Intraoperative Monitoring

Improved Essays
Intraoperative monitoring: A consensus on standard monitoring requirements has not yet established in the literature. Routine monitoring includes electrocardiography, pulse oximetry, capnography, temperature and urine output monitoring. There are many authors who recommend invasive blood pressure monitoring by indwelling arterial catheter in all patients, irrespective of their age 18.Abrupt changes in cerebral blood flow due to changes in intracranial pressure (ICP) is possible during the procedure. Transcranial Doppler is the fastest and most reliable method to detect any fluctuations in cerebral blood flow due to changes in ICP 19.It has got high sensitivity to changes in cerebral blood flow. But practical objections restrict it’s routine …show more content…
But Injury of the Basilar artery is the most feared intraoperative complication. Artery is located under the floor of third ventricle and can be subjected to trauma by the catheter tip21.This can lead to massive intraventricular and subarachnoid haemorrhage, hemiparesis and midbrain damage. Manipulation of delicate structures around the third ventricle (hypothalamus & brain stem) can lead to intraoperative cardiac bradyarrhythmias, hypotension, hypertension and even cardiac arrest22.This procedure can also result in reduction of cerebral perfusion or even ischemia secondary to an increase in intracranial pressure. Other reported neurological complications are paralysis of III and VI nerves, delayed awakening, transitory mental confusion, headache, loss of memory, infection, convulsions, and pneumocephalus.Hypothermia is a potential complication that can result in delayed awakening and disordered coagulation.However, some of the reported post operative complications such as vomiting and respiratory problems are not specific to the procedure. Overall, a good long term outcome after ETV is between 70-80% in most case series 23.With expertise, complication rates are bound to come down. In fact it is now accepted as a therapeutic option ahead of shunt revision in cases of obstructive hydrocephalus

Related Documents

  • Improved Essays

    Septic Shock Case Studies

    • 566 Words
    • 3 Pages

    SHOCK Salve Aguilar West Coast University Pathophysiology Dr. Isabelle Tardif July 17, 2015 Abstract The case identifies the type of shock that CC encountered right after his traumatic accident. He was experiencing hypovolemic shock as evidenced by low blood pressure and increased heart rate.…

    • 566 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    INTRODUCTION My article of choice has the title of “Unlocking Paralysis” by Lisa Fitterman. Lisa Fitterman is a Toronto-based writer who is also known to be a reporter, editor, columnist and a freelance writer for a wide range of both national and international magazines. She has authored a variety of stories, ranging from profiles of women in the Russian opposition to immigration and racism in certain countries. In this article however, she talks about how a new invention, Endovascular Thrombectomy has changed the lives of people who had suffered from stroke and how it will save future stroke-sufferers from living a life of dependence on others and avoiding permanent paralysis.…

    • 960 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    POSTOPERATIVE CARE At 2000hrs, when Mrs. Audrey returns from the theatre, assessment of observations, neurovascular (pulse, motor strength, temperature, sensation and movement), neurological should be conducted to prevent any further complications postoperatively according to the hospital protocol (Brigham and Women’s Hospital, 2010). Along with this, a quick physical examination could be done to detect any potential problems. Mrs. Audrey should be provided a maximum level of comfort which can be done by making her pain free. Therefore, a proper assessment is essential to manage postoperative pain.…

    • 847 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    During a surgical procedure he will monitor the patient’s blood pressure, heart rhythm, amount of oxygen in the blood, temperature, and level of consciousness. Paying close attention to detail at all times would be strenuous for most individuals, but anesthesiologists fight through to ensure their patients are safe and…

    • 638 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    This week was my first Foley catheter insertion. I was a bit nervous, but most of all I just did not want to hurt the patient since he was already in a lot of pain. Prior to inserting the Foley, I talked to the patient and his wife and asked what happened, if he was allergic to anything, and if there was anything he needed. My professor helped me through the procedure. The most important part of this procedure was to keep sterility.…

    • 223 Words
    • 1 Pages
    Improved Essays
  • Improved Essays

    The incision looked normal to me, when comparing it to past post-operative deep brain stimulator patients. I asked if he had any more concerns or if he would be comfortable with me sending her home. She was alert, had clear breath sounds, non- labored breathing, tolerable pain, her color was pink and she had a steady gait to the restroom. He said that he was comfortable with my assessment and the patient was okay to be…

    • 1102 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    Abstract Purpose: to detect the clinical and histological effects of preoperative subconjunctival injection of both Bevacizumab and Mitomycin C (MMC) one month before surgical excision of primary pterygium using a bare sclera technique. Patients and Methods: 20 patients with primary pterygium underwent subconjunctival combined injection of 0.1 ml of MMC (0.2 mg/ml) and 0.1 ml of Bevacizumab (1.25mg/0.1ml ) one month before a bare sclera pterygium excision. The excised pterygium tissues were examined histologically and patients were followed up for at least two years. The excised pterygium of 2 patients without preoperative injection were used for histological comparison.…

    • 213 Words
    • 1 Pages
    Improved Essays
  • Improved Essays

    Elevated intracranial pressure (ICP) is a common and potentially life threatening condition arising from a variety of pathological conditions including traumatic brain injury (TBI), intracranial hemorrhage, disturbance of cerebral spinal fluid (CSF) circulation and brain tumors. Although ventriculostomy continues to be the gold standard modality, the potential risks of misplacement, infection, hemorrhage and obstruction have led to development and implementation of alternative intracranial devices and techniques for monitoring ICP1. Recently, transorbital ultrasonography has gained popularity as it is a noninvasive bedside exam that has been shown to be useful for detecting raised ICP by evaluating the change in the optic nerve sheath diameter (ONSD)2-4.…

    • 468 Words
    • 2 Pages
    Improved Essays
  • Decent Essays

    Patient Observation

    • 313 Words
    • 2 Pages

    This week I was able to observe how the clinic handles inbox telephone messages received from patients and inbox referrals for new patients when they need to be seen by Becky Godby. Chuck asked me to assist him with a vaginal cyst examination. Dr. Rosengren allowed me to draw up an injection with lidocaine and triamcinolone acetonide (Kenalog), which was performed under his direct supervision. I observed a Papanicolaou (PAP) smear procedure, setup, and collection with theThinPrep Pap test. Under the direction of Raymond, I set up a nebulizer treatment and observed a patient perform a peak flow meter measurement, which must be performed before and after the nebulizer treatment is given.…

    • 313 Words
    • 2 Pages
    Decent Essays
  • Decent Essays

    Medical Surgical Scenario

    • 169 Words
    • 1 Pages

    I enjoyed reading your post and I commend you for wanting to take the necessary actions to becoming certified in medical-surgical or other specialty area once eligible. I would imagine that having a medical-surgical certification would make a nurse feel more competent in the specialty of medical-surgical nursing care. Nurses who decide to purse certification in their desired specialty area realizes the importance of continuing their nursing education, which will benefit the nurse personally, the nurses’ employer, and most important, the nurses’ patients (Boyle, Cramer, Potter, Gatua, & Stobinski, 2014). Some studies have shown that nurses who are certified in medical-surgical have an increased knowledge base and understanding of nursing measures…

    • 169 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    I was assigned a patient who was admitted for a right lower lobe wedge resection. During post op day one the patient was progressing as expected; stable vital signs and able to…

    • 373 Words
    • 2 Pages
    Improved Essays
  • Great Essays

    Intraoperative management was similar for all patients. Patient’s respiratory rate, blood pressure, ECG, saturation of O2 and CO2 were monitored throughout the procedure. Hemodynamic stability was maintained using packed red cell transfusion or fresh frozen plasma as and when required. Post-operatively extubation was based mainly on preoperative hemoglobin (Hb) and albumin (Alb), previous abdominal surgery, lower intraoperative or postoperative pH, higher estimated blood loss (EBL) and higher volume of the intraoperatively transfused blood products (>30…

    • 2030 Words
    • 9 Pages
    Great Essays
  • Improved Essays

    I went to Ruby Pardue Blackburn Adult Day Healthcare Center on April 5, 2016 and April 6, 2016 for the Wilkes Community College, Nursing Class of 2017 for observation. Three another students and I were assigned to this observation site from 8:30am-2:30pm both days. When we got there the nurse gave us a tour of the facility and talked about basic information of care. Throughout the day, we were able to talk to the “participants” and staff to obtain more information. There were plenty of differences between the role of the medical-surgical nurse and the adult daycare center, but not many similar roles.…

    • 900 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Gradually, I fell in sleep. When the surgical operation was done it Li 3 was three hours passed, it was 6:00pm at night. The nurse wake me up, and told me the operation was very successful, no need worry. When I try to move, I realize the IV(intravenous) tubes are inserted into my nostrils and stomach. I saw so many appliance around me for checking my condition.…

    • 1440 Words
    • 6 Pages
    Improved Essays
  • Decent Essays

    There are a lot of theories and researched that covers the topic about computed tomography perfusion (CTP) to roll- out acute stroke. However my literature search was made to encourage the UAE to do a CT perfusion for patient who has acute stroke. This research is very important because it will help them to safe the patient’s life within the golden hours. In addition, CTP has an advantage to outline ischemic areas of the brain which may be recovered by intervention (e.g. thrombolysis ), known as the penumbra, from the parts which are infarcted or irrevocably destined to go onto infarct regardless of therapy, known as the infarct core. ( Dr. Ayush Goel and Dr. Frank Gaillard,2015)…

    • 261 Words
    • 2 Pages
    Decent Essays