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Acknowledgments
Contents
RCSI
Department of Surgery
Beaumont Hospital
2001
Dr Molly Eng - Mr G. McGreal - Mr S. Tierney - Mr A. Ireland - Prof D.B. Hayes
Acknowledgments
Contents
Surgical Management Strategies
Hazard Areas
Abdominal Aortic Aneurysm
Upper Gastrointestinal Haemorrhage
Shock
Head Injury
Important associations
Transfers
Check lists upon accepting transfers
Trauma patients
Splenectomy
Immunoprophylaxis in elective splenectomy
Immunoprophylaxis in emergency splenectomy
Communication and Surgical documentation
Communication with patients
Consent
Communication amongst colleagues
Daily ward rounds
Military approach
Notes
Social history
Rectal examination
Operative Notes
Operative Note:Varicose Veins
Operative Note:Appendisectomy
Flow charts (Available on ABC ward)
Communication with GPs at the time of patient discharge
Hand written
Telephone
Fluid and Electrolytes
Requirements: Volume
Requirements: Electrolytes
Administration fluid guidelines
Specific replacement fluids of specific losses
Common Clinical Care of Surgical Patients
History taking
Intestinal Obstruction
Pancreatitis
Smoker and C
H
OH Dependence
C
H
OH
Tobacco
Urinary Catheterisation
Nasogastric drainage and feeding tubes
Complications of naso gastric tubes
Medical problems in surgical patients
Chest Pain
Respiratory distress
Hyperkalaemia
Hyponatreamia
Confusion
Preoperative Care
Consent
Consent:Varicose veins
Consent:Peripheral Bypass
Consent:Abdominal Aortic Aneurysm
Consent:Carotid Endarterectomy
Consent:Laparoscopic cholecystectomy
Inform Relatives
Anaesthetists
Test Results
X-Rays
Blood
Frozen section
Evaluation Preop
Operative
DVT Prophylaxis
Timing of Enoxaparin administration
Exceptions
Dangerous Drugs
Aspirin, Plavix
The pill, HRT
Monoamine oxidase inhibitors
Antibiotic Prophylaxis
Note
Blood ordering schedule
Vascular Surgery
Femoral angiograms, work-up
Vascular Bypass Operations - Fem/Pop/Distal etc.
Abdominal Aortic Aneurysm repair
Carotid Endarterectomy
Varicose veins
AV Fistula
Embolic screen
General Surgery
Biliary Surgery
Laparoscopic Cholecystectomy
Non jaundiced patients
Jaundiced patients
Thyroid Surgery
Thyrotoxic patients
Parathyroid Surgery
Colorectal Surgery
Preparation for Colonoscopy and Colonic Surgery
Stomas
Antibiotic Prophylaxis
Herniorrhaphy
Neck Surgery
Laparoscopic Nissen's
Lobectomy / Pneumonectomy
Esophagectomy
Breast Surgery
Preoperative Checklists
Day Care Unit
Day Care Anaesthesia guidelines
Suitable patients
Hypertension
Ischaemic Heart Disease NYHA grade 1
Asthma/COAD
Epilepsy
Unsuitable patients
Preoperative Investigations
Routine (asymptomatic patients)
Additional tests for patients with known systemic disease
Preoperative medications
Operating Theater
Operating Lists
Order of patients on theater list (generally)
Indicate side
SHOs in the Operating Theater
Postoperative Care
IV Fluid Orders
Fluid Challenge
Analgesics
Central Venous Lines
Line insertion
Catheter-Related Sepsis
Protocol for suspected catheter-related sepsis
Evaluation of Postoperative Fever
Differential Diagnosis
Fever pattern
Timing of fever
Investigations
Important points
Management of peri-operative anticoagulation
Treatment of proven DVT or PE
Heparinisation
Protamine Sulphate Usage
Warfarinisation
Tinzaparin (
Innohep
)
Postoperative Checklists
Special Topics
Iloprost infusion
Drug Dilution
Use with Infusion Pump
Dose titration : Day 1,2 and 3
Commonly occurring Side Effects
Recommended duration of treatment
Surgery in the Diabetic Patient
Exceptions to above
Care of Amputation Sites
Indications for Insertion of Greenfield Filter
Guidelines for Muscle Biopsy
Nutrition and Dietetic
Monitoring of patients on TPN
Adrian P. Ireland
H
OH Dependence