Always carry your Scalpel

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SMACC Conference

This document discusses various surgical procedures that may need to be performed in emergency situations, including surgical airways, open thoracostomies, lateral canthotomies, escharotomies, field amputations, clamshell thoracotomies, and perimortem hysterotomies. It provides tips for performing these procedures and emphasizes having the necessary skills and equipment prepared in case an infrequently performed life-saving procedure is needed. Cognitive preparation is important as some of the procedures are not visually guided. Potential outcomes and complications are also addressed.

Gesundheit & Medizin Technologie Business

Disclosures

courtesy http://www.ranulphﬁennes.co.uk

Always Carry Your Scalpel
Brian Burns

Procedures
Are sometimes performed infrequently

by Fiona Reardon

Life saving
YOU MUST PREPARE FOR THESE PROCEDURES
Cognitive hurdle

Surgical Airway

courtesy jack milenius

Surgical Airway

courtesy jack milenius

SURGICAL AIRWAY is
NOT a VISUAL procedure

SURGICAL AIRWAY is
NOT a VISUAL procedure
DECIDE

SURGICAL AIRWAY is
NOT a VISUAL procedure
DECIDE
LOCATE

SURGICAL AIRWAY is
NOT a VISUAL procedure
DECIDE
LOCATE
INCISE

SURGICAL AIRWAY is
NOT a VISUAL procedure
DECIDE
LOCATE
INCISE
FEEL

SURGICAL AIRWAY is
NOT a VISUAL procedure
DECIDE
LOCATE
INCISE
FEEL
BOUGIE

SURGICAL AIRWAY is
NOT a VISUAL procedure
DECIDE
LOCATE
INCISE
FEEL
BOUGIE
TUBE

SURGICAL AIRWAY is
NOT a VISUAL procedure
DECIDE
LOCATE
INCISE
FEEL
BOUGIE
TUBE
ETCO2

Surgical Airway - tips

Open thoracostomy

courtesy BMJ

Sight Saving Procedure

Lateral Canthotomy

Lateral canthotomy-tips

Escharotomy

Field Amputation

Field Amputation

Clamshell thoracotomy

Indications
Contraindications

Clamshell
Thoracotomy

Possible Outcomes….

courtesy London HEMS

Clamshell thoracotomy-TIPS

courtesy London HEMS

Things to avoid….

Perimortem hysterotomy

Cardiac arrest > 24 weeks gestation
<5 minutes to deliver baby from cardiac arrests
Takes 1 minute, hence start at 4 minutes after arrest

Perimortem hysterotomy

Cardiac arrest > 24 weeks gestation
<5 minutes to deliver baby from cardiac arrests
Takes 1 minute, hence start at 4 minutes after arrest
dogma ?

Perimortem hysterotomy

Scalpel & Scissors

Perimortem hysterotomytips
Umbilicus =20 w. 1 week/cm above that
Don’t stop chest compressions
Cut around the umbilicus

Things not cool with a
scalpel
cutting yourself during procedure
cutting the pilot tube of an ETT instead of trachy tape
NOT using it when indicated
forgetting to bring your scalpel

Thank you !

Always carry your Scalpel

Always carry your Scalpel

Always carry your Scalpel

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ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx

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ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx

In this captivating lecture, Dr. Faiza, an esteemed Assistant Professor of Physiology, embarks on a comprehensive journey into the multifaceted realm of local blood flow regulation. With meticulous detail and clarity, she unravels the intricate mechanisms that govern the dynamic balance between tissue perfusion and vascular resistance, shedding light on both acute and chronic aspects of blood flow control. Beginning with an exploration of acute influences, Dr. Faiza elucidates how physiological factors such as metabolic demand, myogenic responses, and autoregulatory mechanisms orchestrate rapid adjustments in local blood flow. Students gain insight into the vasodilator theory, which elucidates the role of metabolic byproducts and vasoactive metabolites in promoting vasodilation, alongside the oxygen demand theory, which underscores the interplay between tissue oxygenation and nutrient demand. Delving deeper, the lecture delves into the fascinating realm of humoral control, where hormones and vasoactive substances wield significant influence over vascular tone. Dr. Faiza navigates through the intricacies of endothelial-derived factors like nitric oxide (NO) and histamine, alongside hormonal regulators such as angiotensin II and vasopressin. Through vivid explanations and illustrative examples, she unveils the intricate dance of vasodilation and vasoconstriction orchestrated by these biochemical messengers. Moreover, the lecture extends its gaze to the extrinsic control of blood flow, where sympathetic innervation exerts a profound impact on vascular dynamics. Dr. Faiza elucidates the role of sympathetic tone in modulating vascular resistance, highlighting its implications in diverse physiological and pathological scenarios. From skin perfusion to coronary circulation, students gain a nuanced understanding of how neural inputs shape local blood flow patterns. Enriched with clinical insights and contemporary research findings, this lecture equips students with a holistic understanding of blood flow regulation. By exploring concepts like active and reactive hyperemia, vascular remodeling, and collateral circulation, Dr. Faiza fosters a deeper appreciation for the adaptive responses of the cardiovascular system to changing physiological demands and pathological insults.

Control of Local Blood Flow: acute and chronic

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Electrocardiogram (ECG) physiological basis .pdf

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ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx

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Control of Local Blood Flow: acute and chronic

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Always carry your Scalpel

1. Disclosures courtesy http://www.ranulphﬁennes.co.uk

2. Always Carry Your Scalpel Brian Burns

3.

4. Procedures Are sometimes performed infrequently by Fiona Reardon Life saving YOU MUST PREPARE FOR THESE PROCEDURES Cognitive hurdle

5. Surgical Airway courtesy jack milenius

6. Surgical Airway courtesy jack milenius

8. SURGICAL AIRWAY is NOT a VISUAL procedure

9. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE

10. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE

11. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE

12. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE FEEL

13. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE FEEL BOUGIE

14. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE FEEL BOUGIE TUBE

15. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE FEEL BOUGIE TUBE ETCO2

16.

17.

18.

19. Surgical Airway - tips

20.

21. Open thoracostomy

22.

23.

24. courtesy BMJ

25.

26.

27. Sight Saving Procedure

28.

29. Lateral Canthotomy

30. Lateral canthotomy-tips

31. Escharotomy

32.

33. Field Amputation

34.

35.

36.

37. Field Amputation

38. Clamshell thoracotomy Indications Contraindications Clamshell Thoracotomy

39.

40.

41.

42.

43. Possible Outcomes….

44. courtesy London HEMS

45. Clamshell thoracotomy-TIPS courtesy London HEMS

46. Things to avoid….

47.

48. Perimortem hysterotomy Cardiac arrest > 24 weeks gestation <5 minutes to deliver baby from cardiac arrests Takes 1 minute, hence start at 4 minutes after arrest

49. Perimortem hysterotomy Cardiac arrest > 24 weeks gestation <5 minutes to deliver baby from cardiac arrests Takes 1 minute, hence start at 4 minutes after arrest dogma ?

50. Perimortem hysterotomy Scalpel & Scissors

51. Perimortem hysterotomytips Umbilicus =20 w. 1 week/cm above that Don’t stop chest compressions Cut around the umbilicus

52. Things not cool with a scalpel cutting yourself during procedure cutting the pilot tube of an ETT instead of trachy tape NOT using it when indicated forgetting to bring your scalpel

53.

54.

55. Thank you !