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Thumbs Up on Safety Scalpels - Outpatient Surgery Magazine - May 2019

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Pre-op and post-op screenings In many cases, older surgical patients don't realize they've suf- fered from postoperative brain fog until weeks after surgery. Friends and family may actually be the first to notice the signs, which could be a grandmother who keeps repeating the same facts to her grand- child or a group of bridge players who notice their friend's game has slipped. If the delirium status of the patient is unknown, use a delirium screening process to identify patients who might be at risk for compli- cations from anesthesia. Ask your older patients to do a preoperative memory test or to draw a time on a clock face. Go through this process again after surgery, and you'll get a sense of how your patients' mental state has changed and if they're going through a post- op cognitive slide. Before your patients head into surgery, ask them these key ques- tions taken from the ASA/AARP Brain Health Initiative: • Have you ever had a problem with your memory or thinking ability after hospitalization or surgery? • Have you ever had an episode of confusion, or imagining things that were not real? • Are you taking drugs to help your thinking or memory, such as Namenda (memantine) or Aricept (donepezil)? These questions help you prepare for patients who might be suscep- tible to postoperative cognitive decline and delirium. Remember, there's no one-size-fits-all approach to caring for older patients. You need to have a different set of expectations for the patient who is already on memory drugs and the one who is still solving Sudoku puz- zles every morning. 1 M A Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 5

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