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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 O N L I N E | N O V E M B E R 2 0 1 5
Bad Blood
All bleeding eventually stops. I just wish it would never start.
B
leeding is
part of a sur-
geon's world.
We fear it and do
whatever we can to
avoid it. As a shoulder
arthroscopist, even
the slightest amount
of oozing can make a
routine case turn into
Nightmare on Elm
Street. Who's to blame
for bleeding problems
in the OR? Patients,
anesthesiologists and
surgeons can all con-
tribute.
• Patient-related.
Despite our strongest
admonitions, patients still either forget to stop their aspirin/Plavix
before surgery, or they simply reason, "What harm can one itty-bitty
pill do?"
Well, 1 low-dose aspirin can transform a routine shoulder scope into
a bloodbath. These oozers can be recognized by the diffuse punctate
bleeding that peppers the surgical field. Despite the use of epineph-
rine in the irrigation bags, oozers morph the shoulder joint into the
red tide. The only recourse for the surgeon is to increase the pump
pressure to 1,000 atmospheres and work quickly.
C U T T I N G R E M A R K S
John D. Kelly IV, MD
Pamela
Bevelhymer,
RN,
BSN