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Friday, October 26, 2007

SAFETY IN THE OR: By Association of Peri Operative Registered Nurses, ALAMEDA county #0501

The Peri-Operative registered Nurses of Alameda country chapter #0501 has this fabulous informative site about what and what not to do in the OR, OR safety and policies. Though it was written for vendors (the suppliers and tech's), it is a great informative sources for anyone in the OR, the neurophysiolgosits and neuromonitoring crew's may find this very useful and informative, I did so. Thanks to the AORN for such a useful resources of knowledge in OR.
Vendor Policy - AORN of Alameda County
VendorsIn The Operating Room

Following completion of the self-directed learning module, the Vendor will be able to:
1. Classify various areas within the surgical suite, (e.g., restricted, semirestricted and unrestricted).
2. Describe proper surgical attire.
3. Describe proper handwashing technique and its importance.
4. Compare and contrast the communicability of HIV, HAV and HBV.
5. Describe steps to follow during a fire in the operating room.
6. Describe basic procedure during electrical outage.
7. Name plans for prevention of tuberculosis exposure.
Aseptic Technique
Aseptic technique is essential in all operating rooms. It should be considered the "law of the land". If breached, the consequences can be far-reaching and potentially devastating to the patient and the reputation of the hospital involved. The patient is particularly at risk for invasion of exogenous bacterial infections because the most significant protective barrier (the skin) is interrupted during surgery. Therefore, this is one of the most important sections in this module.

For the full site and details of the safety policy, read at:
the above images are obtained from the article:
Making the Operating Room a Safer Place
Michael Garvin, MHA11/01/2002
Making the Operating Room a Safer Place
By Michael Garvin, MHA

Remifentenil Reduces Patient Movement during Neurosurgery?

Doctors Guide is a very informative website on various fields of medicine and related subjects, mainly aimed to serve the doctors and information seekers in the allied health field and general public. http://www.docguide.com. It is freely accessible, if you want to personalize, you have to register and it is free.

The following article is relevant and interesting to neurophysiologists who do intraoperative neuromonitoring, also for anesthesiologists and the neurosurgeons who are concerned about patient movement during surgical procedure. In the recent annual meeting of the "American Soceity of Anesthesiologists the following work on Remifentanil was presented. Arushi Sinha, PhD writes about a presentation on how remifentanil can reduce patient movement during neurosurgery.

New Approaches for Reducing Patient Movement During Neurosurgery:
Presented at ASA
By Arushi Sinha, PhDSAN FRANCISO, CA -- October 23, 2007 --
Remifentanil reduces the risk of movement in the absence of muscle relaxants among patients undergoing elective craniotomy, researchers reported here at the Annual Meeting of the American Society of Anesthesiologists (ASA).In the case of neuroanaesthesia surgeries, muscle relaxants may not be indicated, particularly if intraoperative monitoring of motor evoked potentials or electromyography are involved. Alternative agents, such as remifentanil and propofol, may be used in such settings according to recent research.Marco Maurtua, MD, Assistant Professor, Department of Anesthesiology, Cleveland Clinic Foundation, Cleveland, Ohio, United States, and his colleagues designed a study to characterise the role of remifentanil in reducing movement associated with neurosurgical stimuli and to examine the incidence of bradycardia and hypotension in elective craniotomy patients.

[Presentation title: Remifentanil Prevents Movement During Neurosurgery in the Absence of Neuromuscular Blockade. Abstract A1481]