In the OT

Posted: November 25, 2011 by gerardloh in Orthopaedics & Traumatology

Types of Surgery

Elective (under GA/LA/Spinal)

Emergency

Trauma list

 

Common Surgical Procedures

Open Reduction Internal Fixation

K wiring

Plating with screws, Interlocking plate

Tension Band Wiring

TKR- Total Knee replacement

AKA/BKA- Above/Below knee amputation

WD – wound debridement

Fasciotomy (for compartment syndrome)

Intramedullar nail, gamma nail

Arthroplasty

 

Before entering OT – contact OT sister for orientation
1
) use the correct entrance
2) wear correct surgical attire
3) Learn technique of scrubbing
4) Learn technique of closed gloving
learn here

 

Before Op
1) check-OT List, patient’s name, age, diagnosis and procedure
2) make sure orders done – surgery ordered, Antibiotics to OT, blood or GXM available, I-I ordered, MA present
3) Write details on the OT whiteboard
4) Open patient’s history (eHIS) and Xrays (on PACS system)
5) prepare antibiotics (if indicated)
6) call MO or specialist once patient is under anaesthesia

 

 

Antibiotics prep in OT

1. Take 10cc of water in syringe, inject into bottle of antibiotics (powder)

2. Shake the bottle till well dissolved

3. Give in IV line ( do not inject IM!!!)

 


Applying a torniquet

1. Find the tourniquet inflating apparatus

2. Select cuff- Small with green string= upper limbs, large brown string = lower limbs

3. Wrap 3-5 layers orthoban around area. Always apply as proximal as possible.

4. Locate the connector plug. Make sure it is facing towards the patient’s body

5.  Apply the cuff. Hold on to end strings, wrap the strap tightly.

6. Elevate the limb to empty veins.

7. Adjust the pressure 250 for UL and 350 for LL, and timer (*Max duration for UL = 60mins, LL = 120mins)

8. Press INFLATE

 

 

CBD

1. Get a CBD set. Prepare correct catheter, lignocaine gel, syringe, 10cc water for inflation
2. Wear sterile gloves, with apron
3. Cleanse the penis with Clorrhexidine/normal saline
4.  Administer some lignocaine into urethra with syringe (1-2ml)
5. Lubricate the end of the cathether. Pull down the foreskin. Hold the penis at 90 degrees.
6. Insert the catheter slowly until urine flows out.
7. Inflate with 10cc of water (see catheter for accurate volume of water) Tug to confirm insertion.
8. Retract foreskin !! (failure to do so may result in phimosis)
9. To remove catheter, syringe out the 10cc water and tug slowly till removed completely

 

<to be continued…Ring and ankle block..>
This guide is based on my experience in Hospital Ampang’s OT. Other hospitals may vary in steps.

Hopefully this may help you in your OT

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