2: Surgical hemostatisis and electrosurgery Flashcards
(38 cards)
Hemostasis definition
Process by which hemorrhage is arrested
Drugs that affect bleeding times
Acetylsalicylic acid Warfarin adequan heparin NSAIDs
PTT tests
intrinsic coagulation
PT tests
extrinsic coagulation
Platelet count test
platelet contribution to hemostasis
Buccal mucosal bleeding time test
Platelet contribution to hemostasis
FDP test
intravascular coagulation
3 factors that help achieve hemostasis
vascular factors
intravascular factors
Extravascular factors
Examples of vascular factors
reflex vasospasm
vascular retraction
inversion of the intima of the blood vessel
Result of the interaction of intravascular factors
thrombus formation
Primary hemostasis
Platelet plug temporarily closes the opening in a vessel
Secondary hemostasis
conversion of soluble fibrinogen into the insoluble fibrin clot
Examples of extravascular factors
Tissue elasticity
Release of tissue thromboplastin
What does a pressure pad control
low pressure hemorrhage from small vessels
When do you use hemostatic forceps
when bleeding vessels are to be sacrificed rather than repaired
Small low pressure vessels
Goal of hemostatic forceps
Hemorrhage is temporarily arrested
vascular wall is sufficiently injured to activate the physiologic clotting mechanisim
Pros of vascular ligation
most secure method of hemostasis from severed vessels
Cons of vascular ligation
introduction of foreign material in the wound
increased application time
Square knot
Used for ligatures
Security without excessive bulk
Surgeon’s knot
Increased friction
More bulk than square
Granny knot
Accidental
Tie a square knot over it
Modified Miller’s knot
Ligate vascular pedicles
Trans fixation type ligation
increased security
suture and needle penetrate vessel and then encircle
Ligating clips advantages
Fast
Good for hard to access areas
