Outpatient Surgery Magazine - Subscribers

Focused Factories - November 2015 - 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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1 5 0 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

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