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| Haitian Earthquake Inspires Surgical Assistance |
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Surgical personnel from across the country are putting their personal and professional lives on hold to provide relief after the magnitude 7 earthquake rocked Haiti on Jan. 12. Here are just a few examples:
Marcy Sasso, director of operations at the Ambulatory Surgical Center of Union County, N.J., is collecting medical supplies for the American Red Cross and United Way to transport to Haiti. Her center, located at 950 West Chestnut Street in Union, will be accepting donations, Mondays through Fridays between 6:30 a.m. and 5 p.m., until March 26. Contact Ms. Sasso at msasso@ascunion.com or (908) 688-2700 for more information.
In addition to encouraging New Jersey-area readers to donate supplies, she also encourages surgical facilities nationwide to contact the Red Cross or United Way about becoming drop-off centers in their areas.
A surgical team from Park Ridge Hospital in Ashville, N.C., is preparing for a 10-day trip to Haiti. "It sounds like it will involve a lot of orthopedic trauma," says Carolyn Davis, RN, BNS, a charge nurse in the outpatient surgery department at Park Ridge, part of the Adventist Health System. Ms. Davis expects to be working on repairing broken bones and amputations amid reports of a nursing shortage on the scene.
Instruments of Mercy, a nonprofit organization, is offering to repair surgical instruments - including flexible endoscopes, rigid endoscopes, power equipment, stainless instruments and laparoscopic and specialty instruments - for teams headed to Haiti at no cost. Surgeons or team members volunteering their services toward disaster relief effort should contact Toney Peer at toneypeer@instrumentsofmercy.org or (205) 913-6032.
Mike Fitzgerald, chief operating officer of Orthopaedic Associates of Michigan in Grand Rapids, helped to send a team of physicians to Haiti last week. One surgeon from his group reported operating on 50 patients during his first day there as hundreds more waited for care. Mr. Fitzgerald says he anticipates his team will focus on patients whose compound fractures have not yet been set and who face risks of infection and amputation. You can follow the team's progress on their blog.
Be sure to read Outpatient Surgery Magazine's February cover story for an in-depth look at how the American surgical community is helping to put Haitians, and Haiti, back together.
Outpatient Surgery Editors |
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| Judge Rejects Fentanyl Tech's Plea Deal |
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Kristen Diane Parker, the surgical tech whose drug theft and tampering infected patients at 2 Colorado surgical facilities with hepatitis C, is reconsidering her legal options after a federal judge nixed the plea agreement she'd made with prosecutors.
Ms. Parker was scheduled to be sentenced to 20 years in prison in a Denver courtroom on Friday. But at that hearing, U.S. District Judge Robert E. Blackburn said the agreement restricted his latitude in sentencing and failed to address the victims who argued 20 years wasn't long enough.
This announcement left Ms. Parker to decide whether to accept a potentially longer sentence, renegotiate with prosecutors or withdraw her guilty plea and go to trial. Her next hearing has been scheduled for Feb. 5.
Ms. Parker, 27, pleaded guilty in September to tampering with a consumer product and obtaining a controlled substance by deceit or subterfuge. She'd been accused of stealing and injecting herself with fentanyl, swapping out the syringes for used, saline-filled ones.
While patients at the Rose Medical Center in Denver and the Audubon Surgery Center in Colorado Springs were found to have been infected by Ms. Parker's thefts, investigators have linked no cases of hepatitis C to the Mount Kisco, N.Y., and Houston facilities which previously employed her.
David Bernard |
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| Surveillance Colonoscopy Over- and Underused |
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A new study shows a substantial overuse of surveillance colonoscopy among patients at low risk of colorectal cancer and an underuse of follow-up screenings among patients at higher risk.
Researchers led by Robert Schoen, MD, of the University of Pittsburgh School of Medicine, retrospectively surveyed 3,627 participants in a cancer screening trial and published their findings in the January issue of the journal Gastroenterology.
Only 58.4% of patients whose initial diagnostic colonoscopies revealed advanced adenomas received a follow-up colonoscopy within 5 years as recommended. Meanwhile, the average time between the initial diagnostic colonoscopy and a follow-up among 1,029 patients whose initial exams showed no precancerous colorectal growths was 3.9 years, much sooner than the recommended 5 to 10 years. Researchers found no documented medical evidence to justify the early follow-ups. "This misuse wastes healthcare resources and risks development of cancers in high-risk patients that might have been preventable," writes Dr. Schoen in a statement.
In a related commentary, John I. Allen, MD, of the University of Minnesota School of Medicine suggests several possible reasons for the "misuse" of endoscopy, including unclear scientific guidelines, primary care physicians ordering tests without consulting endoscopists, inefficient recordkeeping and a fee-for-service system that encourages overuse. He proposes the development of a patient outcome registry and a shift to value-based payments for colorectal cancer screenings.
Irene Tsikitas |
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| InstaPoll: Which Procedure Do You Want to Add? |
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Register your vote in this week's InstaPoll for the one procedure you'd most like to add to your case mix: retina, spine, bariatrics, pain management or endoscopic sinus surgery. We'll report the results in this space next week.
Slightly more than half of last week's respondents use consciousness monitors to measure the depth of anesthesia, with 31% saying every patient is monitored and 23% saying some are. The other 46% of our 83 respondents say they never use brain wave monitors.
Dan O'Connor |
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| News & Notes |
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Tip of the week Discussing patient outcomes with family members in the waiting room compromises confidentiality, so use your facility's consultation room for more than just bad news, suggests Elizabeth Edel, RN, MN, CNOR, CNS, of the MD Anderson Cancer Center in Houston, Texas. "Our policy is to call all family members to the consultation room to receive updates regarding diagnosis or surgery outcome, regardless of whether the news is good, bad or somewhere in between."
Medicare won't require cataract outcomes The Centers for Medicare and Medicaid Services are dropping a proposal to require hospital departments and ultimately ASCs to determine whether a patient scheduled for cataract surgery would achieve a 20 percent improvement in vision before allowing the procedure. The ophthalmology community had united against the proposal on scientific, clinical and practical grounds. ASCs are ill-equipped to evaluate potential cataract outcomes, says the Outpatient Ophthalmic Surgery Society, since the facilities are not involved in the events preceding surgery against which outcomes are measured or those that follow surgery as healing occurs.
Lighter sedation, less delirium Elderly patients undergoing hip fracture surgery with light propofol sedation via spinal anesthesia are 50% less likely to experience post-op delirium than those sedated deeply, according to researchers at Johns Hopkins School of Medicine. Keeping patients above 80 on the bispectral index will prevent 1 post-op delirium incident among every 3.5 to 4.7 patients, report the authors in the January issue of the Mayo Clinic Proceedings. |
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