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At least 991 records · Page 55Linked to original sources
PubMed1996

The routine wearing of gloves: impact on the frequency of needlestick and percutaneous injury and on surface contamination in the operating room.

The impact of wearing gloves on surface contamination and on the incidence of percutaneous injury were prospectively compared for two 4-mo periods in a single anesthesia department. Period I was immediately prior to the institution of mandatory glove wearing, and Period II followed a 1-mo adjustment period of mandatory glove use. Recording of all needlestick and other percutaneous injuries was performed on an ongoing basis, and incident reporting was actively and regularly solicited. During the final week of each period, 12 specific sites at each of nine anesthetizing locations were tested for occult blood. The incidence of needlestick injury was 0.28% for Period I versus 0.10% for Period II (P = 0.10) and the incidence for all percutaneous injuries was 0.60% for Period I and 0.27% for Period II (P = 0.06). If the one needlestick that occurred during noncompliance with gloving during Period II is eliminated, then there was a significant reduction in both needlestick and overall percutaneous injury (P < 0.05). Of 109 operating room sites, 42.2% were contaminated after Period I versus 31.2% after Period II (P = 0.07). The implementation of a mandatory glove use policy was associated with nonsignificant trends toward reduction in the incidence of needlestick and other percutaneous injury and in the level of surface contamination in the anesthesia workplace. Compliance with glove use resulted in a significant reduction in needlestick injury and overall percutaneous injuries.

Accidents, Occupational↗
PubMed1994

Usefulness of transesophageal echocardiography for guiding pulmonary artery catheter placement in the operating room.

The usefulness of transesophageal echocardiography (TEE) for guiding the placement of a pulmonary artery (PA) catheter was evaluated in 31 patients (TEE group); 31 patients who were treated before TEE guidance was used (control group). In the control group, use of the PA catheter was abandoned in two patients; because of an unstable condition and marked arrhythmias, respectively. The key findings for TEE guidance were: (1) pulsatile to-and-fro movement of the balloon, i.e., "shuttle movement" and (2) loss of shuttle movement at wedging of the balloon, i.e., "anchoring sign." When the PA catheter did not enter the right vertricle (RV), the balloon was found to be in the inferior vena cava or the right atrium (RA) without shuttle movement. Coiling of the catheter was suggested in the latter situation. Coiling also occurred in the RV, often associated with frequent arrhythmias. These findings indicate that the catheter should be withdrawn once. TEE allowed for readjustment of the catheter tip position by enabling the balloon to be wedged twice. An excessively deep placement of the catheter tip was seen in 5 of the controls, but in none of the TEE group. Biplane TEE was found to be advantageous for guiding PA catheter placement and for visualizing the RV inflow and outflow tract in a single view, with the shuttle movement of the balloon in its long axis. TEE acts as an "eye" in the operating room, as does fluoroscopy, enabling smooth placement of the PA catheter.

Adult↗
PubMed2000

A new frontier: magnetic resonance imaging-operating room.

Developments in technology have led to the merger of two distinct environments, that of magnetic resonance imaging and that of the operating room. The major advantage of this merger for neurosurgical procedures is the ability to perform real-time imaging to help guide surgery. This review discusses the role of the anesthesiologist in the planning and administration of safe anesthesia in this new and challenging environment.

Anesthesia↗
PubMed1996

Blood glucose reagent strip tests in the operating room: influence of hematocrit, partial pressure of oxygen, and blood glucose level--a comparison of the BM-test 1-44, BM-Accutest, and Satellite G reagent strip systems.

OBJECTIVE: The objective of our study was to assess the influence of hematocrit (HCT), partial pressure of oxygen (PO2), and blood glucose level upon results obtained with three different blood glucose reagent strip tests used in conjunction with the appropriate meter: BM-Test 1-44, BM-Accutest, and Satellite G. METHODS: Our study was designed as a consecutive sample study of patients undergoing coronary artery surgery. The setting was the hospital theater and intensive care unit. We conducted blood analysis for HCT, PO2 and blood glucose on 20 consecutive patients undergoing coronary artery surgery using three blood glucose reagent strip testing systems and a laboratory analysis of plasma glucose. RESULTS: All three blood glucose reagent strip tests showed a significant bias when compared with plasma glucose: BM-Test 1-44, 0.89 mmol/L; BM-Accutest, -1.27 mmol/L; Satellite G, 0.75 mmol/L (p < 0.05). The error found when using the Satellite G system was worse than that of either of the other two systems. Results obtained with the BM-Accutest strips were unaffected by PO2 (p = 0.745). Blood glucose value and HCT both had an influence on the results of all three blood glucose strip systems. CONCLUSIONS: Caution must be taken when using reagent strip systems in the operating room or intensive care setting because, of the three systems tested, all showed a significant bias, all were influenced by blood glucose level and HCT, and only the BM-Accutest reagent strips used with the Accutrend meter was unaffected by PO2.

Bias↗