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Introduction to common surgical equipment

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Update time : 2023-10-20 10:55:00
Operating room equipment is an important material basis for improving surgical quality and ensuring patient safety. Its quantity and type are increasing day by day. Major hospitals regard the updating of operating room equipment as an important symbol of hospital modernization.
An electric defibrillator is an instrument for rescuing cardiac arrest. It releases high voltage and weak current, and hits the heart through the chest wall or directly in a short time, causing all myocardial fibers to completely stop contracting, and then the heart has strong self-discipline. The sinus node sends impulses to control heart activity to restore normal heart rhythm. It consists of a control system, an electrocardiogram system, an electrode plate and its wires. It has two methods of external indirect defibrillation and thoracotomy direct defibrillation. It is often used for rescuing patients with cardiac arrest, electrical rhythm conversion and defibrillation during heart surgery. There are two power sources available: DC and AC. In order to reduce or avoid myocardial damage, DC is often used.
Instructions
1. Turn on the power of the defibrillator and turn on the power switch.
2. Generally select the "non-synchronized" position, and the "discharge" switch is in the "human body" position (the usage of electric defibrillators produced by different factories varies).
3. When performing external chest defibrillation, coat the electrode plate with conductive glue or wrap it with gauze soaked in saline, and insert the electrode leads into the corresponding jacks of the defibrillator.
4. Press the charging button and pay attention to the indicator needle on the electric meter. When the expected energy is reached, charging will stop. The general energy for external chest defibrillation is 00~300J, not exceeding 350J. The energy for intrathoracic defibrillation is 50J. Start with a small energy and gradually increase it.
  5. There are two ways to place electrode plates: the left and right method on the chest and the front and back method on the chest. The former method is convenient, quick and effective, and can prevent the operator from being shocked, so it is commonly used. The method is as follows: one electrode plate is placed under the right clavicle, at the second intercostal space on the right edge of the sternum, and the other electrode plate is placed at the apex of the heart below the left nipple. The center of the electrode plate is above the anterior axillary line. The two electrode plates are separated by more than 10cm to prevent Short circuit and electric shock. In chest defibrillation, spoon-shaped electrode pads are used to clamp the heart.
6. Only when it is confirmed that the surgeon and other staff are no longer in contact with the patient and the hospital bed can the "discharge" button be pressed.
7. Immediately observe the electrocardiogram waveform on the oscilloscope screen after discharge or auscultate whether the heart beats again. If the heart does not beat again, you can continue to press the heart or inject epinephrine or sodium bicarbonate before giving an electric shock. Each electric shock can be separated by 1 to 2 minutes, and this can be repeated 2 to 3 times.
8. After defibrillation, turn off the power first, wipe the electrode plates, clean the wires, and place them neatly for next use.
Precautions
1. Check the instrument regularly (usually once a month) to keep it in good condition and ready for use.
2. Place the accessories neatly after use, and clean the conductive adhesive after using the electrode plate.
3. If the defibrillator is not used after being charged, do not discharge the two electrode plates in direct contact. If it has a discharge function, you can directly press the defibrillation discharge switch to discharge. If it does not have this function, it can be discharged between the two electrode plates. Clamp a soapy discharge wrapped in a damp cloth.
4. The surgeon must be very serious when pressing the "discharge" button and do not press it casually.
5. The electrode plates used for intrathoracic defibrillation must be sterilized. Therefore, the electrode plates need to be sterilized and placed for emergency use. They can be packaged in wrapping paper and sterilized with ethylene oxide gas for later use.
6. Grounded defibrillators must be connected to the ground wire before use.
An infusion pump is an electronic mechanical device that electronically measures the speed of liquid input into blood vessels. There are many structures and styles of infusion pumps currently used, but the overall purpose is to inject a certain amount of liquid at a constant speed as required.
Features and uses
The infusion pump can use an external power supply or battery, and has a sensitive alarm device that can sound an alarm when there are bubbles in the pipeline, the pipeline is blocked, the door is opened, the infusion is completed, or the battery is under-voltage. The use of infusion pumps in the operating room is mainly used for continuous anesthesia medication, pediatric infusion and blood transfusion control, continuous microinjection of rescue drugs for critically ill surgical patients, and injection of anticoagulants during extracorporeal circulation.
Precautions for use
1. The infusion pump can generally be fixed on the infusion stand. Care must be taken to tighten the fixing screws to prevent them from falling to the ground. When using the AC power supply, the wire plugs must be placed properly to avoid power interruption. When the infusion pump sends an alarm, find the cause promptly.
2. Before connecting to the infusion pump, the air in the infusion pipeline must be exhausted, otherwise the infusion pump will alarm and stop the infusion.
3. During the infusion process, one should strengthen observation and always pay attention to whether the catheter is indeed in the blood vessel where it was originally inserted, and timely detect obstruction of the catheter, extravasation of drug solution, etc. to prevent tissue damage caused by the spillage of irritating drugs.
4. After using the infusion pump, wipe away any medicine that may have dripped on the machine and place it in a fixed position to avoid pressure.
Classification
It is divided into two types: push syringe infusion pump and conventional infusion pump. The former only accepts syringe infusion, usually using 60ml or 20ml syringes, and the speed control range is 0.1~360ml/h; the latter can accept the infusion of syringes, bags and bottles of liquid, and the preset range of the infusion speed is generally 1~1000ml /h. In addition to the earliest single-channel infusion pumps, there are currently dual-channel and multi-channel infusion pumps (a specific cartridge inputs independent liquids, and each channel is controlled by a separate program. The computer program allows multiple groups of liquids to be administered in different ways. speed input).
Blood gas analyzer refers to an instrument that uses electrodes to measure related indicators such as pH, partial pressure of carbon dioxide (PCO2), and partial pressure of oxygen (PO2) in arteries in a short period of time.
Instrument features
Automatic calibration, automatic sampling, automatic detection and fault self-diagnosis and other functions, easy to operate, fast analysis speed and high accuracy.
working principle
Under the negative pressure suction of the pipeline system, the sample blood is sucked into the capillary tube and comes into contact with the pH reference electrode, pH, PO2, and PCO2 electrodes on the capillary wall. The electrodes convert the measured parameters into their respective These electrical signals are amplified and converted into analog-to-digital signals before being sent to the instrument's microcomputer. After calculation and processing, the measurement results are displayed and printed out, thereby completing the entire detection process.
Clinical application
1. Cardiovascular surgery: During the perioperative period of cardiovascular surgery, the patient's breathing is controlled by a ventilator. During extracorporeal circulation, the heart and lung functions are replaced by an artificial heart-lung machine. The acid-base balance of blood gases is artificially controlled. In addition, the use of low temperature also profoundly affects blood gases and acidity. Base steady state. Therefore, blood gas and acid-base homeostasis management are of special significance to ensure the safety of cardiovascular surgery. The use of POCT blood gas analyzer for dynamic monitoring of blood gas and acid-base homeostasis can accurately and comprehensively reflect the body's cardiopulmonary function and tissue metabolism, which is of great significance to the formulation, implementation and revision of surgical plans.
2. Anesthetized patients: Anesthetized patients are prone to blood gas changes and acid-base imbalance due to the effects of disease, anesthesia, surgery, intraoperative bleeding, blood transfusion, and infusion. About 60% of cardiac arrests occur during anesthesia and recovery from anesthesia. % is related to hypoxemia and hypercapnia. During this period, the application of POCT blood gas analyzer can comprehensively understand the patient's respiratory function, timely detect and accurately diagnose hypoxemia and hypercapnia, and provide a basis for the correct handling of anesthetized patients. Provide the basis for the blood gas changes and acid-base imbalance that occur. This can avoid the occurrence of anesthesia accidents caused by this, ensure the safety of patients during anesthesia and surgery, reduce surgical risks, and reduce the occurrence of intraoperative and postoperative complications.
3. ICU: Critically ill patients in ICU are often accompanied by multiple organ dysfunction due to the disorder of the body's internal environment, especially lung and kidney dysfunction. They are easily complicated by abnormal arterial blood gases and acid-base balance disorders, and severe acid-base balance disorders. It can also affect the function of important organs, and sometimes becomes the direct cause of death of patients. Therefore, even if it is correctly identified and treated, it is often one of the key factors in saving critically ill patients. Not only should we race against time when rescuing critically ill patients, but dynamic detection of changes in arterial blood gases during the treatment process will have a more guiding role in the treatment of critically ill patients.
 
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