{"id":565,"date":"2022-12-07T16:08:09","date_gmt":"2022-12-07T16:08:09","guid":{"rendered":"https:\/\/perioperative1001.slc-courses.ca\/?p=565"},"modified":"2022-12-15T18:38:43","modified_gmt":"2022-12-15T18:38:43","slug":"module-6-b-methods-of-hemostasis","status":"publish","type":"post","link":"https:\/\/perioperative1001.slc-courses.ca\/?p=565","title":{"rendered":"Module 6: B. Methods of Hemostasis"},"content":{"rendered":"\n

Methods of Hemostasis<\/h2>\n\n\n\n

The surgical team can stop bleeding and achieve hemostasis in three unique ways, click on the boxes to learn more:<\/p>\n\n\n\n

Mechanical<\/strong><\/p>\n\n\n\n

  1. Direct pressure such as holding a sponge or towel on a bleeding site <\/li>
  2. Suture materials <\/li>
  3. Ligating clips <\/li><\/ol>\n\n\n\n

    Thermal-Based Energy<\/strong><\/p>\n\n\n\n

    1. Electrocautery <\/li>
    2. Lasers <\/li><\/ol>\n\n\n\n

      Chemical<\/strong><\/p>\n\n\n\n

      1. Medications<\/li><\/ol>\n\n\n\n

        Let us look at each of these <\/a>methods more closely.<\/p>\n\n\n\n

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        Methods of Hemostasis \u2013 Mechanical<\/h5>\n\n\n\n

        Different mechanical tools can be used during surgery to provide temporary or permanent hemostasis.<\/p>\n\n\n\n

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        Hemostatic clamps <\/strong><\/p>\n

        There are many different configurations of hemostatic clamps that can be used to occlude vessels and stop bleeding temporarily during a surgical procedure without causing significant trauma to the vessel. <\/p>\n

        Clamps are used temporarily until a vessel can be anastomosed or repaired.<\/p>\n <\/div>\n <\/div>\n

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        Clips<\/strong><\/p>\n

        Clips can be placed across a vessel and then clamped to occlude and stop blood flow.  Clips are more often used on larger vessels and are frequently made of titanium. These clips will remain in the patient permanently. There are polymer clips, as well, which will eventually be reabsorbed. Clips are often placed in pairs in case one becomes dislodged.   <\/p>\n\n

        For more information on hemoclips and appliers watch this video Hemoclip appliers  Surgical Instruments: Hemoclip Appliers – Anatomy Guy<\/a><\/p>\n <\/div>\n <\/div>\n

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        Ligatures (ties)<\/strong><\/p>\n

        They are often called ties. <\/p>\n

        They are strands of suture material without a needle that can be tied around a vessel to manually occlude the blood vessel.  <\/p>\n <\/div>\n <\/div>\n

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        Pledgets<\/strong><\/p>\n

        These are small pieces of Teflon felt that either come already on a suture or are placed there by the scrub nurse. They are used when the surgeon is suturing a vessel and the hole from the needle causes bleeding. They are most often used in cardiac surgery. <\/p>\n <\/div>\n <\/div>\n

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        Packing<\/strong><\/p>\n

        A surgeon may use gauze packing to maintain pressure on a wound surface to help control oozing. <\/p>\n\n

        Packing must often be pre-moistened with warm saline.  <\/p>\n <\/div>\n <\/div>\n

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        Patties<\/strong><\/p>\n

        These are small, compressed cotton sponges that are radiopaque and can be used for hemostasis on the brain tissue surface.<\/p>\n

        They should be soaked before use with normal saline or an antibiotic solution. <\/p>\n <\/div>\n <\/div>\n

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        Bone Wax<\/strong><\/p>\n

        This is made from a sterile non-absorbable mixture which contains beeswax. Bone wax is used to provide a tamponade barrier on bone surfaces to stop oozing. <\/p>\n\n

        It should be used sparingly, with any excess removed. <\/p>\n\n

        It can be rolled into small balls and presented on an elevator so the surgeon can apply it to bleeding bone edges. <\/p>\n <\/div>\n <\/div>\n \n<\/div>\n\n\n\n

        (Phillips & Hornacky, 2020)<\/p>\n\n\n\n

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        \ud83d\udcc1 Documentation Highlight<\/h5>\n\n\n\n

        Clips used for hemostasis must be meticulously documented in the patient record because it is vital to keep track of any implants being left in the patient<\/a>. Why is this important? If the patient requires any diagnostic imaging in the future, including an MRI, the technicians need to be able to identify if there are metal implants and if they are MRI-compatible. Follow your institution\u2019s charting policies as to what is required for documentation.<\/p>\n\n\n\n

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        Thermal-based Energy<\/h5>\n\n\n\n

        Different thermal-based equipment can be used during surgery to provide hemostasis.<\/p>\n\n\n