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ST2E2

QuestionAnswer
1 cm/day (rate of removal of a ___) rate to pull a PENROSE DRAIN out of a wound that it is draining
3 functions of drains Evacuate fluid, approximate tissue, prevent a potential space
4 parts of a drain Collection chamber, on/off valve (e.g. heplock), fenestrated tubing, air vent plug
2 things to check daily with a drain Signs of infection, if it’s WORKING
48 hours (wounds and drains) 1. WOUNDS: Substrate phase…..2. DRAINS: After 2 days, infection rates soar….
30 cc/24 hr (drains) When have less than this amount, can REMOVE a drain
1-3 days, 2-5 days, 2-7 days. Drain removal after these # of days for: 1-3 - POSTOP BLEEDING. 2-5 days - ABSCESS/BACTERIAL INFECTION. 2-7 days - LARGE DEAD SPACE.
16 French (usu size for_____) Usual adult size for NG tube
14-20 French (range for ___) Range NG tube sizes
Example: 21 French is the same as _______mm 7 mm
4 areas of resistance when inserting an NG tube Soft palate, crichoid area, carina, LES
100 cc/hr Basic IV fluid rate
1:1 Ratio for colloid:fluid loss replacement
3:1 Ratio for blood:fluid loss replacement
48 hours, 72 hours - time for GI function to return (after complete anesthesia) to: 48 - SMALL BOWEL PERISTALSIS. 72 - LEFT COLON.
20cc of sterile water (NG tubes) The FLUSH needed before removing NG tube to prevent drawing stomach acid into nose.
16-18 French (range for ___) Range of catheter sizes
6 hours between checking on pts ability to ______ after removing a ______. Checking on ability to urinate. Example: 12:30 complaint. 6p check with pt, or do straight cath. New foley at midnight if needed.
14ga needle, catheter unit, and a strip of tape. 2nd ICS and 90 degree angle. All for a: Needle chest compression
4th or 5th ICS. 1.5-2cm incision. All for a: Chest tube for pneumothorax, effusions.
If have less than 200 ccs for a pneumo: The chest can resolve on its own
24 hours after leaks stop, or if drainage is <200mL/24h and serous: Can remove a chest tube. NOTE: For intubated pts, leave chest tubes in until off of vent.
3 haustral markings Sign of large bowel obstruction
10-12cm (on AXR) Indicates operation of bowel obstruction – this will rekink at home!
1/3rd’s (spleen) 1/3rd of platelets stored in spleen. 1/3rd of spleen required to maintain physiologic function.
200 gm (spleen) Normal mass. >200gm is splenomegaly.
The three fifties of splenectomy complications: Pulmonary complications up to 50%. Leokocytosis in 50% of pts. Thrombocytosis (plts >400k!) in 50% of pts.
____ count of > 750k requires action! Platelets. E.g. ASA to address plt plugs.
5 steps of splenectomy PROCEDURE 1. Dissect inferior pole @ flexure… 2. Dissect splenorenal ligament, move posterior… 3. Transect @ splenic hilum, preserve pancr bl flow! … 4. Dissect short gastric using underrun… 5. Remove spleen w/ underrun and clamps.
5 steps of splenectomy PREP 1. Supine pt…. 2. Skin prep…. 3. Four squareout towels… 4. Two halfsheet drapes… 5. Final covering drape
25-60 mmHG. (esoph) Normal resting pressure of UES. Usu about 30mmHG.
20 mmHG, 0mmHG. (esoph) Normal resting pressure of LES, pressure of LES at swallowing
A 5 cm leiomyoma (cutoff between) Not problematic and problematic – it is now OBSTRUCTIVE.
A 6 cm Zenker diverticula (cutoff between) Imbrication and diverticuloplexy – both usu accompanied with myotomy
Created by: clc4711