EXAM 1: Lecture 8 - principles of hemostasis Flashcards
All hemorrhage ______________
stops eventually!
T/F: Hemostasis is a simple process that only involved clotting factors
false! it is a COMPLEX process that involves platelet activation and circulating clotting factors
what are the benefits of surgical hemostasis
allows appropriate visualization of tissue and prevents life-threatening hemorrhage
how do you use hemostatic forceps
you grab the vessel and clamp it for several minutes until it coagulates
when should you ligate a vessel
when it is a larger vessel
when do you use double ligatures
larger vessels particularly arteries
when should you use transfixation ligatures
may be used for larger arteries to prevent the ligature from slipping off the vessel
what are the benefits and disadvantages of circumferential ligature
benefits - less likely to bleed than transfixation
disadvantages - more likely to slip than a transfixation
what are the benefits and disadvantages of transfixation ligature
benefits - penetrates the lumen of the vessel and less likely to slip than a circumferential
advantages - more likely to bleed than circumferential
what type of throw should NOT be used for vessel ligation
surgeons throw
what are the types of topical hemostatic agents
bone wax, gelatin-based hemostatic products (gel-foam, vetspon), and cellulose-based hemostatic products (surgicel)
when should you not use gelatin-based hemostatic product
in the closure of skin incisions as they may interfere with healing
how does gel foam work
when it has contact activation, it sells and exerts pressure on the wound
should you put gel foam in infected sites
no! it may exert unnecessary pressure on neighboring vital structures
how does surgicel work
it is cut to the size needed and placed on an area of hemorrhage
what is electrocautery
coagulates small vessels/cuts tissue by using heat generated by direct electrical current into a metal wire or probe
T/F: with electrocautery, the electrical current enters the patients body
false! It does not
what is electrosurgery
generating heat inside the tissue using an alternating electric current that passes through the tissue creating a circuit
what is this
electrocautery
what is this
electrosurgery
what size vessels is electrosurgery commonly used for
less than 1.5-2mm in diameter
what happens on the “cut” setting of electrosurgery
there is a constant waveform that produces heat quickly to vaporize or cut tissue
what happens on the “coagulation” setting of electrosurgery
there is intermittent waveform that produces less heat and creates a coagulum rather than vaporizing tissue
what is the most common form of electrosurgery
monopolar electrosurgery
