Patent Ductus Arteriosus
Surgical Closure

 

Reviewed by Charge Nurse - Newborn
October
2006
Clinical Guidelines Back Newborn Services Home Page
Preparation of Equipment Preparation of Baby Postoperative Care

Preparation of Equipment/Consent Forms

Step Action

1

Ensure:
  • Parents are kept informed by Cardiac Team/Paediatrician prior to surgery.
  • Check Consent form has been completed for surgery and the administration of blood and blood products.  Anaesthetic consent completed just prior to surgery.
  • Check pre op blood results are available and blood is available for transfusion.
  • Anaesthetist may require 4% albumin and/or packed RBC to be available on the unit (Dr/NS-ANP to confirm).

2

Equipment required for surgery is prepared:
  • Radiant heat table (must be away from the wall).
  • Diathermy pad, machine and cable (brought by theatre staff)
  • Trolley and large sterile trolley covers (brought by theatre staff).
  • Suture material (brought by theatre staff).
  • Theatre hats.
  • Separate suction bottle connected to wall suction (for Surgeon to use) [the Scrub Nurse brings packs and instruments from Starship Hospital].
  • Alcohol Povodine-Iodine solution
3 Equipment required by the Anaesthetist is prepared:
  • Check resuscitation trolley.
  • Ensure Neopuff and mask are working and easily accessible on heat table (the baby is usually kept on the ventilator during surgery).
  • Check the following drugs are available in the room:

Preparation of Baby

Step

Action

1 Place baby on heat table (away from the wall).
2 Continuous monitoring (recorded hourly):
  • cardiorespiratory
  • SpO2
  • blood pressure or Dinamap
  • skin temperature
3 Ventilation as per orders.  Suction ET tube immediately prior to surgery.
4 IV fluids as prescribed.
5 Baby is kept nil by mouth for 4 hours prior to surgery.
6 Ensure preoperative preparation check list has been completed.
7 Ensure two identification labels are on baby.
8 Ensure there is no metal touching the baby, e.g. metal splint.
9 Aspirate gastric tube (immediately pre-op).
10 Place the baby on right side.
11 Keep left chest clear (left chest electrode may be placed on left groin).
12 Close room to visitors/parents while procedure in progress (takes approximately 1 hour). Place notice on door re room closed, also ensure masks are available outside door.

Postoperative Care

Step

Action

1 Ensure continuous monitoring is maintained and recorded hourly.
2 Maintain ventilation as per orders.
3 Keep baby nil by mouth until further orders.
4 IV fluids as prescribed.
5 Observe wound site for bleeding.
6 Comfel dressing to be left insitu for one week (or as per surgeon's order).
7 Pain relief as prescribed.
8 6 hourly urine output totals - urinalysis every nappy change.
9 Keep parents informed of baby’s condition.
10 Pleural drain insitu - remove on surgeon's orders.

 

Usual Follow-Up