An operation is a mechanical effect on the human body with the help of special equipment and tools in order to restore his health. Therefore, preparation for the operation of both the patient and the team of doctors is necessary. All activities that take place between a person’s admission to a surgical hospital and the operation itself are called preoperative preparation.
The time that the patient spends under observation before surgical treatment is divided into two periods:
- diagnostic;
- preoperative preparation period.
Their duration depends on the urgency of the operation, chronic diseases, complications, the severity of the patient's condition, and the skills of medical personnel.
Training standard
Preparation for surgery is necessary in any case, even if the patient is urgent (i.e., emergency). It provides for the following actions:
- Twelve hours before surgery and in the morning before it, you need to wash the patient. The further processing of the surgical field depends on how clean the patient is.
- Before surgery, under general anesthesia, you need to do a cleansing enema or drink a laxative. This is necessary so that after the introduction of muscle relaxants and relaxation of the smooth muscles of the intestine, the operating room is not sterilized.
- On the day of the procedure, you can not eat or drink anything.
- More than half an hour before surgery, you must call the anesthetist for sedation.
- The main task that needs to be performed at this stage is to maximally protect both the patient and the surgeons from surprises during the operation.
Psychological training
A lot depends on how trusting the patient, surgeon and anesthesiologist are. Therefore, it is extremely important on the part of the doctor to show sensitivity, care and understanding to the patient’s situation, take time for him, explain the essence of the intervention, its stages, tell what and how it will take place in the operating room. This will help reassure the patient, give him confidence in the qualifications of the doctor and the professionalism of his team.
The surgeon needs to be able to persuade the patient to the most correct decision, because, having a lot of scattered information, it is difficult for an unprepared person to understand it. On the day of surgery, the doctor should go to his ward in the morning, find out his well-being, mood. Reassure again if necessary.
Features of the preparation of children and the elderly
Since the children's body is still growing and developing, and many systems are not fully formed, they need a special approach. First of all, it is necessary to find out the exact age and weight of the small patient (for the calculation of drugs). Prohibit parents from feeding their child six hours before surgery. Cleanse his intestines with an enema or mild laxative, and gastric surgery recommends washing. To build relationships with the child and postoperative supervision, the surgeon must work closely with the pediatrician.
For older people, the surgeon invites a therapist to consult. And already under his control prepares the patient for intervention. It is necessary to collect a complete history, make an ECG and chest x-ray. Anesthetists need to take into account the characteristics of senile physiology and calculate the dose of the drug not only by weight, but also make an adjustment for the deterioration of all body systems. The surgeon must remember that, in addition to the main one, the patient also has concomitant pathologies that require attention. As with children, it is difficult to build trusting relationships with older people.
Work algorithm
When the patient is transported to the operating room, a sister begins to conjure over him. She must prepare a workplace for the surgeon. And it always works according to one plan.
Processing the surgical field, the algorithm of which every nurse should know, begins with the preparation of tools:
- sterile dressing material;
- forceps;
- slippers and clamps;
- sterile surgical underwear, masks, gloves;
- blanks of antiseptic agents and containers for disinfection;
Before the treatment of the surgical field begins, the surgical nurse should wash her hands according to the rules of aseptic and antiseptic, put on sterile underwear and transfer all the necessary tools to the operating table.
Patient treatment
The methods for processing the surgical field may differ depending on the type of surgical intervention, but the most common option is according to Filonchikov-Grossikh. It includes four mandatory lubrication of the patient's skin with a solution of antiseptics:
- before covering with sterile linen;
- after applying operating linen;
- before suturing;
- after suturing.
Antiseptics
Antiseptics for processing the surgical field may be different. But most often it is iodonate in 5% concentration, diluted five times. Processing of the surgical field can be carried out even on dirty skin. The effect of the drug should last at least a minute.
The next remedy is iodopyron. This is a mixture of iodine and a synthetic antibacterial drug. Compared to ordinary iodine, it is easy to store, soluble in water, odorless and does not cause allergies.
And the last drug is gibitan. It is already available in the form of a solution, but before the operation it is diluted forty more times. Processing of the surgical field lasts longer, since the exposure of the antiseptic should last more than three minutes, and it must be repeated twice.
Final stage of processing
But the use of antiseptics does not end the processing of the surgical field. The algorithm should be logically completed by cleaning its workplace. For this, the nurse places all used tools and material in containers with disinfectant solutions. Then he removes rubber gloves and washes his hands under running water, according to the rules of asepsis and antiseptics.
The patient is ready for surgery, it remains only to wait for the surgeon and anesthetist - and you can start.
