Activity 10.4: Reflective practice

What information do you think the anaesthetist and scrub practitioner should handover in relation to the care of the patient during anaesthesia and surgery?

Anaesthetist:

  • Patient information: name and age; relevant medical history, pre-existing conditions; specific patient information, e.g. communication needs; patient’s psychological state
  • During anaesthesia: type of anaesthetic; drugs given; iv lines in situ (peripheral cannula, arterial lines, central lines, etc.; untoward events pre- and intra-operatively; vascular monitoring lines; analgesia, iv fluids and drugs given pre- and perioperatively
  • During surgery: surgical procedure performed; indications for surgical procedure; blood loss; urine output; drain tubes; patient positioning; confirmation of throat pack removal, if applicable
  • Observations before, during and at end of surgery: conscious state; BP, HR, respiratory rate
  • Post-operative information: analgesia, IV fluids and drugs prescribed for post-operative use; oxygen requirements/ prescription; monitoring requirements; post-operative instructions; where the anaesthetist will be if needed; physiological parameters required prior to discharge; if anaesthetist needs to review patient prior to discharge; orders for any further investigations, e.g. blood test, chest x-ray

Scrub practitioner:

  • Patient information: check patient’s name, hospital number and date of birth against identity bracelet and notes; care of patient’s personal belongings, e.g. dentures, hearing aids
  • Surgery information: Surgical procedure performed; Blood loss; Intraoperative events/incidents; Wound closure: suture type, clips; Dressings: location, type, amount; Patient positioning; Problems with skin pressure areas
  • Surgery information (If applicable): drains – type, location, care instructions; Presence of urinary catheter; Presence of stoma; Infiltration with local anaesthetic; Confirmation of throat pack removal if applicable
  • Surgeon’s post-operative instructions
  • Location of notes, if not with patient
  • Ensure correct charts and x-rays are with patient