AORN journal
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Review Case Reports
Damage control surgery for the patient who has experienced multiple traumatic injuries.
PATIENTS WHO HAVE EXPERIENCED multiple traumatic injuries present one of the greatest challenges for perioperative teams. IN A TRAUMA PATIENT who is hemorrhaging, increased risk of death arises from a vicious cycle of hypothermia, coagulopathy, and metabolic acidosis known as the triad of death. A STAGED SURGICAL APPROACH predicated on specific priorities for treating multiply injured patients can help save the lives of these patients.
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Postoperative pulmonary complications are potentially preventable adverse events that are a major source of postoperative morbidity and mortality. Although these events occur more frequently than cardiac complications, less is known about how to predict their occurrence. This review of the literature identifies significant risk factors for postoperative pulmonary complications. Nurses can be instrumental in preventing postoperative pulmonary complications by identifying patients at risk for their development.
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ALTHOUGH THE APPLICATION of cricoid pressure is a technique that is performed almost daily in the OR, perioperative nurses may not be applying cricoid pressure correctly. THE PURPOSE of this quality improvement project was to develop an education program to assess perioperative nurses' skills and educate and train them regarding correct application of cricoid pressure. OF 51 PERIOPERATIVE NURSES who participated in a pretest, an education program, and a posttest, the number of participants who could apply the appropriate amount of pressure to the correct location increased from two (3.9%) on the pretest to 35 (68.6%) on the posttest.
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This systematic review examines whether preventing hypothermia during surgery prevents postoperative complications and thereby improves outcomes for patients. Twenty-six randomized controlled trials were identified, and data extraction and assessment of study quality were carried out by two researchers independently. ⋯ Postoperative complications identified were shivering, cardiac events, need for blood transfusion, wound infections, and pressure ulcers. The majority of studies favored treatment.