Rotator Stuff Repair Case Study
Rotator Cuff Repair
Jordan Lowe
Jordan Lowe
Bill Hammer
Case study
Working Draft
October 20, 2017
Rotator Cuff Repair A “Rotator Cuff” is a group of muscles that holds the head of the humerus in its socket, these muscles are the Supraspinatus, Infraspinatus, Teres minor, and Subscapularis. The supraspinatus muscle is in charge of abduction, or lifting the arms from your side to above your head, the infraspinatus and teres minor are for exorotation, lastly the subscapularis is used for endorotation. The need for a Rotator Cuff repair is when the muscle group is partially or completely torn. The surgery in the simplest form is reconnecting the torn muscles back to the head of the humerus.
Etiology, cause, and prevention
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Gowns
Gloves
Anesthesia
3 lead EKG
Pulse oximeter
BP cuff
6 Liters Oxygen given through a mask to the airway
Versed 2 mg-anti anxiety
100-150 mcg Fentanyl-pain and for intubation
80 mg lidocaine- pain of versed in IV
200 mg propofol- puts patient to sleep
50 mg rocuronium- paralyze patient for intubation, specifically vocal cords
4 mg Zofran-anti nausea
8 mg Decadron- anti nausea
2g Cefazolin- antibiotic broad spectrum preventative lactated ringers IV infusion for hydration
Desflurane for anesthetic gas to stay
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A pillow may be put under the legs to help with the patient's back. To secure the patient there is a safety strap that will go across their lap.
Operative skin prep Occasionally if needed the arm may need to be shaved to get rid of excessive hair which is collected with tape before you begin the skin prep. The last step before the skin prep is to wipe the whole arm down with sponges that are soaked in alcohol. The skin prep is typically chloraprep which starting at the neck of the affected side to mid chest all the way down to the wrist circumferentially covering the entire arm. The chloraprep should be on the skin for 3 minutes to allow for it to air dry before draping. A large sheet is placed under the arm to rest on, a stockinette is placed over the hand and rolled up to around the elbow to cover the area that is not prepped, 4 sheets that have a sticky line across them are used to “square off’ the area that the operation will be performed. After the square offs a drape in the shape of a ‘U’ is placed along the same area as the square offs
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