Rapid Perioperative Care

Paul Wicker is Visiting Professor at the First Hospital of Nanjing, China and Fellow of the Higher Education Academy, UK. Sara Dalby is Surgical Care Practitioner at Aintree University Hospital Trust, and Associate Lecturer at Edge Hill University, UK.

Preface ix

Acknowledgements xi

Abbreviations xiii

Section 1 Preoperative Preparation 1
Paul Wicker

1 The Role of the Anaesthetic Practitioner 3

2 The Role of the Surgical Practitioner 7

3 The Role of the Recovery Practitioner 11

4 Preoperative Assessment of Perioperative Patients 14

5 Perioperative Patient Care 21

6 Operating Theatre Attire and Personal Protective Equipment 27

7 Surgical Safety Checklist 29

8 Teaching Students How to Use Operating Theatre Equipment 32

9 Perioperative Equipment 37

10 Managing Perioperative Medication 41

11 Interprofessional Learning and Collaboration 46

12 Preventing Surgical Site Infection 49

13 Skin Preparation for Surgery 52

References and Further Reading 54

Section 2 Anaesthesia 65
Paul Wicker

14 Preoperative Evaluation of the Anaesthetic Patient 67

15 Preparing Anaesthetic Equipment 70

16 Checking the Anaesthetic Machine 74

17 Anatomy and Physiology: The Cardiovascular System 78

18 Anatomy and Physiology: The Lungs 82

19 General Anaesthesia 85

20 Local Anaesthesia 89

21 Regional Anaesthesia 93

22 Rapid Sequence Induction 96

23 Total Intravenous Anaesthesia (TIVA) 101

24 Airway Management 104

25 General Anaesthetic Pharmacology 109

26 Intraoperative Fluid Management 112

27 Monitoring Perioperative Patients 115

References and Further Reading 118

Section 3 Surgical Specialities 129
Sara Dalby

28 Laparoscopic Surgery 131

29 Vascular Surgery 134

30 Cardiothoracic Surgery 138

31 Orthopaedics and Trauma 143

32 Gynaecology Surgery 148

33 Plastic Surgery 153

34 Urology 157

35 Breast Surgery 161

36 Endocrine Surgery 165

37 Colorectal Surgery 168

38 Upper Gastrointestinal Surgery 174

39 Hepato-Pancreato-Biliary Surgery 178

References and Further Reading 183

Section 4 Surgical Scrub Skills 191
Sara Dalby

40 Basic Surgical Instrumentation 193

41 Surgical Positioning 196

42 Thermoregulation 201

43 Skin Preparation 205

44 Surgical Draping 208

45 Surgical Site Marking 210

46 Swab Counts, Sharps and Instrument Checks 213

47 Measures to Prevent Wound Infection 217

48 Electrosurgery 221

49 Wound Healing and Dressings 225

50 Bladder Catheterisation 229

51 Tourniquet Management 232

52 Haemostatic Techniques 236

53 Surgical Drains 241

54 Handling of Specimens 245

References and Further Reading 248

Section 5 Surgical Assisting 257
Sara Dalby

55 Legal, Professional and Ethical Issues 259

56 Surgical First Assistant 263

57 Surgical Care Practitioner 265

58 Pre and Postoperative Visiting 269

59 Retraction 273

60 Cutting of Sutures 276

61 Suture Materials 278

62 Surgical Needles 282

63 Wound Closure 285

64 Suturing Methods 287

65 Alternative Methods of Wound Closure 290

66 Injection of Local Anaesthetic for Wound Infiltration 293

67 Injection of Local Anaesthetic for Wound Infiltration – Caution and Complications 297

68 Camera Holding 301

References and Further Reading 304

Section 6 Recovery 311
Paul Wicker

69 Recovery Room Design 313

70 Patient Handover 317

71 Postoperative Patient Care 320

72 Postoperative Patient Monitoring and Equipment 324

73 Maintaining the Airway 330

74 Diagnosis and Management of Postoperative Infection 334

75 Postoperative Pain Management 337

76 Fluid Balance in Postoperative Patients 340

77 Postoperative Medications 343

78 Managing Bleeding Problems 347

79 Managing Postoperative Nausea and Vomiting 350

80 Critical Issues in Postoperative Care 354

81 Enhanced Recovery 357

References and Further Reading 362

Section 7 Perioperative Critical Care 375
Paul Wicker

82 Critical Care Nurses and Practitioners Roles 377

83 Management of the Critically Ill Surgical Patient 380

84 Malignant Hyperthermia 383

85 Inadvertent Hypothermia 386

86 Congestive Heart Failure 391

87 Venous Thromboembolism 397

88 Latex Allergy 402

89 Pressure Ulcers 406

90 Managing Diabetes in Perioperative Patients 412

91 Smoking, Alcohol and Drug Abuse 416

92 Perioperative Care of Elderly Patients 419

93 Anaemia, Coagulopathy and Bleeding 423

94 Care of Morbidly Obese Patients 426

References and Further Reading 431

Index 443