Q: How has instrument maintenance changed in the past few years? A: In the past, it was very difficult -- if not impossible -- to understand the full circle of instrument utilization, including the number of sets in inventory, how often they had been used in the OR, were the correct manufacturer’s instructions available for the technicians when processing instruments, when was the last time any of the instruments or sets had been repaired, who had touched the sets during processing and where they had traveled before being used on a patient.
Tom Kerr of Pittsburgh will never forget the long-distance call from his elderly mother, who was in a hospital in the Cleveland area with a broken leg. She phoned her son, more than 100 miles away, because no one in the hospital was answering her call button. Mr. Kerr quickly called the hospital operator, tracked down the floor nurse and asked for someone to check on his mother.
In this Tuesday April 26, 2011 photo a medical worker stores blood units at the National Center for Hematology and Transfusion in Sofia. It's a grim reality for patients and families in Bulgaria, a struggling EU nation where donors are troublingly scarce, hospitals are strapped for funds and blood traders -- mainly Gypsy, or Roma, men -- are thriving.
Medicine and technology are converging in patient care at a faster pace than most people realize. May 27, 2011 Space age advancements from point-of-care health technologies like telemedicine to medical robots performing surgery are fast becoming commonplace in many hospitals.
When I was a first-year medical student, I earned a few extra dollars by working the 4 p.m.-to-midnight shift in our hospital’s nursing office, where I scheduled private-duty nurses. One evening, about 9 p.m., a nurse called to inform me that her patient had “expired” and that she would need to be assigned to a different patient for the next day.
A surgeon discusses why retained surgical items occur, and what needs to be done to prevent this problem. May 25, 2011 For the past 10 to 12 years, Verna Gibbs, MD, a general surgeon at San Francisco Veterans Affairs Medical Center and professor of clinical surgery at the University of California-San Francisco, has been pondering the issue of retained surgical items (RSI).
By Alfons Pomp, MD, FACS, FRCSC Leon C. Hirsch Professor, Vice Chairman, Department of Surgery, Chief, Section of Laparoscopic and Bariatric Surgery Weill Medical College of Cornell University New York Presbyterian Hospital May 23, 2011 Twelve years of doing laparoscopic weight loss surgery permits a surgeon to have a robust series of memorable cases.
Every Friday morning, the patient, a homeless man in his 60s, lumbered into one of our exam rooms, slipped off the running shoes he wore like bedroom slippers and gingerly lifted his swollen legs so we could remove the medicated bandages and examine the raw wounds on his inner ankles. Those baseball-size leg ulcers were only one of his many medical problems.
The best laid plans of mice and men often go awry. -Robert Burns Her eyes were lowered, and she would not meet my gaze. I was certain I knew why. I skimmed her chart and reviewed my notes. “How have you been doing since your last clinic visit?” I asked.
This was a female patient, about 40 years old, who had a prior gastric bypass done by another institution. About eight years later, she came to us with chest pain, nausea, vomiting and a bowel obstruction. When we worked her up, we realized she had a herniation of her gastric pouch and Roux limb into the posterior mediastinum.
I was in practice about five years and was about to do a radical nephrectomy on a patient. I met with the patient and his son in my office and the son informed me that he and his father were Jehovah’s Witnesses and that he didn’t want his father to receive any blood or blood products before, during, or after surgery.
What was one of your most challenging bariatric surgery cases? How did you handle it, and what advice do you offer fellow surgeons facing a similar case? May 17, 2011 One of the most challenging cases I had to deal with was a female with a previous history of gastro esophageal reflux that underwent a laparoscopic Nissen fundoplication five years prior.