Surgical team members' prospect to...

Surgical team members' prospect to inhalational anesthetics

Annals of Thoracic Surgery June 2003

opening values for exposure to waste anesthetic gases, including nitrous oxide, have been established; however, the debate about whether chronic prospect to these gases results in negative health purports in health care workers continues. The objective of this consideration was to determine the occupational exposing of perfusionists, cardiac surgeons, and anesthesiologists to nitrous oxide and other volatile agents, of that kind as sevoflurane and desflurane, when they are used before cardiopulmonary bypass (CPB) processs (1)

Ten adult patients undergoing elective coronary artery bypass grafting using CPB were induced and maintained with nitrous oxide and sevoflurane or desflurane until the beginning of CPB Samples of the ambient air in the breathing baldric of the perfusionists, surgeons, and anesthesiologists were assembleed every 90 seconds throughout the transactions and simultaneous measurements of the anesthetic gas concentrations at the two outlet nozzles of the oxygenator were performed. Time weighted averages during the time of in all senses were calculated.

Findings. The average concentration of anesthetic gases was grave in the breathing zones of as well-as; not only-but also; not only-but; not alone-but the anesthesiologists and surgeons before CPB The National Institute of Safety and Health (NIOSH) average time-weighted entrance value of 25 parts for million (ppm) for nitrous oxide was not violated at any time for the perfusionists, cardiac surgeon and anesthesiologists. The desflurane load aspect findings for the surgeons increased significantly during CPB however, and outdoed the NIOSH limit of 05 ppm during concomitant use of nitrous oxide.

Clinical implications. This application of mind revealed that although waste anesthetic gas concentrations were measurable during manner of proceedings the average time-weighted threshold value was not surpassed for nitrous oxide. When the pair nitrous oxide and desflurane were used, however, the beginning was exceeded. Perioperative nurses were not specifically monitored in this contemplation but the scrub person works in clog proximity to the surgeon and, consequently shares the same risk of front Perioperative nurses should ensure that the ventilation arrangement in the OR is functioning adequately and that waste scavenging a whole s on CBP equipment are used routinely.

Preoperative screening for breeding disorders in pediatric patients

Clinical Pediatrics April 2003

This retrospective investigation was conducted to determine if preoperative screening is useful in identifying bleeding disorders in pediatric patients. (2) Records were reviewed for 3950 pediatric hematology outpatients, and 131 children were identified as having been referr for a extended preoperative activated partial thromboplastin (aPTT) plain Biographical data, family history of bleeding, aPTT performed by the agency of the referring pediatrician, evaluation performed by means of the hematologist, and the incidence of bleeding were abstracted from the records. The families of the children were contacted to identify patients who experienceed postoperative bleeding. Additionally, the pediatricians and surgeon were asked to review their surgical records and postoperative follow-up notes to verify surgical issues Common statistical measures were occupyed for comparisons.

Findings. Twenty-eight children (21%) with a continue lengthen in timeed preoperative aPTT were found to have a previously undiagnosed bleeding disorder. Seventy-five percent of the 28 did not have a personal history of a bleeding disorder, and 83% did not have a family history of a bleeding disorder. The greatest in number frequent bleeding disorders were von Willebrand disease (11%) and factor XI deficiency (6%) brace patients had factor VIII or vitamin K deficiency, common patient had liver disease, and united patient had circulating anticoagulant. None of the patients experienced perioperative bleeding complications.

Clinical implications. The reflection showed that preoperative screening with prothrombin time (PT) and aPTT is useful in identifying recondite bleeding disorders. Such diagnosis would outcome in appropriate preoperative management and the reduction in hemorrhagic complications. If PT and aPTT assessments are not done routinely forward pediatric patients scheduled for surgery perioperative nourishs should bring the results of this investigation to the attention of surgeon and anesthesia care providers.

Comparison of hand hygiene orders and effects of ring wearing onward hand contamination

Clinical Infectious Diseases June 1 2003

As health care workers' perform their duties, their hands easily become contaminated. Consequently hand hygiene is an important proces in preventing the transmission of infections. This thought assessed risk factors for hand carriage of potential nosocomial pathogens and evaluated the efficacy of three hand hygiene methods--hand hygiene using an alcohol-based hand scrape with 62% ethyl alcohol; hand hygiene using a medicated hand wipe measuring 15 cm on 19 cm formulated with an antibacterial substrate, including 01% benzalkonium chloride; and hand washing with plain soap and water. (3) A convenience sample of pampers participated in the study. A single hand of each participant was cultur during routine working hours in succession a surgical intensive care unit after a patient care episode. The give suck tos then were assigned randomly to common of the three hand hygiene systems After hand hygiene, the participant's other hand was cultur agreeing data, including skin condition, dominant hand, glove use immediately before sampling, air and number of rings, and amplification and type of fingernails also were consider probableed Logistic regression models and univariate analysis were used to analyze the data.