Course in the ward (intraoperative

phase)
August 18, 2014
At around 3:20pm our patient is entered at the operating room #5.Before the
procedure, they put a ifc to the patient and also aseptic technique is done.
They put the patient at the or table and preparing for general anesthesia.
The induction time is 3:35pm. At around 3:45pm cutting time started. The
surgeon is going to remove the femoral head and neck. 1st, the surgeon cuts
the skin with scalpel handle#7 then uses a cautery machine to cut into the
inner layer of the muscle and bone. The surgeon uses skin retractors to open
the skin tissues. The surgeon positioned the hip to expose thebone and sof
tissues then uses an special instruments to remove the femoral head and
neck. 4:15pm is the time when the femoral head and neck is out. Then the
surgeon measures the femoral head with a special device to know what will
be the size of the prosthesis to be inserted. The size of the thompson
prosthesis is 45. The surgeon sets other special orthopedic instruments to
set the thigh bone for the insertion of the stem prosthesis. The surgeon
shapes the femur to fit the prosthetic stem. When the surgeon gets the exact
shape and size of the femur and the prosthesis, it is now ready to attach the
prosthesis into the femur. During the surgery, the surgeon also asks to
prepare for blood transfusion (packed RBC). When the prosthetic is attached,
the surgeon prepares a special cement to attach the prosthesis to secure it.
We waited for 12 mins until the special cement is done. After the procedure,
the surgeon is now ready to close the incision. The surgeon place a drain at
the hip then closed the hip with stiches and staples. The surgeon place
bandages to secure the hip. After the procedure, the client goes to PACU to
be monitored at the recovery area. They also get the x-ray result at the pacu
to make sure that the procedure done is successful.