- Get acclimatized to the nursing home. Find out whether things and injectables are available and where they are stored.
- Palpate the vein before puncturing or cannulating. Ask the patient as to where he is taking the injections. Choose the site of puncture depending on nature of operation and the position of the patient during surgery. This is your lifeline. In obese and small children spend some time to find a vein. Do not use the vein on the side where arterio-venous fistula is created.
- Listen to the patient his choices and thoughts. Work according to his choice if possible or try to convince him what is best for him.
- Children for IV puncture usually cooperate well in sitting position and talking to them explaining what you intend to do. Some children may not cooperate. Avoid premedication by injection as far as possible.
- Plan your anaesthesia in such a way that patients are fully conscious as far as possible at the end of procedure. If not make sure they are at least rousable. If the patient is deep observe before sending him back to the ward. Before releasing the patient, try the “Gharpure sign”--The patient on closing both nose and mouth must involuntarily open the mouth to breathe.
#16-20: Private Practice Anesthesia- Do’s and Dont’s
