Outpatient Surgery Magazine

Manager's Guide to Surgery's Ambulatory Anesthesia - July 2015

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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6 0 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E J U LY 2 0 1 5 All angles covered PONV can lead to post-op complications, including pulmonary aspiration, bleed- ing, wound dehiscence, dehydration, electrolyte imbalance and esophageal rup- ture, just to name a few. It lengthens patients' stays in recovery and delays dis- charge. It doesn't do any favors for patient satisfaction, either. The matching of interventions to patients for effective relief is easier said than done. Some drugs aren't suitable for some patients, certain patients' comorbidi- ties contraindicate the use of specific agents, and sometimes providers' knowl- edge deficits mean that potentially useful doses go untried. That's the necessity of a multimodal approach, and why the targeted prophy- laxis specifies minimum numbers of interventions for low-, medium- and high- risk patients. The higher the risk, the more opportunity you have to potentially forestall it. Your providers must ensure, however, that when multiple interventions are administered, each is selected from different classes of antiemetics. You don't want to give a patient several doses from the same class of drugs; but instead aim to work on different receptors for the best chance at PONV prevention. They must also monitor the incidence of PONV among their patients in PACU in order to determine whether and which of their interventions worked. Patient satisfier Perhaps your pre-op screenings gloss over PONV with a single question: "Have you experienced problems with anesthesia in the past?" What's more, PONV incidence rates often go unrecorded and unreported, even though the use of evi- dence-based tools can help you identify at-risk patients and take preventive steps against PONV. Including an evidence-based pre-op screening tool to determine a patient's risk of PONV in the electronic medical records system can help to streamline aware- ness, assessment and prophylaxis into the process. It will prompt providers to

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