Thoracic Spine Exposure
Set-Up
Thoracotomy tray, rib tray, cautery extension, chest retractor/rib spreader, Omni retractor, small and medium clips with long appliers, pediatric metal tip suction, long meeker, 0 prolene with pledgets, #1 Ticron, heavy vicryl, 0 looped Maxon, 32fr chest tube, 0-silk suture for chest tubes and for a diaphragm retraction stitch, 2-0 silk ties – long, blanket in plastic bag.
Mediastinoscopy
Set up
Right radial A-line
Head of bed to Right side of room
Head at top of bed, then even a little higher
Shoulder roll
ETT to R side of mouth, turn head slightly to Right
Prep entire chest – do not shave entire chest
Procedure
Suction bovie – set at 20, pedal at r foot
3 biopsy forceps – small, usually use 2 working at once
Specimens
Pathology – take down and receive verbal confirmation that specimen is received and adequate
Cultures – Don’t ever forget to to do cultures! – AFB, gram stain, fungal, aerobic/anaerobic