Operative positions, instruments, prep Flashcards
1
Q
Dorsal/ supine position
A
Lying on back
2
Q
Lithotomy
A
Legs abducted by stirrups
- Vaginal or perianal surgeries
3
Q
Fowlers/ sitting
A
Inclined position of 45-60 degrees
- Abd drainage following surg
4
Q
Prone
A
Lying on stomach
5
Q
Knee/ chest
A
- Ass in the air
- Useful for sigmoidoscopy, lumbar and anorectal exam
6
Q
Jackknife
A
Butt in air
- Gluteal and anorectal procedures
7
Q
Lateral
A
- On side with top knee flexed
Access to spine, rectum
8
Q
Trendelenburg
A
- Supine, feet 15-30 degrees higher
- Increase brain circulation, abd hernia reduction
- Central line
- Increased resp perfusion
9
Q
Reverse tredelenburg
A
- Legs lower than head
- Reducing intracranial pressure
10
Q
Tissue forceps
A
Used for grasping and holding tissue
- Tweezer looking
11
Q
Clamps
A
- Ratcheting device
- Hold things in place, compression of vessels
- Application of staples
12
Q
Scissors
A
- Dissecting/ cutting through tissue
- Cut sutures
13
Q
Needle holders
A
- Used to hold needles steady during suture
14
Q
Hand held retractor
A
- Blades and rakes to hold tissue open
- Not sharp
15
Q
Self retaining retractor
A
- Place retractor and leave open and in place
16
Q
Suction
A
Removal of blood and debris
17
Q
Cautery
A
- Heat to stop vessel bleeding
18
Q
Bovie
A
- Electrode knife used for cutting or coagulation
19
Q
Diathermy
A
- Electromagnetic or US heat for muscle relaxation
20
Q
Informed consent
A
- PARQ
- ID meds
- Lifesaving measures wanted
21
Q
Presurgical bowel prep
A
- Decrease bacterial load
- Polyethylene glycol to rid stool
- Abx prophylaxis- Neomycin and erythromycin
22
Q
NPO status/ nasogastric tube
A
- Last solid food 6-8 hrs prior to anesthesia
- Reduces risk of aspiration
- Nasogastric tube to empty contents if gastric retention
23
Q
DVT prophylaxis
A
- 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
Q
Abx prophylaxis
A
- 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
