By Lawrence W. Way
College of California, San Francisco. Lange scientific booklet sequence. re-creation of a Brandon/Hill clinical checklist first-purchase choice. Reference on illnesses controlled via surgeons, for scientific scholars, citizens, and practitioners. 88 participants, eighty five U.S.
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Additional resources for Current Surgical Diagnosis and Treatment
One should acquire the habit of performing a complete examination in exactly the same sequence, so that no step is omitted. When the routine must be modified, as in an emergency, the examiner recalls without conscious effort what must be done to complete the examination later. The regular performance of complete examinations has the added advantage of familiarizing the beginner with what is normal so that what is abnormal can be more readily recognized. All patients are sensitive and somewhat embarrassed at being examined.
THE IMMEDIATE POSTOPERATIVE PERIOD The major causes of early complications and death following major surgery are acute pulmonary, cardiovascular, and fluid derangements. The postanesthetic recovery room is staffed by specially trained personnel and provided with equipment for early detection and treatment of these problems. All patients undergoing major procedures should be initially monitored in this specialized unit. While en route from the operating room to the recovery room, the patient should be accompanied by a physician and other qualified attendants.
B. Pulmonary Dysfunction The patient with compromised pulmonary function preoperatively is susceptible to postoperative pulmonary complications, including hypoxia, atelectasis, and pneumonia. Preoperative evaluation of the degree of respiratory impairment is necessary in patients at high risk for postoperative complications. These include a history of heavy smoking and cough, obesity, advanced age, major intrathoracic or upper abdominal surgery, and known pulmonary disease. Pertinent factors in the history include the presence and character of cough and excessive sputum production, history of wheezing, and exercise tolerance.
Current Surgical Diagnosis and Treatment by Lawrence W. Way