In medicine, there are innumerous amounts of tests and procedures performed every day. These procedures irrespective of how invasive or noninvasive they are require patients to be ‘Nil per Oral’ (NPO) for several hours prior to the procedure. Traditionally fasting preoperatively has been mandatory to prevent any risks related to aspiration during anesthesia. When anesthesia is induced in patients, it inhibits the patients cough and swallow reflex posing a higher risk for the patient to aspirate any gastric contents. The gastric contents which are highly acidic can cause irritation and inflammation in the lungs which can hinder the gas exchange leading to imminent death of the patient (Andrew-Romit & Mortel, 2011). Therefore long fasting periods were always implemented to enable stomach emptying during the induction of anesthesia. However, current studies display a lot of information and evidence showing that pulmonary aspiration arises very rarely as a complication of modern general anesthesia (Gunawardhana, 2012).
Cardiac catheterization or coronary angiogram is one of the most common and minimally invasive procedures performed by a cardiology intensivist. Pre-procedure fasting or NPO has been the standard protocol of care since beginning due to the vomiting very commonly caused by the first generation of radio contrast materials which were nearly toxic in nature (Kern, 2010). However, the modern contrast media which is approved Food and Drug Administration (FDA) is much safer as various studies show very rare incidences of any adverse effects like vomiting, contrast related hypotension or arrhythmias (Kern, 2010). For a patient cardiac cath can be a nerve racking experience as it reveals any blockages in the coronary arteries ...
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...ilization. Journal of Clinical Anesthesia, 12(1), 48-51. Retrieved from http://www.jcafulltextonline.com/article/S0952-8180(99)00139-7/abstract
Polit, D. F. & Beck, C. T. (2012). Nursing research: generating and assessing evidence for nursing practice (9thed.) Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Rosengarten, J., Ozkor, M., & Knight, C. (2007). Fasting and cardiac catheterisation - should we be following the evidence? Controversies and Consensus in Imaging and Intervention, 5(2), 21-23. Retrieved from http://c2i2.digithalamus.com/vol_v_issue_2/Fasting_and_cardiac_catheterisation.asp
Salman, O. H., Asida, S. M., & Ali, H. S. (2013). Current knowledge, practice and attitude of preoperative fasting: A limited survey among Upper Egypt anesthetists. Egyptian Journal of Anaesthesia , 29(2), 125–130.doi:10.1016/j.egja.2012.10.007.
This essay will discuss the risks for patients during the preoperative, intraoperative and postoperative stages of the perioperative journey and how both patients and healthcare professionals involved in the perioperative stages can work together to prevent perioperative hypothermia.
Inadvertent perioperative hypothermia is a common anesthesia-related complication with reported prevalence ranging from 50% to 90%.(ref 3,4 of 4) The clinical consequences of perioperative hypothermia include tripling the risk of morbid myocardial outcomes and surgical wound infections, increased blood loss and transfusion requirements, and prolonged recovery and hospitalization.(ref 5)
Loiselle, C. G., Profetto-McGrath, J., Polit, D. F., Beck C. T., (2007). Canadian essentials of nursing research (2nd ed.) Philadelphia: Lippincott Williams & Wilkins.
In a healthy individual receiving a general anaesthetic, the anaesthetist must be aware of the causes and treatment of acute onset AF, both intra-operatively and peri-operatively. Patients with AF often develop a decline in left ventricular performance and other hemodynamic instabilities including reduced diastolic filling and tachycardia mediated cardiomyopathy1, all of which can reduce cardiac output and pose difficulties for the anaesthetist.
LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice (8th ed.). St. Louis, MO: Elsevier, Inc.
Chloe was anxious I knew this because during general observation Chloe had an increased heart rate. Chloe looked pale and when using touch to reassure Chloe I noticed that her pales felt sweaty to touch. Chloe also told me she felt nervous about the central catheter insertion. The doctor reassured Chloe through conversation prior to the central venous catheter insertion.
Nursing research is a systematic enquiry that seeks to add new nursing knowledge to benefit patients, families and communities. It encompasses all aspects of health that are of interest to nursing, including promotion of health, prevention of illness, care of people of all ages during illness and recovery (or) towards a peaceful and dignified death (ICN 2009)
American Association of Nurse Anesthetists. Professional Aspects of Nurse Anesthesia Practice. Philadelphia: F. A. Davis Company, 1994. Print.
...., & Jr, L. H. (1992). Release of vasoactive substances during cardiopulmonary bypass. Annals of Thoracic Surgery. doi:10.1016/0003-4975(92)90113-I-6
I never had a formal clerkship in anesthesiology during my medical school and had always been on the surgical end of the operating table, but working with the Anesthesiology Department at Wayne State School of Medicine to implement the Enhanced Recovery Program gave me an insight to the field. I would spend my extra hours shadowing in the OR. I realized that the anesthesiologist does not merely plays a support-role in the operating room, the anesthesiologist is an equal member of the surgery team - an intensivist whose expertise in supporting life functions and quick but masterfully considered decisions during surgery are required for the other team-members to fix a focal
Polit, D., & Beck, C. (2006). Essentials of nursing research: appraising evidence for nursing practice (7th ed.). Phildelphia: Lippencott Wilkins & Williams.
..., and initiate administration of mannitol for further control. Rapidly stabilize vital signs, and simultaneously acquire an emergent computed tomography (CT) scan.”
Cullum, N. Ciliska D. and R. Haynes, Marks (2008;) Evidence – based Nursing: An Introduction.
Polit, D. F., & Beck, C. T. (2010). Essentials of Nursing Research (7th ed): Lippincott, Williams & Wilkins.
“Transesophageal scans done in the operating room provide real-time feedback to the surgeon about the health and functioning of the heart and its valves, so that appropriate choice of surgery required may be made at the time of cardiac surgery (hopkinsmedicine.org n.pag.). TEE is most commonly used in open heart surgeries if the patient will allow. It can also be very common in cardiac procedures such as mitral valve repair. During these type of operations, the transesophageal echocardiogram acts as a monitoring tool for the surgeons. It can be used immediately after procedures to make sure everything went as