Today's OR nurse
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1. Although many adult ocular procedures may be done equally well under local or general anesthesia, with children, the anesthesiologist almost always has to administer general anesthesia to guarantee satisfactory surgical conditions. 2. ⋯ In general, anesthetic induction is accomplished in an age-appropriate fashion. 3. Basic discharge criteria include the following: Vital signs should be stable and normal; there should be no signs of respiratory distress; mental status should be age-appropriate and back to baseline; the patient should demonstrate the ability to either swallow fluids, cough, or have an intact gag reflex; the patient should be able to ambulate, if age-appropriate and baseline; and the patient always must have a responsible, well-informed escort home. engaging and diverting; have a collection of stories or songs ready.
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1. Providing optimal trauma care for large populations requires the collaboration and cooperation of hospitals providing all levels of care. 2. ⋯ In two regional trauma networks, 24% of injured patients were referred to a trauma center for definitive care. Overall survival was excellent.
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1. Our clinical service department, perioperative care, had several long-standing issues that needed resolution. Many seemed to revolve around OR delay starts, yet data were necessary to validate the scope of the issue. ⋯ The overall issue of delay starts, the focus of the work team, and the plan of approach were reviewed. A problem was identified and corrected. Twelve months later, a formal review of delay starts demonstrated an 80% reduction in delays from scheduling information.
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1. Direct carotid-cavernous sinus fistulas usually result from multi-trauma or head injuries. These patients are more likely to be seen at trauma-based hospitals. 2. ⋯ The ultimate diagnostic test for direct carotid-cavernous sinus fistulas is cerebral arteriography of both the internal and external carotid arteries. 4. The optimal treatment of a direct carotid-cavernous sinus fistula is closure of the abnormal arteriovenous communication with preservation of internal carotid artery patency. Detachable, flow-guided balloons are presently used to close most direct carotid-cavernous sinus fistulas.
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1. Every operating room has the elements necessary to start a fire: oxidants (O2, N2O), ignition sources, and fuel. 2. ⋯ An appropriate fire safety program can be developed based on the test results. 4. Fire evacuation drills and hands-on use of fire extinguishers should be included in any OR fire safety program.