Case Study: Rodrigo is a 57 year old man who admitted to the emergency department (ED) following a motor vehicle accident. Rodrigo was driving delivery van that was struck head on by another vehicle. Rodrigo has severe injuries to both lower extremities: (1) closed femur fracture of the left leg and (2) open fracture of the right tibia and fibula with near amputation. A chest tube was inserted on arrival in the ED. Rodrigo is neurologically intact. He is now scheduled for surgery on his legs. As you prepare for the case, the patient is brought into room. The circulator has to use a translator to help verify the patient's identity prior to placing the patient on the OR table.
Q1. A. This case represents what category of surgical intervention?
B. what is the specialty surgical classification for this case?
Q2. What is the difference between emergent and urgent surgical intervention?
Q3. What is an elective surgery? provide an example.
Q4. Consult with your instructor: Is elective surgical intervention the same thing as "minor" surgery?
Q5. As the circulator enters the room with the patient, you notice that the open fracture has an avulsion of the muscle with heavy grass and dirt contamination. As you greet the patient, a translator translates your name and greeting. The circulator is trying to assess the patient and move him over to the gurney. You need several instruments and supplies for the case and need the circulator to obtain and open them. How and when would you communicate your needs?
1. category of Surgical intervention:
A. Emergency surgery: As the patient got a Motor vehicle accident and resultant fractures , he is scheduled for the surgery to manage or treat those fractures. This should be carried out within first 24 to 48 hours of hospitalization as it is a trauma case.
B. Speciality Surgical classification of the case:
Orthopaedic trauma surgery: As the patient got fractures of left femur ( closed), open fracture of right tibia and fibula , the Doctors scheduled for the surgeries. The speciality of surgery is Orthopaedic trauma surgery.
2. Emergent and urgent surgical intervention
Emergent surgery should perform immediately to save the life of a patient or to prevent a disability, so it is also called as emergency surgery. Example: Appendicitis, trauma etc.
Urgent surgery: A surgery , that should be done ,once the patient is medically stable and the maximum time period for waiting is 2 days.
3. Elective surgery: A surgery that scheduled not in an emergency situation, but in advance . The surgery may schedule according to the convenient time for the surgeon, hospital and , patient .
Example: Cataract surgeries, Inguinal hernia surgery, Cosmetics surgery , laser Eye surgeries etc.
4. Elective surgery and minor surgery:
The term 'Elective surgery ' may apply to any surgery that is planned in an advance. It may be Minor or major surgery. Minor surgery usually do not require a penetration of body cavity and may perform superficially and there is no need for Anaesthesia, whereas Major surgery requires overnight stay, Anaesthesia, penetration of body cavity cavity etc.
Examples of Minor surgeries: Removal of warts, hemorrhoids, repair of small cuts and wounds , biopsies etc.
5. A circulating nurse is a Registered nurse, who visit the patient preoperatively , makes preparation for the operation , do patient assessment, monitor the progress of surgery and responsible for instruments and specimens.
( I ) have to communicate with circulator as soon as possible ,and can ask her to arrange the instruments for the back table. Pre operative preparation of the surgical site , and cleaning of the area has to be done before shifting the patient to Operating Room table.
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