Question

Marilyn Hughes is a 45-year-old female who suffered a left mid-shaft tibia-fibula fracture when she slipped on icy stairs this morning. She was taken to surgery for an open reduction with internal fixation (ORIF). She returned from surgery at 1:45 p.m. with a below-the-knee ace/splint dressing. Vital signs have been stable, and neurovascular checks have been within normal range. She has an IV of Lactated Ringer’s infusing at 75 mL/hour and is tolerating liquids well without nausea. Her diet could probably be advanced to regular dinner this evening. A family member has been with her at the bedside throughout the day. She began complaining of pain shortly after returning from surgery and was given morphine 6 mg IV at 2:15 p.m. She is now on every-30-minute postoperative vital signs. Last vital signs were BP: 130/82, HR: 88, RR: 16.
Please answer the following questions.
1. What complications can occur to someone after having surgery involving general anesthesia?
2. Discuss pathophysiology and pharmacological treatments of compartment syndrome.
3. Which diagnostic tests are necessary to collect prior to a patient's surgery?
4. What is a "time out" mean, in terms of a surgical procedure?
5. Which assessment data would lead you to a conclusion of compartment syndrome?

Answer 1

Answer:

1-Complications could be:

A misadministration of anesthetic doses that could lead to death of the patient, cardiac disorders, variation in body temperature, intolerance to liquids and solids, dizziness or headaches, mystical delays or momentary confusion.

2-The treatment consists of eliminating everything that generates compression in the area, in this case the casts would be a negative effect for said treatment, in addition, in extensive cases of necrosis due to the compartment syndrome they could be treated with the amputation of the limb.

The pathophysiology of this disease is a priority before the fracture, that is why it is necessary to remove the plaster from the fracture area or look for alternative methods that do not affect the patient in both pathologies.

3-Diagnostic tests to check a fracture would be: X-RAY, COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE. In addition to routine laboratory analysis, complete blood count, and clinical history or clinical inspection of the patient.

4-It is the time it takes for the anesthesia to stop having effect, it lasts approximately 1 or two hours.

5- The signs are: pallor, absence of pulse, presence of necrosis, increased edema in the compartments, possible altered mental state, but the most important symptom of this syndrome is worsening pain over time.

This symptom is essential to be able to detect it for the suspicion of this syndrome.

Explanation:

The success of the treatment begins in the correct detection of the diagnosis in pathologies such as this, that is why it is essential to know certain knowledge in patients where the risk of life is high.