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Total Knee Replacement – Patient Saftey Packet


How We Are Committed to Protecting Your Safety:
         How We Protect You From Infection
         How We Protect You From  Blood Clots:


What you should know before your surgery?
        your laboratory results
                your hematocrit should be between 30 and 45%
                        - if your hematocrit drops below 25-26% during your surgery, we may recommend a blood transfusion.

        what type of knee is your surgeon going to use?
                        


What to Expect When You Come to the Hospital?

The Day of Your Surgery
     The nurse will take your blood pressure, pulse, temperature, and a pulse oximetry (oxygen level in the blood) every 4 to 8 hours.
           - its OK to have a small temperature elevation for the first three days after surgery;
     The nurse will measure your urine output.
           - there should be at least 300 ml per 8 hour shift.
     A blood drawing technician will draw your blood at 5 pm (will test for your red blood cell level - hematocrit - and a chemitry level)
           - ask your nurse about your hematocrit (should be above 30 and if the hematocrit is below 26 we may recommend a transfusion)
     The pulse oximeter machine will measure a continuous heart rate and blood oxygen level
           - the pulse should be below 100 and the oxygen saturation should be above 95% (or you will need oxygen) 

Post Operative Day One
     A blood drawing technician will draw your blood at 6 AM (will test for your red blood cell level - hematocrit - and possibly chemitry level)
             ask your nurse about your hematocrit (should be above 30 and if the hematocrit is below 26 we may recommend a transfusion)
     The pulse oximeter machine will measure a continuous heart rate and blood oxygen level
           - the pulse should be below 100 and the oxygen saturation should be above 95% (or you will need oxygen) 
     Try to restart a normal diet.
     Consider removal of Foley Catheter (bladder catheter)
     Physical therapy will see you and will attempt to walk you;
            We will get you out of bed for at least 2 hours;
            CPM is going 2 hours on and 2 hours off; 
     The nurse will give you a shot in the abdominal fat to prevent blood clots (Lovenox).
             Ask her to teach you how to give these shots as they are often given for a week or two at home.
             You are encouraged to move your feet back and forth for two minutes every 30 min (2 min during each TV commercial)
     A hospital Internist will introduce himself and will attend to your medical (non orthopaedic needs)
     A blood drawing technician will draw your blood at 5 pm (will test for your red blood cell level - hematocrit - and a chemitry level)
     
Post Operative Day Two
     A blood drawing technician will draw your blood at 6 AM (will test for your red blood cell level - hematocrit - and possibly chemitry level)
             ask your nurse about your hematocrit (should be above 30 and if the hematocrit is below 26 we may recommend a transfusion)
     Foley Catheter (Bladder Catheter) is removed if you are mobilizing well
     Physical therapy will see you and will attempt to walk you;
             CPM is going 2 hours on and 2 hours off; 
             We will get you out of bed for at least 2 hours;
             You are encouraged to move your feet back and forth for two minutes every 30 min (2 min during each TV commercial)

     The nurse will give you a shot in the abdominal fat to prevent blood clots.
     The hospital internist will continue to follow your medical (non orthopaedic needs)

Post Operative Day Three
     A blood drawing technician will draw your blood at 6 AM (will test for your red blood cell level - hematocrit -  a platlet level and possibly chemitry level)
             ask your nurse about your hematocrit (should be above 30 and if the hematocrit is below 26 we may recommend a transfusion)
             ask your nurse about your platlet level (it can fall with the Lovenox shots)         

      Foley Catheter (Bladder Catheter) needs to go
      Ask the nurse for help with a bowel movement if there is a need.
      The hospital internist will continue to follow your medical (non orthopaedic needs)
      Physical therapy will see you and will attempt to walk you - consider going up and down stairs;
                  CPM is going 2 hours on and 2 hours off; 
                 You are encouraged to move your feet back and forth for two minutes every 30 min (2 min during each TV commercial)

      The nurse will give you a shot in the abdominal fat to prevent blood clots.

Post Operative Day Four
      Ask the nurse for help with a bowel movement if there is a need.
     Physical therapy will see you and will attempt to walk you;
     CPM is going 2 hours on and 2 hours off; 
     The nurse will give you a shot in the abdominal fat to prevent blood clots.
     Consider discharge planning.
     The hospital internist will continue to follow your medical (non orthopaedic needs)
      By now, you should have a home occupational therapy packet of safety items (pick up stick, elevated commode) as well as other items
            such as a hospital bed.


Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Saturday, December 15, 2007 12:55 pm