Operative positions, instruments, prep Flashcards Preview

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Flashcards in Operative positions, instruments, prep Deck (27):
1

Dorsal/ supine position

Lying on back

2

Lithotomy

Legs abducted by stirrups
- Vaginal or perianal surgeries

3

Fowlers/ sitting

Inclined position of 45-60 degrees
- Abd drainage following surg

4

Prone

Lying on stomach

5

Knee/ chest

- Ass in the air
- Useful for sigmoidoscopy, lumbar and anorectal exam

6

Jackknife

Butt in air
- Gluteal and anorectal procedures

7

Lateral

- On side with top knee flexed
Access to spine, rectum

8

Trendelenburg

- Supine, feet 15-30 degrees higher
- Increase brain circulation, abd hernia reduction
- Central line
- Increased resp perfusion

9

Reverse tredelenburg

- Legs lower than head
- Reducing intracranial pressure

10

Tissue forceps

Used for grasping and holding tissue
- Tweezer looking

11

Clamps

- Ratcheting device
- Hold things in place, compression of vessels
- Application of staples

12

Scissors

- Dissecting/ cutting through tissue
- Cut sutures

13

Needle holders

- Used to hold needles steady during suture

14

Hand held retractor

- Blades and rakes to hold tissue open
- Not sharp

15

Self retaining retractor

- Place retractor and leave open and in place

16

Suction

Removal of blood and debris

17

Cautery

- Heat to stop vessel bleeding

18

Bovie

- Electrode knife used for cutting or coagulation

19

Diathermy

- Electromagnetic or US heat for muscle relaxation

20

Informed consent

- PARQ
- ID meds
- Lifesaving measures wanted

21

Presurgical bowel prep

- Decrease bacterial load
- Polyethylene glycol to rid stool
- Abx prophylaxis- Neomycin and erythromycin

22

NPO status/ nasogastric tube

- Last solid food 6-8 hrs prior to anesthesia
- Reduces risk of aspiration
- Nasogastric tube to empty contents if gastric retention

23

DVT prophylaxis

- Pneumatic compression devices
- Early ambulation
- Low dose heparin if moderate risk
- High risk = heparin and compression device
- Must stop 24 hrs prior to surg

24

Abx prophylaxis

- Clean contaminated or contaminated cases
- Decrease rate of infection
- Choose by sensitivity studies

25

Blood type, cross and screen

- Type and cross all pts at risk of blood loss

26

Anesthesia risk

- Completed by anesthesiologist
- Perioperative classification scheme- Normal, well controlled chronic, poorly controlled chronic, emergency

27

Anxiety reduction

- Provide reassurance, comfort and data regarding M&M
- Benzos 15 min prior