Surgical emergencies
The number to call for codes at CRH.
What is 3333?
Information you must write on the TSIN wrist band insert.
What are date and month of TSIN blood draw?
Has multiple names like Crile or snap but is called this on our count record.
What is hemostat?
This safety item should always be applied on a patient, especially during induction and emergence.
What is a safety strap?
Reasons why you may not need a full cavity count even when a full initial count was required.
What is the incision was not extended - too small to lose anything, or the cavity was not entered?
To prepare to perform this lifesaving intervention, you need to, as applicable: remove surgical instruments, pack & cover the wound, and ensure the patient is in supine position.
What is BLS- chest compressions?
A product from TM for fibrinogen replacement that does not need freezing or refrigeration.
What is RiaSTAP?
Instrument that when attached to cautery is often used in a lap chole to dissect the gallbladder off of the liver bed.
What is the L or J hook?
These may happen during preparation or administration, and are usually due to human error, poor labelling, or communication failures. Examples include wrong route, and wrong time...
What are medication errors?
The minimum number of counts required for a laparotomy.
What is 3 - initial - full, cavity - full, and skin - partial?
The drug to give and loading dose in a Malignant Hyperthermia crisis- for the majority of our patient population.
What is Dantrolene 2.5mg/kg?
What are transfusion tags?
These must be carefully placed back in their original container (preferably with lid on) with nothing heavy on top of them. Cords can be loosely coiled in the basin if they don’t easily fit in the original container.
What are scopes- omni / hysterscopes, laparoscopes, cysto / ureteroscopes, ent scopes, arthroscopes…?
The three times we use the Safe Surgery Checklist during every surgery.
What are: before anesthesia (briefing), before incision/ procedure start (time out), before patient leaves the room (debriefing)?
NV (not visualized) can be used only during these types of closing counts and must be reconciled in subsequent counts.
What are relief and cavity within a cavity counts.
Anesthesia room, medication cart, bottom right drawer- white liquid in IV bag.
Where I find lipids for LAST? (Local anaesthetic systemic toxicity)
We don’t need a full MHP- but we require emergent RBCs for our patient who does not have a valid T&S. The is the first step to order these emergent units.
What is call TM at 6050 and state urgent need for uncrossmatched RBCs?
The “lobster claw” and “pointy” ones in my Synthes small frag set may not be sufficient for the surgeon's needs - this set will give me more options.
What is the bone reduction set?
The reason this MIFU says to wait 3 minutes minimum and up to 1 hour before draping.
What is the dry time for Chloraprep - to prevent trapping flammable fumes?
The final count is not considered complete until this is done.
What is: all sharps are removed from instruments and contained in the needle counter?
Calm, organized, closed loop- with a defined leader.
What is the type of communication and team dynamics required in an emergency situation?
Transfusion tag matches patient ID and TSIN bands, component/product number, ABO Rh on component; ABO Rh is compatible with patient; item is not expired; item passes visual inspection; it is the item ordered.
What are things to check while verifying blood with a 2nd healthcare provider?
When the chest saw doesn’t work / isn’t available, I can open this set for these two items for the surgeon to “crack the chest”.
What is the Thoracotomy extras set - for the Lebsche knife and mallet?
First aid for formalin exposure through the eyes, skin, inhalation, or ingestion.
What is: skin - remove contaminated clothing- wash with soap and water - get help if irritation persists; eyes- flush with water for 15 minutes - get help; lungs - get to fresh air immediately - may require oxygen - get help; digestive system - do not vomit unless directed to do so - rinse mouth with water - get help?
The three most common reasons why an item may be counted in surgery.
What is: to prevent unintentionally retained foreign objects, to prevent loss of instruments, and sharps safety?