Interventional angiography for trauma is being used more than ever, including traditional uses like pelvic fracture and solid organ hemorrhage control and newer applications like penetrating vascular injuries in difficult to reach areas and aortic stent grafting for BAI. The Hybrid OR provides an environment with angiographic equipment and personnel (anesthesia, OR) plus the opportunity to quickly transition from or to open surgery if needed.
Indication: High likelihood of concurrent open and angio procedures
Staff resources:
OR will supply circulator for documentation.
Anesthesia will manage airway and sedation.
Angio will supply a tech.
Supplies will be charged through the OR except for those brought
from angio (eg via cart) in which case they are charged through VIR.
Equipment:
Sonosite machine is generally
located near the hybrid suite.
Process:
Trauma surgeon will:
Post the case by calling the OR to request the
hybrid suite for angio-intervention for TRAUMA.
Post as “emergency”.
Communicate if coming immediately or in
designated time period.
Indicate sequence (open first or angio first).
Contingency Plan (in the event that the hybrid suite is unavailable):
Begin open stabilization in room 6A as usual and move to hybrid suite, if available, after open portion of procedure, or
Perform operation in trauma OR suite (6A) and then utilize 3rd floor PavH angio suite afterward, or
Start in angio suite then perform open operation after completion of angio-intervention.
Begin open stabilization in room 6A as usual and move to hybrid suite, if available, after open portion of procedure, or
Perform operation in trauma OR suite (6A) and then utilize 3rd floor PavH angio suite afterward, or
Start in angio suite then perform open operation after completion of angio-intervention.
Key individuals: Andrew Bernard (Trauma), Phil Chang
(Trauma, OR), Julie Hudson (OR), Rob Edwards (Angio), Ryan Pennington (Angio),
Stephanie Devore (Trauma Program),
Ned Bowe (Anesth), Liz Oates (Radiology)
