2: Surgical hemostatisis and electrosurgery Flashcards Preview

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Flashcards in 2: Surgical hemostatisis and electrosurgery Deck (38):
1

Hemostasis definition

Process by which hemorrhage is arrested

2

Drugs that affect bleeding times

Acetylsalicylic acid
Warfarin
adequan
heparin
NSAIDs

3

PTT tests

intrinsic coagulation

4

PT tests

extrinsic coagulation

5

Platelet count test

platelet contribution to hemostasis

6

Buccal mucosal bleeding time test

Platelet contribution to hemostasis

7

FDP test

intravascular coagulation

8

3 factors that help achieve hemostasis

vascular factors
intravascular factors
Extravascular factors

9

Examples of vascular factors

reflex vasospasm
vascular retraction
inversion of the intima of the blood vessel

10

Result of the interaction of intravascular factors

thrombus formation

11

Primary hemostasis

Platelet plug temporarily closes the opening in a vessel

12

Secondary hemostasis

conversion of soluble fibrinogen into the insoluble fibrin clot

13

Examples of extravascular factors

Tissue elasticity
Release of tissue thromboplastin

14

What does a pressure pad control

low pressure hemorrhage from small vessels

15

When do you use hemostatic forceps

when bleeding vessels are to be sacrificed rather than repaired
Small low pressure vessels

16

Goal of hemostatic forceps

Hemorrhage is temporarily arrested
vascular wall is sufficiently injured to activate the physiologic clotting mechanisim

17

Pros of vascular ligation

most secure method of hemostasis from severed vessels

18

Cons of vascular ligation

introduction of foreign material in the wound
increased application time

19

Square knot

Used for ligatures
Security without excessive bulk

20

Surgeon's knot

Increased friction
More bulk than square

21

Granny knot

Accidental
Tie a square knot over it

22

Modified Miller's knot

Ligate vascular pedicles

23

Trans fixation type ligation

increased security
suture and needle penetrate vessel and then encircle

24

Ligating clips advantages

Fast
Good for hard to access areas

25

Ligating clips disadvantages

Foreign bodies
potential for being dislodged

26

Vascular forceps

atraumatically occlude blood vessels during surgery

27

Absorbable gelatin sponges (gelfoam)

provide physical matrix for clotting
physical barrier to hemorrhage
Slowly absorbable

28

Oxidized cellulose-treated surgical gauze (gurgicel)

Interacts with protein and platelets
mechanical barrier

29

Bone wax

arrest bleeding from edges of cancellous bone
non-absorbable

30

Epinephrine and norepinephrine

Vasoconstrictive
may cause arrhythmias

31

Primary vascular repair

maintains vessels

32

When is primary vascular repair used

critical vascular structures
during transplantation of organs

33

Electrocautery

thermal cautery

34

Electrocautery advantages

Functions in a bloody field
inexpensive

35

Electrocautery disadvantages

extensive tissue destruction
effective only on very small vesseles

36

High frequency electrocoagulation

Electrode is not hot
Tissue resistance causes heat

37

Electrocoagulation disadvantages

No function in bloody field
Don't use near heart or spinal chord

38

Bipolar coagulation units advantages

Functions in bloody field
Safer near spinal chord or heart