Dx: Surgical Procedure, Schemes and Mind Maps of Surgical Pathology

Download Dx: Surgical Procedure and more Schemes and Mind Maps Surgical Pathology in PDF only on Docsity! University of Washington Department of Orthopaedics & Sports Medicine Surgical Worksheet Surgery Date__________________________ Surgeon: Winston J Warme
See surgeon prior to surgery
Pav or Main Only
R2 OK
Complex Case Dx: Surgical Procedure:
Scope
Open
Possible Open Interpreter:
No
Language: Diabetic:
No
Yes Latex allergy:
No
Yes Transmission Issues:
No
(MRSA TB) Sleep Apnea:
No
Yes Developmental Delay:
No
Yes Pacer or defiber:
No
Yes Pt > 400 lbs:
No
Yes Mobility/transportation issues:
No
P R E O P Issues impacting Pre-op prep time day of surgery: P C C Length of Stay: (OP 1-2 Days 2-3 Days) Length of Surgery: (1 Hour 1.5 Hours 2 Hours 2.5 Hours 3 Hours) Admission:
OP
LS
AM Admit
IP
Day Before Surgery First Post-op:
2 Week
1 Week
Same Week
No
Other: Anesthesia:
Choice
Interscalene Block
No Block
Other: Labs:
Routine: CBC
Arthroplasty or >40y/o: CBC/CMP/COAGS/Hep C/HCG/UAcC&S
Sed/CRP Transfusion:
None
T + S Units (Arthroplasty) T + C Units (2 if Arthroplasty and pt of concern) Consult:
None
Medicine
Social Work
ID
Other: O R PAT Position:
Lateral
Beach Chair
Supine
Prone
Other: O/R Table:
Regular
Fx Table
RA Table
Beach Chair Attach
Other: O/R X-ray:
None
C-Arm
Mini C-Arm
Other: Special Equip:
Scope Boom
CPM Bed
None
McConnell Arm Hldr
Other:
Arm Holder
Radiolucent Arm
Cardiac Board
Hand Table BRACE:
Shoulder S M L
Ultrasling
Other: IMPLANTS/ Special Instruments: Depuy Global Advantage
TSA
Ream and Run
CTA
Fx
Proximal Humerus Plate Exactech
Equinoxe Shoulder Fracture System
InterSpace Shoulder Cement Spacer Encore
Reverse Shoulder Prosthesis System Wright Medical
Evolve Radial Heads Zimmer
Coonrad-Moorey Elbow Implant
Olecranon Elbow Plate
Periarticular Prox Lat Humeral Locking Plate Clavicle
Acumed Locking Clavicle Plate
Synthes Clavicle Hook Plates
Synthes Locking Clavicle Plate Set
Synthes Small Frag Set
Synthes Pelvic Recon Screws & Plates: 3.5
Synthes Long 2.7 Plates and Screws (3 sets)
DePuy Rockwood Clavicle Pin NW Tissue Center
Allograft(s):
Hamstring Allograft Synthes
Locking Prox Humerus Plate (Sm Lock Frag)
X-Long LCP Proximal Humerus Plate Set
Locking Olecranon Plate Set
Locking Distal Humerus Plate Set
Mini Frag Set: 1.5, 2.0, 2.7 mm Screws
Sm Frag Set: 3.5 Cortex Screws
Lg Frag Set: 4.5 Nar & Brod, 6.5 Cancellous
Locking Mini Fragment (2.0, 2.4, 2.7)
Locking Small Fragment Set
Locking Large Fragment Set
Pelvic Recon Screws & Plates 3.5 & 4.5 mm
Recon Plate Set(s) 2.7 mm & 3.5 mm
X- long 2.7 mm Screw Rack
2.7 mm DCP plate Set
2.5mm term thread K Wires (Sm Ext Fixator Set)
Kirschner “K” Wires – single ended Hardware Removal Tools
Snap-On Extraxtion Set (drivers) 50057
Spine Implant Removal Set (easy outs) 50319
Broken Screw Removal Set 50077
DePuy Cement Removal Set 40047
Ultra Drive Cement Remover 50472
Big Bertha (slap hammer set) 50083 Grafting
ConMed Linvatec Tendon Stripper
Arthrex Tendon Stripper
Smith & Nephew Acufex Graftmaster II Arthroscopy Gear Arthrex
4.5mm FT Bio-Corkscrew Anchor
5.5mm FT Bio-Corkscrew Anchor (RCR)
4.5mm PushLocks
3.0mm Bio-SutureTak (Bankart/SLAP)
STaR Sleeve
Biotenodesis Set and screws
Biceps buttons
4.75 Bioswivelocks ConMed Linvatec
DryDoc Cannula 8.0mm x 75mm (red)
DryDoc Cannula 8.0mm x 85mm (yellow)
Suture Saver Kit Smith & Nephew
4.5 Full Radius Bonecutter (Yellow)
5.5 Full Radius Bonecutter (Orange)
4.5mm Synovator (Forest green)
5.5mm Synovator (Melon yellow)
4.5mm Helicut Burr
Endobuttons: (CL) (Free)
RCI Bioscrews Arthrocare
90º Turbovac Other Tools
Midas Rex c Metal Burrs and “Midas Wheel”
Sterile x-ray film (protect from metal debris)
Sterile lubricant PLEASE COMPLETE BOTH SIDES Filled out by/Date: Affix Pt Label Here Name: U Number: DOB: DOS: