🔬

Sentinel Node Biopsy Procedure

Patient consultation and decision for sentinel node biopsy

Patient provides informed consent

Prepare patient for the procedure

Administer local anesthesia

Inject radioisotope tracer to identify sentinel lymph node

Scan patient to locate sentinel lymph node

Mark location of sentinel node on the skin

Administer blue dye as secondary method to identify sentinel lymph node

Perform incision on marked location

Locate and remove sentinel lymph node

Send removed lymph node to pathology for immediate evaluation

Approval: Pathology Results

If cancer cells are detected, proceed to remove more lymph nodes

Close incision and apply sterile dressing

Monitor patient's vitals and recovery from anesthesia

Provide post-procedure care instructions

Schedule follow-up appointment

Document procedure and findings in patient's medical record

Inform patient of biopsy results and discuss next steps

Approval: Procedure Report

Patient consultation and decision for sentinel node biopsy

Provide a friendly consultation to the patient and discuss the importance and benefits of a sentinel node biopsy. Explain how this procedure plays a crucial role in determining the spread of cancer and guiding further treatment decisions. Address any concerns or doubts the patient may have, ensuring they have all the necessary information to make an informed decision. Ask questions to gauge their understanding and readiness for the procedure. Make sure to document the patient's decision in their medical record.

Patient name

Notes from consultation

Patient decision

1

Proceed with biopsy
2

Decline biopsy
3

Undecided

Prepare patient for the procedure

In this task, the healthcare provider will prepare the patient physically and emotionally for the sentinel node biopsy. This includes providing instructions on dietary restrictions, medication adjustments, and any necessary tests or evaluations before the procedure. The goal is to ensure the patient is well-prepared and comfortable, minimizing any anxiety or discomfort they may experience.

Patient Name

Preparation date

Preparation instructions

1

NPO after midnight
2

Avoid blood-thinning medications
3

Shower with antibacterial soap
4

Remove jewelry and piercings
5

Wear loose clothing

Administer local anesthesia

During this task, the healthcare provider will administer local anesthesia to the patient to numb the area where the biopsy will be performed. The purpose of this step is to ensure that the patient remains comfortable and pain-free during the procedure. It is essential to explain the process to the patient, addressing any concerns or questions they may have about anesthesia.

Patient Name

Anesthesia date

Anesthesia administered

1

Yes
2

No

Inject radioisotope tracer to identify sentinel lymph node

In this task, the healthcare provider will inject a radioisotope tracer into the area surrounding the suspected tumor. The tracer will help identify the sentinel lymph node, which is the first lymph node where cancer cells are likely to spread. The purpose of this step is to improve the accuracy of identifying the sentinel node, guiding the subsequent steps of the procedure.

Patient Name

Injection date

Tracer injected

1

Yes
2

No

Scan patient to locate sentinel lymph node

During this task, the healthcare provider will use a handheld scanner or a gamma camera to locate the sentinel lymph node. The scanner detects the radioactive tracer injected in the previous step. The goal is to precisely identify the location of the sentinel node to guide the subsequent steps of the procedure. This task is critical to ensure the accurate removal of the sentinel lymph node.

Patient Name

Scanning date

Sentinel node located

1

Yes
2

No

Mark location of sentinel node on the skin

In this task, the healthcare provider will mark the location of the identified sentinel lymph node on the patient's skin using a surgical marker or other suitable method. This marking serves as a reference point during the incision and removal of the sentinel node, ensuring precision and minimizing the risk of damage to surrounding tissues.

Patient Name

Marking date

Location marked

1

Yes
2

No

Administer blue dye as secondary method to identify sentinel lymph node

During this task, the healthcare provider will administer a blue dye as a secondary method to identify the sentinel lymph node. The dye helps visualize the lymphatic vessels and can aid in confirming the location of the sentinel node found using the radioisotope tracer. This step increases the accuracy of identifying the sentinel lymph node.

Patient Name

Dye administration date

Dye administered

1

Yes
2

No

Perform incision on marked location

In this task, the healthcare provider will make an incision at the marked location to access the sentinel lymph node. The goal is to perform a precise incision, ensuring proper exposure of the sentinel node while minimizing damage to surrounding tissues. Careful attention should be given to maintaining a sterile environment to prevent infection.

Patient Name

Incision date

Incision performed

1

Yes
2

No

Locate and remove sentinel lymph node

During this task, the healthcare provider will locate and remove the previously identified sentinel lymph node. The goal is to perform a meticulous dissection, ensuring complete removal of the sentinel node while minimizing trauma to surrounding structures. Proper handling techniques and strict adherence to sterile protocols are critical to prevent contamination and infection.

Patient Name

Removal date

Sentinel node removed

1

Yes
2

No

Send removed lymph node to pathology for immediate evaluation

In this task, the healthcare provider will send the removed sentinel lymph node to the pathology department for immediate evaluation. The goal is to obtain prompt results regarding the presence or absence of cancer cells in the sentinel node. This information will guide further treatment decisions and provide valuable prognostic information to the patient.

Patient Name

Pathology date

Lymph node sent for evaluation

1

Yes
2

No

Approval: Pathology Results

Send removed lymph node to pathology for immediate evaluation
Will be submitted

If cancer cells are detected, proceed to remove more lymph nodes

If cancer cells are detected in the sentinel lymph node during the immediate evaluation, this task directs the healthcare provider to proceed with the removal of additional lymph nodes in the same region. The purpose is to ensure accurate staging of the cancer and to guide further treatment decisions. Surgeons may remove additional nodes using the same or a different approach, depending on the patient's specific case.

Patient Name

Additional nodes removal date

Additional nodes removed

1

Yes
2

No

Close incision and apply sterile dressing

During this task, the healthcare provider will close the incision made to remove the sentinel lymph node. The goal is to achieve optimal wound closure, preventing infection and promoting healing. This task includes the application of a sterile dressing to protect the incision site and maintain a clean environment.

Patient Name

Closure date

Incision closed

1

Yes
2

No

Monitor patient's vitals and recovery from anesthesia

In this task, the healthcare provider will closely monitor the patient's vital signs and recovery from anesthesia after the procedure. The goal is to ensure the patient's stability and identify any potential complications or adverse reactions to the anesthesia. Monitoring includes regular assessments of blood pressure, heart rate, respiratory rate, and oxygen saturation levels.

Patient Name

Monitoring date

Patient's vitals stable

1

Yes
2

No

Provide post-procedure care instructions

During this task, the healthcare provider will provide the patient with specific instructions for post-procedure care. The goal is to ensure the patient understands how to care for the incision site, manage pain, and identify signs of complications that require immediate medical attention. Clear communication and patient education are crucial to promote optimal recovery and minimize the risk of complications.

Patient Name

Post-procedure care instructions

Schedule follow-up appointment

In this task, the healthcare provider will schedule a follow-up appointment with the patient to monitor their progress, review the biopsy results, and discuss any necessary further treatment plans. The goal is to ensure continuity of care and provide appropriate support and guidance to the patient during the recovery process.

Patient Name

Follow-up appointment date

Document procedure and findings in patient's medical record

During this task, the healthcare provider will document the sentinel node biopsy procedure and its findings in the patient's medical record. Accurate and comprehensive documentation is essential for quality assurance, communication between healthcare providers, future reference, and legal purposes. This task ensures that all relevant details are recorded in a timely manner.

Patient Name

Procedure documented

1

Yes
2

No

Inform patient of biopsy results and discuss next steps

In this task, the healthcare provider will inform the patient of the biopsy results and discuss the next steps based on the findings. The goal is to provide the patient with a clear understanding of the results, implications, and potential treatment options. This task plays a crucial role in patient education, shared decision-making, and support throughout the treatment journey.

Patient Name

Results discussed