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Surgeon Has ultimate responsibility Surgical assistant Specially trained to help surgeon Holding area nurse See patient before surgery, give iv, confirms chart is correct before patient is sent to OR Circulating nurse Not sterile, controls traffic, keeps track of all fluids Scrub nurse Sterile, can also be surgical assistant, can not suture, can hold and hand things to surgeon Insufflation Gas injected to improve ability to visualize area and separate parts, may cause discomfort and distention General anesthesia Riskiest, pt unconscious, requires intubationand ventilation, pts with lung dx may not be candidates Conscious sedation Pt can respond to others and maintains own airway Local anesthesia Loss of sensation in a body part or region of the body, pt is conscious with iv med to induce sleepiness, may be administered topically (EMLA) or with local infiltration Regional anesthesia Field block, nerve block,k spinal or epidural Malignant hyperthermia Rare, genetic, K and Ca levels rise, acidosis develops, pt develops a sudden, very high fever, muscle becomes extremely rigid Tantrum (dantrolene) Treatment for malignant hyperthermia Urecholine (betanechol) Causes bladder contraction Narcan (naloxone) Narcotic overdose Flumazenil (ramazicon) Benzodiazepine overdose