AORN journal
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Allergies to certain foods such as soybeans and eggs contraindicate the use of propofol, a short-acting hypnotic medication used by many anesthesia care providers. Understanding the safe use and handling of propofol and communicating known patient allergies to all surgical team members is crucial to providing safe perioperative care. The perioperative nurse's preoperative assessment supports and improves the plan of care for the patient by identifying the patient's risk factors. Obtaining a correct and precise history of allergies, not only to medication but to food, and concise hand-off reporting are essential for patient safety.
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During 2003 and 2004, a multidisciplinary team at the Children's Hospital at Montefiore, Bronx, New York, successfully separated twin infants who presented with a total craniopagus vertical O'Connell type 1 conjoining. The twins underwent a series of four staged separation procedures over 10 months. ⋯ The fourth stage involved dividing the remaining dura and veins, transecting shared brain tissue not detected in preoperative imaging, replacing dura in twin B, and replacing skin over native dura in twin A. Planning and carrying out separation of the conjoined twins required organization and cooperation of all the disciplines involved to prepare the children preoperatively, care for them perioperatively and postoperatively, and support the mother during the process.