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Game Changers in Surgery - June 2019 - Subscribe to Outpatient Surgery Magazine

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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J U N E 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 3 Why does having a quiet convective warmer matter? Operating room noise continues to be excessively high, with some surgical procedures recorded to have noise levels as high as 108 dB 1 to 131dB. 2 Operating room noise reduces effective communication, 1, 3 which could lead to distractions and interruptions affecting surgical out- comes. 4 It's been demonstrated that chronic exposure to loud sounds, or excessive noise, can lead to hearing loss. While some loss can be attributed to age-related hearing loss, the median hearing threshold in anaesthesiologists under 55 has been found to be worse than the general population. 5 What makes the Level 1® convective warmer safe? The Level 1® convective warmer has three outlet temper- ature settings, which provide flexibility in patient treat- ment: 37°C, 40°C, and 43°C. These three temperature settings are controlled by thermistors placed at the end of the hose where the hose connects to the convective warming blanket. A fourth temperature setting delivers ambient-temperature air. The safety circuit provides an independent means of shutoff, which discontinues power to the heater and prevents patient exposure to excessive temperatures. Over-temperature is monitored and alarms separately for each temperature setting. 6 How often is maintenance needed on the Level 1® convective warmer? The air filter in the convective warmer should be replaced every 1,000 hours of operation. 6 See operator's manual for routine maintenance recommendations. What is the importance of the filter in the convective warmer? Filtration is another critical safety factor. While pore size is relevant, it is not the most important factor when assessing a filter. Filtration efficiency is the key indicator of how well a filter will protect your patients and staff. The Level 1® filter is designed to help reduce the trans- mission of bacterial and viral and particulates. It provides 99.97% efficiency at the 0.2μ particulate size and 99.999% bacterial and viral efficiency. 6 What is the importance of keeping patient warm? Unintended perioperative hypothermia is associated with numerous complications. A meta-analysis of out- comes and costs found that "hypothermia averaging only 1.5°C less than normal resulted in cumulative adverse outcomes adding between $2,500 and $7,000 per surgi- cal patient to hospitalization costs across a variety of sur- gical procedures." 7 Why does noise matter when it comes to patient satisfaction? Studies have shown many patients find the noise during induction and emergence from anesthesia to be distress- ing. 8 As more facilities deploy temperature management strategies throughout the entire perioperative period, reducing noise levels will become increasingly important. 1. Hodge B, Thompson JF: Noise pollution in the operating theatre. Lancet 1990; 335:891- 4. 2. Fritsch MH, Chacko CE, Patterson EB: Operating room sound level hazards for patients and physicians. Otol Neurotol 2010; 31:715-21. 3. Kracht, Jonathan M., Ilene J. Busch-Vishniac, and James E. West. "Noise in the operat- ing rooms of Johns Hopkins Hospital." The Journal of the Acoustical Society of America 121.5 (2007): 2673-2680. 4. Gawande, Atul A., et al. "Analysis of errors reported by surgeons at three teaching hos- pitals." Surgery 133.6 (2003): 614-621. 5. Wallace, Mark S. Michael N. Ashman, and M. Jane Matjasko. "Hearing acuity of anaes- thesiologists and alarm detection." Anesthesiology 81.1 (1994): 13-28. 6. Level 1® Convective Warmer Operator's Manual. Part Number: ML-0001-558 Rev. 301 (05/18). ©2018 Smiths Medical. 7. Mahoney CB, Odom, J. "Maintaining intraoperative normothermia: a meta-analysis of outcomes with costs." AANA journal 67.2 (1999): 155. 8. Liu EH, Tan S: Patients' perception of sound levels in the surgical suite. J Clin Anesth 2000; 12:298–302 Issues and Answers in Patient Warming Prevent hypothermia, safely and quietly. Sponsored by SPECIAL ADVERTISING SUPPLEMENT

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