CLASSIFICATION OF SURGICAL INSTRUMENTS

OTMANAGE

An essential task in otmanage is to;
Prepare and provide surgical instruments for procedures
This requires recognition of instruments
Assembeing sets for planned procedures
Sterilizing these sets


The surgical instruments used for operation are classified as:
1. Sharp cutting instruments
2. Dissecting forceps
3. Haemostats (artery forceps)
4. Tissue forceps
5. Gastric and intestinal clamps
6. Needle holders
7. Suture materials
8. Tubes, catheters and drains
9. Retractors
10. Dilators
11. Special instruments
12. Diagnostic instruments

Any questions be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for your access and review
Visitors that follow the site may post contributions to the site.
To aid consumer/provider convergence visit http://www.surgseminar.blogspot.com/
http://bit.ly/cPTh6f
Click on image to see detail.

RECOVERY

. RECOVERY ROOM

- On the completion of a surgical procedure the patient is
allowed to recover from the effect of the anesthesia agents
and relaxants by giving appropriate medication.
To the point that the patient is respiring spontaneously and
adequately.
- He is disconnected from the anaesthetic machine and the endo-
trachael tube can now be removed after ensuring that the
patient has a clear air-way by sucking out all secretions.
- He is then wheeled in the recovery room where he can be
observed frequently till complete recovery from the effects
of the pre-medication and the anaesthetic agents.
The points to be observed are:
* Continuous free airway
* Adequate perfusion is observed by skin colour, temperature,
pulse, blood pressure records
* Prevention of aspiration
* Medication for pain

Patients that are severely ill because of extensive surgery are
kept in an intensive care unit.
Monitoring to gain information
on;
- Cardiac function (ECG)
- Blood biochemistry, pH, PCO2
- Pulse, Blood pressure and central venous pressure records
- Adequate ventilation

Any questions be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for your access and review.
Visitors that follow the site may post contributions to the site.
For provider/consumer convergence visit http://www.drmmkapur.blogspot.com/
http://www.surgseminar.blogspot.com/
Click on image to see detail.

PREMEDICATION

6. THE PRE-OPERATIVE PREPARATIONS
The stomach, rectum and bladder should be empty before taking the
patient to the theatre.
I
It is customary to have a patient on empty stomach and a low enema given the night before.

6.1 PRE-ANAESTHETIC MEDICATION
A patient is usually apprehensive, therefore, may spend a
sleepless night prior to the operation.
It i$ desirable to sedate the patient with a hypnotic, or a
tranquilliser (barbiturates or valium).

6.2 AN HOUR PRIOR TO SURGERY
The patient receives;
* Injection of Pethidine 50 mg.
* Phenargen 25 mg., and injection Atroprine 1/100th of grain
intramuscularly.
This produces basal narcosis which is the ideal state for the
patient prior to the induction of anaesthesia.
The choice of the type of anaesthesia will depend upon the
surgical procedure to be undertaken, and the result of the pre-
anaesthetic check in which the health status has been defined.

Any questions be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for your access and review.
Visitor that follow the site May post contributions to the site.
For provider/consumer convergence visit www.surgseminar.blogspot.com
www.drmmkapur.blogspot.com
Click on image to see detail.

ANESTHESIA SPINAL

Neuroaxial Block

Spinal and Epidural Anesthesia

Spinal anesthesia is produced by injecting very low doses of LA (e.g., 50mg Lidocaine) via lumbar puncture into the cerebrospinal fluid below the termination of the spinal cord.

The LA diffuses in the CSF and produces dense anesthesia extending cephalic from the sacral dermatomes to as high as the lower cervical dermatomes.

A single dose of LA through fine-gauge (22- to 29-gauge) needle is usually injected, which results in a limited duration of anesthesia, but catheters can be placed in the subarachnoid space for prolonged anesthesia.

Spinal LA blocks somatic and visceral sensory afferent nerves, as well as efferent motor and autonomic (sympathetic) fibers. Sensory anesthesia, muscle relaxation and sympathetic block are the result of this technique

Spinal anesthesia is usually chosen for procedures performed in the dermatomes at or below the midabdonan.

Epidural anesthesia is produced by injection of LA into the epidural space outside the dura mater.

An epidural injection requires significantly more LA in both volume and dose than a spinal injection, but the injection can be made anywhere from the cervical epidural space to the sacral hiatus (caudal anesthesia).

The spinal nerves are blocked most intensely at the site of injection and less intensely both above and below that site.

Compared to spinal anesthesia, epidural anesthesia is often performed through a catheter introduced into the epidural space through a large (16- to 18-gauge) needle.

The catheter provides flexibility for prolonged anesthesia as well as prolonged analgesia for days into the postoperative period with infusion of dilute LA.

Any questions be sent to drmmkapur@gmail.com

All earlier posts are stored in archives for your access and review.

Visitors that follow the site may post contributions to the site.

For provider /consumer convergence visit www.surgseminar.blogspot.com

www.drmmkapur.blogspot.com

Click on image to see detail.