By way of explanation, These links are summed up by me according to my working experience. It is not a uniform standard in the industry, I may have missed some important steps because they were too routine. I hope people in the industry can help me supplement. I am divided into three parts: preoperative, intraoperative and postoperative. First, preoperative 1. Hospitalization for hospitalization procedures, allocation of beds, The first-line bed doctor will meet with you, According to the medical records, we will make detailed inquiries. Doctors will make rounds every day. Some departments check twice in the morning and evening. 2. Preoperative examination This is a basic examination of the patient’s physical condition. In order to judge whether the patient has the operation conditions, Let doctors also have a number in their hearts. Specific items include: Chest radiograph, electrocardiogram, blood routine, urine routine, fecal routine, blood biochemistry, tumor markers, coagulation function, serum eight items, blood type. Focus on serum eight items, Including hepatitis B, two-and-a-half and five items, Add AIDS, syphilis and hepatitis C. If the patient carries these viruses, While preparing for the O.R., It should be treated differently from ordinary patients, For example, all disposable tools should be used. In addition, the medical staff involved in the operation should be informed. Let them take precautions. 3. Talk before surgery. The day before surgery, The doctor will talk to the family, Please ask the family members to sign the informed consent form. This process is guaranteed by law. This document must be signed before any surgery. If the surgery is completed without a signature, Even if the operation is successful, Doctors should also bear the responsibility. The preoperative conversation will inform the family members of the necessity of the operation, the operation process, the expected effect after the operation, the operation risks and other matters. With the tension in the doctor-patient relationship in recent years, The risk of surgery is getting more and more attention. In fact, Informed consent is not what many people think, It’s a doctor’s disclaimer, It is only used to protect the right to know of patients and their families, There was a medical accident during the operation, Doctors are still responsible. The main controversy now is that The complications caused by non-human factors during the operation led to serious consequences. The patient’s family did not understand, Even if the complication is clearly stated on the informed consent form, They will also sue the doctor for not explaining it to them in the preoperative conversation. In order to prevent this situation, Many hospitals now make audio and video recordings of preoperative conversations. In addition to the surgeon’s conversations, Anesthesiologists will also visit the ward for preoperative visits. Usually we hope that the patient himself and at least one family member who knows everything about the patient will be in the ward from noon to night the day before the operation. 4. Prepare for the day before the operation. In order to facilitate the operation, The nurse will perform necessary treatment on the patient, such as skin preparation, Is to shave off the epidermis of the operation area, Brain surgery shaves your hair, Chest surgery shaves chest hair, Lower abdominal surgery shaves pubic hair. For example, Larger abdominal surgery will prepare the patient’s intestines and stomach, It is to take laxatives to have diarrhea until all the water comes out. This is to prevent intestinal leakage and feces from polluting the abdominal cavity during the operation. By the morning of the operation, The nurse inserts a gastric tube through the patient’s nasal cavity, Mainly to prevent things in the stomach from flowing back into the trachea after surgical anesthesia. After the gastric tube is inserted, The nurse will push the patient into the operating room. Second, during the operation 1. Operating room staffing the standard configuration of surgical medical personnel is: One surgeon, one assistant, one assistant, one anesthesiologist, one instrument nurse and one itinerant nurse. If it is a more complicated operation, There will be more assistants and nurses. To explain, The nurse who specially wipes the doctor’s sweat on TV is not available. If the doctor does sweat, the itinerant nurse will come and wipe it. 2. When the operating bed is first pushed into the operating room, there are nurses and anesthesiologists inside. The nurse will let the patient lie on a very narrow bed, which is the operating bed. Why can’t it be wider? Because if it is too wide, The doctor will lean forward when operating, Not convenient. After that, the nurse will ask you to take off your clothes. Don’t be shy, Everyone has seen more. In this bed, You are a pile of meat in the eyes of doctors and nurses, There is no social attribute. 3. After surgery, anesthesia and bed, Anesthesia is coming. The two common anesthesia are spinal anesthesia and general anesthesia. Surgery below the waist, Such as caesarean section, You can use [spinal anesthesia], This is called subarachnoid anesthesia. This anesthesia only loses consciousness below the waist. Consciousness is still clear. You can’t use this anesthesia any more, Because it inhibits breathing in the lungs. Most major operations are performed under general anesthesia. After going to bed, The anesthesiologist will say [give you a small needle], Is to establish a venous pathway, For infusion. Then an oxygen mask will be put on the nose and mouth. After that, I’ll let you get dozens of times. At this time, He has pushed the intravenous anesthetic through the venous passage just now, Within 10 seconds, You will be unconscious. So, In the memory of most patients, Is to count to five, six, Then someone called his name, And in this middle [disappearing] period, The paramedics have completed an operation. 4. Anesthesia aids After the patient loses consciousness, Anesthesiologists do tracheal intubation. Actually, After intravenous anesthesia helps the patient to enter a state of anesthesia, The subsequent anesthesia is completed by combining the anesthetic gas injected through the trachea with intravenous anesthesia. This is because, Intravenous anesthesia has certain risks, May inhibit the patient’s breathing, After tracheal intubation, oxygen and anesthetic gas will be inhaled. This risk is eliminated. After that, A central venous pathway is usually established at the root of the patient’s neck, Or an arterial access, This allows continuous detection of the circulatory system during the operation. Then, The nurse will insert a catheter into the patient. Previously, this step was completed before entering the operating room. Patients will feel pain and embarrassment. Now, Many hospitals have raised their awareness of human care, All of them were performed after anesthesia. 5. The operation was officially started and the preparations were completed. First and second aid came on, Do some preparatory work such as skin opening, laparotomy and dissociation. After that, The main knife came on stage ceremoniously, Complete the key steps with the cooperation of the first aid. After the completion, the main knife will give up the curtain call. First aid, second aid and then close the abdomen, sew skin, Retreat. Anesthesiologists pull out tracheal intubation and monitoring equipment, Also retreat. The nurse moved the patient from the operating bed to the cart. Push out the operating room. Third, if the operation is relatively large after the operation, Patients after the operation will be pushed into ICU for observation for several days. Because the ICU equipment is monitored 24 hours a day, If there is a problem, Someone will deal with it soon. After the operation, The bed doctor (usually the second assistant during the operation) will accompany the patient. Call the patient to wake up. When I first woke up, The patient will feel groggy and want to sleep, But the doctor won’t let you sleep, Will talk to you all the time, I want you to respond, Because it is very likely that there is a what problem. After the operation, The anesthesiologist did not withdraw immediately after pulling out the tube and withdrawing from the monitoring. Instead, they work with the workers to safely send the patients to the recovery room, ICU or ward and receive monitoring. Only when they are safe can they leave the patient. Some hospitals stipulate that, O.R. Nurses are also taking patients. On the first day after surgery, It is often the most painful day for patients, Because the wound on this day is the most painful. Generally speaking, Doctors will give patients some pain-relieving drugs to relieve them. There are also some operations to prevent bacterial infection. Some antibiotics will also be dripped intravenously. If it is abdominal surgery, Whether it’s gastrointestinal surgery, Or hepatobiliary surgery, Or gynecologic surgery, The nurse will pay close attention to the patient’s exhaust (fart) after the operation. Because a few days after the operation, The gastrointestinal tract will not peristalze as normally as before, A recovery process is required, Exhaust is a sign of recovery. Before exhausting, Patients can’t eat, if it is gastrointestinal surgery, even can’t drink water. If the patient has no abnormality after the operation, it will enter the recovery period. According to the recovery progress, the doctor will gradually pull out the gastric tube, urinary catheter, drainage tube (if any), venous catheter (that is, the channel of infusion), and remove the suture. After that, you can recover and be discharged from the hospital.
