The Surgery
Preparation
While George is undergoing the anaesthetic, the rest of the theatre team are preparing equipment and instruments for George's procedure. This includes a important aspect of safety carried out by the scrub practitioner 'the count', this process ensures that every instrument and consumable is accounted for before the start of the case, this 'count' will be performed at the mid-point and end-point of the procedure to ensure nothing is misplaced and potentially left inside the patient.
Once finished and George is anaesthetised and positioned the sign-in is done where both the scrub practitioner and surgeon confirm the consent form and any relevant information is given, for instance any patient allergies. Once completed the surgery may proceed.
Moorehead, (2023)
What happened?
During the surgery, the surgeons clamped the aorta to enable them to attach a graft from the aorta to the femoral artery. This action led to a large drop in blood pressure when it was applied, with the Anaesthetist bolusing Metaraminol and giving more fluids in a attempt to raise the blood pressure.
To add to this, when applying the clamp the surgeons damaged the aorta and had little room to attach the graft. With these issues the lead surgeon asked for a time out to have a MDT between themselves and the anaesthetic consultant, the decision was to abandon the aorta bifemoral graft and proceed to a femoral to femoral crossover and femoral to popliteal bypass. Although this was not the original plan, the surgeons had discussed this possibility with george and had added this procedure as a precaution to the consent form George had signed.
At this point the patient had been on the operating table for around 6 hours and the change in procedure would take a further 4 hours, increasing the risk of complications to George.
Create Your Own Website With Webador