Question

The patient requires marking when:

a) the procedure sites involve laterality (right versus left), bilateral surface, spine levels, and specific digits to be treated
b) for any procedure including midline, single organ procedures, spinal or epidural punctures, and endoscopies with intended laterality
c) for procedures in which the sidedness may be re-determined after incision, such as planned "left ovarian cystectomy," where the consent and schedule also include "possible right," both sides must be marked

Answer 1

The patient requires marking mainly for procedures involving laterality, bilateral surfaces, spine levels, and digits to ensure accuracy and safety in surgical procedures (option A). Identification, consent, known allergies, and airway risks must be assessed prior the protocol prior to surgery. Neurological functions such as laterality of perception and sensory discrimination help pinpoint damage or assess neurological status.

Step-by-step explanation:

The patient requires marking for a surgical procedure when there are factors such as laterality (right versus left), when procedures are performed on bilateral surfaces, on specific spinal levels, or on specific digits. In situations where there could be ambiguity, such as a planned procedure on one side with the possibility of needing to address the opposite side, both sites must be marked (option A).

This is essential for avoiding wrong-site surgeries and for ensuring the correct side or area is treated. Additionally, marking is important in scenarios where the sidedness might need to be determined after incision or for procedures that could involve laterality, like an ovarian cystectomy where either the left or right ovary may be implicated. These practices help in ensuring safety and accuracy in surgical procedures.

Prior to a procedure, it is also important that the patient has verified their identity, the surgical site and procedure, and given consent. A pulse oximeter should be functioning on the patient, and any known allergies must be communicated to all team members. Airway and aspiration risk assessments are required to ensure that appropriate equipment and assistance are available.

Medical tests, such as double simultaneous stimulation and sensory discrimination exams, are used to assess neurological functions and pinpoint any damage, possibly in the spinal cord or the parietal cortex. These tests are straightforward but can provide crucial information. For example, damage to the contralateral posterior parietal lobe may be suggested if a patient does not perceive touch equally on both sides of their body during double simultaneous stimulation.