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Operation room management

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https://www.readbyqxmd.com/read/29332055/operating-room-scheduling-and-surgeon-assignment-problem-under-surgery-durations-uncertainty
#1
Hongwei Liu, Tianyi Zhang, Shuai Luo, Dan Xu
BACKGROUND: Scientific management methods are urgently needed to balance the demand and supply of heath care services in Chinese hospitals. Operating theatre is the bottleneck and costliest department. Therefore, the surgery scheduling is crucial to hospital management. OBJECTIVE: To increase the utilization and reduce the cost of operating theatre, and to improve surgeons' satisfaction in the meantime, a practical surgery scheduling which could assign the operating room (OR) and surgeon for the surgery and sequence surgeries in each OR was provided for hospital managers...
December 29, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29328748/analysis-of-neuro-theatre-utilisation-and-reasons-for-cancellation-to-improve-efficiency-and-productivity
#2
Feras Sharouf, Asfand Baig Mirza, Vazira Moosajee, Sarah Plummer, Imran M Bhatti, Malik Zaben
In neurosurgery, much emphasis has recently been placed on theatre cancellation and time utilization as a key hospital management performance indicator. We sought to evaluate our unit's theatre throughput efficiency and identify the causes of elective surgery cancellations. We retrospectively audited all scheduled elective neurosurgical procedures over a period of nine months. Mean theatre utilization time was 47.0%. The common causes of cancellations were lack of theatre time (32%), non-availability of beds in recovery room (18...
April 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29317119/noninvasive-ventilation-during-endoscopic-procedures-rationale-clinical-use-and-devices
#3
REVIEW
Marina Pieri, Giovanni Landoni, Luca Cabrini
Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself...
September 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29303921/blood-loss-management-in-spine-surgery
#4
Jesse E Bible, Muhammad Mirza, Mark A Knaub
Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29299520/the-efficacy-of-lavender-aromatherapy-in-reducing-preoperative-anxiety-in-ambulatory-surgery-patients-undergoing-procedures-in-general-otolaryngology
#5
Michael Wotman, Joshua Levinger, Lillian Leung, Aron Kallush, Elizabeth Mauer, Ashutosh Kacker
Background: Preoperative anxiety is a common problem in hospitals and other health care centers. This emotional state has been shown to negatively impact patient satisfaction and outcomes. Aromatherapy, the therapeutic use of essential oils extracted from aromatic plants, may offer a simple, low-risk and cost-effective method of managing preoperative anxiety. The purpose of this study was to evaluate the efficacy of lavender aromatherapy in reducing preoperative anxiety in ambulatory surgery patients undergoing procedures in general otolaryngology...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29299478/the-r%C3%A3-ttinger-approach-for-total-hip-arthroplasty-technique-comparison-to-the-direct-lateral-approach-and-review-of-literature
#6
Ronald E Delanois, Assem A Sultan, Ahmed A Albayar, Anton Khlopas, Chukwuweike U Gwam, Nipun Sodhi, Suela Lamaj, Jared M Newman, Michael A Mont
Background: Multiple approaches to the hip joint have been developed utilizing various intervals and/or intermuscular planes when performing a total hip arthroplasty (THA), each proposing certain advantages. Of these, the Röttinger approach (modified anterolateral or Watson-Jones) is potentially muscle-sparing. Multiple studies have demonstrated favorable outcomes with this approach. However, others showed more complications with a slow learning curve. Due to the paucity of evidence we conducted this study to: (I) present our operative experience and technique of the Röttinger approach; (II) compare short-term complications and operative room (OR) times of this approach to the direct lateral; and (III) review the available literature...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29289460/risk-management-for-surgical-energy-driven-devices-used-in-the-operating-room
#7
F Borie, M Mathonnet, A Deleuze, B Millat, J-F Gravié, H Johanet, J-P Lesage, J Gugenheim
Complications related to energy sources in the operating room are not well-recognized or published, despite occasionally dramatic consequences for the patient and the responsible surgeon. The goal of this study was to evaluate the risks and consequences related to use of energy sources in the operating room. PATIENTS AND METHODS: Between 2009 and 2015, 876 adverse events related to health care (AERHC) linked to energy sources in the operating room were declared in the French experience feedback data base "REX"...
December 27, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29289394/laparoscopic-guided-abdominal-wall-nerve-blocks-in-the-pediatric-population-a-novel-technique-with-comparison-to-ultrasound-guided-blocks-and-local-wound-infiltration-alone
#8
Alessandra Landmann, Mihaela Visoiu, Marcus M Malek
BACKGROUND: Abdominal wall nerve blocks have been gaining popularity for the treatment of perioperative pain in children. Our aim was to compare a technique of surgeon-performed, laparoscopic abdominal wall nerve blocks to anesthesia-placed, ultrasound-guided abdominal wall nerve blocks and the current standard of local wound infiltration. METHODS: After institutional review board approval was obtained, a retrospective chart review was performed of pediatric patients treated at a single institution during a 2-year period...
December 27, 2017: Surgery
https://www.readbyqxmd.com/read/29286969/simultaneous-ipsilateral-dislocation-of-the-hip-and-the-knee-a-case-report
#9
Antonio Arenas Miquelez, Filippo Familiari, Lucas Arbeloa, Andrea D'Arrigo Azzarelli
CASE: A patient was struck by an agricultural vehicle and sustained ipsilateral hip and knee dislocations. Closed reduction of the hip was accomplished in the emergency department; the patient required general anesthesia in the operating room to reduce the knee dislocation. Nonoperative treatment was used for both injuries, with a good long-term outcome. CONCLUSION: Simultaneous ipsilateral hip and knee dislocations are rare and complex injuries that usually result from high-energy trauma...
October 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29286452/esophageal-heat-transfer-for-patient-temperature-control-and-targeted-temperature-management
#10
Melissa I Naiman, Maria Gray, Joseph Haymore, Ahmed F Hegazy, Andrej Markota, Neeraj Badjatia, Erik B Kulstad
Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time...
November 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29283921/a-simulation-study-to-evaluate-improvements-in-anesthesia-work-environment-contamination-after-implementation-of-an-infection-prevention-bundle
#11
Grete H Porteous, Helen A Bean, Crystal M Woodward, Ryan P Beecher, Jennifer R Bernstein, Sarah Wilkerson, Ian Porteous, Robert L Hsiung
BACKGROUND: Microbiological contamination of the anesthesia work environment (AWE) is a potential source of health care-associated infections. Medication syringes, stopcocks, and many other areas are routinely contaminated during anesthetic care, and adherence to hand hygiene recommendations is poor. Using a simulation model, we investigated whether AWE contamination could be reduced by implementing an intervention bundle focused on infection prevention. METHODS: Twenty-five anesthesia providers were enrolled in this nonrandomized simulation scenario crossover design study...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29280859/outcome-analysis-of-free-flap-salvage-in-outpatients-presenting-with-microvascular-compromise
#12
Rene D Largo, Jesse C Selber, Patrick B Garvey, Edward I Chang, Matthew M Hanasono, Peirong Yu, Charles E Butler, Donald P Baumann
BACKGROUND: Extensive flap salvage attempts are routinely performed in patients with late-onset flap vascular crisis despite low flap survival rates. A knowledge gap exists in management of compromised free flaps in patients who present with perfusion-related complications after hospital discharge. METHODS: A retrospective review of 7443 free flaps used in 7128 cancer patients at a single institution from January of 2001 to March of 2015 was performed. RESULTS: Of 7443 free flap reconstructions, 856 patients (12 percent) were taken back to the operating room...
January 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29278578/situation-dependent-medical-device-risk-estimation-design-and-evaluation-of-an-equipment-management-center-for-vendor-independent-integrated-operating-rooms
#13
Marianne Maktabi, Thomas Neumuth
OBJECTIVES: The complexity of surgical interventions and the number of technologies involved are constantly rising. Hospital staff has to learn how to handle new medical devices efficiently. However, if medical device-related incidents occur, the patient treatment is delayed. Patient safety could therefore be supported by an optimized assistance system that helps improve the management of technical equipment by nonmedical hospital staff. METHODS: We developed a system for the optimal monitoring of networked medical device activity and maintenance requirements, which works in conjunction with a vendor-independent integrated operating room and an accurate surgical intervention Time And Resource Management System...
December 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29260043/oculocardiac-reflex-elicited-by-orbital-floor-fracture-and-inferior-globe-displacement
#14
Chau M Pham, Steven M Couch
Purpose: To review the physiology, presentation and management of the oculocardiac reflex (OCR) by describing a case of the OCR associated with an orbital foreign body and complete ocular prolapse through a large orbital floor fracture in a 40-year-old male following a motor vehicle accident. Observations: The patient demonstrated marked bradycardia and hypotension necessitating intubation and medical therapy for autonomic shock. A computed tomography (CT) showed a total blow out floor fracture and complete dislocation of a radiographically intact globe with uninterrupted rectus muscle attachments into the left maxillary sinus...
June 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29246590/developing-a-national-simulation-based-surgical-skills-bootcamp-in-general-thoracic-surgery
#15
Colin Schieman, Hideki Ujiie, Laura Donahoe, Waël Hanna, Richard Malthaner, Simon Turner, Kasia Czarnecka, Kazuhiro Yasufuku
BACKGROUND: The use surgical simulation across all subspecialties has gained widespread adoption in the last decade. A number of factors, including the small number of trainees, identified gaps in surgical skill training from cross-sectional surveys, increased national collaboration, and support from the national specialty committee identified a need to construct a surgical skills "bootcamp" in thoracic surgery in Canada. OBJECTIVE: The goals of the surgical skills bootcamp, as identified by the residency training program directors and the national specialty committee were to create a national, centralized, simulation-based skills workshop that focused on key foundational procedures within thoracic surgery, particularly those identified as areas of weakness by former residents; to smooth the transition to intraoperative teaching; to provide exposure to important but not necessarily universally available procedures such as advanced endoscopy; to teach non-medical expert competencies, and lastly to provide a venue for networking for residents across the country...
December 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29243254/graduating-otolaryngology-resident-preparedness-for-fellowship-as-assessed-by-fellowship-faculty
#16
Julie Highland, Cristina Cabrera-Muffly
OBJECTIVES/HYPOTHESIS: The purpose of this study was to evaluate fellowship program directors' perceptions of incoming clinical fellows' preparedness for subspecialty training and to thereby identify strengths and shortcomings in otolaryngology training programs' ability to prepare residents for fellowship. STUDY DESIGN: Validated e-mail survey. METHODS: Two hundred eleven otolaryngology subspecialty fellowship program directors and faculty directly involved with training fellows were contacted...
December 15, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29239803/ultrasound-guided-ureteroscopy-in-children-safety-and-success
#17
Jeffrey C Morrison, Jason P Van Batavia, Kassa Darge, Christopher J Long, Aseem R Shukla, Arun K Srinivasan
INTRODUCTION: Ureteroscopy has been shown to be a highly efficacious and safe modality for the treatment of pediatric urolithiasis. However, conventional ureteroscopy relies on fluoroscopy for intraoperative guidance, exposing both patient and operating room personnel to ionizing radiation. Pediatric urolithiasis patients are at a particularly increased risk from this radiation exposure. The use of ultrasound in place of fluoroscopy for intraoperative guidance has emerged as one modification that can reduce radiation exposure during ureteroscopy...
October 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29238657/30-day-adverse-event-rates-following-penile-prosthesis-surgery-an-american-college-of-surgeons-national-surgical-quality-improvement-program-based-evaluation
#18
Isaac Palma-Zamora, Akshay Sood, Ali A Dabaja
Background: Commonly utilized as a third-line therapy for erectile dysfunction (ED) management, the penile prostheses have become a staple treatment for ED refractory to pharmacological interventions. There is however a paucity of data in the literature pertaining to short-term adverse outcomes following penile prosthesis surgery. We thus sought to leverage the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to evaluate such outcomes within 30 days of surgery in these patients...
November 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29234940/st-gallen-consensus-on-safe-implementation-of-transanal-total-mesorectal-excision
#19
Michel Adamina, Nicolas C Buchs, Marta Penna, Roel Hompes
BACKGROUND: The management of rectal cancer has evolved over the years, including the recent rise of Transanal Total Mesorectal Excision (TaTME). TaTME addresses the limitations created by the bony confines of the pelvis, bulky tumours, and fatty mesorectum, particularly for low rectal cancers. However, guidance is required to ensure safe implementation and to avoid the pitfalls and potential major morbidity encountered by the early adopters of TaTME. We report a broad international consensus statement, which provides a basis for optimal clinical practice...
December 12, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29232665/the-laryngeal-mask-airway-and-its-use-in-neonatal-resuscitation-a-critical-review-of-where-we-are-in-2017-2018
#20
Satvik Chaitanya Bansal, Stefano Caoci, Eugene Dempsey, Daniele Trevisanuto, Charles Christoph Roehr
Studies using videotape recordings and respiratory function monitoring have shown that both face mask (FM) application and endotracheal tube (ETT) placement represent a challenge for resuscitators. Hence, there is a strong need for devices that can largely be used independently of individual operator training levels, in order to ensure more reliable support in time-critical situations, such as neonatal resuscitation. The laryngeal mask airway device (LMA) has evolved as a potentially very valuable tool. We conducted a systematic review of studies evaluating the use of the LMA in neonatal resuscitation...
December 13, 2017: Neonatology
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