Performing a Venogram to confirm correct Blood Flow
13
Approval: Blood Flow Confirmation
14
Removing the Catheter
15
Closing incision and bandaging
16
Monitor vital signs post procedure
17
Discharging patient with post-procedure care instructions
Patient confirmation and Pre-operative Assessment
This task involves confirming the patient's identity and conducting a pre-operative assessment. It is essential for ensuring the patient's safety during the procedure. The desired result is accurate patient information and a thorough assessment. Have you confirmed the patient's identity? What challenges could arise during the assessment and how would you overcome them? Resources needed include patient records and assessment forms.
1
Driver's license
2
Passport
3
ID card
4
Health insurance card
5
Birth certificate
Lab testing for determining Liver function
Lab testing is necessary to evaluate the liver function before the procedure. This task helps identify any abnormalities or contraindications. The desired result is accurate liver function test results. What lab tests will you perform? How will you interpret the results? Mention any challenges that may affect the testing process. Resources needed include lab equipment and sample collection kits.
1
Liver function panel
2
Complete blood count
3
Coagulation profile
4
Electrolyte panel
5
Renal function tests
Approval: Lab Testing Result
Will be submitted for approval:
Lab testing for determining Liver function
Will be submitted
Obtaining Informed consent from Patient
Obtaining informed consent is a crucial step to ensure the patient understands the procedure, possible risks, and benefits. This task informs the patient about the procedure and seeks their consent. The desired result is a signed informed consent form. How will you explain the procedure to the patient? How will you address any concerns or questions? Resources needed include consent forms and patient education materials.
Preparation of Procedure theater
Proper preparation of the procedure theater ensures a sterile and safe environment for the shunt placement. This task involves setting up the instruments, sterilizing the equipment, and arranging the necessary tools. The desired result is a fully prepared procedure theater. What steps will you take to sterilize the equipment? How will you ensure the availability of all required tools? Resources needed include sterilization equipment and surgical instruments.
1
Arrange surgical instruments
2
Sterilize equipment
3
Prepare sterile drapes
4
Check availability of catheters
5
Set up ultrasound machine
Administration of Anesthesia
Administering anesthesia ensures the patient's comfort and pain management during the procedure. This task involves selecting and administering the appropriate anesthesia method. The desired result is a patient in a comfortable and pain-free state. What anesthesia method will you use? How will you monitor the patient's vital signs during anesthesia? Resources needed include anesthesia drugs and monitoring equipment.
1
General anesthesia
2
Local anesthesia
3
Spinal anesthesia
4
Conscious sedation
5
Regional anesthesia
1
Blood pressure
2
Heart rate
3
Oxygen saturation
4
Respiratory rate
5
Temperature
Performing the Ultrasound to locate Vein
Ultrasound imaging is used to locate the target vein for the shunt placement. This task involves using the ultrasound machine to visualize and guide the catheter insertion. The desired result is accurate identification of the target vein. How will you ensure proper positioning of the ultrasound probe? What challenges could arise during vein identification? Resources needed include the ultrasound machine and ultrasound gel.
Creating Incision and inserting Catheter
Creating a small incision and inserting the catheter into the target vein are critical steps for the shunt placement. This task involves making a precise incision and ensuring proper catheter insertion. The desired result is a successfully placed catheter. What techniques will you use to create the incision? How will you confirm the correct catheter placement? Resources needed include surgical instruments and catheters.
1
Fluoroscopy
2
Intraoperative ultrasound
3
Contrast-enhanced CT scan
4
Direct visualization
5
Venography
Confirming correct Catheter placement via X-Ray
Confirming the correct placement of the catheter using X-ray imaging ensures optimal shunt functionality. This task involves obtaining X-ray images and analyzing them to verify proper catheter placement. The desired result is confirmation of correct catheter position. How will you ensure the quality of the X-ray images? What signs will indicate incorrect catheter placement? Resources needed include X-ray equipment and radiographic films.
Creating the Pathway to the Liver using a Balloon
Creating a pathway to the liver is necessary for the shunt placement. This task involves using a balloon to dilate the pathway and ensure smooth catheter insertion. The desired result is a clear and functional pathway to the liver. How will you select the appropriate balloon size? What challenges could arise during pathway creation and how would you address them? Resources needed include the balloon dilation catheter and contrast medium.
1
4 mm
2
6 mm
3
8 mm
4
10 mm
5
12 mm
Inserting Stent and expanding it
Inserting the stent and expanding it ensures proper blood flow redirection in the shunt procedure. This task involves advancing the stent and expanding it to maintain the patency of the pathway. The desired result is a fully functional stent. How will you ensure accurate stent positioning? How will you expand the stent? Resources needed include the stent, delivery system, and angioplasty balloon.
1
Inflation with contrast medium
2
Self-expanding stent
3
Balloon-expandable stent
4
Covered stent
5
Open-cell stent
Performing a Venogram to confirm correct Blood Flow
Performing a venogram is essential to confirm proper blood flow in the shunt. This task involves injecting contrast medium and imaging the blood flow to evaluate the shunt's functionality. The desired result is confirmation of correct blood flow. How will you administer the contrast medium? How will you interpret the venogram images? Resources needed include contrast medium, catheter, and imaging equipment.
Approval: Blood Flow Confirmation
Will be submitted for approval:
Performing a Venogram to confirm correct Blood Flow
Will be submitted
Removing the Catheter
Removing the catheter marks the end of the shunt placement procedure. This task involves gently withdrawing the catheter from the vein. The desired result is a successfully removed catheter. How will you ensure a smooth catheter removal? How will you handle any bleeding or complications? Resources needed include hemostatic agents and wound closure materials.
Closing incision and bandaging
Closing the incision and applying appropriate bandaging helps promote proper wound healing. This task involves suturing the incision and ensuring an aseptic bandage application. The desired result is a well-closed incision with adequate wound protection. What suturing technique will you use? How will you apply the bandage? Resources needed include sutures, sterile dressings, and adhesive tapes.
Monitor vital signs post procedure
Monitoring the patient's vital signs post-procedure is crucial for assessing their stability and recovery. This task involves regular monitoring of vital signs and documenting any abnormalities. The desired result is stable and well-documented vital signs. What vital signs will you monitor? How frequently will you record them? Resources needed include vital signs monitoring equipment and documentation forms.
1
Blood pressure
2
Heart rate
3
Respiratory rate
4
Temperature
5
Oxygen saturation
Discharging patient with post-procedure care instructions
Discharging the patient with proper post-procedure care instructions ensures their well-being after leaving the healthcare facility. This task involves providing clear instructions and educating the patient about potential complications and follow-up appointments. The desired result is an informed and well-prepared patient post-discharge. What care instructions will you provide? How will you address any questions or concerns? Resources needed include discharge forms and patient education materials.
