Can't Beat the Heat
RACE stands for
RESCUE PATIENTS
ALARM - PULL FIRE ALARM
CONFINE - confine the fire
EVACUATE / EXTINGUISH
Ryanodex/Dantrolene is located in these departments at Lincoln Hospital
PACU (MH cart); 5A L&D ; 9th floor MICU
This device should be used after every procedure before wound closure with exception of waived counts
RFID Wand
These types of specimens are sent immediately after they have been excised.
Fresh and frozen section
Examples of external indicators
Color change on tape
Color change on tab dots to black
Loading sticker
Heat, Fuel, and Oxygen
Three types of anesthetic inhalants that trigger an MH crisis
Halothane, sevoflurane, isoflurane,
This is the recommended sequence of counting soft goods and instruments on the back table, unsterile/sterile fields.
operative site > mayo stand > back table > kick buckets/off sterile field.
The pink vial is used for the collection
Type and screen
Length of time for the initial scrub of the day and length of time thereafter
What is initial 5 minutes; 3 minutes thereafter
3 examples of an ignition source
laser, electrocautery, light source/camera
This is the maximum concentration of CO2 and the end of exhalation serving as indicator of ventilation and pulmonary perfusion, and metabolism. The normal range is 35-45 mmHg.
End Tidal CO2 (capnograpghy)
The green band
What is used to indicate a patient has intentional packing
Describes the process for handling the collection of an amputated limb...
1. wrap and secure specimen in a water proof material
2. place specimen order
3. place 3 id tags and surgeon to fulfill certificate
4. send to holding area to be brought to morgue
Patient Identification
Procedure
Medications
Type of anesthesia
Presence of instruments/implants
Fire Risk Score
Three risks of the fire safety score
1. surgical site or incision above the xyphoid
2. open oxygen source
3. ignition source
4. use of prep
The The Malignant Hyperthermia Association of the United States (MHAUS) hotline can be reached at
800-MH-HYPER (800-644-9737).
Identified as the different counts completed during Intra op
Initial count
Cavity count
Wound count
Skin count
Final count
Bullets and knives collected should
collected and contained by hospital police and RN to document specimen hand off in intra op notes and
All elements of a completed Surgical Consent (B1)
Procedure
Signature of patient/proxy/parent etc.
Witness
Language Interpreter
Risks and Benefits
Performing Attending Surgeon signature and ID number
Step by step process on how to manage a patient ON fire...
1. smother fire with wet towel or saline/water solution
2. stop ignition source
3. stop flow of O2 and convert to room air
4. activate code blue/call for help; charge to pull fire alarm system
These are 3 ways to manage MH crisis.
1. Pre op
2. Anesthesia machine prep
3. Manage Body Temperature
4. Capnography
5. Give Dantrolene
Prioritize the steps taken when there is a miscount or discrepancy with counts
verbal confirmation of item
notify holding area
scrub to search on sterile field
rn to search non sterile areas
scan with wand to assist with search
call xray if item not found
if item found do a recount
Steps to handle a frozen section
1. identify the specimen name and time excised
2. complete frozen section form
3. collect specimen
4. place in biohazard bag with order and label
5. Bring to holding area and communicate with charge RN
68 Degrees - 73 degrees
30% -60%