Kit used to clean up Formalin spills
Spill Kit
Surgeon does this to check for bladder integrity
Backfill the bladder
Surgiflo is used for
Hemostasis
Patient patient prep
Closed leg prep-hair clipped with clipper and sticky mit to pick up loose hair.
Chg abdominal prep
Preop checklist
Etiology of Malignant Hyperthermia
MH-life threatening genetic condition characterized by a hypermetabolic state. It is triggered by inhaled general anesthetic agents.
Spill Kit location(s)
OR dirty utility (outside of OR 1)
Items needed from Omnicell to check bladder integrity
Indigo Carmine and 500 mL warmed Normal Saline
Location of Surgiflo
OR Omnicell
Two types of skin prep in OR
Duraprep-paint prep on skin.
Chloraprep-
-Scrub at the incision for 30 seconds
- Gentle, repeated strokes up the abdomen
- Use second prep on the legs and pubis area
Location of Malignant Hyperthermia cart & hotline number
PACU next to OR 1. Hotline number is listed on the side of cart along with instructions.
Formalin location
OR 1 and OR 2 in the far left cupboard, bottom shelf
Items needed to backfill the bladder
Indigo Carmine, warmed normal saline, needle, syringe, clamp (Curve/Kelly from Scrub), filter needle and IV tubing
Components of the SurgiFlo package
Thrombin, vial adapter, needle free syringe, sterile water, sterile liquid transfer cup
Preop documentation
Preop Checklist-take credit for doing the closed leg prep and CHG wipes on the abdomen.
Location of Malignant hyperthermia fluids and ice
Anesthesia workroom in main OR-cold extra IV fluids. Dietary has extra ice. Call House Manager at time of onset to help with process and send extra staff for supplies.
Supplies/PPE found in the Spill Kit
Goggles, respiratory mask, gloves, black trash bag, dust pan, broom
Before administering the fluid into the bladder, this needs to be done to the catheter drainage tubing
Clamp the tubing (At least 3 inches below the port)
Number of times to transfer syringe with sterile thrombin solution into syringe with gelatin matrix
6
Types of Surgical dressings
Primapore-24-48 hours in hospital. Not water resistant.
Mepilex Border Post-op-covers incision for up to 7 days. Water resistant. May shower with dressing on.
Mepilex AG-(has antimicrobial action)Can be worn up to 7 days postop-water resistant. May shower with dressing on.
Pico-wound vac applied in OR. Can be worn 7-10 days. For patients with high risk for SSI. Send home extra dressing, tape and give pt the battery clip.
Symptoms of Malignant Hyperthermia
Tachycardia, Arrhythmias, tachypnea, hypoxemia, muscle rigidity, profuse sweating and/or mottling of the skin, acidosis, extreme temperature elevation, hyperkalemia, cyanosis, coagulopathy, myoglobinuria (dark urine)and kidney failure.
Correct method to apply STARDUST to a formalin spill
Around the perimeter of the formalin spill
DOUBLE JEOPARDY!!
Demonstrate how to backfill the bladder
DOUBLE JEOPARDY!!
Demonstrate Surgiflo assembly as the Scrub RN
Use educational kit
Double Jeopardy!!
Demonstrate discharge instructions
Double Jeopardy!!
Look through the MH cart and familiarize yourself with the medications and contents of the cart, the hotline number and the procedural manual.