4.

Clinical Procedures

4.1 Preoperative assessment and preparation

We recognize the importance of thorough preoperative assessment and preparation in
ensuring the safety and success of surgical procedures. Thus, we aim to optimize patient
safety, satisfaction, and outcomes during the preoperative period, setting the stage for a
successful surgical experience.

Our commitment to excellence in preoperative assessment and preparation is guided by the

following principles:

1. Comprehensive Assessment: We conduct comprehensive assessments of patients

scheduled for surgery, including medical history review, physical examination, and
diagnostic testing, to identify and address any potential risks or contraindications to
surgery.

2. Patient Education: We provide patients with clear and accurate information about
their upcoming surgery, including details about the procedure, expected outcomes,
potential risks and complications, and preoperative instructions, empowering them to
make informed decisions and actively participate in their care.

3. Optimization of Health Status: We collaborate with patients and other members of

the healthcare team to optimize patients' health status before surgery, addressing
any underlying medical conditions, managing medications, and implementing lifestyle
modifications as needed to reduce surgical risks and enhance recovery.

4. Preparation for Anesthesia: We assess patients' suitability for anesthesia and

provide preoperative instructions related to anesthesia, including fasting guidelines,
medication management, and anesthesia consent procedures, to ensure safe and
effective anesthesia administration during surgery.

5. Setup of Operating Room: We ensure all necessary equipment, instruments, and

supplies are prepared and sterilized. We also verify functionality of surgical
equipment, including anesthesia machines, monitors, and lights, arrange surgical
tables, drapes, and positioning devices according to the specific requirements of the
procedure.

6. Coordination of Care: We facilitate seamless coordination of care between surgical

teams, anesthesia providers, and other healthcare professionals involved in patients'
 perioperative care, ensuring that all necessary preparations and precautions are
taken to promote a smooth and successful surgical experience.

7. Emotional Support: We offer emotional support and reassurance to patients and

their families throughout the preoperative period, addressing any concerns or
anxieties they may have and providing resources and assistance as needed to
promote comfort and confidence before surgery.

4.2 Intraoperative protocols and techniques

We uphold the highest standards of surgical excellence and patient safety as we aim to
deliver safe, effective, and compassionate surgical care to our patients, promoting their
health, well-being, and quality of life.

Our commitment to excellence in surgical protocols and techniques is guided by the

following procedures:

4.2.1 Intraoperative Procedures

1. Patient Positioning:

● Position the patient according to the surgical approach and access required for the
procedure.
● Secure the patient's limbs and extremities to prevent movement during surgery,
taking care to avoid pressure injuries.

2. Surgical Incision:

● Surgeons make the initial incision following aseptic techniques and anatomical
landmarks.
● Control bleeding using electrocautery, hemostatic agents, or other appropriate
methods.

3. Surgical Exposure:
 ● Use retractors and/or surgical assistants to optimize exposure of the surgical site.
● Maintain clear visualization of anatomical structures using appropriate lighting and
magnification.

4. Tissue Dissection and Manipulation:

● Perform tissue dissection and manipulation according to the planned surgical

approach.
● Use surgical instruments with precision and care to minimize trauma to surrounding
tissues.

5. Surgical Intervention:

● Complete the necessary surgical steps as per the preoperative plan, which may
include excision, repair, reconstruction, or other interventions.
● Ensure meticulous hemostasis to minimize bleeding and improve surgical field
visibility.

6. Specimen Management:

● Collect tissue specimens for pathological analysis as indicated.

● Label specimens accurately and submit them to the pathology department following
institutional protocols.

7. Closure:

● Close surgical incisions using appropriate suture material and technique.

● Ensure optimal wound approximation and alignment to promote healing and minimize
scarring.

4.2.2 Monitoring and Documentation:

 1. Vital Signs Monitoring:

● Continuously monitor the patient's vital signs, including heart rate, blood pressure,
oxygen saturation, and respiratory rate.
● Document vital sign measurements at regular intervals throughout the procedure.
2. Procedure Documentation:

● Maintain accurate and comprehensive documentation of intraoperative events,

including surgical steps, complications, and any deviations from the planned
procedure.
● Record details of surgical instruments, implants, and other materials used during the
operation.

3. Communication:

● Maintain open communication within the surgical team, including surgeons, nurses,
anesthesiologists, and other personnel.
● Promptly address any concerns or unexpected developments during the procedure.

4.3 Postoperative care and monitoring

Our commitment to our patients extends beyond the operating room. We aim to promote
optimal recovery, minimize complications, and enhance the overall patient experience
following surgery.

Our approach to postoperative care and monitoring is guided by the following principles:

1. Comprehensive Assessment: We conduct thorough assessments of patients

following surgery, monitoring vital signs, pain levels, and surgical site condition to
detect any signs of complications or adverse reactions early and intervene promptly.
 2. Pain Management: We prioritize effective pain management strategies to ensure
patient comfort and promote early mobilization and rehabilitation, tailoring pain
management plans to each patient's individual needs and preferences while
minimizing the risk of opioid-related adverse events.

3. Fluid and Nutrition Management: We monitor patients' fluid and nutritional status
closely, providing appropriate hydration and nutrition support as needed to optimize
recovery and promote healing following surgery.

4. Wound Care: We implement evidence-based wound care protocols to prevent

infections and promote optimal wound healing, including proper wound dressing
techniques, infection prevention measures, and timely assessment and treatment of
wound complications.

5. Patient Education: We provide patients and their caregivers with clear and thorough
instructions for postoperative care and self-management, including guidance on
medication administration, activity restrictions, signs and symptoms of complications,
and when to seek medical attention.

6. Rehabilitation and Follow-Up: We collaborate with patients and their healthcare

providers to develop personalized rehabilitation plans and schedules for follow-up
appointments, ensuring continuity of care and support throughout the recovery
process.

4.4 Infection control measures

We are dedicated to maintaining a safe and hygienic environment for our patients, staff, and
visitors. Hence, we aim to minimize the risk of healthcare-associated infections, protect the
health and safety of our patients and staff, and maintain the trust and confidence of those we
serve at Asian Orthopedics.

Our commitment to infection control is guided by the following principles:

 1. Prevention: We prioritize prevention through the implementation of comprehensive
infection control protocols, including hand hygiene practices, environmental cleaning
and disinfection, and adherence to standard precautions and transmission-based
precautions.

2. Education and Training: We provide ongoing education and training for all staff
members on infection control practices, ensuring that they have the knowledge and
skills necessary to effectively prevent and manage infections in the clinical setting.

3. Surveillance and Monitoring: We conduct regular surveillance and monitoring of

healthcare-associated infections (HAIs) and other infectious diseases within our
facility, using data to identify trends, implement targeted interventions, and
continuously improve our infection control practices.

4. Personal Protective Equipment (PPE): We ensure the availability and proper use
of PPE, including gloves, gowns, masks, and eye protection, to protect both
healthcare workers and patients from the transmission of infectious agents.

5. Environmental Management: We maintain a clean and hygienic environment

through routine cleaning and disinfection of patient care areas, medical equipment,
and high-touch surfaces, using appropriate disinfectants and cleaning agents
recommended for healthcare settings.

6. Patient Screening and Isolation: We implement screening protocols to identify

patients at risk of infectious diseases, such as COVID-19, and implement appropriate
isolation measures to prevent the spread of infection to others within the facility.

4.5 Emergency response procedures

The safety and well-being of our patients, staff, and visitors are our top priorities. Thus, we
aim to minimize the impact of emergencies on the safety and well-being of our patients, staff,
and visitors, and ensure a swift and coordinated response to any situation that may arise.

Our commitment to emergency preparedness is guided by the following principles:

1. Preparedness Planning: We maintain comprehensive emergency preparedness

plans that outline specific procedures and protocols for responding to a wide range of
 emergencies, including medical emergencies, fires, severe weather events, and
security threats.

2. Training and Education: We provide regular training and education for all staff
members on emergency response procedures, ensuring that they are familiar with
their roles and responsibilities during emergencies and equipped with the knowledge
and skills necessary to respond effectively.

3. Communication: We establish clear lines of communication within our facility and

with external emergency response agencies, ensuring timely and coordinated
communication before, during, and after emergencies to facilitate a swift and
effective response.

4. Evacuation and Sheltering: We develop evacuation and sheltering plans tailored to

the specific needs and circumstances of our facility, including procedures for safely
evacuating patients, staff, and visitors, and providing shelter and assistance as
needed during emergencies.

5. Resource Allocation: We maintain emergency supply kits, equipment, and

resources to support emergency response efforts, ensuring that necessary supplies
and medical equipment are readily available and accessible during emergencies.

6. Continuous Improvement: We conduct regular drills, exercises, and debriefings to

evaluate and improve our emergency response procedures, identifying strengths and
areas for enhancement to enhance our preparedness and response capabilities.