Paul Wicker is Visiting Professor at the First Hospital of Nanjing, China and Fellow of the Higher Education Academy, UK.Sara Dalby is Surgical Care Practitioner at Aintree University Hospital Trust, and Associate Lecturer at Edge Hill University, UK.

“…this book would be a recommended read for all perioperative practitioners, including students, nurses, ODPs and junior doctors. It covers a wide range of subjects within perioperative care in an easy to follow, step by step guide. Each chapter is short, yet concise, making it straightforward to read. The section regarding the critical care side of perioperative practice is particularly useful and therefore opens this book out to a wider readership.” - Journal of Perioperative Practice

• Preface ixAcknowledgements xiAbbreviations xiiiSection 1 Preoperative Preparation 1Paul Wicker1 The Role of the Anaesthetic Practitioner 32 The Role of the Surgical Practitioner 73 The Role of the Recovery Practitioner 114 Preoperative Assessment of Perioperative Patients 145 Perioperative Patient Care 216 Operating Theatre Attire and Personal Protective Equipment 277 Surgical Safety Checklist 298 Teaching Students How to Use Operating Theatre Equipment 329 Perioperative Equipment 3710 Managing Perioperative Medication 4111 Interprofessional Learning and Collaboration 4612 Preventing Surgical Site Infection 4913 Skin Preparation for Surgery 52References and Further Reading 54Section 2 Anaesthesia 65Paul Wicker14 Preoperative Evaluation of the Anaesthetic Patient 6715 Preparing Anaesthetic Equipment 7016 Checking the Anaesthetic Machine 7417 Anatomy and Physiology: The Cardiovascular System 7818 Anatomy and Physiology: The Lungs 8219 General Anaesthesia 8520 Local Anaesthesia 8921 Regional Anaesthesia 9322 Rapid Sequence Induction 9623 Total Intravenous Anaesthesia (TIVA) 10124 Airway Management 10425 General Anaesthetic Pharmacology 10926 Intraoperative Fluid Management 11227 Monitoring Perioperative Patients 115References and Further Reading 118Section 3 Surgical Specialities 129Sara Dalby28 Laparoscopic Surgery 13129 Vascular Surgery 13430 Cardiothoracic Surgery 13831 Orthopaedics and Trauma 14332 Gynaecology Surgery 14833 Plastic Surgery 15334 Urology 15735 Breast Surgery 16136 Endocrine Surgery 16537 Colorectal Surgery 16838 Upper Gastrointestinal Surgery 17439 Hepato-Pancreato-Biliary Surgery 178References and Further Reading 183Section 4 Surgical Scrub Skills 191Sara Dalby40 Basic Surgical Instrumentation 19341 Surgical Positioning 19642 Thermoregulation 20143 Skin Preparation 20544 Surgical Draping 20845 Surgical Site Marking 21046 Swab Counts, Sharps and Instrument Checks 21347 Measures to Prevent Wound Infection 21748 Electrosurgery 22149 Wound Healing and Dressings 22550 Bladder Catheterisation 22951 Tourniquet Management 23252 Haemostatic Techniques 23653 Surgical Drains 24154 Handling of Specimens 245References and Further Reading 248Section 5 Surgical Assisting 257Sara Dalby55 Legal, Professional and Ethical Issues 25956 Surgical First Assistant 26357 Surgical Care Practitioner 26558 Pre and Postoperative Visiting 26959 Retraction 27360 Cutting of Sutures 27661 Suture Materials 27862 Surgical Needles 28263 Wound Closure 28564 Suturing Methods 28765 Alternative Methods of Wound Closure 29066 Injection of Local Anaesthetic for Wound Infiltration 29367 Injection of Local Anaesthetic for Wound Infiltration – Caution and Complications 29768 Camera Holding 301References and Further Reading 304Section 6 Recovery 311Paul Wicker69 Recovery Room Design 31370 Patient Handover 31771 Postoperative Patient Care 32072 Postoperative Patient Monitoring and Equipment 32473 Maintaining the Airway 33074 Diagnosis and Management of Postoperative Infection 33475 Postoperative Pain Management 33776 Fluid Balance in Postoperative Patients 34077 Postoperative Medications 34378 Managing Bleeding Problems 34779 Managing Postoperative Nausea and Vomiting 35080 Critical Issues in Postoperative Care 35481 Enhanced Recovery 357References and Further Reading 362Section 7 Perioperative Critical Care 375Paul Wicker82 Critical Care Nurses and Practitioners Roles 37783 Management of the Critically Ill Surgical Patient 38084 Malignant Hyperthermia 38385 Inadvertent Hypothermia 38686 Congestive Heart Failure 39187 Venous Thromboembolism 39788 Latex Allergy 40289 Pressure Ulcers 40690 Managing Diabetes in Perioperative Patients 41291 Smoking, Alcohol and Drug Abuse 41692 Perioperative Care of Elderly Patients 41993 Anaemia, Coagulopathy and Bleeding 42394 Care of Morbidly Obese Patients 426References and Further Reading 431Index 443

Paul Wicker is Visiting Professor at the First Hospital of Nanjing, China and Fellow of the Higher Education Academy, UK.Sara Dalby is Surgical Care Practitioner at Aintree University Hospital Trust, and Associate Lecturer at Edge Hill University, UK.

“…this book would be a recommended read for all perioperative practitioners, including students, nurses, ODPs and junior doctors. It covers a wide range of subjects within perioperative care in an easy to follow, step by step guide. Each chapter is short, yet concise, making it straightforward to read. The section regarding the critical care side of perioperative practice is particularly useful and therefore opens this book out to a wider readership.” - Journal of Perioperative Practice

• Preface ixAcknowledgements xiAbbreviations xiiiSection 1 Preoperative Preparation 1Paul Wicker1 The Role of the Anaesthetic Practitioner 32 The Role of the Surgical Practitioner 73 The Role of the Recovery Practitioner 114 Preoperative Assessment of Perioperative Patients 145 Perioperative Patient Care 216 Operating Theatre Attire and Personal Protective Equipment 277 Surgical Safety Checklist 298 Teaching Students How to Use Operating Theatre Equipment 329 Perioperative Equipment 3710 Managing Perioperative Medication 4111 Interprofessional Learning and Collaboration 4612 Preventing Surgical Site Infection 4913 Skin Preparation for Surgery 52References and Further Reading 54Section 2 Anaesthesia 65Paul Wicker14 Preoperative Evaluation of the Anaesthetic Patient 6715 Preparing Anaesthetic Equipment 7016 Checking the Anaesthetic Machine 7417 Anatomy and Physiology: The Cardiovascular System 7818 Anatomy and Physiology: The Lungs 8219 General Anaesthesia 8520 Local Anaesthesia 8921 Regional Anaesthesia 9322 Rapid Sequence Induction 9623 Total Intravenous Anaesthesia (TIVA) 10124 Airway Management 10425 General Anaesthetic Pharmacology 10926 Intraoperative Fluid Management 11227 Monitoring Perioperative Patients 115References and Further Reading 118Section 3 Surgical Specialities 129Sara Dalby28 Laparoscopic Surgery 13129 Vascular Surgery 13430 Cardiothoracic Surgery 13831 Orthopaedics and Trauma 14332 Gynaecology Surgery 14833 Plastic Surgery 15334 Urology 15735 Breast Surgery 16136 Endocrine Surgery 16537 Colorectal Surgery 16838 Upper Gastrointestinal Surgery 17439 Hepato-Pancreato-Biliary Surgery 178References and Further Reading 183Section 4 Surgical Scrub Skills 191Sara Dalby40 Basic Surgical Instrumentation 19341 Surgical Positioning 19642 Thermoregulation 20143 Skin Preparation 20544 Surgical Draping 20845 Surgical Site Marking 21046 Swab Counts, Sharps and Instrument Checks 21347 Measures to Prevent Wound Infection 21748 Electrosurgery 22149 Wound Healing and Dressings 22550 Bladder Catheterisation 22951 Tourniquet Management 23252 Haemostatic Techniques 23653 Surgical Drains 24154 Handling of Specimens 245References and Further Reading 248Section 5 Surgical Assisting 257Sara Dalby55 Legal, Professional and Ethical Issues 25956 Surgical First Assistant 26357 Surgical Care Practitioner 26558 Pre and Postoperative Visiting 26959 Retraction 27360 Cutting of Sutures 27661 Suture Materials 27862 Surgical Needles 28263 Wound Closure 28564 Suturing Methods 28765 Alternative Methods of Wound Closure 29066 Injection of Local Anaesthetic for Wound Infiltration 29367 Injection of Local Anaesthetic for Wound Infiltration – Caution and Complications 29768 Camera Holding 301References and Further Reading 304Section 6 Recovery 311Paul Wicker69 Recovery Room Design 31370 Patient Handover 31771 Postoperative Patient Care 32072 Postoperative Patient Monitoring and Equipment 32473 Maintaining the Airway 33074 Diagnosis and Management of Postoperative Infection 33475 Postoperative Pain Management 33776 Fluid Balance in Postoperative Patients 34077 Postoperative Medications 34378 Managing Bleeding Problems 34779 Managing Postoperative Nausea and Vomiting 35080 Critical Issues in Postoperative Care 35481 Enhanced Recovery 357References and Further Reading 362Section 7 Perioperative Critical Care 375Paul Wicker82 Critical Care Nurses and Practitioners Roles 37783 Management of the Critically Ill Surgical Patient 38084 Malignant Hyperthermia 38385 Inadvertent Hypothermia 38686 Congestive Heart Failure 39187 Venous Thromboembolism 39788 Latex Allergy 40289 Pressure Ulcers 40690 Managing Diabetes in Perioperative Patients 41291 Smoking, Alcohol and Drug Abuse 41692 Perioperative Care of Elderly Patients 41993 Anaemia, Coagulopathy and Bleeding 42394 Care of Morbidly Obese Patients 426References and Further Reading 431Index 443

Paul Wicker is Visiting Professor at the First Hospital of Nanjing, China and Fellow of the Higher Education Academy, UK.Sara Dalby is Surgical Care Practitioner at Aintree University Hospital Trust, and Associate Lecturer at Edge Hill University, UK.

“…this book would be a recommended read for all perioperative practitioners, including students, nurses, ODPs and junior doctors. It covers a wide range of subjects within perioperative care in an easy to follow, step by step guide. Each chapter is short, yet concise, making it straightforward to read. The section regarding the critical care side of perioperative practice is particularly useful and therefore opens this book out to a wider readership.” - Journal of Perioperative Practice

• Preface ixAcknowledgements xiAbbreviations xiiiSection 1 Preoperative Preparation 1Paul Wicker1 The Role of the Anaesthetic Practitioner 32 The Role of the Surgical Practitioner 73 The Role of the Recovery Practitioner 114 Preoperative Assessment of Perioperative Patients 145 Perioperative Patient Care 216 Operating Theatre Attire and Personal Protective Equipment 277 Surgical Safety Checklist 298 Teaching Students How to Use Operating Theatre Equipment 329 Perioperative Equipment 3710 Managing Perioperative Medication 4111 Interprofessional Learning and Collaboration 4612 Preventing Surgical Site Infection 4913 Skin Preparation for Surgery 52References and Further Reading 54Section 2 Anaesthesia 65Paul Wicker14 Preoperative Evaluation of the Anaesthetic Patient 6715 Preparing Anaesthetic Equipment 7016 Checking the Anaesthetic Machine 7417 Anatomy and Physiology: The Cardiovascular System 7818 Anatomy and Physiology: The Lungs 8219 General Anaesthesia 8520 Local Anaesthesia 8921 Regional Anaesthesia 9322 Rapid Sequence Induction 9623 Total Intravenous Anaesthesia (TIVA) 10124 Airway Management 10425 General Anaesthetic Pharmacology 10926 Intraoperative Fluid Management 11227 Monitoring Perioperative Patients 115References and Further Reading 118Section 3 Surgical Specialities 129Sara Dalby28 Laparoscopic Surgery 13129 Vascular Surgery 13430 Cardiothoracic Surgery 13831 Orthopaedics and Trauma 14332 Gynaecology Surgery 14833 Plastic Surgery 15334 Urology 15735 Breast Surgery 16136 Endocrine Surgery 16537 Colorectal Surgery 16838 Upper Gastrointestinal Surgery 17439 Hepato-Pancreato-Biliary Surgery 178References and Further Reading 183Section 4 Surgical Scrub Skills 191Sara Dalby40 Basic Surgical Instrumentation 19341 Surgical Positioning 19642 Thermoregulation 20143 Skin Preparation 20544 Surgical Draping 20845 Surgical Site Marking 21046 Swab Counts, Sharps and Instrument Checks 21347 Measures to Prevent Wound Infection 21748 Electrosurgery 22149 Wound Healing and Dressings 22550 Bladder Catheterisation 22951 Tourniquet Management 23252 Haemostatic Techniques 23653 Surgical Drains 24154 Handling of Specimens 245References and Further Reading 248Section 5 Surgical Assisting 257Sara Dalby55 Legal, Professional and Ethical Issues 25956 Surgical First Assistant 26357 Surgical Care Practitioner 26558 Pre and Postoperative Visiting 26959 Retraction 27360 Cutting of Sutures 27661 Suture Materials 27862 Surgical Needles 28263 Wound Closure 28564 Suturing Methods 28765 Alternative Methods of Wound Closure 29066 Injection of Local Anaesthetic for Wound Infiltration 29367 Injection of Local Anaesthetic for Wound Infiltration – Caution and Complications 29768 Camera Holding 301References and Further Reading 304Section 6 Recovery 311Paul Wicker69 Recovery Room Design 31370 Patient Handover 31771 Postoperative Patient Care 32072 Postoperative Patient Monitoring and Equipment 32473 Maintaining the Airway 33074 Diagnosis and Management of Postoperative Infection 33475 Postoperative Pain Management 33776 Fluid Balance in Postoperative Patients 34077 Postoperative Medications 34378 Managing Bleeding Problems 34779 Managing Postoperative Nausea and Vomiting 35080 Critical Issues in Postoperative Care 35481 Enhanced Recovery 357References and Further Reading 362Section 7 Perioperative Critical Care 375Paul Wicker82 Critical Care Nurses and Practitioners Roles 37783 Management of the Critically Ill Surgical Patient 38084 Malignant Hyperthermia 38385 Inadvertent Hypothermia 38686 Congestive Heart Failure 39187 Venous Thromboembolism 39788 Latex Allergy 40289 Pressure Ulcers 40690 Managing Diabetes in Perioperative Patients 41291 Smoking, Alcohol and Drug Abuse 41692 Perioperative Care of Elderly Patients 41993 Anaemia, Coagulopathy and Bleeding 42394 Care of Morbidly Obese Patients 426References and Further Reading 431Index 443