AORN journal
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Review Case Reports Randomized Controlled Trial Clinical Trial
Effects of warming therapy on pressure ulcers--a randomized trial.
Postoperative pressure ulcers are a common and expensive problem. Intraoperative hypothermia also is a common problem and may have a connection with impaired tissue viability. Researchers in this study hypothesized that intraoperative control of hypothermia may reduce the incidence of postoperative pressure ulcers. ⋯ Results indicated an absolute risk reduction in pressure ulcers of 4.8% (i.e., 10.4% to 5.6%) with a relative risk reduction of 46% in patients who received warming therapy. Although not reaching statistical significance, the clinical significance of almost halving the pressure ulcer rate is important. A correlation between body temperature and postoperative pressure ulcers was established.
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As the senior citizen population has grown, the incidence of osteoarthritis and joint replacement has increased. Bilateral total knee arthroplasty (BTKA) can be performed sequentially during one anesthetic. Studies have shown the complication rates differ only slightly for total knee arthroplasty procedures performed sequentially during one anesthetic or separately requiring two hospitalizations. With the use of staggered tourniquet deflation times, efficient OR time and motion techniques, and careful postoperative management, patients can achieve successful outcomes after BTKA during one anesthetic.
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The application of cricoid pressure is a common technique used to decrease the risk of aspiration during anesthetic induction. Research recommends that 3 to 4 kg of cricoid force be applied to achieve effective esophageal occlusion. The purpose of this study was to assess perioperative nurses' knowledge regarding the recommended amount of cricoid force that should be applied to the cricoid cartilage and to assess the amount of force generated when cricoid pressure was applied to a scale-mounted model. ⋯ Five percent of participants identified the correct amount of force necessary. Applied force was significantly less than the recommended amount. Findings of this study suggest perioperative nurses lack both knowledge and clinical skill for generating effective amounts of cricoid force.