Under general anaesthesia, hypothermia occurs in three stages. In the first stage, Redistribution stage, heat redistribution is responsible for the large drop of core temperature which occurs as vasodilatation promotes the transfer of heat from the core to periphery (Singh, 2014, p. 76). The second stage, Linear stage, happens at the start of the surgical procedure as the patient is exposed to factors which cause heat loss to exceed heat production (Singh, 2014). Radiation, conduction, convection and evaporation are the four mechanisms responsible for the total cutaneous heat loss (Lobato et al, 2008). The last stage is the Plateau stage and usually develops two to four hours after anaesthesia (Lobato et al, 2008). This happens when heat production …show more content…
Anaesthesia should not be induced unless the patient is normothermic. If the patient is already hypothermic pre-induction, the thermal effect associated with anaesthesia will only exacerbate the thermal imbalance; therefore, active warming should be given. This also applies to patients who are identified high-risk or when their expected surgery time is greater than thirty minutes (John & Harper, 2014). At this stage, temperature should be monitored every half an hour until the surgery finishes (John & Harper, …show more content…
It is expected for nurses to be able to assess the early signs of hypothermia and implement prevention and treatment strategies; therefore, nurses should have the knowledge of the recommended practice guidelines for the prevention and treatment of hypothermia. Part of the goal is to reduce the time that patients spend in the PARU (Cooper, 2006).
The PARU Nurse monitors the patient in the immediate post-operative period in accordance with the type of anaesthesia and surgery the patient has undergone. The PARU Nurse assesses and documents vital signs including blood pressure, heart rate, oxygen saturation, respiratory rate and temperature. These must be continually checked along with the patient’s level of consciousness, pain score, nausea/vomiting, bleeding, fluid balance and urine output. These clinical observations should be recorded every 10 minutes (Carr & Cairns,
Inadvertent perioperative hypothermia is a common anesthesia-related complication with reported prevalence ranging from 50% to 90%.(ref 3,4 of 4) The clinical consequences of perioperative hypothermia include tripling the risk of morbid myocardial outcomes and surgical wound infections, increased blood loss and transfusion requirements, and prolonged recovery and hospitalization.(ref 5)
This essay describes how the anaesthetic machine and airway management equipment are prepared in operating theatres and discusses how they are ensured safe for use. It evaluates the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines related to safe practice and the preparation of the ET tubes, laryngeal masks, guedels, Naso pharyngeal airways and the laryngoscope. The function of the anaesthetic workstation is to deliver a mixture of anaesthetic agents and gases safely to the patient during the induction process and throughout surgery. In addition, it also provides ventilation to support breathing and monitors the patient’s vital signs to minimise the anaesthetic risks to the patient whilst in the care of health professionals. The pre-use check is vital to patient safety as an inadequate check of the anaesthetic machine or airway management equipment can and does lead to significant harm of the patient including mortality (Medicines and Healthcare Products Regulatory Agency (MHRA), 2008 and Magee, 2012).
There are numerous risks for a patient during the preoperative stage of the perioperative journey. All patients undergoing a surgical procedure are at risk of developing perioperative hypothermia, although there are various factors which also further increase an individual’s susceptibility (Burger & Fitzpatrick, 2009). An individual’s body type can cause them more susceptible to heat loss during the perioperative period. The patient’s nutritional state and being malnourished, if the individual is female and is of low body weight therefore a high ratio of body surface area to weight and limited insulation to prevent heat loss, these are all factors which negatively affect heat loss and therefore increasing the individual’s risk of perioperative hypothermia (Lynch et al.,
Breathing is the most important AL (Roper et al, 1998). A detailed assessment of her airway would be performed because protection of the airway throughout anaesthesia is essential (Yates, 2000). This does not just include recording of respiration rate and oxygen saturation (SpO2) but also noting any use of accessory muscles, shortness of breath, auscultation of chest and lungs areas for wheezes/crackles and asking patient about history of any respiratory illness/smoking (McArthur-Rouse, 2007).
and giving medicine and IVs. A RN makes sure the patient has knowledge of their situation and
American Association of Nurse Anesthetists. Professional Aspects of Nurse Anesthesia Practice. Philadelphia: F. A. Davis Company, 1994. Print.
When I see a patient before they go into an operation, I like to speak to them to make sure they have an understanding of what surgery will be performed and what the process will be in regards to transporting them from the pre-operative area, to the operating room, and then to the recovery area. The environment of the operating room can be a scary place for patients, it is a cold, bright room with lots of equipment in it that patients have probably never seen before. I like to explain to my patients what the room will be like and let them know I will be with them the whole time if they need anything. The main topic is usually the temperature of the room, approximately 65 degrees, so I like to make sure the patients know we will have warm blankets waiting for them. Whether the surgery being performed is diagnostic or therapeutic, I like to be sure the patient has an understanding of what is being done for their health. I am very proud of being a nurse and do my best to be sure my actions prove it. I strive to do the best for my patients since one of the many responsibilities of being a nurse is to be their advocate, which I take very seriously as my patients cannot usually speak for themselves as they are under
Anesthesia is used in almost every single surgery. It is a numbing medicine that numbs the nerves and makes the body go unconscious. You can’t feel anything or move while under the sedative and are often delusional after being taken off of the anesthetic. Believe it or not, about roughly two hundred years ago doctors didn’t use anesthesia during surgery. It was rarely ever practiced. Patients could feel everything and were physically held down while being operated on. 2It wasn’t until 1846 that a dentist first used an anesthetic on a patient going into surgery and the practice spread and became popular (Anesthesia). To this day, advancements are still being made in anesthesiology. 7The more scientists learn about molecules and anesthetic side effects, the better ability to design agents that are more targeted, more effective and safer, with fewer side effects for the patients (Anesthesia). Technological advancements will make it easier to read vital life signs in a person and help better decide the specific dosages a person needs.
The nature of the work is very similar for the C.N.A. and L.P.N. A C.N.A. work includes performing routine tasks under the supervision of nursing staff. They answer call bells, deliver messages, serve meals, make beds, and help patients eat, dress, and bathe. Aides also provide skin care to patients, take pulse, temperature, respiration, and blood pressure and help patients get in and out of bed and walk. They also escort patients to operating rooms, exam rooms, keep patient rooms neat, set up equipment, or store and move supplies. Aides observe patient’s physical, mental, and emotional condition and report any change to the R.N. Likewise the L.P.N. provides basic bedside care. They take vital signs such as temperature, blood pressure, restorations, and pulse. They also treat bedsores, prepare and give injections and enemas, apply dressings, apply ice packs and insert catheters. L.P.N.’s observe patients and report adverse reactions to medications or treatments to the R.N. or the doctor. They help patients with bathing, dressing, and personal hygiene, and care for their emotional needs.
Traditionally nurse’s role in evaluating a patient has to record the observations made but not to interpret them. The main observation includes pulse, temperature, rate of respiratory, blood pressure and consciousness level (Alice, 1985). The ability of nurse to record such observations accurately will determine the priority of the patient care. Assessment based on priority setting is one of the major skills that nurses that are newly fit may lack. Th...
Time out was done by the anesthesiologist, the circulating nurse, the surgeon, and the scrub tech all pausing before the surgery and verifying the patient’s name and date of birth, the procedure being done, the site and location on the body in which the procedure was being done, and documented the count of all the equipment the scrub nurse had before surgery to compare to after surgery. 5. The patient’s privacy was protected and respected throughout the whole surgical procedure. The staff was very professional and I felt I learned a lot from them during my OR experience. 6. A sponge count is when the scrub nurse counts the sponges that are unused before the surgery she relays this to the circulating nurse and it is documented. After the surgery the count is redone to make sure that there are no sponges left in the patient. 7. The circulating nurse documents the information and signs the chart in the operating room. From pre-op to the operating room the nurses in pre-op gave off report to the circulating nurse by SBAR. From the operating room to PACU the anesthesiologist went with the patient and handed off the patient’s condition and information to the nurse in there. 8. There were no ethical or legal issues that were raised during my observation in the whole surgical process. 9. I learned how the whole operating procedure works from start to finish, all the legal paperwork involved, and how the team interacts and helps each other out to give the patient a safe and
Therapeutic hypothermia has been an identified intervention that will slow the inflammation process and improve neurological outcomes for patients experiencing out of hospital cardiac arrest (Bernard et al., 2010). Therapeutic hypothermia is defined as the controlled induction of reducing a patient’s core body temperature below 34° C while managing the body’s compensatory mechanism by prevent shivering (So, 2010). The integrity of the process is the accurate measurement of the core body temperature, which can be obtained if the probe is place in the central venous, bladder, rectal, or esophageal (So, 2010). Therapeutic hypothermia occurs in the following phases: induction, maintenance, and rewarming (Deckard & Ebright, 2011). The induction phase begins when a health care professional lowers the patient’s core temperature to the target temperature. (Deckard & Ebright, 2011). Cooling methods include a combination of external cooling methods such as, surface cooling with ice packs and cooling blankets, as well as internal cooling methods such as, catheter-based technologies for the infusion of cold fluids (Mooney et al., 2011). During the induction phase it is important for the nurse to pay close attention to the patient’s blood pressure and fluid balance, as
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).
Age is a factor that can influence the temperature as old people tend to have a lower body temperature due to being less active and due to the lack of the fat layer below the skin which makes it hard to indicate the presence of an infection ( Medline plus 2015 ). the body temperature is Also higher in the evening then in the morning (Marieb & Hoehn 2010, cited in Dougherty & Lister 2015). Another factor that can influence the body temperature is food consumption including coffee and alcohol or the amount of exercise done (Marieb & Hoehn 2010, cited in Dougherty & Lister 2015). The body surface that is exposed to the environment like cold or heat for example when having a shower or wearing inappropriate clothing ( Wilson's Temperature Syndrome 2016) .As a non-invasive method temperature measurement can be performed using different sites like oral, axillary and tympanic. The rectal has been demonstrated to be the more accurate one but due to his invasive nature and the fact that not only dignity but also privacy of the patients need to be considered , it is not always the first choice. Therefore, although the ear canal route does not provide the most accurate reading as the procedure might not be performed correctly , the tympanic thermometer tents to be preferred not only by the nurses but also by the patients as it is non-invasive, easy to use, safe (Haugan et al. 2013) and the disposable cover is used for prevention and control of infection( Dougherty & Lister
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.