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What might effective pain management depend upon
What might effective pain management depend upon
Effective pain management the literature
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Laryngectomy is partial or total removal of the voice box (larynx). Your larynx is located at the top of your throat. It lets you speak and breathe by allowing air to pass through your throat. After having a laryngectomy, you will no longer be able to breathe out of your mouth. You will have an opening (stoma) in the front of your neck. After your surgery, you will breathe through the stoma.
LET YOUR HEALTH CARE PROVIDER KNOW ABOUT:
• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Previous problems you or members of your family have had with the use of anesthetics.
• Current steroid use.
• Previous surgeries you have had.
• Any blood disorders
…show more content…
○ A medicine to make you fall sleep (general anesthetic).
• You may have a flexible tube (catheter) put into your bladder to drain urine.
• You may have a tube put through your nose or mouth that goes into your stomach (nasogastric tube). The nasogastric tube removes digestive fluids and prevents you from throwing up or feeling nauseous.
• A U-shaped incision will be made under one side of your jawbone, just beneath your ear, and will continue below your larynx and up to the other side of your jawbone.
• The larynx is separated from the windpipe (trachea) and removed.
• Your surgeon will make the stoma by making an incision in the trachea, at the bottom part of the first incision.
• The new opening to the trachea will be stitched so that it opens up into the stoma.
• The incisions will be closed with stitches (sutures).
The procedure may vary among health care providers and hospitals.
AFTER THE PROCEDURE
• You will have some pain. Pain medicines will be available to help you.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn
Breathing is the most important AL (Roper et al, 1998). A detailed assessment of her airway would be performed because protection of the airway throughout anaesthesia is essential (Yates, 2000). This does not just include recording of respiration rate and oxygen saturation (SpO2) but also noting any use of accessory muscles, shortness of breath, auscultation of chest and lungs areas for wheezes/crackles and asking patient about history of any respiratory illness/smoking (McArthur-Rouse, 2007).
Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). The 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secon Alternatives to indwelling catheter include condom catheter, or intermittent straight catheterization. One of the protocols used in this study is urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters.
The pharynx is a large cavity behind the mouth and between the nasal cavity and larynx. The pharynx serves, as an air and food passage but cannot be used for both purposes at the same time, otherwise choking would result. The air is also warmed and moistened further as it passes through the pharynx. The larynx is a short passage connecting the pharynx to the trachea and contains vocal chords. The larynx has a rigid wall and is composed mainly of muscle and cartilage, which help prevent collapse and obstruction of the airway.
There are many outpatient surgical procedures and one of them is an incision and drainage
Brody, Michael, and Donald Martin. “The Role of Anesthesiologists.” Physicians Protecting Patients. N.p. N.d. Web. October 21, 2015. An anesthesiologist is a physician who has received at least 8 years of schooling and has completed a residency program dealing with anesthesiology. Now, a licensed physician, an anesthesiologist deals with the administration of anesthesia during many medical procedures, including surgical or obstetric procedures, and pain management for acute and chronic illnesses, or cancer related pain. Anesthesiologists are also in charge of “anesthesia care teams” that include the anesthesiologist, an anesthesia assistant, certified registered nurse anesthetist, and an anesthesia technician. As the leader of the care team, the anesthesiologist is responsible for assessing the patient before, during, and after medical procedures, as well as developing and monitoring performance and quality of practices and standards in regards to administering anesthesia. The entirety of
2) “It’s difficult to determine who provides anesthesia care in the studies and the number of cases that actually involved a physician anesthesiologist (p. 11)” the ASA is claiming that the data collected and used in this review, are difficult to determine who did what and when. In other words it is unclear as to who was performing and providing care in these studies and very well could be, the care provided by an anesthesiologist. They say also that the data provided and used by the study has limiting factors to determine whether an anesthesiologist was available as needed, for rescue or advice by a patient being treated by a nurse anesthetist if they were to experience complications under the
American Association of Nurse Anesthetists. Professional Aspects of Nurse Anesthesia Practice. Philadelphia: F. A. Davis Company, 1994. Print.
Subotic, D. and Lardinois, D. 2013. Chapter 9. Surgical treatment of bronchiectasis. European Respiratory Society Monograph, 61 pp. 90-106.
Because of this, I received a tracheostomy and spent two months hooked up to a ventilator. When I was finally weened off the ventilator, I had to do daily breathing exercises with an incentive spirometer to aid in the strengthening of the functional side of my diaphragm.
Anesthesiologists have many responsibilities. 3They measure the patient’s temperature, pulse, heart rate, and breathing rate while under the sedative. They have...
Webster CS, Merry AF, Larsson L, McGrath KA, Weller J. The frequency and nature of drug administration error during anaesthesia. Anaesth Intensive Care 2001; 29: 494-500.
It is performed to muffle or completely eliminate the sounds produced by a dog barking excessively. It is a cosmetic/convenience procedure, as this is for the convenience of the owner and there has been no medical benefit reported (2). This procedure can be performed via two methods: the oral approach, or the laryngotomy approach (3). The oral approach involves anesthetizing the patient and inserting surgical tools into the oral cavity of the patient. These tools are passed through to the vocal cord region of the larynx, where a laryngoscope exposes the vocal cords. A surgical tool, such as a tonsil punch, is used to remove a portion of the vocal cords. The laryngotomy approach involves an incision through the skin, subcutaneous tissue and directly into the larynx, thus bypassing the oral cavity. A laryngoscope exposes the vocal cords, and a second incision is then performed to remove the portion of the vocal cords from the larynx. The cut-edge of the tissue is then sutured to the laryngeal tissue, to prevent blockage of the airway. These sutures are removed approximately two weeks later. Both of these options come with their respective advantages and disadvantages, and the procedure used is decided by the owner and/or the familiarity of the vet with the surgical procedure or tools
3. Nasojejunal (NJ) or Post pyloric: The feeding tube is placed in jejunum by passing the stomach. This prevents the risk of aspiration.
This reflection of vital signs will go into discussion about the strengths and weaknesses of each vital sign and the importance of each of them. Vital signs should be assessed many different times such as on admission to a health care facility, before and after something substantial has happened to the patient such as surgery and so forth (ref inter). I learned to assess blood pressure (BP), pulse (P), temperature (T) and respiration (R) and I will reflect and discuss which aspects were more difficult and ways to improve on them. While pulse, respiration and temperature were fairly easy to become skilled at, it was blood pressure which was a bit more difficult to understand.
Pharmacology is a vital component in the perioperative practice. Medication use is monitored closely during the perioperative period. Preoperatively, there are certain drugs that must be discontinued prior to a surgery as they increase surgical risk, including anticoagulants, tranquillisers, corticosteroids and diuretics (Laws, 2010b). In fact, these drugs can increase the risk of respiratory depression, infection, fluid and electrolyte imbalance and increased risk of bleeding (Hamlin, 2010). Open communication is important in obtaining a medication history, and in identifying the drugs taken prior to the surgery. If any of these medications has be...