Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
-
J. Perianesth. Nurs. · Apr 2008
Adaptation of the OODA Loop to reduce postoperative nausea and vomiting in a high-risk outpatient oncology population.
Postoperative nausea and vomiting (PONV) remains a ubiquitous concern for surgical outpatients with published rates ranging from 14% to 80%. An evidence-based approach was used to reduce PONV in a high-risk adult outpatient oncology population. The Observe, Orient, Decide, and Act (OODA) Loop, a rapid cycle management strategy, was adapted for use in an outpatient surgery center with six ORs. ⋯ The PONV rate for the final protocol stabilized below 4% by 46 weeks and remained stable through 79 weeks. The OODA paradigm provides an effective technique for interfacing health care research with clinical practice. In this case, an effective PONV prophylaxis plan was developed from within a collaborative nursing and medical setting.
-
J. Perianesth. Nurs. · Apr 2008
Lipid emulsion as rescue for local anesthetic-related cardiotoxicity.
Regional anesthesia techniques use local anesthetics to provide sensory and motor block for surgical intervention. Intravascular absorption of the local anesthetics may induce toxic effects, such as seizure activity or cardiac depression, leading to cardiac arrest. ⋯ Research in animals, however, has shown that, with the administration of intravenous lipid emulsion, hemodynamic stability can be restored after local anesthetic-induced cardiac arrest. Recent case reports have detailed successful resuscitation from cardiac arrest in several patients with local anesthetic-induced cardiotoxicity.