Postoperative Protocol - Postoperative Bleeding скачать в хорошем качестве

Postoperative Protocol - Postoperative Bleeding

#PostOperativeBleeding #VascularSurgery #EmergencyProtocol #PatientSafety #BloodClotting #ACTMonitoring #NursingCare This video outlines Dr. Gregory Weir's specific protocol for managing post-operative bleeding in vascular surgery patients. *Immediate Actions for Bleeding from Wound Post-Op:* Alert the nurse in charge/team leader immediately. Remove any bandages or dressings near the bleeding site to visualize. Reassure the patient and ensure they remain still. *Assessing Bleeding Type:* **Arterial Bleeding**: Bright red, pulsatile, spurting with heartbeat, fast flow. If suspected, contact Dr. Weir immediately without delay. **General Oozing or Venous Bleeding**: Apply firm, constant direct digital pressure with a gloved hand on the bleeding spot for a full 20 minutes. This allows the body's clotting system to form a stable clot. *If Bleeding Persists After 20 Minutes of Pressure:* Check the Activated Clotting Time (ACT). *Important**: Obtain the blood sample for ACT *only from an arm vein, not an arterial line, CVP line, or sheath, to avoid falsely high readings from local heparin flushes. *ACT Interpretation and Action:* **ACT more than 140 seconds**: Contact Dr. Weir. He may order protamine sulfate (25mg IV over 15 minutes) to reverse heparin. Repeat ACT 15-20 minutes after protamine to confirm reversal. **ACT less than 140 seconds**: Continue applying pressure. Still contact Dr. Weir to inform him of the situation and ACT result. *After Bleeding Appears Controlled:* Slowly release direct pressure. Observe the wound closely for five minutes to ensure bleeding does not recur. If bleeding restarts during observation, immediately reapply direct digital pressure and contact Dr. Weir again. Once bleeding has stopped and remained stopped, apply a clean wound dressing secured with pressure bandages. *Information to Have Ready When Calling Dr. Weir:* Patient's name/identifier. Current blood pressure. The ACT result. A list of any medications the patient is on that might affect bleeding (e.g., anticoagulants, antiplatelets).