The surgical tech and the surgical patient

Maslows hierarchy of needs and a brief description of each category

Physiological needs- biological requirements for human survival

• Water

• Oxygen

• Food

• Temperature regulation

Security needs- the individuals perception that their environment is safe

• Protection from the elements

• Security

• Law and order

• Stability

Social needs- to be known for and cared for as an individual, and to care for others

• Love

• Acceptance

• Belonging

Esteem needs- a positive evaluation of oneself and others

• A need to be respected and respect others

• Gain recognition

• Status

Self actualization- the individuals need to fulfill what they believe is purposeful

• Education

• Skill development

• Refining of talents

• Caring for others

• Learning a new language

• Traveling

• Winning awards

What are the 2 types of stress?

1. Eustress- “eu” means well or good stress

2. Distress- negative stress

What are some coping mechanisms

1. rationalization- attempts to rationalize illness or disease

2. Regression- patient regresses to an earlier stage of life, and exhibits behaviors unique to that stage

3. Repression- patient represses thoughts or feelings about illness or disease and and does not want to hold any discussions regarding the topic

Religious and cultural influences

1. Jahovah’s witness- no blood transfusion

2. Buddhism- reincarnation and rebirth and influenced by the previous death experience

3. Judaism- death should occur in the midst of a supportive community, never alone, nothing should be done to speed up the process of death, deceased patient should be left untouched for 30 minutes

2 types of euthanasia

1. Passive- when the physician does nothing to preserve life

2. Active- requires actions that speed up the process of dying

What are the stages of grief?

1. Denial

2. Anger

3. Depression

4. Bargaining

5. Acceptance

DNR

An order that states that resurrection should not be attempted if patient suffers a cardiac or respitory arrest

How is DNR different in the OR?

Many hospitals rescind DNR/DNI during surgery because it creates a bad rep for that OR

what is the importance of empathy regarding death/ dying

Gives us the ability to understand and share a patients feelings or experiences

What tissues can be donated after death?

1. tendons

2. Veins

3. Skin

4. Corneas

5. Valves

6. Bone

What organs can be donated after death?

1. Heart

2. Lungs

3. Liver

4. Kidneys

5. Pancreas

6. Intestines

what are some surgical considerations of pediatric patients?

• Children under 6 months cannot shiver!!

• At risk for hypothermia and bradycardia

• Neonates and infants startle easily

• A quiet environment is essential

• Rapid anesthesia induction reduces stress and anxiety

What is the leading cause of death in children 1-15?

Accidents

Key considerations for bariatric/ obese patients?

• High risk patient!

• Placing in reverse trendelenburg (feet down) expands total lung volume and aids in ventilation

• At risk for Venous stasis and thrombophlebitits in this position

• Sequential compression devices are necessary

• At risk for DVT (deep vein thrombosis)

What do bariatric/ obese patients have larger amounts of?

Adipose (fat) tissue

What is diabetic mellitus?

A genetic endocrine disorder that affects the pancreatic production of insulin and glucose tolerance in the body as a whole

What are the surgical dangers of pregnant patients?

Anesthetic agents that affect the fetus by:

• Can increase preterm labor

• Cause fetal death

• Low birth weights

What is the ideal trimester to have a surgical procedure?

Ideally none at all but if it needs to be done, the 2nd or 3rd trimester

What type of PPE will a surgical tech likely use on an isolation patient?

Gowns, eye protection or face shield, masks and respirators

Surgical considerations of geriatric patients?

1. usually have some form of chronic debilitation or decreased physiology status

2. Usually have comorbities

3. Frágil integumentary system

What is the trauma golden hour?

• A shorter response time equates to a greater chance of survival for the trauma patient

• The time immediately after an injury is the best time for rapid and aggressive interventions

• 80% if trauma deaths occur in the first hour after injury

What are the different level hospitals?

1. Level 1- fully equipped and meets all requirements to handle trauma patients 24/7

2. Level 2- can treat seriously injured and ill patients, but does not have all the resources that a level 1 does

3. Level 3- most often an community or rural healthcare facility, offers limited care and can help stabilize patient before moving them to a level 1 or 2 hospital

4. Level 4- available in some states, can provide advanced trauma life support required to stabilize patient to move to a level 1 and 2

What’s the difference between blunt and penetrating trauma?

1. Blunt trauma- results from force ex: getting hit in the head

2. Penetrating- foreign object passes through tissue ex: bullet or knife

What type of personnel is most often affected by PTSD?

Military