SHO
1. Attend Theatre on Tuesday afternoon (1:00 pm start) and 8.45 am Friday
morning.
2. Check that results are all available.
3. Assist at surgery or observe.
4. Write operation notes if appropriate.
5. Complete pathology form, prescription form, and yellow form, as appropriate.
6. Complete log book.
Registrar
1. Attend theatre on Tuesday morning, Tuesday afternoon (if necessary,
as research time due would be provided in lieu), and Friday morning.
2. Check that investigation results are available.
3. Ensure all consent forms (eg for surgery and cytogenetic studies
are completed prior to surgery)
4. Perform, assist at, or observe surgery, as appropriate.
5. Obtain tissue for cytogenetic studies (in sterile fashion).
6. Write operation notes if appropriate.
7. Complete pathology form, prescription form, yellow form, and cytogenetics
form as appropriate.
8. Complete log book.
Consultant
1. Attend theatre on Tuesday (all day), and Friday morning.
2. Perform or supervise surgery, as appropriate. Write operation notes.
3. Write operation notes on computerised database, placing printout
in back of casesheet and writing summary in red ink in notes.
4. Dictate discharge letter.
5. Complete yellow form, plaque request form, proton beam form, pathology
form and cytogenetics form as necessary.
6. Computerise plaque dosimetry.
Oncology Nurse
1. Reassure patients.
2. Assist at surgery, as appropriate.
3. Assist theatre nursing staff as necessary.
4. Co-ordinate collection of tissue and blood specimens for cytogenetic
studies and research for local resection and enucleation patients. On
eve of theatre session, telephone oncology lecturer (Dr Andrea Scholes)
at 4101 or bleep laboratory technician (Suzanne) on 723. During surgery,
(1) ensure that 20 ml of venous blood is collected by ODA/Anaesthetist
and placed into two 10 ml EDTA tubes and (2) ensure that tumour specimen
is placed dry in sterile container for (a) collection by oncology lecturer
or assistant and (b) removal of specimen by surgeon for cytogenetic
studies. At end of operation, surgeon needs to remove cytogenetic specimen
in sterile fashion and place specimen in special container filled with
culture medium. Arrange for cytogenetic specimen and accompanying form
to be transported to the cytogenetics laboratory at the Women's Hospital.
Phone switchboard ( ext. 3332) to order taxi and ask porter to take
specimen to security desk for collection. Send fax to Dr Peter Howard
to inform him that a specimen is on its way and also send a copy of
the fax to 5436 (oncology secretary). Await return fax from Dr Howard
to confirm receipt of specimen, if this does not arrive telephone him
on #6168 ext.4231 and trace specimen until this is located and safely
received by Dr Howard or one of his team.
Theatre nurse
1. Co-ordinate collection of tissue and blood specimens for cytogenetic
studies and research. On eve of theatre session, telephone oncology
lecturer (Dr Andrea Scholes) at 4101 or bleep laboratory technician
(Suzanne) on 723. During surgery, (1) ensure that 20 ml of venous blood
is collected by ODA & Anaesthetist and placed into two 10 ml EDTA
tubes and (2) ensure that tumour specimen is placed dry in sterile container
for (a) collection by oncology lecturer or assistant and (b) removal
of specimen by surgeon for cytogenetic studies. At end of operation,
surgeon needs to remove cytogenetic specimen in sterile fashion and
place specimen in special container filled with culture medium. Arrange
for cytogenetic specimen and accompanying form to be transported to
the cytogenetics laboratory at the Women's Hospital. Phone switchboard
( ext. 3332) to order taxi and ask porter to take specimen to security
desk for collection. Send fax to Dr Peter Howard to inform him that
a specimen is on its way. Await return fax from Dr Howard to confirm
receipt of specimen. If this does not arrive telephone him on #6168
ext.4231 and trace specimen till located and safely received by Dr Howard
or one of his team.
2. Ensure that the plaques are sterilised in the containers specifically
set aside for plaque sterilisation, and that these are processed on
the 121 degree cycle in the steriliser.
3. Ensure that lenses & plaque dummies are in soak at the beginning
of each list and that the correct sterilising solution is used as required
(if you are unsure please check with a senior member of staff).
4. Sets of conformers (i.e. one of each size) for each individual patient
are to be soaked in a solution of precept at least 20 minutes before
required.
5. Dummy plaques should be treated in the ultrasonic washer containing
Haemarinz solution for 5 minutes after each use. They should then be
rinsed, dried and placed back in their container before storing inside
the locked plaque cupboard
6. Complete sealed source book to record plaque usage.
7. Fax plaque request form to Clatterbridge Hospital. The plaque request
form should then be stored in the patient's case notes.
Recovery
1. Ensure that all plaque patients have a double cartella in situ before
leaving recovery.
2. Check posturing requirements with the surgeon prior to admission
to the recovery area or as soon as possible thereafter. Comply with
this request as soon as the anaesthetist is happy that it is safe to
do so.
3. For patients who have undergone hypotensive anaesthesia monitor the
BP via the arterial line. Monitor SAO2 levels and give oxygen as prescribed
by anaesthetist. Continue baseline observations every 5 minutes for
30 minutes or longer and, once the patient is stable, every 15 minutes
until discharge back to ward. Ensure that the anaesthetist is kept informed
of the patient's condition.
4. On removing the arterial line, please apply pressure to the area
for five minutes to prevent bleeding from the insertion site. Continue
to monitor BP using the datascope if necessary.
5. When the patient is discharged to the ward, ensure that written instructions
are documented clearly for the ward staff to ensure continuity of best
possible care. The nurse transferring the patient to the ward should
also be told the nature of the operation and any other relevant information.
