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Comfy ORs - June 2014 - 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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SAFETY 1 5 6 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U N E 2 0 1 4 tively. Platelet testing may offer valuable insights into bleeding risks as well as the risk of ischemic events. If platelet reactivity is low, we tend to wait to do the surgery until the effects of antiplatelet meds fully dissipate. If platelet reactivity is high, the blood is clotting well and it's likely safe to proceed with the surgery from a bleeding per- spective within 24 hours . While point-of-care platelet function testing is being used more fre- quently, it has yet to become standard of care. A study conducted by my research team involving 200 patients showed that timing surgery based on the thrombolastography results of a platelet function test can reduce the surgical wait time and need for hospitalization by 50% — an important consideration for outpatient surgery facilities. Large- scale studies demonstrating that platelet function testing improves patient outcomes would lead to a paradigm shift in pre-op assess- ments and ultimately improve the overall quality of care for surgical patients. Reducing risks Developing strategies to proactively avoid excessive bleeding and thrombotic events during surgery is vitally important. Both conditions increase morbidity and mortality, but may be reduced with thoughtful planning and management, including platelet function test results and the offset effects of the antiplatelet agents the patient is taking. OSM Dr. Gurbel ( pg urb el@lifeb ridg ehealth.org ) is an interventional cardiologist at Sinai Hospital of Baltimore and director of the Sinai Center for Thrombosis Research in Baltimore, Md. OS_1406_part3_Layout 1 6/13/14 11:56 AM Page 156

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