General Instructions –
DO NOT USE ANY TAPE OR ADHESIVES ON HIS SKIN.
Do not use Latex gloves.
Lubricate gloves with Aquaphor or similar lubricant.
Vitals need to be taken over bandages or wrap Transfer (T) or Conco (roll gauze) over his arm first.
Do not rub him when picking him up. Do not pick him up under his arms. Scoop him up instead.
Move him by lifting, NOT SLIDING.
Do not rub alcohol (or anything else) on his skin. Dab lightly instead.
Pad the table. (egg crate or sheepskin?)
Lubricate anything that will come into contact with his skin.
Heavily lubricate his eyes.
Pulse Ox –
1. For VELCRO kind – wrap Conco (roll gauze) on digit or place small Transfer strip (T) or square on skin and Velcro over bandaging. If it won’t register and is soft material, may can go straight on his skin – lubricate skin first. Should not rub.
2. For CLIP kind - wrap Conco (roll gauze) or place small square or strip of Transfer (T) around finger/toe first and then clip on.
3. For ADHESIVE kind –
Remove any sticky part.
Lubricate skin or probe.
Place thin Kleenex or Conco on skin.
Place probe on top of Kleenex or Conco.
(Can possibly go directly on skin if it won’t register over Kleenex or Conco.)
Secure with square of Transfer (T) or Lite (L) or Lite Border (LB) or Conco (roll gauze).
OR
Wrap light layer of Conco (roll gauze) and put probe on top. Tape probe down to Conco (NOT skin) or wrap more Conco on top to secure.
IV –
1. DO NOT suture IV unless absolutely necessary.
2. Secure IV after he’s sedated. (LUBRICATE mask well or just hold mask over face, not touching skin.)
3. DO NOT RUB his skin or let catheter touch his skin.
4. After it’s in, wrap Transfer (T) around arm underneath the IV catheter. Use the Mepitac tape (M), Conco (roll guaze) or Tubifast (stretchy tubular cloth) to secure catheter to Transfer.
5. Mepitac Tape (M) -but only Mepitac- can go on his skin if necessary. Please let me remove or remove slowly and carefully. If edges are stuck, use Aquaphor to release.
6. ONLY TAPE THE IV TO THE BANDAGES.
7. DO NOT PUT TAPE ON SKIN.
8. If for some reason you must put tape on his skin, ONLY use the MEPITAC tape I’ve provided.
9. Let me remove any EB safe adhesive from skin. I have special spray that will help remove it.
Leads –
1. Remove adhesive.
2. Lubricate skin where lead will touch skin if lead will still register that way. (ultrasound gel?)
3. Cover with squares of Lite Border (LB), Lite (L) or Transfer (T). (They are EB safe adhesives.)
4. You can also wrap Conco (roll gauze) around his chest over the Transfer if you need more security. DO NOT WRAP TIGHTLY. If they dig into his skin, he will blister.
5. REMOVE GENTLY AND SLOWLY. You can “soak” off bandaging with Aquaphor under edge or with water. Do not pull off quickly or his skin will tear.
After Surgery:
1. Only remove what you have to. If anything is stuck to his skin that can stay on outside of the OR, please let me remove it.
2. Put piece of Lite (L) around the stoma, under button, so tube will not lay directly on his skin.
3. Extubate him before he wakes up. Go slowly and gently.
4. All limbs and torso (as much as possible) need to be rewrapped before he wakes up or his general movement will cause him to blister himself.
PRIVATE room.
Reverse Isolation.
Trash to be left outside, so custodial staff does not enter his room.
OWN vitals equipment, to reduce infection risk.
Low dose steroids to reduce inflammation in airway?
Anti-nausea meds?
I still have to cut and label all the individual bandage pieces and put them in corresponding bags labeled Pulse-Ox, IV, Leads, and Post-Op.
And pack four days of bandaging supplies.
And pack everything else.
Don't be surprised if you don't get a lake post from me until Christmas.
I emailed all this info to the surgeon and anesthesiologist and felt the need to end the email with: "I'm not crazy and overbearing although it may seem like it. :)"Why do I feel the need to explain or rationalize my control issues?
EMBRACE THE CRAZY, people. Embrace the crazy.
