Rich Antoine, product manager for surgical tables at MAQUET, discusses with Surgical Products the latest developments in surgical tables, how they’ve evolved to accommodate bariatric patients, and what facilities looking to purchase new tables should know for the future.
Over the past few weeks I’ve had ample opportunity to be on the other side. Not like some parents with chronically ill children or those with children who have suffered tragic illness. No, not like that; I am fortunate that hospitals aren’t a part of my family’s everyday (except for work).
Paro the robot baby harp seal was the final straw. I had vowed to myself not to think about or write about “the internet makes you smarter, the internet makes you dumber” argument. Even when some of my favorite authors (Steven B. Johnson, Clay Shirky, Nicholas Carr, and Jonah Lehrer) weighed in, I thought it best not to participate.
Patients have several strikes against them from the start in the surgical environment. In surgery they are naked, anesthetized, in a cold room and perhaps receiving cold IV and/or irrigation fluids. All of these factors can lead to inadvertent perioperative hypothermia. (Hypothermia defined as a core temperature below 36 degrees C or 96.
As a young medical student I remember the arrival of the first video arcade games very clearly: Asteroids, Space Invaders and Pacman. I spent whatever spare cash I had on them, never playing long enough to be any good, or rich enough to get any better. When I bought my first computer in my late-twenties, I relived my excitement with the newest computer games, spending a disproportionate amount of time long into many a night.
Managing patient temperature in the operating room has always been a critical part of any surgical procedure. When patients undergo large open surgical procedures, such as liver, cardiovascular, burn or any large abdominal incision, heat loss is common due to the patient being exposed to the cold OR temperature and the cooling effect of the anesthesia and mechanical ventilation.
Obesity is a huge healthcare problem in the United States. It has reached the proportions of an epidemic and continues to get worse. Multiple medical problems including heart disease, hypertension, diabetes, sleep apnea and cancer are closely associated with obesity. The patients with extreme obesity can reach a body weight of five, six or seven hundred pounds and even higher.
The Joint Commission is focusing on patient normothermia issues for patient safety and new SCIP measures require that upon release to the PACU body temperature be maintained at 36 C or higher. One of the easiest ways to help unintended hypothermia in patients is to warm the temperature of the OR .
A few years ago after learning of the death of a favorite teacher, a friend from surgical training and I began exchanging e-mail messages reminiscing about the man we once alternately referred to as “the Silver Fox” because of his dapper looks and “Chuckles” because of his easygoing manner.
Increasingly our Western world culture assumes that most things in medicine can be reduced to a linear, data-driven, algorithmic process. One only needs to witness the now-famously heralded article on ICU check-lists to understand the unwavering trust we have in this model. ICU medicine's complexity reinforces our trust in this approach because patients are usually too sick to contribute to their care.
Back in the times when EHRs were just EMRs, they had a very simple and humble mission. The software was supposed to help providers of health care services better manage their business. EMRs were supposed to help physicians adhere to CMS documentation rules, automate patient flow management and get rid of all the mountains of paper floating around a typical medical office or hospital .
I get emails, and one which caught my interest was this recent one from loyal reader Nurse J (lightly edited): "Do you assess everybody that comes into your ER for everything, or do you just assess the complaint? I am a newish critical care nurse at A Great Big Hospital, and my wife is a sixth year ICU nurse at a Smaller Hospital.
This is a painful story to write. A close friend of mine, in his 40’s, had a persistent light cough for many months. Finally, when he had an X-ray taken, it showed a large tumor on his lungs. He was diagnosed with stage 4 lung cancer. As a non-smoker and strapping, physically fit man, he was shocked, as you can imagine.
What should surgical professionals consider when purchasing temperature management equipment in order to achieve adequate temperature in the OR for both patients and surgeons? Patients and surgeons are both interested in the same goal – the best possible outcome. According to several studies, patients who successfully maintain normothermia (36C – 38C) during surgery require fewer transfusions, experience less post-operative bleeding, spend less time on mechanical ventilators, require less time in intensive care and go home sooner.
During my internship, the first year after graduating from medical school, I took care of a middle-aged woman who began our first conversation with a question that patients still ask me today. “So doctor,” she said as I pulled my stethoscope out to listen to her heart, “where did you go to medical school?” In a social context, I might have considered her question to be polite chatter, a filler during an awkward quiet moment.