C09986242 / invoice 10000

Reason: Lump Removal x 2 - SB Laboratory: PAS Mild changes on CBC including mild lymphopaenia, none of concern MBA Mild to moderate elevation ALT and mild decrease Urea ALKP remainder WNL Tang and discuss with Sarah - Snake envenomation in Sept '25. Biochem not run. Sept '24  PAS WNL Plan: options dc with Sarah - OK to proceed with Sx today. Repeat boichem / imaging / benign neglectTreatment:Pre-med:  0.36ml ACP  0.72ml Methone  Induction: 2.9 ml Alfaxan IVMaintenance: 2- 3%  Isoflurane Not a smooth anaesthetic. Heart rate fluctuated between 100-200bpm with an unpredictable Arrythmia noted. 3 x ECG traces printed and attached to file. This will be sent to RW Peri-operative intravenous fluids: 120 ml/hr Hartmanns Recovery: Smooth uneventful Nurse: GTLUMP REMOVAL:Lump description: Dorsal thorax ~15mm as well as dorso - lumbar ~20mm raisedCytology performed and results: Done at consult - no specific findings Lump removed with  5mm margins and 1 fascial plane. 4ml Bupivicaine injected block. Wound closed with 3-0 PDS Continuous for s/c and 2/0 polypropylene for skin.1.9ml Carprieve IV40mg Carprieve BID PO Plan:S/O 14 Days    Vital Signs    Weight: 24.5;       MMColour: pink;       Temperature: 38.2;       HeartRate: 90;       BodyScore: 7/9;       RespirationRate: 20;       CRT: 1 sec;