Pre- & Post -OP

Proceedings during a Surgical Intervention

Surgery is a demanding procedure that cannot be approached in a spontaneous manner. Even in conditions of extreme urgency, a minimum of precautions are indispensable in order to hope for satisfactory results.

Before (Pre - OP)

Operative indication
Biological, electrophysiological and radiological examinations.
Anaesthesia consultation
Cardiology consultation if required.
Explaning the reasons for the operation, its purpose, its outcome.
Signature of an informed consent between the patient, family members if present and the surgeon.
Provision of all supplies and medicines.
Verification of the correct operation of the equipment.
Displaying of X-ray film(s).
Setting up the surgical equipment.
OP theatre Temperature at 22°C.
Installation of the patient.
Psychological preparation by the nursing staff and the anaesthetist.
Noise and movement limitation as soon as the patient is installed.
Induction after verification of vital parameters by the anaesthetic team.
Positioning of the patient in the corresponding decubitus position.
Covering with warm-touch at 37°C.
Setting up of the microscope & amplifier.
Cleaning of the operating site.
Surgeon's preparation.
Sterile covering of the patient and all optical and radioscopic equipment.
Team-Time In (Reminder to all of the surgical team on reasons for the surgery: Patient's identity, complaints, part of the body and side to be operated on, possible difficulties in the course of the operation).

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After (Post - OP)

Team-Time-Out
(At the end of the operation, clearly explain the difficulties that have arisen, to the whole team, give clear instructions on post-Op care.
Extubation and stabilisation.
Checking the positioning of the drains.
Transfer of the patient to the recovery room.
Monitoring and close supervision.
Checking the patient's mobility and alertness.
Post-Op Check-ups (tests).
Mobilisation depending on the case.
Post-Op treatment to be prescribed.
Verification of healing (scaring)

1. Team - Time - In

The operating theatre can only be started if the pre-operative preparations have been completed and have been conclusive for the surgical team. The patient is taken to the operating theatre and is presented to the team again as soon as he or she enters. His or her identity, diagnosis and planned treatment are to be repeated aloud. The patient, if not comatose, must participate in this dentification by answering either yes or no to the information shared about him or her. This is the TEAM-TIME-IN.

2. Team - Time - During

Before and during the induction period, the operating theatre staff check and adjust the medico-surgical and anaesthetic equipment. They remain on constant alert and ready to react to the slightest request. This requires a great deal of organisational work beforehand (Ordering - Identification - Storage - Checking the stock etc.). The solutes, instruments, special medicines... all of these must be controlled by the non-sterile team in order to guarantee a good outcome to the surgical operation.

3. Team - Time - Out

At the end of the operation, the surgeon informs the whole surgical and anaesthetic team on the assessment of the expected results - Possible complications (nerve damage, vascular damage, organ damage etc...) must absolutely be shared with others and the post-operative follow-up organised according to the symptoms and current knowledge.

The patient is transferred to the recovery room followed by an anaesthesia protocol and a prescription with recommendations.