Interventions for Intraoperative Clients Care

Members of the Surgical TeamSurgeonSurgical assistantAnesthesiologistCertified registered nurse anesthetistHolding area nurseCirculating nurseScrub nurseSurgical technician/ Operating room technician

Environment of the Operating RoomPreparation of the surgical suite and team safetyLayoutHealth and hygiene of the surgical teamSurgical attire Surgical scrub

Surgical Scrub, Gowning, and Gloving

AnesthesiaInduced state of partial or total loss of sensation, occurring with or without loss of consciousness. Used to block nerve impulse transmissions, suppress reflexes, promote muscle relaxation, and, in some instances, achieve a controlled level of unconsciousness.

General AnesthesiaReversible loss of consciousness is induced by inhibiting neuronal impulses in several areas of the CNS.State can be achieved by a single agent or a combination of agents.CNS is depressed, resulting in analgesia, amnesia, and unconsciousness, with the loss of muscle tone and reflexes.

Stages of General AnesthesiaStage 1: analgesiaStage 2: excitementStage 3: operativeStage 4: danger

AnesthesiaInduced state of partial or total loss of sensation, occurring with or without loss of consciousness. Used to block nerve impulse transmissions, suppress reflexes, promote muscle relaxation, and, in some instances, achieve a controlled level of unconsciousness.

Administration of General AnesthesiaInhalation: intake and excretion of anesthetic gas or vapor to the lungs through a maskIntravenous injection: barbiturates, ketamine, and propofol through the blood streamAdjuncts to general anesthesia agents: hypnotics, opioid analgesics, neuromuscular blocking agents

Balanced AnesthesiaCombination of intravenous drugs and inhalation agents used to obtain specific effectsCombination used to provide hypnosis, amnesia, analgesia, muscle relaxation, and reduced reflexes with minimal disturbance of physiologic function.

Complications from General AnesthesiaMalignant hyperthermia: possible treatment with dantroleneOverdoseUnrecognized hypoventilationComplications of specific anesthetic agentsComplications of intubation

Local or Regional AnesthesiaSensory nerve impulse transmission from a specific body area of region is briefly disruptedMotor function may be affectedPatient remains conscious and able to follow instructionsGag and cough reflexes remain intactSedatives, opioid analgesics, or hypnotics are often used as supplements to reduce anxiety.

Local AnesthesiaTopical anesthesiaLocal infiltrationRegional anesthesia-field block-nerve block-spinal anesthesia-epidural anesthesia

Complications of Local or Regional AnesthesiaAnaphylaxisIncorrect delivery techniqueSystemic absorptionOverdosage

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Epidural AnesthesiaLocal anaesthetic solutions are deposited in the peridural space between the dura mater and the periosteum lining the vertebral canal. The peridural space contains adipose tissue, lymphatics and blood vessels. The injected local anaesthetic solution produces analgesia by blocking conduction at the intradural spinal nerve roots.

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Differences between Spinal and Epidural Anesthesia *

Risk for Perioperative Positioning InjuryInterventions include:Proper body positionRisk for pressure ulcer formationPrevention of obstruction of circulation, respiration, and nerve conduction

Special DrainsRemove pusRemove bloodRemove other body fluids from wound

Does not result in faster wound healing or prevent infection.

Penrose Drain

Jackson Pratt or JP

Hemovac

Ace wrapsTo reduce the swelling of an injured area of the bodyTo hold wound bandages in placeTo wrap around a arm or leg splint during healingTo improve blood flow to a limb like an arm or legTo hold cold or hot packs in place on a body part

Ice packA general rule of thumb is to ice an injury over a period of 24 to 72 hours. Apply cold packs for periods of up to 20 minutes every two to four hours. When your skin starts to feel numb, it's time to give your body a break from a cold pack.

Potential for HypoventilationContinuous monitoring of:-breathing -circulation-cardiac rhythms-blood pressure and heart rateContinuous presence of an anesthesia provider

A surgical drain is a tube used to remove pus, blood or other fluids from a wound. Drains inserted after surgery do not result in faster wound healing or prevent infection but are sometimes necessary to drain body fluid which may accumulate and in itself become a focus of infection. The routine use of drains for surgical procedures is diminishing. Better radiological investigation and confidence in surgical technique have reduced their necessity. It is felt now that drains may hinder recovery by acting as an 'anchor' limiting mobility post surgery and the drain itself may allow infection into the wound. In certain situations their use is unavoidable.

*Always use some kind of barrier like a towel. Dont apply directly to the site. Hospital cold packs have material surface.

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