AAA!!!! Help/Info

hello, i am an rn in the or for 4 years, recently changed to a community based hospital......in changing jobs, aaa are potential cases. in order to increase my knowledge, does anyone know of a great website that would explain the surgical procedure, does anyone have any advice for scrub or circulate an aaa? incision, suction, clamp?

holy mackeral! you can read the procedure in alexander's but nothing is going to tell you how any particular surgeons prefers things. my questions would be: is this an emergent aaa? (not all aaa's are emergent). is there kidney or iliac involvement? what type of graft is preferred? some surgeons prefer to have cell-saver in room at all times, and others not -depends on gravity of case. certainly blood on order and in the fridge in substerile is critical. if you get into a pickle (audible bleeding), and all else fails, hand over a straight debakey clamp and have prolenes and pledgets at the ready. the folks with the hardest job (besides surgeons) is anesthesia and the circ. orders will be shouted out, and hopefully you'll have appropriate pre-counted stuff at the ready. i can't imagine being thrown into something like that without having already had plenty of vascular experience.

These are big involved cases that can go south in a hurry. Staff NEED to be preceptered before tackling these solo. A google search of "abdominal aortic aneurysm" will turn up a ton of information including streaming video of a live stenting procedure.

This new job NEEDS to know you haven't done these, so they can get you trained in the scheduled ones, so you'll be preprared for the emergent ones. That is not the the time to "wing it".

First off, get a copy of each surgeon's preference sheet for AAA for your own reference.

Second, ask questions to either the specialty coordinator or someone who has scrubbed on them a lot.

Third, see if you're allowed to pop open an aneurysm instrument set and "examine" the instruments. See if you can find an instrument picturebook to pair up while you do this.