Cat Lung Lobectomy - advice please!

Re: Cat Lung Lobectomy - advice please!

Paula Wright RVN Ncert (A&CC) — Tue, 02 Jul 2013 16:09:43 GMT

If you are likley to do open thorax surgeries it would be a very good idea to invest in a capnograph at your practice. Hope the op went well.

Re: Cat Lung Lobectomy - advice please!

Nick Shackleton — Mon, 01 Jul 2013 21:05:15 GMT

No worries Kelly. Good luck. Shame no capnograph. make use of everything you got to hand. As I said you're better off manually venting this type of patient. Let us know how you get on.

Re: Cat Lung Lobectomy - advice please!

Kelly1985 — Mon, 01 Jul 2013 20:59:05 GMT

Thanks so much for all the advice Nick! That's a fantastic help, already made me feel more confident about the situation. We have doppler but unfortunately no capnograph but we do have pulse ox so will make full use of all the equipment we have. I really appreciate your advice! I will certainly be implementing it all tomorrow!

Re: Cat Lung Lobectomy - advice please!

Kelly1985 — Mon, 01 Jul 2013 20:55:52 GMT

Unfortunately we do not have ventilators so it will be little old me doing ippv whilst the others do the running around. Thanks for the advice!

Re: Cat Lung Lobectomy - advice please!

Nick Shackleton — Mon, 01 Jul 2013 20:02:39 GMT

Tilt the table. This takes pressure off the diaphragm and aids the surgeon and the patient Multiparmeter monitoring equipment. Do you have Doppler for BP or CVP? Capnogrph. Look for trends rather than one off highs or lows. Extra pair of hands, you're likely to have to ventilate the patient once the chest is open. Someone who can open extra instruments for surgeons and get other equipment or medication for you. Local anaesthetic Try and shave the patient prior to anaesthesia, after premed is probably best, but try to not to stress the patient Manual ventilation is probably preferable from the surgeons point of view so that they are able to control when you give a breath to the patient especially during ligation of the lobe. Although I do like the use of a ventilator I'd prefer to use manual ventilation for thoracic surgery. T-Piece is prob preferable. Hope they using a surgical stapler. This allows quick and easy ligation of the lobe. Quick in and out. External heat source: the patients temp will drop rapidly one the chest is open. Fluids used to flush should be warmed to help prevent further heat loss. Ensure you have everyone to hand such as repeat medication, range of chest drains to hand etc... that's what I can think of off the top of my head am sure there is other stuff I have missed. If you think of any questions feel free to ask.. Good lick am sure it'll go well

Re: Cat Lung Lobectomy - advice please!

leanne walker — Mon, 01 Jul 2013 17:06:29 GMT

what is your set up at your practice? do you have ventilators? multi parameter machines? if not....looks like you will be busy doing ippv so you will need someone else in theatre with you doing all of the running around opening kits.....good luck, im sure it will go fine, often these things we worry about the most go really smoothly and we are left wondering what we worried about...its always good to be prepared for every eventuality though. if you expect the worst it wont happen.