Open Reduction Internal Fixation (ORIF) - Trochanter
Updated On: December 2, 2024
Anesthetic Approaches
These patients are typically induced on the bed they come in with. They are then moved to the Hana table. A translucent drape will be put along the lateral side of the patient on the affected/surgical side. Because of the location of the injury, a tourniquet is not an option. These surgeries can result in significant blood loss. The patients having this procedure are typically elderly/fragile with multiple comorbidities. Paralytics are not necessary, but helpful to run the patient low on gases to preserve hemodynamics.
High Blood Loss (general considerations): Type and cross, CBC, and CMP should be done prior to the procedure. Consider having an A-line, blood tubing, and extra push-lines. Depending on the fragility of the patient, you may want to have blood in the room and available.
Fluoroscopy / Xray (general considerations): Have lead aprons and thyroid shields available. Alternatively, distancing yourself 3 to 6 feet will reduce scatter radiation to 0.1% to 0.025% respectively. Occupational maximum exposure to radiation should be limited to a maximum average of 20 Sv (joules per kilogram - otherwise known as the Sievert/Sv) per year over a 5 year period. Limits should never exceed 50 Sv in a single year.