Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses
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As time goes on, more professional societies and individual states are mandating stricter standards for office surgical facilities to ensure quality of care. As the nurse is often the person who coordinates accreditation efforts within the facility, he or she needs to be "savvy" regarding the implementation and maintenance of these standards. The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) criteria are discussed with strategies and rationale for implementation.
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Advancements in technology and pharmacology, as well as improved techniques and instrumentation have allowed for much greater flexibility in how and where surgical and anesthesia care can be provided safely. Many procedures now take but a fraction of the time they used to take to complete and can be performed with minimal risk of blood loss and far less postoperative pain. Office-based surgery has emerged as a safe and viable alternative to traditional in-hospital surgery. This article provides an overview of the comprehensive "Standards for Office-Based Anesthesia Practice" developed by the American Association of Nurse Anesthetists (AANA).
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Cyanoacrylate tissue adhesives are used in numerous settings to close wounds without the use of sutures. The product and its use for closing chest tube wounds is discussed.
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Malignant hyperthermia (MH) is a hypermetabolic syndrome triggered in genetically susceptible individuals when certain potent inhalation anesthetics or succinylcholine are administered. The signs of MH include a greatly increased body metabolism, muscle rigidity and eventual hyperthermia that may exceed 110 degrees F. Death can result from cardiac arrest, brain damage, internal hemorrhaging or failure of other body systems. ⋯ High-risk patients cannot always be identified by history, and preparation of every OR is essential. Supplies of dantrolene and other medications must be kept in the OR area. If MH develops, acting within minutes may save a life.