Guiding the management of intubated patients with pneumonia and ventilator-associated events using serial catheter-directed bronchoalveolar lavage.

Background: We evaluated the role of serial catheter-directed bronchoalveolar lavage (CDBAL) in the diagnosis and management of pneumonia in ventilated surgical intensive care unit patients.

Methods: Intubated surgical intensive care unit patients were prospectively evaluated with serial CDBALs from September 1, 2012, to May 31, 2013. Initial CDBALs were performed if patients developed the following signs of pneumonia: white blood cell count greater than 11 or less than 4, temperature greater than 38.

The frequency and significance of discrepancies in the surgical count.

Objective: To prospectively evaluate and accurately describe the rate and type of discrepancies encountered in the surgical count.

Introduction: Despite near-universal implementation of manual counting protocols for surgical instruments and sponges, incidents of retained sponges and instruments (RSI) persist. Retrospective analyses have shown that RSI are rare and most often involve final counts erroneously thought to be correct, leading some surgeons to question the value of counting.

Bar-coding surgical sponges to improve safety: a randomized controlled trial.

Objective: A randomized, controlled trial was performed to evaluate a computer-assisted method for counting sponges using a bar-code system.

Background: Retained sponges are a rare and preventable problem but persist in surgery despite standardized protocols for counting. Technology that improves detection of counting errors could reduce risk to surgical patients.