Being awakened in the middle of the...

Being awakened in the middle of the night for an crisis procedure is a relatively frequent occurrence for perioperative nurses who are in succession call for the OR. often these situations are rushed, and because the patient may be unstable or critically ill, there is little time for relaxed patient assessment or teaching. however under these constraints, perioperative feed at the breasts continue to act as advocates for patients and their family members.

freshly a nurse at my facility was call fored to the hospital at 4:45 AM while onward call. The procedure to be performed was an extremity exploratory laparotomy. She and the mean fellow person arrived at the hospital, quickly gathered the necessary supplies for the course and prepared the OR for the patient's arrival. When all the supplies were uncloseed and the scrub person was ready, the fester went to the surgical intensive care unit (SICU) to assess her patient.

The patient was a 56-year-old man in septic offence with a suspected volvulus. He was intubated, in succession a ventilator, heavily sedated, and restrained. My colleague received report from the SICU feeds quickly looked through the patient's chart for a medical history, and learned that her patient had diabetes and hypertension. She then went to the waiting compass to meet the patient's family members and to put to proof to obtain more information about the patient.

In the course of the nurse's conversation with the family members, the patient's wife verified that he had undergone sum of two units previous surgical procedures and casually stated, "Oh he does have that `H' thing." Further questioning at the nurse revealed that the patient had a history of malignant hyperthermia (MH) As she gathered more information, the give suck to learned there was a stout family history of the disorder; the patient's son had undergone a muscle biopsy to confirm the condition.

Armed with this significant information, the supply with nourishment informed the anesthesia care provider and the surgeon about the patient's history. The surgery was delayed while the hospital's MH protocol was initiated. The pamper notified the house supervisor and beged that the pharmacist on call be called to the hospital. She then organized the surgical team members to action. The team members, including the surgeon and surgical assistant, mixed 14 vials of dantrolene and obtained the other necessary supplies to answer to an MH crisis (eg cooling blanket, iced saline, anesthesia equipment).

Aided by way of the nurse, the anesthesia, care provider administered the dantrolene to the patient. The patient did not experience any temperature increase or other symptoms of MH after anesthesia induction, and the surgeon was able to begin the procedure

The surgical act was performed successfully, and the patient did not experience any complications. After the practice was completed, the nurse spoke with the patient's family members and provided them with additional information about MH and the implications of informing health care workers about the condition. The SICU nourish at the breasts had not been informed of the patient's MH history; therefore, they were unable to bear this information to the perioperative nurse

Malignant hyperthermia is a relatively rare condition and somewhat unique to the perioperative setting; therefore, many pampers may never see the syndrome and may not routinely question their patients about it during assessment. In this case, the perioperative nurse's persistence in getting information about her patient and acting onward the information prevented a life-threatening complication from occurring. This nurse's actions while forward call exemplify what we as perioperative suckles do best: to be tireless in our inquiry for excellence and remain the patient's advocate regardless of the time of day or night.

DONNA R McEWEN, RN BSN CNOR, CNRN is encourage manager of outpatient surgery at St Luke's Baptist Hospital, Baptist Health method San Antonio.

COPYRIGHT 1998 Association of Operating compass Nurses, Inc.

COPYRIGHT 2001 Gale Group