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| ASA Issues OR Fire Advisory |
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Seeking to promote awareness and prevention of a rare but dangerous surgical risk, the American Society of Anesthesiologists has unveiled its "Practice Advisory for the Prevention and Management of Operating Room Fires."
The practice advisory, which appears in the May issue of the journal Anesthesiology, aims "to identify situations conducive to fire, prevent the occurrence of OR fires, reduce adverse outcomes associated with OR fires and identify the elements of an effective fire response," says Robert A. Caplan, MD, chairman of the ASA's task force on the subject, in a press release.
In the advisory, the task force recommends that anesthesiologists and surgical team members:
undergo fire safety training specific to the OR setting;
participate in regular, formal fire drills;
identify high-risk situations and determine how to prevent and manage potential fires;
take appropriate actions to reduce the risks posed by oxidizers, ignition sources and fuels present in the OR; and
work together to detect fires early, extinguish them quickly and minimize the damage they cause.
The advisory defines OR fires as those "that occur on or near patients who are under anesthesia care, including surgical fires, airway fires, and fires within the airway circuit." The volatile combination of oxidizers (such as oxygen and nitrous oxide), ignition sources (such as lasers, drills, electrosurgery devices or defibrillator paddles) and fuels (which include tracheal tubes, drapes or alcohol-containing solutions) in routine surgery enhances the risk of fire.
The ASA estimates that 50 to 100 OR fires occur in the U.S. each year, although "without a national reporting system for OR fires, it is hard to gauge the exact number," says Dr. Caplan.
Irene Tsikitas |
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| Cardboard Nurses Encourage Hand Hygiene |
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Clinical nurse operations coordinator Lindsay Boughey has figured out how to be in two places at once. While undertaking her daily tasks at Stafford General Hospital and Cannock Chase Hospital in Staffordshire, U.K., a life-size cardboard representation of her reminds staff and patients to wash their hands as part of the hospital's infection control campaign.
"It feels a little strange to come face-to-face with myself as I go about my job," says Ms. Boughey, "but I'm glad to be helping to keep the [campaign's] 'hands up for the cleanest hospital' message uppermost in people's minds."
The cardboard Ms. Boughey includes text encouraging passersby to wash their hands when entering and leaving wards. Cut-outs of another infection control nurse at King's Mill and Newark hospitals include electronically recorded spoken messages that play whenever built-in sensors detect someone close to the signs.
"They're personalized to the ward and environment they're in and give a message to help everyone address infection control, particularly around hand hygiene," senior infection control nurse Elaine Overton, SRN, told BBC News. "It's about different ways of getting the message across and about changing emphasis so it's not getting boring."
Nathan Hall |
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| A Simple Test For Recognizing OSA |
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A simple pre-op questionnaire may help identify patients who present for surgery with obstructive sleep apnea, helping anesthesiologists avoid OSA-related complications, say researchers at the University of Toronto. Anesthesiologist Frances Chung, MD, and her colleagues developed the "STOP exam," a scoring system based on four questions:
Do you Snore loudly?
Do you often feel Tired during the day?
Has anyone Observed you stop breathing during sleep?
Have you been or are you being treated for high blood Pressure?
Patients answering "yes" to two or more questions are considered high-risk cases for OSA complications.
"Identifying patients with OSA is the first step in preventing postoperative complications," says Dr. Chung in a statement. "Untreated OSA patients are known to have a higher incidence of difficult intubation, postoperative complications, increased intensive care admissions and greater duration of hospital stay."
Jeffrey B. Gross, MD, chairman of the American Society of Anesthesiologists' task force for perioperative management of patients with OSA, says anesthesia providers who are aware of sleep apnea concerns can prepare to use appropriate anesthesia techniques and equipment in a facility outfitted to handle potential complications.
Dr. Chung's research team also tested and confirmed the efficacy of the Berlin Questionnaire and the ASA Checklist, two traditional sleep apnea screening tests that had previously not been validated for use on surgical patients.
Daniel Cook |
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| News and Notes |
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LEGISLATIVE LANGUAGE THAT WOULD HAVE BANNED physician-owned specialty hospitals was dropped from a bill under consideration in the U.S. House of Representatives after objections from lawmakers backed by the American Medical Association. The provision, attached to a farm bill, would have blocked physicians from referring Medicare patients to hospitals in which they held financial stakes.
BECAUSE CHILDREN ARE AT HIGHER RISK of suffering adverse drug events, the Joint Commission has issued a Sentinel Event Alert addressing pediatric medication errors. Among the alert's recommendations: all pediatric patients should be weighed in kilograms, the standard measure for medications; prescribers should write out calculations used to arrive at dosage; clinicians should not administer high-risk drugs until the patient has been weighed, and should use pediatric-specific formulations and concentrations.
HEALTHCARE PROVIDERS WHO WEAR WRISTWATCHES are more likely to be contaminated with Staphylococcus aureus than their colleagues who are bare below the elbows, according to a study presented at the European Congress of Clinical Microbiology. Researchers evaluated two consecutive cohorts of wristwatch-wearers and non-wristwatch-wearers (a total of 655 participants) and found bacteria was more common on the wrists of watch wearers - though not on their hands. By taking off their watches for the study's sampling, however, they contaminated their hands.
CRIME SCENE INVESTIGATION METHODS can be used to detect a hospital's infection risks, according to researchers at Deventer Hospital in the Netherlands. Inspired by television police dramas, researchers used luminol, a chemical that glows bright blue when it touches iron-rich blood, to uncover traces of blood on tables, cupboard handles, telephones and floors in a seemingly clean hospital room. "It can be used to monitor cleaning and disinfection procedures, and alert healthcare workers to the possibility of contamination," writes a researcher in the April edition of the Journal of Hospital Infection. |
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