Stroke in the heart surgery department
The heart surgery department consists of 18 rooms with 26 beds, which consists of 10 rooms with a private bathroom and 8 double-glazed rooms. Two private rooms are used for isolated patients. Private rooms are numbered (408 - 409 - 410 - 411 - 412 - 429 - 430 - 431 - 432 - 433) and double rooms of the number (434 - 435 - 436 - 437 - 438 - 439 - 440 - 441 ) is .
Cardiac surgery ward with a nursing station, a dressing room, a treatments, and a room Rest and dirty work double room and a dressing room and bathroom Shvrkhanh T is for personnel.
Patient rooms. Room: Equipped with a sanitary and bathroom service, and above each bed patient has central suction and central oxygen and a special patient ring, and a serum connected to the bed and a table for food at the bottom of each bed and a lacquer or a special small patch There is a large wall-mounted cabinet for the patient's equipment, as well as a bed for a bed in the patient's bedside, and there are two infectious and non-infectious garbage bins in each room.
Dressing room: This dressing room for patients with heart surgery or dressing is required, and the equipment of this room includes a portable and portable oxygen saturation bed and a perforated / and a dressing trailer equipped with Bicks Sterile gas, and bandaging and betadine and dressing sets, in addition to the large set of ready-made sets and ready-made trays, including LP -kit, CVP set
Sets of dressing - Sinking tray - NGTUP tray and Surgical mouthpiece and two sterile pelvis. There is also a parachute in this room, as well as two bins of infectious and noninfectious waste in the dressing room, and a toilet sink to keep the hygiene in place. is .
Heart Surgery Personnel:
The heart surgery department staff includes a head nurse and a staff member , as well as 15 nurses and 9 nurses and 6 service personnel involved in the department. There are two permanent personnel in the morning and two staff in the long off and two in charge of the shift. In each shift, the age of 4 nurses, three clinical nurses and one shiftman, operate in the shifts of the night, and in addition to the shift nurses In the evening, 3 assistants and 2 night care assistants and 1 male surgeon services, and in the morning shift, head nurses and staff and 3 nurses and one secretary and 3 assistants and 2 services, and if there is a problem for each one Of the alternative personnel.
Physicians in the heart surgery department include:
A ) Surgeons: Alphabetical: Dr. Ali Asghar Bellourian
Dr. Seyyed Ahmad Hasantash
Dr. Mohammad Hossein Mandegar
Dr. Seyyed Mohammad Mahmoud Majidi Tehrani
B ) Internal cardiologists: in alphabetical order: Dr. Mohammad Abazari
Dr. Yedala Salamatari
Dr. Seyyed Hashem is deserving
Dr. Afshin Ghofrani
Dr. Massoud Ghasemi
Dr. Mohammad Hasani
Dr. Yaghoubpour Sharif
Decker Hadi Fadawi
Dr. Reza Kia
Dr. Amirali Mehrabanfar
C ) Doctors counseling:
Internal: Infection - Endocrinology - Ophthalmology - Women - Psychiatry - Neurology - ENT - Physiotherapy - Anesthesia - Lung
Surgery: Neurology - Vascular - General - Orthopedic - Women
Head Nurse: Samira Hajizadeh Internal Affairs Department: 2492 - 2493
Root Cardiac Surgery for Post Angiography and Angioplasty:
- Patients undergoing angiography in the lining of the lobe are transferred to the department by a nurse in the department of cardiac surgery and a flatbed (stretcher) aid, and if the angiography is femoral, after placing the sandbag in the lining of the lips after Departure of the patient is recommended to the patient that he does not bend in any way. Otherwise, he will bleed, and the relevant nurse will report and report the angiography (for example, the patient: Medical Followup or candidate CABG is an angioplasty candidate) as well as CD and angiography depot for patient delivery.
- After transferring the patient to the section of the recommendation, the patient will be given a non-bending leg. Signs are checked regularly, and the place of departure for the trachea is checked for bleeding and hematoma. The sandbag remains on the site and the pulse of the two feet is checked.
- كيسه شن روي فمور به مدت 6 ساعت باقي مي ماند و پس از كنترل محل در صورت نداشتن خونريزي برداشته مي شود بيمار پس از آنژيوگرافي پس از ورود به بخش بعد از 2 ساعت اجازه دارد غذا بخورد و همچنين پس از ورود به بخش نوارقلب گرفته مي شود .
- In the cases of radial angiography were Bracelets made of plastic called TR clause in the radial jacket lips closed, which filled the air TR ward since entering the sector after the angiography after 2 hours A clinical nurse bracelets with a special syringe begins to lower the air, and then performs it every hour and leaves it unchecked after not having bleeding. And if bleeding is the same amount of air that is released, it is returned to radial patients after angiography, they can eat about 30 minutes after entering the department and they are advised not to bend their wrists and to It does not push.
- Patients undergoing angioplasty in the lining of the lining of the lobe are transported to one of the two posts of the cow orCCU with a dye in the femur to be monitored so that the clinical nurse of the surgical department is obliged to remove the patient from the lining and, by helping the patient The affected part will be transmitted and the illness delivered from the lips will be checked by the nurse of the pulse control unit on the leg on the femur and the pulse of the hand (in the case of angiography by radial) and checked for bleeding.
- Patients with angioplasty usually return to the heart surgery department after 24 hours, and if they do not have a 24-hour problem, they are monitored in the heart surgery department and then discharged by a physician.
Root Cardiac Surgery for Preoperative Patients, CABG and Valve:
- Sending routine and marker tests include:
(ESR -PT-PIT-BT-CT-CRP-U / A-CPK MB-LDH-Trop-BillT, D - Albumin-CBC-VLDL - Uric Acid-Mg-P-Ca-AST-ALT-ALK.P - CPK-ESR - Chol-TG-K-Na-Cr-BUN-FBS)
And markers include (HCV-HIV-HBS) .
- Pixel and plate reservation and FFP (8 units - 10 units - 10 units), at least 4 units ready for each one.
- Provide the financial OK sheet with the patient and send the Letter of Information to the OR into the operating room and send the OH Letter to the ICU OH Department
- Perform chest graph
- Acceptance of patient's consent and first degree fellowship
- Perfect body shape
- Set up a heart file
- CD attachment and angiographic riporot
- Carotid doppler echo or eczema and doppler sonography, especially over age 60 if ordered by a physician
- Consultation with respect to patient problems and OK doctor patient, for example (for diabetes endocrinology consultation and advice for patients with pulmonary lung)
- Carry anesthetic consultation
- Interruption of aspirin and plavix (aspirin 5 days before surgery - Plavix one week before surgery)
- Heparin discontinuation of a dose before surgery
- Having an IV Line Right Hand
- In the case of patients with a valve in the event of a problem with dental treatment
- If patients have valvular injection of warfarin, discontinue warfarin and initiate heparin or clexan injections with a physician's order.
- NPO being patient 8 hours before surgery
Routine Heart Surgery For Patients After Heart Surgery:
- Patients undergoing heart surgery are delivered to the ICU OH unit from the operating room , and after 48 hours they are usually delivered to the surgery department by the ICU nurse .
The patient undergoing cardiac surgery is checked by a clinical nurse, including control of vital signs, control of emphysema, IV Line Control, burner-induced burn control in the operating room, control of patient's consciousness, urine control and patient disposal, as well as local control Action for bleeding or abnormal discharge
- The patient has a CABG valve after 48 hours of intact outflow control for 48 hours and a 2-day post- duct drainage bath. A patient's pacemaker is taken out according to the physician's instructions. ECG is performed daily. Daily dressing is done by a nurse.
- Performing routine post-surgical tests (... .., PT, Cr-BUN-K-Na- FBS )
- Chest screening is usually one day after the patient transmits to the department
- Daily physiotherapy and spirometry
- Encouraging the patient to walk and eat well
Special equipment for heart surgery department and instructions for working with the device:
- Prophylaxis: For diphtheria, which should be used as a dip the patient, the digital droplet is used. (Mark JMS Model SP-500 )
- Syringe pump: To regulate serum drops used in heart surgery for blood infusion ( JMS mark )
- Oxymetric pulse device: Available to access the patient's O2 Sat and PR with a fingertip and a small monitor. (MarkOxypleth )
- Portable Skelet: Available for suctioning patient secretions that is movable (Mark Tecno )
- DC shock device : One of the essential equipment on the TRALI-code, which was used by patients for special shock-induced shock and other than shocking capabilities, such as monitoring and Syncoroniz , etc. (Mark Welch Allyn ModelPLC 30 )
- ECG: Used to reach the ECO Cardiovascular Panel from the patient in the department that is the most widely used equipment in the department (Mark Schiller AT- 1 model )
- Pissing machine: A device that can be used for post-operative heart pacemakers if needed.
- Warm Incinerator: Used to keep the patient's room in a humid place (Mark Vaporizer )
- Cold incubation: To keep the patient's room intact (Mark Osen )
- The Nurse Call device , located in a nursing station, is informed by the patient in need of a patient (Mark Cr 104 - NCS )
- Oxygen capsule
- Basque Scale
- Wheelchairs - stretcher
- Trali Code:
Trawl is specially designed for patients with aesthetic or respiratory and cardiac arrest for any reason and are equipped with essential drugs, syringes and needles and serum sets, and gastric and vaginal tubes of Kacl , dextrose, as well as laryngoscopes , ambobs and Foley catheters, and Nlatvn and serums and set dressing gauze , scissors, sterile , sterile gloves , cotton alcohol , Betadine pads pacemaker and pence Mgyl and Zbangyr and flashlights and battery and interface bagging the drugs trolley code as follows: ampoule Adrenaline , Atropine , Dopamine , Dobutamine , Amiodarone , Lidocaine , Adenosine, Mates and Pearl TNG , heparin , verapamil, Inderal , Digoxin , Lasix , naloxone , midazolam , diazepam , phenytoin , Fnvbarytal , haloperidol, calcium gluconate , Hydrvkvtyzvn , ranitidine , Plazyl , tablets ASA , magnesium sulfate , vials dextrose 20 and 50 , Sodium Bicarbonate Vial , Sodium Chloride Vial ,Salbutamol Salmon , Dexamethasone)