دانلود کتاب Expertise in the Operating Room: Logistics, Fundamentals and Nuances

فهرست مطالب :

Preface
Acknowledgments
Contents
List of Videos
Contributors
Part I: Preparation Before the Operating Room
Chapter 1: The Surgeon’s Preparation Before the Operating Room
Appendix 1: Patient Preoperative Timeline
Today
Two Weeks Before Surgery
Two Days Before Surgery
Day Before Surgery
Day of Surgery
Appendix 2: Aspirin and Aspirin-Like Drugs to Avoid Before Surgery
Reference
Chapter 2: The Anesthesiologist’s and Nursing Team’s Preparation Before the Operating Room
2.1 The Anesthesiologist
2.1.1 Patient History, Physical Exam, and Laboratory Assessment
2.1.1.1 Anesthesia-Specific History Form
2.1.1.2 Patient Physical Examination
2.1.1.3 Cardiac Risk Assessment
2.1.1.3.1 METs and Perioperative Risk
2.1.1.3.2 Examples of Activities Greater Than 4 METs
2.1.1.3.3 Examples of Activities Less Than 4 METs
2.1.2 Surgical and Cardiac Risk Assessment
2.1.2.1 Airway Assessment
2.2 Appropriate Anesthetic Materials
2.2.1 Standard Preparation
2.2.2 Emergency Equipment/Planning for Crisis/Contingency
2.2.3 Appropriate Medications
2.2.3.1 Routine
2.2.3.2 Emergency
2.3 Possible Need for Transfusion
2.4 Perioperative/Circulator Nurse
2.5 Scrub Nurse/Scrub Technologist
References
Part II: Preparation in the Operating Room-Before Anesthesia
Chapter 3: Universal Protocol
3.1 Universal Protocol
3.1.1 Conduct a Preprocedure Verification Process
3.1.2 Mark the Procedure Site
3.1.3 Perform a Time-Out
Appendix
Speak Up™
The Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery™
Guidance for Healthcare Professionals
Conduct a Preprocedure Verification Process
Mark the Procedure Site
Perform a Time-Out
Reference
Chapter 4: Sterility
4.1 The Operating Staff
4.1.1 Attire: Clothing, Headwear, Jewelry, and Footwear
4.1.2 Hand Preparation: “Scrubbing”
4.1.3 Avoiding Hand Contamination: “Scrubbed” Hand Position
4.1.4 Hand Drying
4.1.5 OR Environment
4.1.6 Instruments
4.2 Patient
4.2.1 Preoperative Preparation
4.2.2 Intraoperative Optimization
4.2.3 Prophylactic Antibiotics
References
Part III: Preparation in the Operating Room-After Anesthesia
Chapter 5: Patient Preparation
5.1 The Airway
5.2 Tracheal Tube Security and Access
5.2.1 Endotracheal Tube Security
5.2.2 Nasotracheal Tube Security
5.2.3 Tracheal Tube Access and Visualization
5.3 Eye Protection
5.4 Ear Canal
5.5 Patient Positioning
5.6 Skin Preparation
5.6.1 Debridement
5.6.2 Solutions
5.7 Draping
5.7.1 Drapes
5.8 Tubes and Cords
5.9 Monopolar Electrocautery: The Bovie and the Grounding Pad
5.10 Intermittent Pneumatic Compression (IPC) Devices (Venodyne Boots) (Fig. 5.7)
References
Part IV: Surgery
Chapter 6: Logistics and Ergonomics
6.1 Equipment
6.1.1 Operating Table
6.1.2 Lighting
6.1.3 Team Positioning
6.1.4 Operative Assistance
6.1.5 Retraction
6.2 Instrument Selection and Passing
6.3 Hemostasis (Suctioning)
6.4 The Operation’s End
6.4.1 The Patient
6.4.2 The Instruments
References
Chapter 7: Fire
7.1 The “Fire Triad”
7.1.1 Oxidizer
7.1.2 Heat or Ignition Source
7.1.3 Fuel
7.2 Fire Prevention
7.2.1 Oxidizer
7.2.2 Heat or Ignition Source
7.2.3 Fuel
7.3 Specific Guidelines for Using a LASER [4]
7.4 Responding to an OR Fire
7.4.1 OR Fire Resources
References
Part V: The Surgeon’s Tools
Chapter 8: Surgeon’s Instruments
8.1 Cutting and Dissecting
8.2 Scalpel: Surgical Blades and Handles
8.2.1 Surgical Blades
8.2.1.1 Standard Blades
8.2.2 Knife Handles
8.3 Scissors
8.3.1 Mayo Scissors
8.3.2 Metzenbaum (“Metz”) Scissors
8.3.3 Small, Delicate Scissors
8.3.3.1 Iris Scissors
8.3.3.2 Tenotomy Scissors
8.4 Forceps
8.4.1 Toothed vs. Smooth
8.4.1.1 Toothed Forceps
8.4.1.1.1 Adson
8.4.1.1.2 Adson-Brown
8.4.1.1.3 Bishop-Harmon (“Iris”)
8.4.1.1.4 Bonney
8.4.1.1.5 Rat Tooth
8.4.1.2 Smooth Forceps
8.4.1.2.1 DeBakey
8.4.1.2.2 Nonvascular
8.5 Clamps (Locking Forceps)
8.5.1 Clamps That Secure Tissue
8.5.1.1 Allis
8.5.1.2 Babcock
8.5.2 Clamps That Crush Tissue
8.5.2.1 Jacobson (“Mosquito”)
8.5.2.2 Crile (“Snap”)
8.5.2.3 Kelly
8.5.2.4 Kocher
8.5.2.5 Mixter (“Right Angle”)
8.5.2.6 Tonsil “Schnidt”
8.6 Exposing and Retracting
8.6.1 Simple Retractors
8.6.2 Handheld Retractors
8.6.2.1 Army-Navy
8.6.2.2 Senn-Miller (“Senn”)
8.6.2.3 Hooks
8.6.2.4 Richardson (“Abdominal Wall”) Retractor
8.6.2.5 Deaver
8.6.3 Self-Retaining Retractors
8.6.3.1 Weitlaner
8.6.3.2 Gelpi
8.6.3.3 Bookwalter and Lonestar
8.7 Suctioning
8.7.1 Yankauer
8.7.2 Pediatric (“Tonsil”)
8.7.3 Frazier
8.8 Needle Holders
Reference
Chapter 9: Sutures and Needles
9.1 Sutures
9.2 Suture Diameter
9.3 Biomechanical Properties
9.3.1 Tensile Strength
9.3.2 Memory
9.3.3 Elasticity
9.3.4 Coefficient of Friction
9.3.5 Knot Security
9.3.6 Tissue Reactivity
9.4 Mono- and Multifilament Sutures
9.4.1 Monofilament
9.4.2 Multifilament
9.5 Suture Degradation
9.5.1 Absorbable
9.5.2 Nonabsorbable
9.5.3 Materials
9.5.3.1 Absorbable Suture Materials
9.5.3.1.1 Plain Gut
9.5.3.1.2 Chromic Gut
9.5.3.1.3 Vicryl (Polyglactin 910)
9.5.3.1.4 Monocryl (Poliglecaprone 25)
9.5.3.1.5 PDS (Polydioxanone)
9.5.3.2 Nonabsorbable Suture Materials
9.5.3.2.1 Silk
9.5.3.2.2 Nylon
9.5.3.2.3 Prolene (Polypropylene)
9.5.3.2.4 Polyester
9.6 Barbed Sutures
9.7 Topical Skin Adhesives
9.8 Needles
9.8.1 Suture Attachment: Needle Eye/Swage
9.8.2 Body
9.8.2.1 Needle Body Curvature (Fig. 9.2)
9.8.2.1.1 Typical Uses of Needle Body Curvatures (Adapted from Byrne and Ally)
9.8.3 Needle Point
9.8.3.1 Cutting Needles
9.8.3.2 Taper
9.8.3.3 Blunt Point Needles
9.8.4 Securing the Needle
Part VI: Surgical Devices
Chapter 10: Local Anesthetics
10.1 Local Anesthetics
10.1.1 Mechanism of Action
10.1.2 Structure
10.1.2.1 Onset of Action
10.1.3 Potency
10.1.4 Types of Local Anesthetics
10.1.5 Duration of Action (DOA)
10.1.6 Types of Nerve Fibers and Their Sequence of Blockade
10.2 Local Anesthesia and Hemostasis
10.2.1 Vasoconstrictors and Hemostasis
10.2.2 Dosing
10.3 Safety and Toxicity
10.3.1 Maximum Dosing
10.3.2 Toxicity
10.3.2.1 Central Nervous System (CNS) Toxicity
10.3.2.2 Cardiovascular Toxicity
10.3.2.3 Methemoglobinemia
10.3.2.4 Digital Ischemia
10.3.2.5 Allergic Reactions
10.4 Management of Suspected Toxicity
References
Chapter 11: Electrocautery
11.1 Electrosurgical Unit (ESU)
11.2 Monopolar Electrocautery (The Bovie)
11.2.1 Modes of Operation
11.2.1.1 Pure Cut Function
11.2.1.2 Coagulation Function
11.2.1.3 Blend-Cut Function
11.2.2 Monopolar Safety
11.2.2.1 Fire
11.2.2.2 Burns
11.2.2.3 Jewelry
11.2.2.4 Pacemaker and Internal Cardiac Defibrillator (ICD) Interference
11.3 Bipolar Electrosurgery
References
Chapter 12: Surgical Tourniquets
12.1 Use of Tourniquets
12.2 Tourniquet Application (See Video 12.1)
12.3 Tourniquet Placement
12.4 Tourniquet Guidelines
12.5 Tourniquet Effects and Complications
References
Part VII: Wound Closure
Chapter 13: Drains
13.1 Active (Suction) Drains
13.1.1 Indications
13.1.2 Function
13.1.3 Design
13.1.4 Skin Exit and Stabilization
13.1.5 Drain Removal
13.1.6 Antibiotics
13.2 Passive Drains
13.2.1 Indications
13.2.2 Design
13.2.3 Positioning
13.2.4 Drain Removal
13.2.5 Skin Immobilization
13.3 Summary
References
Chapter 14: Suture Closure
14.1 Surgical Knots
14.2 Knot Construction
14.2.1 Slip Knots and Square Knots
14.2.1.1 The Square Knot
14.3 Knot Failure
14.4 Hand Tying
14.4.1 Two-Hand Tying
14.4.2 Instrument Tying
14.5 Technical Considerations for Primary Wound Closure
14.5.1 General
14.5.1.1 Skin Markings and Temporary Closure
14.5.1.2 Suturing Techniques for Primary Closure
14.5.1.2.1 Interrupted Buried Deep Dermal Closure
14.5.1.2.2 Running Subcuticular (Intradermal) Closure
14.5.1.2.3 Continuous Percutaneous Closure
14.5.1.2.4 Simple Interrupted Closure
14.6 Skin Adhesives
References
Chapter 15: Surgical Dressings
15.1 Passive Dressings
15.1.1 Primary Dressings
15.1.2 Secondary Dressings
15.1.3 Tertiary Dressings
15.2 Interactive Dressings
15.2.1 Wet-to-Dry Dressings
15.3 Negative Pressure Wound Therapy (NPWT)
15.3.1 Basic Components
15.3.2 Mechanism of Actions of NPWT
15.3.2.1 Macrostrain
15.3.2.2 Microstrain
15.3.3 Fluid Removal from the Wound
15.3.4 Indications for NPWT
15.3.5 Contraindications to NPWT
15.3.6 NPWT Application (Fig. 15.6)
15.3.6.1 NPWT Pressure Setting
15.3.6.2 NPWT Removal
15.3.7 Potential Complications
15.3.8 Troubleshooting
15.3.9 Difficult Scenarios
15.3.9.1 Y Technique
15.3.9.2 Bridging Technique
15.3.9.3 Fecal Incontinence
15.3.9.4 Tunneling
References
Index