Case No: Minor Scrub 1

Name of Student: Salazar, Nica Sharmaine C.

Year/Section & RLE: 3NUR8 RLE4

Name of Patient: Larry Martino Sr. Age: 53 Sex: M Civil Status: Married
Date of Admission: 10/12/17 Time Started & Ended: 2:20-2:40 PM
Date of Surgery: 10/12/17
Bed #: 3011 Hospital No: 17-130000098151 Admission No: 17000355

Surgeon: Dr. Jeremy Munji Anesthesiologist: Dr. Magday

Assistant Surgeon: Dr. Baylon Scrub Nurse: Charmaine Lei M. Lacson, RN
Circulating Nurse: Kristina A. Tan, RN

Chief Complaint: Difficulty ambulating / Diabetic foor Right

Rationale/Definition: Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and
neuropathic osteoarthropathy is called diabetic foot syndrome

Post-Operative Diagnosis: deep dissection and debridement of deep infection of multiple areas of foot- RLS
Rationale/Definition: Debridement is a common treatment used for a range of skin wounds and disorders as skin
healing necessitates the removal of damaged tissues. This procedure removes extremely damaged skin due to eczema or
severely infected skin by cutting dead tissues away

Complete Surgical Procedure: Debridement of eczematous or infected skin Right foot

Definition: This procedure removes extremely damaged skin due to eczema or severely infected skin by cutting dead
tissues away
Type of Anesthesia: Regional Anesthesia
Specific Technique: Spinal Anesthesia
Skin preparation/ Assistance done:
Items used to Administer Anesthesia: Stimuplex 20Gx4.30, Terumo G21 (5cc&10cc), Terumo G23 (3cc), Spinocan 27Gx
3 , needle 25G, Spinocan 25Gx3 , KY lubricant, Stimuplex HNS12
Main Anesthetic Agent: Sevoflurane
Main Anesthetic Agent: bupivacaine 0.5% hyperbaric
Mechanism of Action: Bupivacaine binds to the intracellular portion of voltage-gated sodium channels and blocks sodium
influx into nerve cells, which prevents depolarization. Without depolarization, no initiation or conduction of a pain signal can
occur.
Other Medications:
Fentanyl
Mechanism of Action:
Opiate receptors are coupled with G-protein receptors and function as both positive and negative regulators of synaptic
transmission via G-proteins that activate effector proteins. Binding of the opiate stimulates the exchange of GTP for GDP on
the G-protein complex. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma
membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase.
Medazolam
Mechanism of Action: Benzodiazepines increase the activity of GABA, thereby producing a calming effect, relaxing
skeletal muscles, and inducing sleep. Benzodiazepines bind to the benzodiazepine site on GABA-A receptors, which
potentiates the effects of GABA by increasing the frequency of chloride channel opening.
Position: Supine
Equipment used for Positioning: Straps/ safety belt, donut and arm splint/board
Incision: n/a
Skin Preparation: from inguinal area to the sole of the foot
Disinfectant Used: benzalkonium chloride
Draping: Laparotomy sheets
Sutures and needles

TISSUE LAYER NEEDLE NAME OF SUTURING

SUTURE USED TECHNIQUE
N/A N/A N/A N/A

INSTRUMENTS

CLAMPING RETRACTING GRASPING CUTTING OTHERS

Towel clips N/A Tissue forceps Straight mayo Kidney basin
Kelly regular Metzembaum Medicine cup
Curved mayo Bowl
bone curette