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24 - Immediately after the operation
Published online by Cambridge University Press: 18 December 2009
Summary
At the end of any operation, the author's first inclination is to bolt to the tea-room at the earliest opportunity, and eat all the muffins before someone else does. However, it is best not to do this too often because it will certainly be noticed, even if it is not commented upon.
Instead, it is better to help with some of the innumerable small jobs to be done after any operation. Put the X-rays back in their packet, ideally in their proper order. Help wheel in the patient's bed, and help transfer the patient onto it from the operating table, especially if he or she is heavy. Fill in forms, such as histopathology request forms or audit forms. In a day-surgery unit, you may write a short discharge summary or coding report.
It is possible you may prescribe the patient's drugs or non-drug treatment orders. In this setting, drugs may be classified into the patient's usual medications (e.g. antihypertensives), and additional or alternative medications he or she may need perioperatively. Regarding the patient's usual drugs, it is very important to note that some should be continued, some temporarily withheld, and others given in a modified form. As examples, typically antihypertensives are continued, anticoagulants are temporarily withheld, and oral hypoglycaemics are replaced by subcutaneous insulin. Additional drugs may include antiemetics, analgesics, antibiotics, and prophylactic anticoagulants, such as subcutaneous heparin injections. Intravenous or other fluids may also be placed in this category.
Non-drug treatment orders include observations (routine including heart rate, blood pressure, respiratory and temperature or ‘special’ observations such as neurovascular observations), fasting status, drain management, special requirements for positioning the patient, and coughing and breathing exercises.
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- Assisting at Surgical OperationsA Practical Guide, pp. 189 - 191Publisher: Cambridge University PressPrint publication year: 2006