Arthroscopy
I've been setting up hip arthroscopies a lot recently. Five in the last two days, so the list for them is in my head. It's quite a folderol.
1. Get computer and monitors started, as for any case. Return between each job to hit various prompts as system progresses.
2. C-arm in room, on correct side. If both left and right will be done that day, plug in main power to monitor so it can be switched from side to side without unplugging. Bag foot pedal, place under bed.
3. Adjust standard bed, leg segment lowered, fetch positioner.
4. Apply positioner, with leg holders on the correct side. Lock everything down.
5. Put pads on leg holders, available for later.
6. Get X-ray aprons in room, get my own thyroid shield from locker.
7. Two neptune suction (20 L) machines in position.
8. Hang and dual-spike 3L LR bags. Check amount of fluid bags on cart.
9. Turn on camera, light, shaver box, electrocautery, unravel foot controls for last two, cover with plastic bags and position under end of bed.
10. Set out chloroprep and shaver, have arm pads and towel clips. Armboards on bed.
11. Sheets on bed - another every case thing.
12. Meet patient.
13. Start music. Literally, not being poetic here.
14. Get local anesthetic.
1. Patient enters room on gurney with anesthesiologist, I get warm blankets, help patient move over. Put armboard on, take gurney out.
2. Remove grip socks, apply foot/leg pads, safety belt.
3. Tie up scrub gown. Assist anesthesiologist as needed.
4. Assist surgeon to position, although he does most of it. I take care of the arm tucked across the chest, apply warming blanket.
5. Get C-arm in position as they drape.
6. Plug in camera, light, shaver, fluid pump, suction, lay down dam blankets, make sure everything is working.
7. Chart, keep fluids and suction going.
8. Set up post op cooling pad and roller on gurney in hall, with O2 tank and mask.
9. Stave off boredom for the next few hours.
10. Move patient onto gurney, clean everything up, do it again.
1. Get computer and monitors started, as for any case. Return between each job to hit various prompts as system progresses.
2. C-arm in room, on correct side. If both left and right will be done that day, plug in main power to monitor so it can be switched from side to side without unplugging. Bag foot pedal, place under bed.
3. Adjust standard bed, leg segment lowered, fetch positioner.
4. Apply positioner, with leg holders on the correct side. Lock everything down.
5. Put pads on leg holders, available for later.
6. Get X-ray aprons in room, get my own thyroid shield from locker.
7. Two neptune suction (20 L) machines in position.
8. Hang and dual-spike 3L LR bags. Check amount of fluid bags on cart.
9. Turn on camera, light, shaver box, electrocautery, unravel foot controls for last two, cover with plastic bags and position under end of bed.
10. Set out chloroprep and shaver, have arm pads and towel clips. Armboards on bed.
11. Sheets on bed - another every case thing.
12. Meet patient.
13. Start music. Literally, not being poetic here.
14. Get local anesthetic.
1. Patient enters room on gurney with anesthesiologist, I get warm blankets, help patient move over. Put armboard on, take gurney out.
2. Remove grip socks, apply foot/leg pads, safety belt.
3. Tie up scrub gown. Assist anesthesiologist as needed.
4. Assist surgeon to position, although he does most of it. I take care of the arm tucked across the chest, apply warming blanket.
5. Get C-arm in position as they drape.
6. Plug in camera, light, shaver, fluid pump, suction, lay down dam blankets, make sure everything is working.
7. Chart, keep fluids and suction going.
8. Set up post op cooling pad and roller on gurney in hall, with O2 tank and mask.
9. Stave off boredom for the next few hours.
10. Move patient onto gurney, clean everything up, do it again.
Labels: surgery
Posted by Zhoen on Saturday, August 27, 2011
4 comments:
In a way, similar to the procedure for a coronary angiocath when I was doing them. A memorable one was when the tip of the catheter dislodged a plaque at the opening of the left main.....
This is all, of course, from the viewpoint of the circulating nurse. The scrub has another set up, particular, but much less extensive. They have to deal more with instrument sets that have to be turned over and sterilized between cases.
Didn't realize there was as much under the bed as you describe.
Phil,
More than most. Three foot pedals, a puddle guppy suction, and bath blankets to contain the fluid on the floor.
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