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At least 613 records · Page 34Linked to original sources
PubMed1985

Pharmaceutical services in a United States Army field hospital.

Pharmaceutical services in a United States Army field hospital are described. The field hospital was deployed to Honduras to support United States troops during military exercises. Pharmaceutical services were provided from a large tent near the hospital, which consisted of an emergency treatment facility, two operating rooms, and a small medical-surgical ward. One pharmacist and four technicians provided outpatient pharmaceutical services 10 hours per day, seven days per week; pharmacy personnel were on call at other times. The majority of pharmacy time was spent prepackaging and labeling medications for use by medical teams visiting local villages to provide health care to Honduran natives. The pharmacy's drug distribution, inventory control, and intravenous admixture activities in light of limited personnel and storage space, long supply lines, and lack of an aseptic working area are described. Pharmacist-physician interactions regarding drug therapy and common ailments of United States troops and Honduran natives are also discussed. During a two-month period, the field hospital pharmacy dispensed approximately 24,000 prescriptions. Pharmaceutical services played an important role in the success of the field hospital's mission and provided aid to the population of an impoverished country that might not otherwise have received it.

Drug Prescriptions↗
PubMed1991

Fighting drug abuse in operating rooms.

A growing problem of drug addicts working in operating rooms is mobilizing hospitals to make it more difficult for staff members to steal drugs for their own use or for sale to others. Monitoring devices and tighter drug distribution security are among measures being used to deter theft by anesthesiologists, technicians or nurses who are addicted to one of many potent narcotics readily available to them.

Drug and Narcotic Control↗
PubMed1992

Paramedic intubation training in a pediatric operating room.

The authors conducted a prospective study to assess the performance of paramedics with prior adult endotracheal intubation experience in pediatric intubation in the operating room of a teaching hospital. Nineteen paramedic students were observed attempting endotracheal intubation on a total of 57 anesthetized pediatric patients undergoing scheduled surgical procedures. The average age of patients was 5.1 years (range, 6 months to 15.2 years). Average duration of intubation attempts was 22.7 +/- 10.7 seconds, with a success rate on first attempt of 74%. Only minor complications occurred, and were limited to intubation attempts of greater than 45 seconds duration in four cases (6%), and patient oxygen saturation less than 90% in one case (2%). The study suggests that paramedics may be successfully incorporated into a hospital's clinical training program, and can receive closely supervised experience in pediatric endotracheal intubation without compromising patient care. Such training may increase the willingness of paramedics to attempt emergent prehospital endotracheal intubation of children, as well as increase their success with this potentially life-saving procedure.

Adolescent↗
PubMedDate not supplied

Role of the first assistant in ophthalmic surgery.

1. As the number of Ambulatory Surgery Centers increases and the Medicare reimbursements for surgeon first assistants decline, the need for non-physician first assistants grows. 2. Qualifications for a first assistant include knowledge skill, and devotion to this speciality. 3. The first assistant is part of a medical team that consists of the surgeon, the first assistant, the scrub nurse or technician, and the circulating nurse. 4. The role of the first assistant helps to increase efficiency in the operating room and enhance the quality of patient care.

Hospitals, Special↗
PubMed1995

Analysis of American College of Surgeons trauma consultation program.

OBJECTIVE: To identify the criteria deficiencies found during peer consultation of hospitals and the relationship to subsequent verification. METHODS: Between September 1987 and December 1992, 52 hospitals had consultation visits using American College of Surgeons criteria. Each report was studied for deficiencies, frequency of deficiencies, and relationship to verification. RESULTS: There are 108 American College of Surgeons criteria. Thirty-five different criteria deficiencies were found. The number of deficiencies per hospital ranged from zero to 12. The more frequent deficiencies included a lack of the following: quality improvement, 35 (67%); trauma service, 20 (38%); trauma surgeon in emergency department, 20 (38%); 24-hour operating room availability, 17 (33%); trauma registry, 17 (33%); trauma continuing medical education, 16 (31%); trauma director, 15 (29%); computed tomography technician in hospital, 15 (29%); research, 14 (27%); trauma coordinator, 14 (27%); and neurosurgeon availability, 13 (25%). No hospital that lacked commitment of surgeons (n = 12) or hospital (n = 3) requested a verification visit. Twenty-four hospitals (46%) achieved verification by February 1994. Twenty-eight hospitals had six or fewer deficiencies, with 19 (68%) verified. Twenty-four hospitals had seven or more deficiencies, with only five (21%) subsequently verified. Verification visits followed consultation by 3 to 52 months. Two hospitals with nine deficiencies were verified after 30 and 48 months, although one failed its first verification visit. CONCLUSIONS: American College of Surgeons consultation assists hospitals to identify their trauma center capability and appears to improve their ability to pass subsequent trauma center verification. Most criteria deficiencies are correctable. Lack of commitment by the surgeons or hospital is difficult to correct. There is an inverse relationship between the number of deficiencies and subsequent verification.

General Surgery↗
PubMed2004

Hernia surgery in the South American woodlands: a surgical adventure in Argentina.

BACKGROUND: Because of the socioeconomic conditions existing today in Argentina, I decided to operate on hernias and incisional hernias among the poorest population in their living environment. METHODS: To achieve this, I organized a group of 19 people, including resident surgeons and technicians, transferring everything in order to set up three surgical rooms in an old house, in the worst surgical environment, in the middle of the woodlands in the northeast tropical part of our country. It was like war-trench surgery but in peacetime. We successfully operated on 83 cases with different techniques in 4 days, in a trip that lasted a week. RESULTS: After 18 months, there is not even one complication or recurrence. CONCLUSIONS: Because of this experience, I must remark that the patients' immunity-cicatricial condition is essential to success.

Adolescent↗
PubMed1991

Current nursing management of an entry-level perioperative nursing course.

In response to today's health care environment, the entry-level course in perioperative nursing is continually evaluated and updated. This reflects our ethical and social responsibilities to new nurses in the operating room and our commitment to high-quality patient care. The need for technical knowledge by the professional perioperative nurse is increasing, but the necessity for patient advocacy and holistic care is not superseded by technical considerations. This is what differentiates the professional nurse from the technician. This theme is constantly emphasized during the course. We believe that this entry-level course is a valid response to the need for perioperative nurses. It is cost-effective. It promotes group interaction and peer support during the learning and socialization process, which in turn makes the new nurse more likely to remain employed in the institution's operating room.

Curriculum↗
PubMed1994

Simple narcotic kits for controlled-substance dispensing and accountability.

Operating rooms require a storage, dispensing and accounting system for restricted drugs which satisfies narcotics control authorities and is compatible with efficient care of patients. We describe narcotic kits containing fentanyl-morphine-midazolam, alfentanil-midazolam and sufentanil-midazolam, for general operating rooms, and two kits with larger quantities of fentanyl and sufentanil for cardiac operating rooms. The container for each kit is a video cassette holder which has a foam-rubber liner with sculpted depressions for each ampoule. Sealed kits are delivered each morning from pharmacy to the locked narcotics cupboard in the recovery room. On request, the recovery room nurse unlocks the cupboard and the anaesthetist signs out the required kit(s) for the day. A drug utilization form is enclosed with each kit, on which the anaesthetist records the amount of drug administered to each patient, and before returning the kit to the locked narcotics cupboard, the total amount of each drug used, discarded, and returned. Used kits are collected the following morning by a pharmacy technician who reconciles the contents and drug form of each kit. More than 40 staff anaesthetists and a similar number of residents have used the system for seven years, during which time 130,000 patients have passed through the operating rooms. Detection of one case of drug diversion by a staff anaesthetist was made partly by the control system, but mainly by behavioural changes. The system is simple, inexpensive, and effective and has been well received by the departments of pharmacy, anaesthesia, and nursing.

Anesthesia Department, Hospital↗
PubMed2006

Establishment of an operating room committee and a training program to improve aseptic techniques for rodent and large animal surgery.

Investigators of our research facility generally accept the concept of asepsis as an important component of adequate surgical care for animals. However, they experience difficulties putting it into practice, especially in the case of rodents. The reasons for this are inconvenience, cost, and lack of training. To better assist investigators in the implementation of aseptic surgical techniques in their laboratories, we have created an Operating Room (OR) Committee modeled after OR committees found in human hospitals. A reconstructive surgeon, a veterinarian, a research scientist, a nurse involved in the training of OR personnel, interns, graduate students, and an animal health technician were chosen as committee members in light of their OR and animal care expertise. The first task of the OR Committee was to establish institutional guidelines for aseptic surgery, taking into account the costs imposed on research budgets by these procedures. The OR Committee also supports a complete training program in aseptic surgery techniques, which consists of lectures, a training manual, videos, and a practical course. Furthermore, when experimental procedures require specialized equipment, the OR Committee collaborates with researchers to develop strategies to achieve asepsis. This OR Committee and the training program proved to be important tools to promote and improve the quality of animal care during surgery.

Animal Care Committees↗