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Challenges and Adverse Events in the Home
Published in Marilyn Sue Bogner, Misadventures in Health Care, 2003
Denise M. Korniewicz, Maher El-Masri
Jean cleaned the stoma site and instructed the patient about when to change the colostomy bags, how to do proper skin care, and approximately how many times a day the colostomy bag would need to be changed. It was now 9 a.m. and Dr. Han had not called back. When Jean phoned the medical supply company authorized by Mrs. Tindell’s Health Maintenance Organization (HMO) for replacement supplies, she was told it was closed on Saturdays and would not be open until Monday. The supplies were urgently needed, so Jean immediately began calling other medical supply companies; however; none would send the supplies because the HMO had already authorized a 1-month supply. Therefore, Jean had to contact the hospital and request delivery of the supplies to meet Mrs. Tindell’s needs until Monday when the medical supply company could provide them. Arranging for the stopgap supplies took Jean over 1½ hours.
Gastrointestinal tract and salivary glands
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Prior to the procedure, with the patient supine, an IV injection of the hypotonic agent Buscopan, a smooth muscle relaxant, is given to allow the bowel to distend to its maximum capacity. A 2 cm slit is made in the colostomy bag, which is not removed. Through the slit a 10F tube (e.g. Law II MerckSorono) is inserted into the stoma. The tube can be passed over the splenic flexure and often as far as the ascending colon. As the stoma has no sphincter control, the retained colostomy bag is able to hold any ejected barium.
Situation awareness
Published in Rhona Flin, George G. Youngson, Steven Yule, Enhancing Surgical Performance, 2015
Rhona Flin, Simon Paterson-Brown
The third element of situation awareness is projection and anticipation of what might happen next. An understanding of the present status coupled with stored knowledge of previous operations enables the surgeon to think ahead about how the situation is likely to develop in the immediate future. This could be preoperatively recognizing that a big hernia will need a very large mesh, a gastroscope might be used to identify the site of a lesion in the stomach or a colostomy may be required in large bowel surgery.
Design of experiment for optimization of 3D printing parameters of base plate structures in colostomy bag for newborns
Published in Journal of Industrial and Production Engineering, 2021
Chia Hung Yeh, Chia Man Chou, Chien Pang Lin
According to the American Cancer Society, approximately 15% of patients with colorectal cancer must undergo colostomy surgery to prolong their survival [1]. The appearance of patients who undergo surgical enterostomy is no different from that of the average person. However, in everyday life, when the intestines are excreted, it is not possible to discharge the excrement through the anus after surgery. Therefore, it is necessary to provide assistance through an auxiliary bag. In this regard, an improper ostomy bag is likely to cause leakage of the excrement, thus causing allergies or damage to the surrounding skin [2]. These problems deeply affect the patient’s physical condition and quality of life and cause changes in the patient’s body. The individual’s psychological and social impact is more physiological than injury-based. A colostomy can be in the small intestine of the upper gastrointestinal tract or in the colon of the lower gastrointestinal tract. The type of enterostomy also varies depending on the location of the lesion and the location of the operation. The distinction is as follows: (1) Permanent stoma: surgical removal of the anus and rectum, pulling the end of the sigmoid colon or descending the colon out of the left abdomen to make a stoma to defecate, as shown in Figure 1. The patient must both learn the use of stoma products and stoma lavage during hospitalization. Among them, stoma lavage is implemented after surgery, which requires enema training to maintain regular bowel habits. (2) Temporary stoma: If there are traumas around the anus, severe anal abscess, or an acute intestinal obstruction caused by disease when a patient undergoes large intestine surgery, those with the three conditions mentioned above will have the abdominal wall of the transverse colon pulled out to create a temporary colon stoma. When the patient recovers, the transverse colon is returned to the abdominal cavity. (3) Urostomy, also known as an artificial bladder: Patients with bladder cancer need to undergo a total cystectomy because of the disease. An opening is made in the right lower abdomen to drain the urine.