Provide tips for pre- and post-operative care…
Any surgery is not just deciding on surgery and its technicalities but equally if not more important is adequate and detailed planning and executing pre and post op care .
Pre op optimisation of patient is very important in terms of:
1.fluid electrolyte balance
2.Nutritional correction and build of of immunity
3.Physical activity including exercise to build muscle mass ( where permitted) and boosting organ functions by breathing exercises spirometry chest physiotherapy etc
4.Using medicines to reduce chances of infection as prophylactic antibiotics or treating existing source of infection .
5.Selective decontamination of gut where indicated or clearing bowels
6.Correction of Blood values eg anemia , clotting issues , protein levels etc
7.Adequate and detailed planning of surgery steps and prepare for contingencies and emergencies on table including keeping instruments , manpower, blood products , emergency meds etc
8.Mentally re running the entire surgical procedure and pre and post op checklists
POST op care must include the following:
1.Patient orientation and look
2.Vitals and stability
3.Organ Functions eg Saturation , urine output, tongue hydration , Cardiac functions, bowel movements, 3rd space losses ie unnatural swellings of body parts , pressure measurements eg CVP , BP , Abdominal, Venous pressures , MAP etc
4.Blood and radiological tests , timing, indication, interpretation and most Importantly treatment course corrections
5.Tubes surveillance eg NG tube , ET tube , Drains , Catheter , Arterial Lines , Venous Lines , Epidural Lines etc
6.Prophyalxis measures eg DVT prophylaxis, Clotting and bleeding issues , Antibiotic without unnecessary abuse , Lung care , back care , skin care , repositioning, Ambulation, Movements etc
7.Progress notes and course Correction on hourly to daily basis.