Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Operating Rooms”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed2000

Age-related thermoregulatory differences in a warm operating room environment (approximately 26 degrees C).

UNLABELLED: Inadvertent hypothermia occurs frequently at typical ambient operating room (OR) temperatures, especially in elderly patients receiving general anesthesia. The aims of the current study were to 1) determine the incidence and magnitude of core hypothermia in an unusually warm OR environment, and 2) to assess age-related differences in perioperative thermoregulatory responses under these circumstances. Forty patients receiving general anesthesia for orthopedic surgical procedures (20 younger patients, 20-40 yr old) and (20 older patients, 60-75 yr old) were enrolled. Mean ambient temperature in the ORs was 25.8 degrees +/- 0.2 degrees C. Core temperature, vasoconstriction, and shivering were compared in the younger and older age groups. Mean core temperature on admission to the postanesthesia care unit was not significantly different in the younger (36.7 degrees +/- 0.1 degrees C) and older (36.4 degrees +/- 0.1 degrees C) age groups. Only 10% of patients (n = 4, 1 younger, 3 older) were admitted with a core temperature <36.0 degrees C. Only 2% of patients (n = 1, older group) had a core temperature <35.5 degrees C. This very mild degree of hypothermia was associated with postoperative vasoconstriction in 80% of the younger and 55% of the older patients (P = 0.18). Postoperative shivering occurred in 40% of the younger patients and in 10% of the older patients (P = 0.06). In summary, an ambient OR temperature near 26 degrees C (79 degrees F) is effective in preventing core hypothermia during general anesthesia regardless of patient age. Even very mild postoperative hypothermia may initiate thermoregulatory responses. IMPLICATIONS: By increasing ambient temperature in the operating room to 26 degrees C (79 degrees F), the incidence of core hypothermia can be dramatically reduced in both younger and older patients.

Adult↗
PubMed1989

Methicillin-resistant Staphylococcus aureus in nosocomial infections in the surgical ward and operating room.

In this study 214 strains of Staphylococcus aureus were isolated from clinical specimens on the surgical ward from 1983 to 1988 and in addition, 62 airborne strains were collected in the operating room. Highly methicillin-resistant strains of S.aureus (H-MRSA, MIC greater than 100 micrograms/ml) not detected in 1983 showed a significant increase in frequency by 1987 accounting for about 60% of MRSA (MIC greater than or equal to 12.5 micrograms/ml). Countermeasures instituted in 1987 such as the use of disinfectant chlorhexidine alcohol significantly decreased the frequency of MRSA and H-MRSA isolates in 1988. In our study of coagulase type, MRSA type IV strains were predominant until 1984, whereas after 1986 type II was prevalent. All airborne strains collected in the operating room were methicillin-sensitive S.aureus, with type VII currently epidemic. We therefore concluded that cross infection with MRSA took place on the surgical ward rather than in the operating room.

Cross Infection↗
PubMed1998

Skin injury in the operating room.

Skin injury occurring in the operating room may occur as a result of electrical current, thermal injury, chemical irritation and mechanical stress. Between 1 December 1996 and 28 February 1997, 19 cases of skin injury from a total of 3657 operations were noted in our hospital. These injuries tend to be ignored because of their early spontaneous healing. We suggest that medical staff should pay more attention to this complication and prevent it from occurring.

Adult↗
PubMed1996

Measurement and reduction of nitrous oxide in operating rooms.

In a program designed to lower exposure to anesthetic gases, nitrous oxide in the breathing zone of anesthesiologists was continuously monitored by means of a direct reading apparatus and a specially designed collar. Initially, the average concentration during anesthesia in intubated patients, determined in 30 operating rooms of seven hospitals, was 68 ppm. During mask anesthesia in children, it was 407 ppm (nine operating rooms, nine hospitals). The main hygienic measures were: a check of the anesthesia apparatus, improvement of the general ventilation in the operating room, and the application of a "double mask." With a combination of measures, the concentration during anesthesia in intubated patients was reduced from 61-90 ppm to 2-15 ppm. During mask anesthesia in children, the concentration decreased from 134-764 ppm to 9-42 ppm. The monitoring system used reveals important differences in the exposure during the separate phases of the anesthesia (induction, maintenance, and extubation). It also indicates which factors determine the exposure of the anesthetist and allows accurate determination of the personal exposure.

Adult↗
PubMed2005

Gel-based surgical preparation resulting in an operating room fire during a neurosurgical procedure: case report.

Despite general reports of fires in the operating room, those during neurosurgical procedures are rare. The most significant contributor to perioperative fires is excess oxygenation. The consideration of novel gel-based surgical preparation solutions as potential fuel sources should be included in the literature. Given the significant patient risk and legal ramifications of surgical fires, education regarding operating room fires and the potential for prevention and treatment is requisite. The authors describe the case of an 18-month-old girl who, while undergoing a resection of a right retroauricular scalp mass, suffered partial thickness bums as a result of the ignition of surgical preparation solution following the use of monopolar electrocautery.

Administration, Topical↗
PubMed1998

Frequency of parenteral exposure and seroprevalence of HBV, HCV, and HIV among operation room personnel.

A study was designed to determine the frequency of needle-stick injuries, immunization status for hepatitis B virus (HBV) and sero-prevalence of HBV, hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections among operation room personnel. Self-assessment questionnaires were completed and blood tested for HBsAg, anti-HBc (total), anti-HCV and anti-HIV. Of 114 operation room personnel studied, the majority (58.8%) reported more than four needle-stick injuries per year, 36.8% one to three needle-stick injuries per year, while 4.4% reported no needle-stick injury in the last five years. Thirty-six percent of personnel had received a complete course of hepatitis B vaccination. There was serological evidence of hepatitis HBV virus and/or HCV infections in 31% of the studied population. Four percent were reactive for HCV infection, 7.5% for HBsAg infection and 25.43% for anti-HBc (total); none was HIV positive. Eighty percent of the HCV positive and 55% of the anti-HBc (total) positive personnel had more than four needle-stick injuries per year in the last five years, while 75% HBsAg-reactive personnel had received one to three needle-stick injuries per year. This study indicates a need for continued efforts to minimize the risk of blood-borne infection by enhancing the compliance of operation room personnel with HBV vaccination and adherence to infection control measures.

Adult↗
PubMed1991

Distribution of bacteria in the operating room environment and its relation to ventricular shunt infections: a prospective study.

In order to study the distribution of bacteria in the operating room environment, cultures were obtained during 111 unselected shunt operations throughout a 10-month period. After routine skin preparation, bacteria were collected by placing Millipore filters on the patient's prepped skin underneath the drapes, on top of the drapes in the operative field, and/or on the sterile instrument table, and left in place for the duration of the case. In 48 patients, full-thickness skin biopsies taken at the initial incision were cultured in lieu of skin surface cultures. Perioperative cerebrospinal fluid cultures and subsequent shunt infections were monitored. Of the 288 environmental (skin and surfaces) cultures, 24 were positive (20 coagulase-negative Staphylococcus and 4 Staphylococcus aureus). Positive cultures were found in 15 of 111 drape cultures (13.5%), 7 of 77 instrument table cultures (9.1%), and 2 of 97 skin cultures (2.1%). Positive environmental cultures were not correlated with the surgeon, length of case, time of day, or type of shunt operation, but were more likely to occur in a room other than the designated neurosurgical operating room. There was a correlation between the occurrence of positive environmental cultures and positive cerebrospinal fluid cultures, although the organisms were not always the same. Coagulase-negative Staphylococcus was the most common organism isolated from all sites. We conclude that bacteria most often associated with shunt infections are airborne in the operating room, rather than originating from the patient's skin, and are distributed in the highest concentration near the surgical team.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Routes of infection. A study of using "tracer particles" in the orthopedic operating room.

Wound irrigates and tissue samples were cultured from clean orthopedic wounds at the conclusion of 280 orthopedic operations. The surgeons used a laminar flow unit and took extra precautions against wound contamination although personnel exhaust systems were not used. It was possible to culture residual organisms but difficult to trace the source of these by bacteriological methods. Artificial or "tracer" particles which could be applied to patient or surgeon were retrieved from the wound and suitably stained. Using albumin microspheres it was possible to identify and differentiate "patient-derived particles" from "surgeon-derived particles" in the majority of all wounds. Contamination from the surgeon was significant even under near optimum operating room conditions. These techniques are useful for development of control measures for residual wound contamination in orthopedic operating rooms.

Bacterial Infections↗
PubMed1989

Is there a place for parents in the operating room?

The presence of a parent in the operating room (OR) during induction of anesthesia is controversial. In order to assess the feasibility, safety, and acceptance of this practice, we evaluated a near-4-year experience with 3,086 patients less than 15 years of age, who were operated on at a free-standing ambulatory surgical center. The age distribution was: 1 to 23 months, 790; 2 to 5 years, 1,190; 6 to 10 years, 775; and 10 to 15 years, 331. The distribution of patients by service was: otorhinolaryngology, 1,597; pediatric surgery, pediatric urology, and plastic surgery, 948; ophthalmology, 443; orthopaedics, 72; and dental, 26. No premedication was employed. Anesthetic gases were delivered via a mask while the parent held or remained close to the child. Vascular access was established after the induction. Only five patients (tonsillectomy, four; circumcision, one) were admitted to the base hospital and subsequently discharged. Advantages of parental presence in the OR during anesthesia induction are decreased psychological trauma (child), smoother induction (child), and decreased parental anxiety. Possible disadvantages include disruption of OR routine, unpredictability of parental behavior, and increased time and cost. Because of careful preoperative preparation of parents by the nurses and anesthetists, the first three problems rarely occurred. The cost of supplies used by each parent was minimal. Practically all parents chose to accompany the child to the OR. The feedback during follow-up from those parents has been excellent. Nurses, anesthesiologists, and surgeons are enthusiastic about the program. In the examined setting, this approach has proven safe, simple, and effective.

Adolescent↗
PubMed2005

The Eindhoven laparoscopic cholecystectomy training course--improving operating room performance using virtual reality training: results from the first E.A.E.S. accredited virtual reality trainings curriculum.

BACKGROUND: This study was undertaken to investigate operating room performance of surgical residents, after participating in the Eindhoven virtual reality laparoscopic cholecystectomy training course. This course is the first formal surgical resident trainings course, using a variety of complementary virtual reality (VR) skills training simulation in order to prepare surgical residents for their first laparoscopic cholecystectomy. The course was granted EAES certification. METHODS: The four-day course is based on multimedia and multimodality approach. A variety of increasingly difficult simulation training sessions, next to intimate focus-group "knowledge sessions" are included. Both basic and procedural VR simulation is featured, using MIST-VR and the Xitacts' LapChol simulation software. The operating room performance of twelve surgical residents who participated in the course and twelve case-control counterparts were compared. The case-control group was matched for clinical number laparoscopic cholecystectomy performance (maximum of 4 procedures). Two observers analyzed a randomly mixed videotape, featuring the part of the "clip-and-cut" procedure of the laparoscopic cholecystectomy, and were blinded for participants' group status. Structured questionnaires including multiple observation scales were used to assess performance. RESULTS: Residents of both the experimental and control group did not differ in demographic parameters, except for number of laparoscopic cholecystectomies in favor of the control group (p-value 0.008). Both observers judge the experimental group to perform significantly better (p-value 0.004 and 0.013). Experimental group residents valued their course highly in terms of their laparoscopic surgical skills improvement and the use of VR simulators in the surgical curriculum. CONCLUSIONS: The Eindhoven Virtual Reality laparoscopic cholecystectomy training course improves surgical skill in the operating room above the level of residents trained by a variety of other training methods.

Adult↗
PubMed2007

Transfer of bacteria between biomaterials surfaces in the operating room--an experimental study.

Bacterial adhesion to and transfer between surfaces is a complicated process. With regard to the success of biomaterials implants, studies on bacterial adhesion and transfer should not be confined to biomaterials surfaces in the human body, but also encompass surfaces in the operating room, where the origin of many biomaterials related infections is found. The purpose of this study was to quantify the transfer of Staphylococcus aureus, Staphylococcus epidermidis, and Propionibacterium acnes from one operating room material to another, while accounting for surface hydrophobicity and roughness, moistness and application of friction during transfer. The tested operating room materials were gloves, broaches (orthopaedic drills), theatre gowns, and light handles. As a possible clinical intervention method to prevent transfer, it was investigated whether dipping the gloves in a chlorhexidine splash-basin affected the viability of the transferred bacteria. Transfer (moist and without friction) was demonstrated to some extent with all bacterial strains and with every material, ranging from 17% to 71%, and was influenced by the bacterial strain, moistness of the inoculum, the application of friction, and the characteristics of both the donating and the receiving surface. Dipping the glove material in 4% or 0.4% chlorhexidine solutions killed all bacteria present, regardless of whether surfaces were dried or moist and thus prevented transfer.

Bacteria↗
PubMed1993

Audibility and identification of auditory alarms in the operating room and intensive care unit.

The audibility and the identification of 23 auditory alarms in the intensive care unit (ICU) and 26 auditory alarms in the operating rooms (ORs) of a 214-bed Canadian teaching hospital were investigated. Digital tape recordings of the alarms were made and analysed using masked-threshold software developed at the Université de Montréal. The digital recordings were also presented to the hospital personnel responsible for monitoring these alarms on an individual basis in order to determine how many of the alarms they would be able to identify when they heard them. Several of the alarms in both areas of the hospital could mask other alarms in the same area, and many of the alarms in the operating rooms could be masked by the sound of a surgical saw or a surgical drill. The staff in the OR (anaesthetists, anaesthesia residents, and OR technologists) were able to identify a mean of between 10 and 15 of the 26 alarms found in their operating theatres. The ICU nurses were able to identify a mean of between 9 and 14 of the 23 alarms found in their ICU. Alarm importance was positively correlated with the frequency of alarm identification in the case of the OR, rho = 0.411, but was not significantly correlated in the case of the ICU, rho = 0.155. This study demonstrates the poor design of auditory warning signals in hospitals and the need for standardization of alarms on medical equipment.

Adult↗
PubMed1991

Operating room satellite pharmacies: demographics, services and implementation.

OR (operating room) satellite pharmacies are still a relatively new addition to the system of pharmacy-coordinated drug distribution. For the last ten years, however, hospitals creating OR satellite pharmacies have found that they provide improved service, reduced inventory, better narcotic control and more efficient drug delivery. Hospital Pharmacy and the OR Satellite Pharmacy Bulletin published a questionnaire to obtain information about OR satellite pharmacies from those actively involved in their planning, implementation, and operation. The questionnaire covered three major areas: demographics, functions and services. This article summarizes the results.

Centralized Hospital Services↗
PubMed1996

[Prevention of ocular infections in the hospital operating room].

Prevention of ocular nosocomial infections in the operation room requires control of several parameters: contamination of the air, a very important step of cleaning and sterilization and a staff trained to avoid infectious risk. The problem of PRION infection requires a particular attention especially about sterilization.

Air Microbiology↗
PubMed1997

Laparoscopic tubal ligation in a minimally invasive surgical unit under local anesthesia compared to a conventional operating room approach under general anesthesia.

OBJECTIVE: This study was done to compare costs, operating and recovery times, safety, and patient acceptance between (a) minimally invasive laparoscopic tubal ligation under sedation and local anesthesia and (b) conventional laparoscopic operating-room-based tubal ligations under general anesthesia. METHODS: Fourteen women desiring sterilization were randomized between tubal ligation under sedation/local analgesia versus general anesthesia. Procedures were performed by supervised residents previously unfamiliar with the minimally invasive technique. Hospital charges were used as a surrogate for cost. Operating or procedure room times, surgical complications, and recovery times were recorded. Patient acceptance was assessed using satisfaction surveys administered in the recovery room and again 1 week postoperatively. RESULTS: The cost of minimally invasive tubal ligation was significantly lower than for the conventional technique ($1,615+/-$134 vs $2,820+/-$110, p < 0.001). Surgical times were not different between the two procedures: 40.4+/-15 min for the conventional technique versus 32.9+/-10 min for minimally invasive surgery. However, the total in-room time required in the operating room significantly exceeded that for the procedure room technique (84+/-10 min vs 60+/-2 min, p < 0.05). Likewise, recovery time for the general anesthesia technique was longer (48+/-6 min vs 14+/-7 min, p < 0.03). No complications were encountered with either surgical method. Patient satisfaction for pain, fatigue, and days of missed work was similar between the two groups. CONCLUSIONS: The use of minimally invasive surgery to perform tubal ligation is advantageous over conventional laparoscopic tubal ligation under general anesthesia with regard to cost and time utilization. The minimally invasive technique appears to be easy to learn, safe, and well tolerated.

Adult↗