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On arrival at the ward I learnt that the ward was checked and stocked up by night staff and signed in the logbook.
Soon after starting my shift our first patient was wheeled to a bay by theatre staff. I put on personal protective equipment and approached the patient. I connected the patient to the monitoring and their airway to the central oxygen.
I learnt from the anaesthetist that the patient Mrs Brown (not her real name) hemiarthroplasty of her right hip operation under general, plus regional anaesthetic. She was in theatre for almost two hours and was stable throughout the operation. Mrs Brown is a 72 years old lady of 57kg, had a fall two days ago that fractured her neck of femur. Her medical history was dementia, untreated hypertension (high blood pressure) and high cholesterol. She had no-known allergies and was not taking any regular drugs except painkillers when needed. In theatre she induced with sevoflurane, was given a fascia-iliac nerve block 100 mcg Fentanyl intravenously on induction, 100 mg Propofol, 30 mg Rocuronium, 4 mg Ondansetron, 3.3 mg Dexamethasone, 50 mg Cyclizine , 75 mg Voltarol, 1 gr Paracetamol, 10 mg Morpheine and Glycopyrronium Bromide 0.5mg and Neostigmine Metilsulfate 2.5 mg at the end of surgery.
The theatre nurse estimated blood loss of 500 millilitres. The patient had two Bellovac drains in situ that were unclamped and had started collecting in theatre, and the wound was dressed using a Mepilex dressing.
A- Airway - the patient’s airway was patent. She had an oropharyngeal (Guedel) airway used as a bite block size 2 (green), and an endotracheal tube size 7 in situ connected to a water circuit and to 10L central oxygen. The bag was moving, and the endotracheal tube was misting.
B- Breathing - Mrs Brown was breathing spontaneously. Her respiratory rate was 12 per minute and shallow in depth, bilateral air entry was present with equal chest
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