Surgery

18. Surgery is one of the most important fields of HS. Traditionally, it has been described as a branch of medicine which treats diseases, injuries, deformities, malformations.

The main controlling factors in surgery are anaesthesia and asepsis. Anaesthesia is used to avoid shock in a patient and to make him insensitive to pain. Asepsis is a complex of measures used to prevent introduction of microorganism into the wound from without.

19. Corrective surgery or plastic surgery is used to correct some congenital and acquired defects such as: clubfoot, harelip, cleft palate, bowlegs and defects caused by accident or disease.

Curative surgery is used in the cure of diseases such as cancers, blood clots, appendicitis and other life-threatening diseases which need surgical operations.

20. Depending on the type of operation and procedures used, there are such types of anesthesia:

• General anesthesia refers to the suppression of activity in the central nervous system.

• Local anesthesia blocks pain in regions of the body without affecting other functions of the body.

• Regional anesthesia is loss of pain sensation with muscle relaxation in certain regions of the body.

• Spinal anesthesia refers to a regional block resulting from a small volume of local anesthetics being injected into the spinal canal.

• Epidural anesthesia is a regional block resulting from an injection of a large volume of local anesthetic into the epidural space.

21. Nurses prepare surgical instruments sterilizing them in specially constructed machines – sterilizers and autoclaves.

The methods of sterilization include boiling, low (or high) pressure steam sterilization, cold sterilization by strong antisepsis, chemical sterilization and radiation sterilization.

22. Prepare the patient for the operation:

• he/she shouldn’t eat or drink anything for 12 hours before the operation

• given an enema to empty the colon from wastes the area to be operated is thoroughly cleaned, shaved and pained with the solution of iodine

• the patient is put on a operation table, covered with a sterilized cloth and administered narcosis.

Afterwards the patient is under special care and attention; his wound is frequently carefully bandaged. The surgeon prescribes the patient proper post-operative treatment. When surgeon are due for removal – this is usually done a week after the operation – the patient is discharged.

23. Surgical instruments prepare the apparatuses for blood transfusion, check up the presence and state or blood substituting solutions and preserved blood.

Surgery requires a large variety of specialized equipment. In addition to the special operating table, there are high-intensity lights and the anaesthesia machine. The main instruments table is covered with a large collection of scalpels, forceps, suture needles, retractors and other instruments.

Medical emergencies

24. There such medical emergencies: when the person has stopped breathing (it may be result of asphyxiation, electrocution, heart attack or other type of accident), severy bleeding, shock (when the victims bodily tissue do not receive an adequate supply of oxygen-containing blood) and poisoning (when the poisonous substance is swallowed).

25. The primary aim of the first aid may be summarized in three key points: to preserve life, to prevent further harm and to promote recovery. The ABC of the first aid refers to the assessment of persons airway, breathing and circulation.

26. Different nature and man-made disasters and such as flood, earthquakes, hurricanes, crowds, traffic accidents, gas or nuclear explosions, fire and others result in emergencies.

27. The ABC of the first aid refers to the assessment of persons airway, breathing and circulation. CPR is the cardiopulmonary resuscitation of victim. It has two aspects. The first is getting oxygen into the blood by blowing air into the lungs. The second is heart massage-application of chest pressure to compress the heart and squeeze blood out of it into the circulatory system.

28. Shock is the condition when the victims bodily tissues do not receive an adequate supply of oxygen-containing blood. Symptoms and signs include tachycardia/tachypnoea, hypotension, loss of consciousness, nausea, vomiting or diarrhea.

The victim should be put supine with feet raised. No food or drink should be given. Bleeding should be controlled and the victim should be kept warm and comfortable until professional assistance arrives.

29. It is to have the necessary equipment and medications readily available in a first aid kit. It should contain sterile cotton wool, gauze pad and saline solution for cleaning wounds; antiseptic wipes or sprays to reduce the risk of infection in the wound; some medications such as aspirin, painkillers, activated charcoal, tranquilizers and others; antiseptic ointment, iodine, brilliant green, burn spray and others.

30. In a case of poisoning the victim should be given the antidote, should be forced to vomit or even gastric lavage in hospital may be needed. Bleeding can be stopped with direct pressure above the place of bleeding (when artery bleeds). If a vein bleeds, the extremity must be elevated.