BME 338 Widener University Carpal Tunnel Syndrome Release

BME 338 Widener University Carpal Tunnel Syndrome Release BME 338 Widener University Carpal Tunnel Syndrome Release i will upload the files that you need if you need anything just text me Read “Carpal Tunnel Surgical Article” How does the Carpal Tunnel cause painful condition to human health? What is the current treatment that can treat and potentially heal the painful condition? What type medical devices have been used for such surgical procedure? Your thoughts on these Medical Devices for potential improvement View online You-tube video of Surgical Operation, your observation includes: Surgical Operating Room size and arrangement and how can we reduce the Surgical Room Size, remove all possible contaminates, and reduce numbers of staff to make the room for clean, less congested, and more sterile environment? What are these critical instruments and Medical Devices typically used and how can we identify the unmet needs of general surgical instruments, e.g., retractors and forceps, to make the surgical process and procedures more simple and safe? Your thoughts and opinions: what should a “perfect” surgical operating room be? Review Lecture 01 slide deck Write down your tentative project title, objectives and deliverable lecture_01_assignment_carpal_tunnel_surgey.pdf lecture_01_bme338_introduction.pdf ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Carpal Tunnel Release What is carpal tunnel release surgery? Carpal tunnel release is a surgery used to treat and potentially heal the painful condition known as carpal tunnel syndrome. Doctors used to think that carpal tunnel syndrome was caused by an overuse injury or a repetitive motion performed by the wrist or hand, often at work. They now know that it’s most likely a congenital predisposition (something that runs in families) – some people simply have smaller carpal tunnels than others. Carpal tunnel syndrome can also be caused by injury, such as a sprain or fracture, or repetitive use of a vibrating tool. It’s also been linked to pregnancy, diabetes, thyroid disease, and rheumatoid arthritis. The median nerve and tendons that allow your fingers to move pass through a narrow passageway in the wrist called the carpal tunnel. The carpal tunnel is formed by the wrist bones on the bottom and the transverse carpal ligament across the top (or inside) of the wrist. When this part of the body is injured or tight, swelling of the tissues within the tunnel can press on the median nerve. This causes numbness and tingling of the hand, pain, and loss of function if not treated. Symptoms usually start slowly, and may get worse over time. They tend to be worse on the thumb side of the hand. During a carpal tunnel release, a surgeon cuts through the ligament that is pressing down on the carpal tunnel. This makes more room for the median nerve and tendons passing through the tunnel, and usually improves pain and function. Why might I need carpal tunnel surgery? A diagnosis of carpal tunnel syndrome is about the only reason to have a carpal tunnel surgery. And even then, your doctor will likely want you to try nonsurgical treatments first. These may include over-the-counter pain medicines, physical therapy, changes to the equipment you use at work, wrist splints, or shots of steroids in the wrist to help relieve swelling and pain. The reasons that a doctor would recommend a carpal tunnel release surgery may include: ? ? ? ? The nonsurgical interventions for carpal tunnel syndrome don’t relieve the pain. The doctor performs an electromyography test of the median nerve and determines that you have carpal tunnel syndrome. The muscles of the hands or wrists are weak and actually getting smaller because of the severe pinching of the median nerve. The symptoms of carpal tunnel syndrome have lasted 6 months or longer with no relief. What are the risks of carpal tunnel surgery? As with most surgeries, carpal tunnel release is not without its risks. Your wrist will be made numb and you may be given medicine to make you sleepy and not feel pain (called local anesthesia) for the procedure. In some cases general anesthesia is used, this when drugs are used to put you into a deep sleep during surgery. Anesthesia poses risks for some people. Other potential risks of a carpal tunnel release surgery include: ? ? ? ? ? Bleeding Infection Injury to the median nerve or nerves that branch out from it Injuries to nearby blood vessels A sensitive scar The recovery from carpal tunnel surgery takes time – anywhere from several weeks to several months. BME 338 Widener University Carpal Tunnel Syndrome Release If the nerve has been compressed for a long period of time, recovery may take even longer. Recovery involves splinting your wrist and getting physical therapy to strengthen and heal the wrist and hand. There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure. How do I get ready for carpal tunnel surgery? ? ? ? ? Tell your doctor about all medicines you are currently taking, including over-thecounter drugs, vitamins, herbs, and supplements. You will probably need to stop taking any medicines that make it harder for the blood to clot, such as ibuprofen, aspirin, or naproxen. If you’re a smoker, try to quit before to the surgery. Smoking can delay healing. You may need to get blood tests or an electrocardiogram (ECG) before surgery. You will usually be asked not to eat or drink anything for 6 to 12 hours before the surgery. Based on your medical condition, your doctor may request other specific preparations. What happens during carpal tunnel surgery? Carpal tunnel release is usually an outpatient procedure, which means that you can go home the same day as the surgery if all goes well. There are 2 types of carpal tunnel release surgery. The traditional method is the open release, in which the surgeon cuts open the wrist to do the surgery. The other method is endoscopic carpal tunnel release, in which a thin, flexible tube that contains a camera is put into the wrist through a tiny incision (cut). The camera guides the doctor as the surgery is done with thin tools put into the wrist through another small cut. In either case, here is the general sequence of events in a carpal tunnel release surgery: 1. You will usually be asked to remove your clothing, or at least your shirt, and put on a hospital gown. 2. Typically, local anesthetic is used for this procedure to numb the hand and wrist. 3. In an open release surgery, the surgeon cuts about a 2-inch incision on the wrist. Then he or she uses common surgical instruments to cut the carpal ligament and enlarge the carpal tunnel. 4. In an endoscopic carpal tunnel release, the doctor makes 2, half-inch incisions. One is on the wrist, and one is on the palm. Then he or she inserts a camera attached to a narrow tube into one incision. The camera guides your doctor as he or she inserts the instruments and cuts the carpal ligament through the other incision. 5. The surgeon will stitch up the incision or incisions. 6. Your hand and wrist will be placed in a splint or bandaged heavily to keep you from moving your wrist. Once the surgery is done, you’ll be monitored for a short time, and then allowed to go home. Only in rare cases or complications is an overnight stay needed for a carpal tunnel release surgery. What happens after carpal tunnel surgery? Your wrist will likely be in a heavy bandage or a splint for 1 to 2 weeks. Doctors usually schedule another appointment to remove the bandage or splint. During this time, you may be encouraged to move your fingers to help prevent stiffness. You’ll probably have pain in your hand and wrist after surgery. It’s usually controlled with pain medicines taken by mouth. The surgeon may also have you keep the affected hand elevated while sleeping at night to help decrease swelling. Once the splint is removed, you will likely begin a physical therapy program. The physical therapist will teach you motion exercises to improve the movement of your wrist and hand. BME 338 Widener University Carpal Tunnel Syndrome Release These exercises will speed healing and strengthen the area. You may still need to sometimes use a splint or brace for a month or so after surgery. The recovery period can take anywhere from a few days to a few months. In the meantime, you may need to adjust job duties or even take time off from work while you heal. Your doctor will talk to you about activity restrictions you should follow after surgery. Let your doctor know about any of the following: ? ? Fever Redness, swelling, bleeding, or other drainage from the incision ? Increased pain around the incision These problems may need to be treated. Talk to your doctor about what you should expect and what problems mean you need to see your doctor right away. Next steps Before you agree to the test or the procedure make sure you know: ? ? ? ? ? ? ? ? ? ? ? ? The name of the test or procedure The reason you are having the test or procedure What results to expect and what they mean The risks and benefits of the test or procedure What the possible side effects or complications are When and where you are to have the test or procedure Who will do the test or procedure and what that person’s qualifications are What would happen if you did not have the test or procedure Any alternative tests or procedures to think about When and how will you get the results Who to call after the test or procedure if you have questions or problems How much will you have to pay for the test or procedure LECTURE 1 Need Finding 2 Welcome to BME 338 !! Team’s Training Journey 3 Engineers Nurses BME 338 and NURS 332: Innovation in Teaching and Learning 4 Engineering Course: BME 338 – Biomedical Devices Nursing Course: NURS 332 – ITL Experiential and Adaptive Learning in a Collaborative Environment Course Goal 5 ? To Bridge the Gap Between Classroom to Clinic While Working in Multidisciplinary Teams Clinical observations and identification of an unmet need Proposing a translational engineering solution Common Goals: Nurses and Engineers 6 Providing solutions for health care needs ? Advancing the science of health care through innovation and practice Training in multidisciplinary teams allows for better preparedness in accomplishing these goals ? Clinical Virtual Tour Goals 7 ? Engineers: in the problem scenario – clinical setting ? Get experience working with clinicians and health care providers ? Use your engineering power to identify a clinical problem ? Get ? Nursing: ? Experience a clinical scenario with not as a provider but as a problem identifier ? Get interdisciplinary working experience ? Be a part of a problem-solving team Team Tasks 8 ? ? ? ? Classroom Discussion Simulation Labs Midterm Presentation Final Presentation Biodesign 9 Clinical Virtual Tour Details : Site 1 10 ? Virtual Tour Orthopaedic Specialist Operations ? Observed a carpal tunnel surgery ? Operating room equipment ? Operating team dynamics ? Found 2 unmet needs: ? Retractors ? Controlling Blood Loss ? Surgical Procedure Complications Carpel Tunnel Syndrome 11 ? Pathophysiology: ? Space-occupying lesion or direct pressure within the carpal canal increases pressure on the median nerve, resulting in compression. ? Compression of the median nerve leads to demyelination and subsequent axonal degeneration, which interrupts normal function ? Stakeholders: ? Patients: lingering pain and weakness & return to daily activities very quickly ? Doctors: Relieve the pressure on the median nerve ? Hospitals: reduce the amount of extensive surgery interventions Taylor, C. (2015). BME 338 Widener University Carpal Tunnel Syndrome Release Fundamentals of nursing: the art and science of nursing care, eighth edition. Philadelphia: Wolters Kluwer Health. Carpel Tunnel Syndrome 12 ? Who is Affected? Three times more common in women than men ? Most common from the ages 45 to 60 ? The disorder affects adults much more commonly than children ? The disorder especially occurs in people who move their wrists continuously (e.g., assembly-line work, sewing, manufacturing, cleaning, food packing, use of a keyboard). ? Diabetic ? Obese ? ? Statistics: Most common nerve entrapment syndrome ? Symptoms usually starting gradually and increasing in severity ? Current Treatment Options 13 ? Conservative Treatment ? Rest ? Splinting ? NSAIDs ? Corticosteroid ? injection Surgery – Video ? Endoscopic ? Open Surgery Unmet Need 1: Retractors 14 ? ? Surgeon only used one hand for surgery, the other was occupied holding the retractor The constant manipulation of retractors during surgery can cause slower healing and increase the visibility of the scar ? Retractor: A retractor is a surgical instrument used to separate the edges of a surgical incision or wound, or to hold back underlying organs and tissues so that body parts under the incision may be accessed. Unmet Need 2: Blood Loss 15 ? ? The procedure the nurses used to absorb the blood and clean the incision was messy and inefficient They used forceps covered in gauze and the gauze had to be changed numerous times Clinical Virtual Tour Details : Site 2 16 ? ? ? ? ? ? ? Surgery: Robotic Prostatectomy Location: Penn Presbyterian Medical Center Surgeon: Dr. David Lee Patient: Male, age 55+ Patient Condition: Prostate Cancer Surgery Length: 4.5 hours long Problem identified ? Removal of debris from the body Dr. David Lee, Chief, Division of Urology, Penn Presbyterian Medical Center Condition: Prostrate Cancer 17 ? ? Prostate cancer begins when cells in the prostate gland start to grow uncontrollably Almost all prostate cancers are adenocarcinomas. These cancers develop from the gland cells (the cells that make the prostate fluid that is added to the semen). Current Treatment Options (Removal of Prostate) 18 ? ? One surgeon uses the Da Vinci Surgical System to perform the surgery The Doctor sits behind a console that is used to control the robot ? The ? ? ? doctor controls the robot by using joys sticks The nurses are in charge of removing unwanted parts of the body Nurses also are in charge of changing the robotic tools during surgery Finasteride (proscar) can help lower prostate cancer risk Unmet Need: Removal of Debris out of the Body 19 ? Current Design: There is a suction tube that is controlled independently from the robot by a nurse. BME 338 Widener University Carpal Tunnel Syndrome Release ? The nurse only has this one insertion hole which is used for the suction tube and is also used to insert wanted materials and remove unwanted materials during surgery ? ? Improved Design: Use the same insertion hole ? Want to keep the suction the same ? Want to have a cage around the suction tube to prevent clogging ? Or design a catch system that will separate the solids and liquids once it has been removed from the body ? Needs and Specifications 20 ? We need to reduce the chances that the suction tube will become clogged while in use during prostate surgeries. ? Specifications ? Low-cost ? Needs to be Sterile ? Needs to be small enough to fit through the entrance hole ? Can’t be too strong of a suction because you do not want to do damage to the body Experience from a Nursing Perspective 21 ? ? ? “Working with engineers and identifying unmet needs allowed me understand how to be a better advocate for my patient” “Taking a step back and fully processing the steps and equipment used in patient care allowed me to get a better understanding of the patient’s care holistically” My Take: Safety is always the priority in nursing. By establishing a rapport with more of the patient’s healthcare team, better information would be provided to the patient. Experience from an Engineering Perspective 22 ? ? ? “Being able to speak with the nurses about issues they face in the clinical setting really gave me a new perspective on how to design medical devices.” “I never realized how much equipment a nurse needed to understand in order to efficiently do their job for a given patient and how many things could go wrong.” My Take: Improving patient recovery and safety are the most important goals of creating a medical device. If the nurses don’t have the proper device in order to treat a patient, or if the device isn’t easy to use, this can be harmful to patient recovery and safety. Next Steps 23 ? ? ? Offer a translation engineering solution to one of the unmet needs identified by teams of engineers and nurses Translate the unmet need design to a Senior Design capstone project Enhance the understanding of Phase 0 (problem identification) of design process that allow better preparedness in the real world In a Nutshell !! 24 ? ? ? ? ? ? Clinical Sites will be finalized Teams will be assigned to a virtual tours of clinical site to identify three unmet need/team Site visits followed by Midterm Presentations One unmet need will be assigned per team Work on the unmet need solution findings and prepare your final presentation Final presentation Course Path 25 October 2020 … Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . 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