthesia
Central venous pressure monitoring
Pulmonary artery catheter
Capnogram
Anesthetic complications
Air embolism
Respiratory complications
Malignant hyperthermia
Intraoperative and postoperative complications
Resuscitation
Mendelson syndrome
Hypothermia in anesthesia
Clinical anesthesia
History of anesthesia
Stages of anesthesia
Preanesthetic assessment
Pediatric anesthesia
Anesthesia in head injury
Cardiovascular anesthesia
Anesthesia in ent
Obstetric anesthesia
Anesthesia in orthopedics
Respiratory anesthesia
Day care anesthesia
Drugs of anesthesia
Preanesthetic drugs
General features of anesthetic drugs
Inhalational anesthetics
Minimum alveolar concentration
Partition coefficient
General features of inhalational anesthetics
Xenon
Nitrous oxide
Trilene
Ether
Helium
Chloroform
Halothane
Enflurane
Isoflurane
Desflurane
Sevoflurane
Methoxyflurane
Intravenous anesthetics
General features of intravenous anesthetics
Propofol
Ketamine
Thiopentone
Etomidate
Local anesthetics
General features of local anesthetics
Bupivacaine
Lignocaine
Prilocaine
Cocaine
Procaine
Bier’s block/IVRA
Peribulbar and retrobulbar block
Stellate ganglion block
Brachial plexus block
Celiac plexus block
Neuromuscular blockers
General features of neuromuscular blockers
Depolarising muscle relaxants – Succinly choline
Features of non depolarizing muscle blockers
D-tubocurarine
Pancuronium
Vecuronium
Mivacurium
Atracurium
Gallamine
Alcuronium
Spinal, epidural and caudal anesthesia and pain management
Splanchnic block
Neuraxial blockade
Spinal anesthesia
Epidural anesthesia
Caudal anesthesia
Other blocks
Pain
General features of pain
Assessment of pain
Analgesic drugs
For more details, visit www.medpgnotes.com
You can send your queries to medpgnotes@gmail.com
The correct application of the safety check steps in our routine theatre operations and procedures will greatly reduce surgically related mortality and morbidity.
A discussion on the risk factors, classification and clinical presentation of surgical site infection. Also elucidates the overview of management approach to SSI.
Surgical site Infection during Internship in medical college.pptxrautkrisna
Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between 814 and 6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wllbeing
Similar to Surgical site infections - Diagnosis, treatment and Prevention guidelines (20)
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
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It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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2. Why this topic?
SSI is MOST COMMON hospital acquired infection in surgical
patients.
3rd most common hospital acquired infection.
Preventable
Prolong the hospital stay (7.3 days)
Expenditure
Over one-third of postoperative deaths
Poor scar, persistent pain and itching, restriction of movement and
a significant impact on emotional wellbeing
3. What is SSI?
Infections that occur
in the wound created
by an invasive surgical
procedure are
generally referred to
as surgical site
infections
5. Superficial incisional surgical site
infections
Infection occur within 30 days of procedure
Involve skin or subcutaneous tissue
• signs or symptoms of infection
• purulent drainage +/-
• organisms isolated
• Diagnosis by experience
Stitch abscess, episiotomy, circumcision in infant, burn wound
6. Deep incisional surgical site infections
Infection occur within 30 days of procedure (or one year in the
case of implants)
Involve deep soft tissues, such as the fascia and muscles.
• purulent drainage, signs of infection
• spontaneously dehisces or opened by surgeon
• an abscess or other evidence of infection
Involving both superficial and deep = DISSI
Space or organ ssi drain through Deep incision = DISSI
7. Organ or space Surgical site Infection
30 days no implant or 1 year with implant
Any part is involved which was opened or
manipulated other than the incision
• Purulent discharge from a drain
• Isolated an organism
• Abscess or other evidence of infection
• Diagnosis by a surgeon
8. Early
• Infection
presents
within 30 days
of procedure
Intermediate
• Occurs
between one
and three
months
Late
• Presents more
than three
months after
surgery
9. Minor
• Wound infection is
described as minor when
there is discharge
without cellulitis or deep
tissue destruction
Major
• When there is pus
discharge with tissue
breakdown , Partial or
total dehiscence of the
deep fascial layers of
wound or if systemic
illness is present.
10. Pathogenesis of surgical site infection
Contaminati
on
•Endogenous
infection
•Exogenous
infection
•Haematogeno
us spread
•Staph
aureus
•Enterobacte
riaceae and
anaerobes
Proliferation
of bacteria
Induce
inflammation
– signs
appear
Identified or
unidentified
Self resolving
-> resolve by
treatment ->
sepsis and
death
11. Wound Assessment
ASEPSIS
• to assess wounds
Southampton Wound
Assessment Scale
• categorized
according to any
complications and
their extent
15. Southampton scoring system
Grade Appearance
• 0 Normal
• I Normal healing with mild
bruises and erythema
A Some bruising
B Considerable bruising
C Mild erythema
16. Grade Appearance
• II Erythema plus other signs
of infection
A At one point
B Around sutures
C Along wound
D Around wound
17. Grade Appearance
• III Clean or haemoserous discharge
A At one point only
B Along wound
C Large volume
D Prolonged
18. Grade Appearance
• IV Major wound complication like pus
A At one point only
B Along wound
• V Deep or severe infection with or
without breakdown
19.
20. Types of Surgery / class of wound
Clean Hernia repair
breast biopsy
1.5%
Clean-
Contaminated
Cholecystectomy
planned bowel resection
2-5%
Contaminated Non-preped bowel
resection
5-30%
Dirty/infected perforation, abscess 5-30%
25. Treatment
• Incisional: open surgical wound,
antibiotics for cellulitis or sepsis
• Deep/Organ space: Source control,
antibiotics for sepsis
26. Management of Incisional surgical site infection
• Removal of sutures with drainage of pus
• Debridement and open wound care
• delayed primary or secondary suture
• 15% of postoperative wounds are treated with
antibiotics -> inappropriate -> resistance
• Wound bed preparation
27. Wound Dehiscence and Evisceration
• Separation of abdominal wound
• Protrusion of abdominal content
• Mean time - 8 to 10 days
• c/f
– Pink serosanguinous discharge from the wound
• t/t
– Reclosure of the wound
28. Reclosure of the wound
• Early closure in early post operative period
• If evesceration – cover OT resuturing
• Retention suturing is not proven
advantageous
• Mesh and biological implants
• In a small dehiscence – secondary suturing
31. Joseph Lister
• 1883-1897
• British surgeon
• Used Carbolic Acid
(Phenol) to clean
hands, instruments
and wipe on surgical
wounds drastically
decreased infections.
32. Guidelines for prevention of
Surgical Site Infection
•Information for patients and
carers
•Preoperative phase
•Intra operative phase
•Post operative phase
33. Guidelines for prevention of SSI
• Explain in detail
Information for patients and carers
• Preoperative showering – none vs chlorhexidine/soap
• Hair removal
• Patient theatre wear
• Staff theatre wear
• Staff leaving the operating area
• Nasal decontamination – mupirocin?
• Mechanical bowel preparation
• Hand jewellery, artificial nails and nail polish
• Antibiotic prophylaxis
Preoperative phase
34. Operative Antibiotic Prophylaxis
1969
Decreases bacterial counts at surgical site
Given within 30 - 120 minutes prior to surgery - Cefazolin
MRSA - Vancomycin 1-2 hours prior to surgery
Allergic – vancomycin + clindamycin
35. Re-dose for longer surgery - twice the half life of drug
Single dose/ Do not continue beyond 24 hours
Do not - for clean non-prosthetic uncomplicated surgery
consider potential adverse effects
Give antibiotic treatment (in addition to prophylaxis)
Operative Antibiotic Prophylaxis
36. However….
• Prophylaxis not effective for
– Lap cholecystectomy
– Herniorraphy
• Insufficient evidence for
– breast reconstruction with or without implants
– abdominal hysterectomy (clean-contaminated)
– uncomplicated appendicectomy in children
38. • Hand decontamination
• Incise drapes
• Use of sterile gowns
• Gloves
• Antiseptic skin preparation
• Maintaining patient homeostasis – temp oxygen glucose
• Diathermy
• Wound irrigation and intra-cavity lavage
• Antiseptic and antimicrobial agents before wound
closure
• Wound dressings, Closure methods
Intra-operative phase
Guidelines for prevention of SSI
39. • Changing dressings
• Postoperative cleansing
• Use tap water for wound cleansing after
48 hours
• No Topical antimicrobial agents - primary
intention
• Dressings - secondary intention
• Debridement
• Antibiotic treatment
Postoperative phase
Guidelines for prevention of SSI
40. Practices to prevent SSI are therefore
aimed at minimising the number of
microorganisms introduced into the
operative site, for example by:
• Removing microorganisms that
normally colonise the skin.
• Preventing the multiplication of
microorganisms.
• Enhancing the patient’s defences
against infection.
• Preventing access of microorganisms
into the incision postoperatively.
41. • Source
– Schwartz’s Principles of surgery
– Sabiston
– Maingot’s Abdominal operations
– Surgical site infection (prevention and treatment of surgical
site infection) 2008
• National Collaborating Centre for Women’s and Children’s Health
– Commissioned by the National Institute for Health and Clinical
Excellence
– Internet