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P A T I E N T
M O N I T O R I N G
It's also important to continuously
Noback. "The latest data show the
monitor the blood sugar of diabetic
anesthesia complication rate — com-
patients. Stress on the body and a
plications, not deaths — to be 1 in
steroid in the IV can cause blood sugar
400,000 cases. That's all due to moni-
spikes, which can be handled with
toring changes that have let anesthesia
short-acting insulin until the stress can
providers be more vigilant about
be resolved by pain medication, and the
micromanaging the surgical environ-
patient can get back on a normal insulin
ment." OSM
and eating schedule. There are now
devices that transcutaneously assess
E-mail swasek @outpatientsurg ery.net.
blood sugar, which makes maintaining
normal levels easier, says Dr. Noback.
Rules to
monitor by
When Dr. Noback worked
at Harbor-UCLA Medical
Center, a sign read: "The
7 rules of anesthesia are
vigilance, vigilance, vigilance, vigilance, vigilance,
vigilance, vigilance." It's
true: Micromanagement
of small details has
increased anesthesia safety remarkably. "When I
started medical school,
anesthesia-related deaths
were 1 in 3,000 to 5,000
procedures," says Dr.
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