Fundamentals of Operating Department Practice Published online by Cambridge University Press Published online by Cambridge University Press Fundamentals of Operating Department Practice Second Edition Edited by Daniel Rodger SeniorLecturerinPerioperativePractice,LondonSouthBankUniversity Kevin Henshaw SeniorLecturerinPerioperativePractice,EdgeHillUniversity,Ormskirk Paul Rawling SeniorLecturerinPerioperativePractice,EdgeHillUniversity,Ormskirk Scott Miller ConsultantAnaesthetist,StHelensandKnowsleyHospitalsNHSTrust Published online by Cambridge University Press UniversityPrintingHouse,CambridgeCB28BS,UnitedKingdom OneLibertyPlaza,20thFloor,NewYork,NY10006,USA 477WilliamstownRoad,PortMelbourne,VIC3207,Australia 314–321,3rdFloor,Plot3,SplendorForum,JasolaDistrictCentre, NewDelhi–110025,India 103PenangRoad,#05–06/07,VisioncrestCommercial,Singapore238467 CambridgeUniversityPressispartoftheUniversityofCambridge. ItfurtherstheUniversity’smissionbydisseminatingknowledgeinthepursuitof education,learning,andresearchatthehighestinternationallevelsofexcellence. www.cambridge.org Informationonthistitle:www.cambridge.org/9781108819800 DOI:10.1017/9781108876902 ©CambridgeUniversityPress2022 Thispublicationisincopyright.Subjecttostatutoryexception andtotheprovisionsofrelevantcollectivelicensingagreements, noreproductionofanypartmaytakeplacewithoutthewritten permissionofCambridgeUniversityPress. Firstpublished2000 ThisSecondEdition2022 PrintedintheUnitedKingdombyTJBooksLimited,PadstowCornwall AcataloguerecordforthispublicationisavailablefromtheBritishLibrary. ISBN978-1-108-81980-0Paperback CambridgeUniversityPresshasnoresponsibilityforthepersistenceoraccuracyof URLsforexternalorthird-partyinternetwebsitesreferredtointhispublication anddoesnotguaranteethatanycontentonsuchwebsitesis,orwillremain, accurateorappropriate. ....................................................................................................................................................... Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateandup-to-dateinformation thatisinaccordwithacceptedstandardsandpracticeatthetimeofpublication.Althoughcasehistories aredrawnfromactualcases,everyefforthasbeenmadetodisguisetheidentitiesoftheindividuals involved.Nevertheless,theauthors,editors,andpublisherscanmakenowarrantiesthatthe informationcontainedhereinistotallyfreefromerror,notleastbecauseclinicalstandardsare constantlychangingthroughresearchandregulation.Theauthors,editors,andpublisherstherefore disclaimallliabilityfordirectorconsequentialdamagesresultingfromtheuseofmaterialcontainedin thisbook.Readersarestronglyadvisedtopaycarefulattentiontoinformationprovidedbythe manufacturerofanydrugsorequipmentthattheyplantouse. Published online by Cambridge University Press Contents Listofcontributors vii Foreword xi 1 TheCaringPerioperative 11 IntroductiontoGeneral Practitioner 1 Anaesthesia 107 JulieQuick JamesIpandJoHanGan 2 Evidence-BasedOperating 12 FundamentalsofAirway DepartmentPractice 9 Management 116 PaulRawling RebeccaSherwood 3 HealthcareEthicsandProfessional 13 ArtificialVentilation 134 RegulationinOperating VickyLester DepartmentPractice 15 14 ManagementofPerioperative EdmundHorowiczandAmyWilliams MedicalEmergencies 143 4 OperatingDepartmentPracticeand NathanGamble theLaw 28 15 TotalIntravenousAnaesthesia 164 EdmundHorowiczandAmyWilliams ScottMiller 5 HealthandSafetyinthe 16 FundamentalsofBasicPatient PerioperativeEnvironment 49 Monitoring 172 KevinHenshaw VictoriaCadmanandEfuaHagan 6 FundamentalsofOperating 17 HaemodynamicMonitoring 180 DepartmentDesign 57 MichaelDonnellon ShaneRoadnightandAnneFollowell 18 FundamentalsofRegional 7 FundamentalsofInfection Anaesthesia 191 PreventionandControlinthe WillAngusandKarimMukhtar OperatingDepartment 69 JoanneFieldingandMarkMilligan 19 FundamentalsoftheAnaesthetic Machine 204 8 FundamentalsofCardiovascular DanielRodger Physiology 81 DominicNielsenandJamesIp 20 AnaestheticBreathing Systems 218 9 RecognitionandInterpretationof CherylWayne-KevanandDaniel theElectrocardiogram 89 Rodger KullySandhu 21 PharmacologicalAgentsin 10 FundamentalsofRespiratory AnaestheticPractice 224 Physiology 100 KathrynNewton,PeterTurton,and SarahJohnandTahzeeb BrianCorrin Bhagat v Published online by Cambridge University Press vi Contents 22 FundamentalsofEmergency 32 UnderstandingSuturesandSkin ObstetricCare 242 Closure 356 VictoriaCadmanandRebeccaHelen SteveMoutreyandPaulBond Lowes 33 PerioperativeCareofthePaediatric 23 CareoftheBariatricPatient 255 Patient 365 HannahAbbott FayeLowryandDaniel Rodger 24 FundamentalsofDecontamination andSterilisation 264 34 PerioperativePain MartinKiernanandRogerKing Management 375 SenthilJayaseelan 25 ManagementandUseofMedical Equipment 274 35 RecoveryofPatientsfrom JulieQuickandLauraGarbett AnaesthesiaandSurgery 384 PatriciaSmedleyandJaneNicholas- 26 FundamentalsoftheSurgicalScrub Holley Role 287 LindsayKeeley 36 TheFundamentalsofEmergency Resuscitation 407 27 FundamentalsofPatientPositioning RobertAyeeandJamieMacpherson forSurgery 301 SarahBrady 37 HumanFactors,Ergonomics,and Non-technicalSkills 422 28 FundamentalsofPerioperative MarkHellaby Thermoregulation 311 CraigGriffiths 38 UnderstandingIntraoperative Death 432 29 FundamentalsofFluidand DanielRodgerandHeather ElectrolyteBalanceduring Hartley Surgery 322 ChrisWoodandRebeccaParker 39 ExtendedandAdvancedRolesin PerioperativePractice 443 30 ThePhysiologyofBloodandIts SallyStuart Administration 334 SuzanneArulogunandPaulWheeler 31 FundamentalsofWoundHealing, Dressings,andDrains 347 Index 452 SteveMoutrey Published online by Cambridge University Press Contributors HannahAbbott VictoriaCadman HeadofSchool,HealthSciences SeniorLecturerinOperatingDepartment BirminghamCityUniversity Practice Birmingham,UK SheffieldHallamUniversity Sheffield,UK WillAngus ConsultantinIntensiveCareMedicineand BrianCorrin Anaesthesia AnaesthesiaAssociate AintreeHospital SheffieldTeachingHospitalsNHS LiverpoolUniversityHospitalsNHSTrust FoundationTrust Liverpool,UK Sheffield,UK SuzanneArulogun MichaelDonnellon SeniorClinicalResearchFellow FormerSeniorLecturerinOperating DepartmentofHaematology,Cancer DepartmentPractice Division UniversityofCentralLancashire UniversityCollegeLondonHospitalsNHS Preston,UK FoundationTrust JoanneFielding London,UK LecturerinOperatingDepartment RobertAyee Practice ClinicalFellowinIntensiveCareMedicine LondonSouthBankUniversity RoyalLiverpoolUniversityHospital London,UK Liverpool,UK AnneFollowell TahzeebBhagat SeniorLecturerinPerioperativePractice ConsultantAnaesthetist BuckinghamshireNewUniversity Guy’sandStThomas’NHSFoundation HighWycombe,UK Trust NathanGamble London,UK SeniorResidentPhysician,Internal PaulBond Medicine PatientSafetyandQualitySupportOfficer UniversityofAlberta TheAssociationforPerioperativePractice Edmonton,Alberta Keswick,UK Canada SarahBrady LauraGarbett LecturerinPerioperativeProgrammes, SeniorLecturerinOperatingDepartment AlliedHealthProfessions(ODPTeam) Practice EdgeHillUniversity BirminghamCityUniversity Ormskirk,UK Birmingham,UK vii Published online by Cambridge University Press viii Listofcontributors CraigGriffiths SarahJohn SeniorLecturerinOperatingDepartment SpecialtyRegistrarinAnaesthesia Practice LiverpoolWomen’sHospital UniversityofSouthWales Liverpool,UK Pontypridd,UK LindsayKeeley EfuaHagan PatientSafetyandQualityLead WorkforceLead TheAssociationforperioperativePractice CroydonUniversityHospital Harrogate,UK Croydon,UK MartinKiernan JoHanGan VisitingClinicalFellow ConsultantAnaesthetist UniversityofWestLondon RoyalBromptonHospital Brentford,UK London,UK and ConjointFellow HeatherHartley UniversityofNewcastle Manager,PerioperativeServices NewSouthWales TrentonMemorialHospital Australia QuinteHealthCareCorporation Ontario,Canada RogerKing SeniorLecturer(Retired) MarkHellaby UniversityofWestLondon NorthWestSimulationEducationNetwork Brentford,UK Manager NHSHealthEducationEngland(NW) VickyLester Manchester,UK ConsultantAnaesthetist StHelensandKnowsleyHospitalsNHS KevinHenshaw Trust SeniorLecturerinPerioperative Prescot,UK Practice EdgeHillUniversity RebeccaHelenLowes Ormskirk,UK LearningandDevelopmentManager SheffieldTeachingHospitalsNHS EdmundHorowicz FoundationTrust LecturerinHealthcareLawand Sheffield,UK Bioethics SchoolofLawandSocialJustice FayeLowry UniversityofLiverpool HeadofResuscitation Liverpool,UK AlderHeyChildren’sNHSFoundation Trust SenthilJayaseelan Liverpool,UK ConsultantinAnaesthesiaandPain Management JamieMacPherson StHelensandKnowsleyTeaching SeniorLecturerinPerioperativeStudies HospitalsNHSTrust EdgeHillUniversity Prescot,UK Ormskirk,UK Published online by Cambridge University Press Listofcontributors ix ScottMiller BirminghamCityUniversity ConsultantAnaesthetist Birmingham,UK StHelensandKnowsleyHospitalsNHS PaulRawling Trust SeniorLecturerinPerioperativePractice Prescot,UK EdgeHillUniversity MarkMilligan Ormskirk,UK LecturerinOperatingDepartmentPractice ShaneRoadnight LondonSouthBankUniversity AssociateProfessorinPerioperative London,UK Practice SteveMoutrey BuckinghamshireNewUniversity SeniorLecturer(retired) HighWycombe,UK UniversityofPortsmouth, DanielRodger Portsmouth,UK SeniorLecturerinPerioperativePractice KarimMukhtar LondonSouthBankUniversity ConsultantinAnaesthetia London,UK StHelensandKnowsleyHospitalsNHS KullySandhu Trust ConsultantInterventionalCardiologist Prescot,UK LiverpoolHeartandChestHospitalNHS KathrynNewton FoundationTrust SpecialistRegistrar Liverpool,UK MerseyDeanery RebeccaSherwood Liverpool,UK SeniorLecturerinPerioperativePractice JaneNicholas-Holley LondonSouthBankUniversity Matron,NuclearMedicine London,UK Guy’sHospital Guy’sandStThomasNHSFoundation PatriciaSmedley EducationLead Trust BritishAnaestheticandRecoveryNurses London,UK Association DominicNielsen UK LocumConsultantPaediatricAnaesthetist SallyStuart CambridgeUniversityHospitalsNHS SeniorLecturerandProgrammeLeadfor FoundationTrust MScinSurgicalCarePracticeEdgeHill Cambridge,UK University RebeccaParker Ormskirk,UK PsychiatricSeniorRegistrar PeterTurton Northerndeanery SpecialistTraineeinAnaesthesiaand UK IntensiveCareMedicine JulieQuick StHelensandKnowsleyHospitalsNHS SeniorLecturerinOperatingDepartment Trust Practice Prescot,UK Published online by Cambridge University Press