Beyond the abacus: Leveraging the electronic medical record for central line day surveillance.

Manual counting is considered the gold standard for device day recording by the National Health Safety Network. We describe the development of a process for an electronic count of central line days across our ten-hospital health care system. Our validation process identified discordance between the electronic count and the manual count for 71% of patient care units.

Office-based anesthesia for the urologist.

This article describes office-based surgery and office-based anesthesia (OBA), including the safe setup of OBA and safety concerns regarding OBA. Also discussed are the preoperative selection and workup of a patient undergoing OBA, anesthetic options, the prevention and treatment of postoperative nausea, vomiting, and pain, and planning for safe discharge.

Does general anesthesia increase the diagnostic yield of endoscopic ultrasound-guided fine needle aspiration of pancreatic masses?

Background: : Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of the pancreas has become the preferred method for tissue diagnosis for pancreatic solid masses. The yield of EUS-FNA in this setting is influenced by multiple factors. We hypothesized that general anesthesia (GA) may improve EUS-FNA yield by improving patient cooperation and stillness during the procedure.

Operating room fires: optimizing safety.

Background: This prospective study was undertaken to determine the safest means of supplemental oxygen delivery for patients undergoing facial cosmetic surgery under conscious sedation. Two common methods of oxygen delivery were used in 20 patients: (1) a nasal cannula and (2) a red rubber nasopharyngeal tube through which the cut ends of the nasal cannula were passed into the posterior pharynx.

Methods: The project was carried out in two parts.

Quality and resource utilization in managing preoperative evaluation.

The evaluation of patients before surgery is a component of anesthesia practice that must be performed to ensure the safe delivery of anesthesia for every patient. How an anesthesia group performs this evaluation differs from institution to institution as the structure of preoperative clinics in hospitals across the country can be quite variable. However, the major question that anesthesiologists must ask when approaching this area of practice is: "Can a system for preoperative evaluation that uses the expertise of anesthesiologists,surgeons, and internists to deliver high quality, cost conscious, and efficient patient preparation for surgery be developed.