Term
| Closed claim data reveals this type of injury is second only behind death/airway mishaps |
|
Definition
| Position related injuries |
|
|
Term
| The underlying cause of ALL tissue damage (muscles, nerves & organs) is |
|
Definition
|
|
Term
| Pressure on a structure results in injury/tissue damage by.... |
|
Definition
| limiting fluid movement into and out of the capillary bed. Increased pressure increases the reasistance to venous outflow from teh capillary bed, reducing the arterial to venous gradiant that drives perfusion. The result is ischemia, tissue edema, and cellular breakdown |
|
|
Term
| describe the functioning of cells in an anaerobic enviroment |
|
Definition
| with lack of perfusion, cell function continues in an anaerobic manner, acidic byproducts accumulate, ion pumps fail due to lack of ATP, sodium accumulates in the cell resulting in swelling which cuts of microcirculation.. the cycle continues |
|
|
Term
| Factors that contribute to compartment syndrome |
|
Definition
| prolonged OR time, limb elevation, hypotension, pneumatic devices, tourniquets. |
|
|
Term
| treatment for compartment syndrome |
|
Definition
| Fasciotomy, untreated will resulr in loss of extremety or death |
|
|
Term
| In compartement syndrome injury and swelling is usually associated with |
|
Definition
| reperfusion, swelling begins when blood flow returns after a period of ischemia |
|
|
Term
| Anything that reduces blood flow can cause compartment syndrome including: |
|
Definition
Tight would closures, expanding hematomas, external pressure from positioning device or surgical team member, compression stockings, body weight.
Positioning, trauma, embolic events, tumors or vascular insufficiency can also cause compartment sydnrome |
|
|
Term
| Positions associated w/higher incidences of compartment syndrome include |
|
Definition
| Lithotomy and lateral decubitus positions |
|
|
Term
| The most common nerve injury in teh upper extremities include |
|
Definition
| Ulnar and brachial plexus nerve injuries |
|
|
Term
| Most common nerve injuries in the lower extremities |
|
Definition
|
|
Term
| Damage to what nerve is common during cardiac surgery as a resulting from median sternotomy and sternal retracting |
|
Definition
| Ulnar nerve injury;incidence is higher in men |
|
|
Term
| Symptoms of ulnar nerve injury include: |
|
Definition
| Progressive weakness in hand, pain, inability to open doors or jars--CLAW hand |
|
|
Term
| Brachial plexus arises from what nerve roots? |
|
Definition
|
|
Term
| In nearly every surgical position, this nerve is vulnerable to injury |
|
Definition
|
|
Term
| Brachial plexus injury can occur if? |
|
Definition
| Shoulders are depressed, head is turned away, arms are abducted >90 deg, shoulders are not adequately supported while pt is in prone position, arms are raised above head-- superman position |
|
|
Term
| Brachial plexus injury most frequently occurs in what position |
|
Definition
|
|
Term
| with Sternal retraction during open heart surgery, particularly during internal mammary dissection the pt is at risk for? |
|
Definition
|
|
Term
| Positioning devices such as shoulder braces for steep trendelenburg during robotic cases are associated with what time of nerve injury |
|
Definition
|
|
Term
| This position is notorous for hypotension |
|
Definition
|
|
Term
| Major complication associated with vascular and thoracic procedures, sitting and prone positions, head flexion in foward sitting position |
|
Definition
| can result in spinal cord injury d/t spinal cord compression itself or a distruption in blood supply to the spinal cord |
|
|
Term
| the Optic nerve is extremely susceptible to what? |
|
Definition
|
|
Term
| Risk factors for POVL include? |
|
Definition
| smokers, male, obesity, diabetes, vascular disease, hypertension |
|
|
Term
| Anesthesia/OR related risk factors for POVL? |
|
Definition
Prone position--Often associated with spinal cases when it occurs!!!
Prolonged procedure time
large blood loss
low HCT
systolic BP <100mmHg |
|
|
Term
| Formula for optic perfusion pressure |
|
Definition
|
|
Term
| Intra-occular pressure is influenced by? |
|
Definition
| aqueous humor and removal |
|
|
Term
| 4 things that will reduce aqueous humor outflow? (dramatically increasing IOP) |
|
Definition
Head down position
Increased abdominal pressure *prone position
Increased right atrial pressure
Obstruction of jugular veins (can occur with extreme neck torquing, tight ETT ties) |
|
|
Term
|
Definition
1.Emboli (air/particulate- high risk during CPB)
2. Glycine toxicity (TURP procedures- irrigation contains glycine)
3. Sickle Cell disease (obstruction d/t sickled cells) |
|
|
Term
|
Definition
|
|
Term
| What is the most common OR position and produces the least hemodynamic/ventilatory changes |
|
Definition
|
|
