Procedure Before prep Ensure their chest and whole legs are shaved including the groin. Ensure patient is supine, and the pelvis and the shoulders are square from the end of the table. The urethral catheter is taken under the thighs and hung on the side. If the patient has an intra-aortic balloon pump, ensure it…
Author Archives: JG
Instruments Scalpels with holders – sizes 11, 20 Swabs Forceps – toothed and non-toothed Needle-holder Diathermy – monopolar/bipolar, 8 Retractors – self-retaining (West), Langenbeck Sutures – absorbable 2-0, non-absorbable for skin Tape for securing tracheostomy tube Tracheostomy tube and connector Suction – Yankauer, Frazier Procedure Patient is supine with sandbags under shoulders to extend neck.…
Instruments Retractors – sternal, double hooks Diathermy – monopolar, setting 7 Swabs – large and small Suction – Yankauer Forceps – toothed, non-toothed Artery forceps – Kocher’s Wire-cutter Needle-holder – heavy for wires and wire-twisting, other for skin Sutures – steel wire for sternum, absorbable for skin Procedure Haemostasis in the pericardial cavity is achieved…
Instruments Marking pen Size 20 scalpel blade and holder Diathermy – monopolar, setting 7, ball and short spatula ends Forceps – non-toothed Swabs – large and small, large towels Sucker – Yankauer Sternal reciprocating saw Sternal retractor Bone wax Procedure Marking the midline. Find the sternal notch, angle of Louis and the xiphisternum and visualise…
Instruments Size 20 scalpel blade and holder Scissors – Mayo (curved and straight), Mcindoe Forceps – toothed, non-toothed Silk ties – 4-0, 2-0 Small artery forceps Swabs Ligaclip handle and clips – small (blue) Bipolar diathermy – setting 7 20ml syringe with cannula Heparinised blood 50 ml West self-retaining retractor for large subcutaneous layers Procedure Position…
Take-away point: Deaneries should publish their study budget utilisation for prospective trainees to factor in when choosing their posts. There is a wide variation between study leave budgets and policies between deaneries across the UK. Although a requirement of 30 days of study leave is widely accepted (see BMA advice: http://bma.org.uk/practical-support-at-work/contracts/leave/study-leave), how this is utilised varies widely…
Ideas and Lessons for Surgical Training from Fighter Pilots “Mental readiness is a combination of commitment, confidence, anticipation and positive thinking. What I have learned from my retraining is to regain confidence and also that one should never give up.” MR de Laval Multiple roles to fulfill – “”not simply pilots: They are instructors, supervisors, standards…
Single Point of Reference Junior doctors applying to specialty training programmes are faced with the prospects of ranking job, holding offers and in many cases, waiting for another year to re-apply. However, in many cases they do not have all the information about the posts to which they are applying. This is a recent phenomenon,…
Rapid publication of serious incidences Near-misses and adverse events should be published after anonymisation, on a national level. Anonymisation might not be possible in all instances, in which case, the lessons learnt from the case should be published. Although the cost of AE may be great to the patient and the team, it is even…
Palm/Thenar Eminence grip Key feature: Fingers do NOT go in the rings of the holder. Position: Middle+ring+little fingers wrapping around one of the rings with no fingers within the rings. Other ring resting on radial aspect of distal thenar eminence, just encircling thumb MCP. Distal part of thumb proximal phalanx against eye-ring insert. Index finger resting…