Apply Aortic and Venous Cannulae for Extracorporeal Circulation
9
Validate Oxygenation and Hemodilution Levels
10
Approval: Specialist to commence Clamping
11
Commence Total Systemic Heparinization
12
Start Cardioplegic Arterial Perfusion
13
Remove the Diseased Part of the Coronary Artery
14
Perform Anastomosis of Coronary Artery
15
Begin Weaning off Bypass and Decannulation
16
Closure of Sternum
17
Approval: Final Inspection by Surgeon
18
Apply Sterile Dressing to Surgical Site
19
Transferring Patient to Intensive Care Unit
20
Complete all Post-Operative Documentation
Confirm Patient Identity and Procedure
Ensure that the patient's identity and the planned procedure match the information provided. This task is crucial as it ensures patient safety and prevents any potential harm or errors. Verify the patient's name, date of birth, and details of the procedure. Double-check all documents and confirm with the patient. If any discrepancies or doubts arise, consult the medical team or supervisor for clarification and resolution.
Ensure Patient is in Correct Position
Verify that the patient is positioned correctly before starting the procedure. Correct positioning is crucial for ensuring accessibility and safety. Check if the patient is lying supine with arms at the sides and neck slightly extended. Ensure proper head and neck support. Confirm the use of positioning aids, such as pillows or straps, if necessary. Notify the medical team or supervisor if any adjustments are required or if there are any concerns about patient positioning.
1
Supine
2
Propped
3
Lateral
4
Trendelenburg
5
Reverse Trendelenburg
Verification of Site Marking
Verify the site marking done prior to the procedure to prevent any errors or confusion regarding the surgical site. Check if the site is properly marked according to the standardized protocols. Ensure that the marking is visible, accurate, and matches the planned procedure. If there are any issues or concerns with the marking, consult the medical team or supervisor for guidance and rectification.
1
Clearly Visible
2
Accurate Placement
3
Matches Planned Procedure
4
Requires Rectification
5
Supervisor Approval
Prepare and Sterilize Surgical Site
Prepare and sterilize the surgical site to minimize the risk of infection and ensure a sterile environment for the procedure. Follow standard protocols for the preparation and sterilization process. Use sterile drapes and cleaning agents to cleanse and disinfect the site. Ensure proper disposal of waste and adherence to infection control measures. Notify the medical team or supervisor if there are any issues or concerns during the preparation process.
1
Following Standard Protocols
2
Use of Sterile Drapes
3
Use of Cleaning Agents
4
Proper Disposal of Waste
5
Adherence to Infection Control Measures
Set up Heart-Lung Machine
Set up the heart-lung machine to provide cardiopulmonary bypass during the procedure. Follow the established procedures and guidelines for setting up the machine. Ensure all necessary components and connections are in place. Verify proper functioning of the machine and check for any potential issues or errors. Seek assistance from the medical team or supervisor if there are any difficulties or uncertainties during the setup process.
1
Follow Established Procedures
2
Ensure Proper Components and Connections
3
Verify Machine Functioning
4
Check for Potential Issues or Errors
5
Supervisor Assistance
Approval: Surgeon to begin Procedure
Will be submitted for approval:
Set up Heart-Lung Machine
Will be submitted
Performing Sternotomy
Perform a sternotomy to gain access to the heart for the cardiac procedure. This task involves making an incision in the sternum to expose the heart. Follow the specified techniques and guidelines to ensure proper incision and access. Communicate with the surgical team during the process and be prepared to adapt to any unexpected situations. Seek assistance from the medical team or supervisor if there are any difficulties or concerns during the sternotomy.
1
Followed Specified Techniques
2
Effective Incision
3
Proper Access to Heart
4
Communication with Surgical Team
5
Supervisor Assistance
Apply Aortic and Venous Cannulae for Extracorporeal Circulation
Apply aortic and venous cannulae to establish extracorporeal circulation using the heart-lung machine. Follow the established protocols and techniques for cannulation. Ensure proper placement and fixation of the cannulae. Monitor the flow and pressure to maintain adequate circulation. Communicate with the medical team to ensure seamless cannulation. Seek assistance from the medical team or supervisor if there are any issues or complications during cannulation.
1
Follow Protocols and Techniques
2
Proper Cannula Placement
3
Secure Fixation of Cannulae
4
Monitor Flow and Pressure
5
Effective Communication with Medical Team
Validate Oxygenation and Hemodilution Levels
Validate and monitor the oxygenation and hemodilution levels during the procedure. Ensure adequate oxygenation of the patient while maintaining appropriate hemodilution levels. Use monitoring devices and techniques to assess oxygenation and hemodilution parameters. Take corrective actions if the levels deviate from the desired range. Collaborate with the medical team to optimize oxygenation and hemodilution during the procedure.
1
Monitoring Devices and Techniques
2
Adequate Oxygenation
3
Maintaining Hemodilution Levels
4
Corrective Actions for Deviations
5
Collaboration with Medical Team
Approval: Specialist to commence Clamping
Will be submitted for approval:
Performing Sternotomy
Will be submitted
Apply Aortic and Venous Cannulae for Extracorporeal Circulation
Will be submitted
Validate Oxygenation and Hemodilution Levels
Will be submitted
Commence Total Systemic Heparinization
Commence total systemic heparinization to prevent clotting and ensure the smooth functioning of the heart-lung machine. Administer heparin following the established protocols and dosages. Monitor the patient's clotting parameters to ensure appropriate anticoagulation. Collaborate with the medical team to maintain optimal anticoagulation throughout the procedure. Seek assistance from the medical team or supervisor if there are any concerns or complications related to heparinization.
1
Follow Established Protocols
2
Administer Appropriate Dosages
3
Monitor Clotting Parameters
4
Collaborate with Medical Team
5
Supervisor Assistance
Start Cardioplegic Arterial Perfusion
Start cardioplegic arterial perfusion to induce temporary cardiac arrest for the procedure. Follow the established protocols and techniques for administering cardioplegia. Monitor the patient's cardiac parameters and ensure appropriate myocardial protection. Collaborate with the medical team to optimize cardioplegic perfusion. Seek assistance from the medical team or supervisor if there are any issues or concerns during cardioplegia administration.
1
Follow Established Protocols
2
Effective Cardioplegia Administration
3
Monitoring Cardiac Parameters
4
Myocardial Protection
5
Collaboration with Medical Team
Remove the Diseased Part of the Coronary Artery
Remove the diseased part of the coronary artery to enable the reconstruction or bypass procedure. Execute the planned technique for removal, which may involve cutting or excising the affected segment. Ensure precise removal and minimize damage to surrounding structures. Communicate and coordinate with the surgical team during the procedure. Seek assistance from the medical team or supervisor if there are any difficulties or uncertainties during the removal.
1
Execute Planned Technique
2
Precise Removal
3
Minimize Damage to Surrounding Structures
4
Communication with Surgical Team
5
Supervisor Assistance
Perform Anastomosis of Coronary Artery
Perform anastomosis of the coronary artery to restore blood flow and ensure bypass. Implement the planned anastomosis technique, such as sewing or grafting. Ensure accurate alignment and secure connection of the vessels. Monitor blood flow and assess the quality of the anastomosis. Collaborate with the medical team to optimize the anastomosis procedure. Seek assistance from the medical team or supervisor if there are any issues or concerns during the anastomosis.
1
Implementation of Planned Technique
2
Accurate Alignment
3
Secure Vessel Connection
4
Monitoring Blood Flow
5
Collaboration with Medical Team
Begin Weaning off Bypass and Decannulation
Begin the process of weaning off bypass and decannulation to restore normal heart function. Gradually decrease the flow and support provided by the heart-lung machine while monitoring the patient's cardiac parameters. Ensure stable hemodynamics and oxygenation throughout the weaning process. Remove cannulae once the patient's circulation is stable and self-sustaining. Collaborate with the medical team to optimize the weaning off bypass procedure.
1
Gradual Decrease in Flow
2
Monitoring Cardiac Parameters
3
Stable Hemodynamics and Oxygenation
4
Cannulae Removal
5
Collaboration with Medical Team
Closure of Sternum
Close the sternum to secure the chest and protect the internal structures. Utilize appropriate closure techniques, such as sutures or wires. Ensure precise closure and proper alignment of the sternum. Monitor the patient's response during the closure process. Communicate with the surgical team and be prepared to address any concerns or complications. Seek assistance from the medical team or supervisor if there are any difficulties or uncertainties during the closure.
1
Appropriate Closure Techniques
2
Precise Closure and Alignment
3
Monitoring Patient's Response
4
Communication with Surgical Team
5
Supervisor Assistance
Approval: Final Inspection by Surgeon
Will be submitted for approval:
Closure of Sternum
Will be submitted
Apply Sterile Dressing to Surgical Site
Apply a sterile dressing to the surgical site after closure to ensure protection and promote healing. Follow sterile dressing protocols and techniques. Use appropriate materials and ensure proper coverage of the site. Monitor the dressing for any signs of infection or complications. Collaborate with the medical team to optimize wound care and healing. Seek assistance from the medical team or supervisor if there are any issues or concerns regarding the dressing.
1
Follow Sterile Dressing Protocols
2
Use of Appropriate Materials
3
Proper Coverage of Surgical Site
4
Monitoring for Infection or Complications
5
Collaboration with Medical Team
Transferring Patient to Intensive Care Unit
Transfer the patient to the intensive care unit (ICU) after completion of the procedure. Ensure a safe and smooth transition of care. Communicate with the ICU team to provide relevant information about the procedure, patient's condition, and any post-operative requirements. Assist in the transfer process if necessary. Coordinate with the medical team and ICU staff for a successful transfer.
1
Safe and Smooth Transition
2
Communication with ICU Team
3
Sharing Procedure Details
4
Assistance in Transfer
5
Coordinate with Medical Team and ICU Staff
Complete all Post-Operative Documentation
Complete all necessary post-operative documentation to ensure accurate and comprehensive record-keeping. Record details of the procedure, including any complications or deviations from the plan. Document the patient's vital signs, medications, and any post-operative instructions. Follow the established documentation protocols and guidelines. Seek assistance from the medical team or supervisor if there are any uncertainties or concerns regarding the documentation.
