An Audit of All Waste Leaving the Operating Room: Can the Surgical Suite Be More Environmentally Sustainable?

2021 ◽  
Author(s):  
Zoe Rammelkamp ◽  
Jane Dirnberger ◽  
George Johnson ◽  
Steven Waisbren
Keyword(s):  
Operating Room ◽  
Environmentally Sustainable ◽  
Surgical Suite

scholarly journals Faster extubation time with more stable hemodynamics during extubation and shorter total surgical suite time after propofol-based total intravenous anesthesia compared with desflurane anesthesia in lengthy lumbar spine surgery

2016 ◽  
Vol 24 (2) ◽  
pp. 268-274 ◽  
Author(s):  
Chueng-He Lu ◽  
Zhi-Fu Wu ◽  
Bo-Feng Lin ◽  
Meei-Shyuan Lee ◽  
Chin Lin ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Length Of Stay ◽  
Operating Room ◽  
Spine Surgery ◽  
Total Intravenous Anesthesia ◽  
Lumbar Spine Surgery ◽  
Surgical Time ◽  
Intravenous Anesthesia ◽  
Extubation Time ◽  
Surgical Suite

OBJECT Anesthesia techniques can contribute to the reduction of anesthesia-controlled time and may therefore improve operating room efficiency. However, little is known about the difference in anesthesia-controlled time between propofol-based total intravenous anesthesia (TIVA) and desflurane (DES) anesthesia techniques for prolonged lumbar spine surgery under general anesthesia. METHODS A retrospective analysis was conducted using hospital databases to compare the anesthesia-controlled time of lengthy (surgical time > 180 minutes) lumbar spine surgery in patients receiving either TIVA via target-controlled infusion (TCI) with propofol/fentanyl or DES/fentanyl-based anesthesia, between January 2009 and December 2011. A variety of time intervals (surgical time, anesthesia time, extubation time, time in the operating room, postanesthesia care unit [PACU] length of stay, and total surgical suite time) comprising perioperative hemodynamic variables were compared between the 2 anesthesia techniques. RESULTS Data from 581 patients were included in the analysis; 307 patients received TIVA and 274 received DES anesthesia. The extubation time was faster (12.4 ± 5.3 vs 7.0 ± 4.5 minutes, p < 0.001), and the time in operating room and total surgical suite time was shorter in the TIVA group than in the DES group (326.5 ± 57.2 vs 338.4 ± 69.4 minutes, p = 0.025; and 402.6 ± 60.2 vs 414.4 ± 71.7 minutes, p = 0.033, respectively). However, there was no statistically significant difference in PACU length of stay between the groups. Heart rate and mean arterial blood pressure were more stable during extubation in the TIVA group than in the DES group. CONCLUSIONS Utilization of TIVA reduced the mean time to extubation and total surgical suite time by 5.4 minutes and 11.8 minutes, respectively, and produced more stable hemodynamics during extubation compared with the use of DES anesthesia in lengthy lumbar spine surgery.

Patient Preparation and Monitoring for Carotid Stenting: The Operating Room Nurse's Perspective

1996 ◽  
Vol 3 (2) ◽  
pp. 224-227 ◽  
Author(s):  
Sylvie Plat ◽  
Isabelle Hilaire ◽  
Elisabeth Vuillemin ◽  
Maryse Lafaye
Keyword(s):  
High Resolution ◽  
Operating Room ◽  
Endovascular Procedures ◽  
Wound Care ◽  
Carotid Stenting ◽  
Carotid Angioplasty ◽  
Cervical Approach ◽  
Patient Preparation ◽  
Surgical Suite

Endovascular procedures should be performed by a trained surgical staff in a surgical suite equipped with a high-resolution fluoroscopic unit. The operating room nurse must be skilled in the handling and preparation of specialized instruments and equipment necessary for carotid angioplasty procedures. Patient preparation and postprocedural wound care techniques are particular to the cervical approach for carotid angioplasty; the operating room nurse should be well trained in these areas in order to provide optimum assistance during the procedure.

Estimating the Incidence of Prolonged Turnover Times and Delays by Time of Day

2005 ◽  
Vol 102 (6) ◽  
pp. 1242-1248 ◽  
Author(s):  
Franklin Dexter ◽  
Richard H. Epstein ◽  
Eric Marcon ◽  
Johannes Ledolter
Keyword(s):  
Statistical Method ◽  
Operating Room ◽  
Confidence Intervals ◽  
Time Course ◽  
Relevant Information ◽  
Time Of Day ◽  
Error Rates ◽  
Type I ◽  
Sample Mean ◽  
Surgical Suite

Background Prolonged turnover times cause frustration and can thereby reduce professional satisfaction and the workload surgeons bring to a hospital. Methods The authors analyzed 1 yr of operating room information system data from two academic, tertiary hospitals and Monte-Carlo simulations of a 15-operating room hospital surgical suite. Results Confidence interval widths for the mean turnover times at the hospitals were negligible when compared with the variation in sample mean turnover times among 31 hospitals. The authors developed a statistical method to estimate the proportion of all turnovers that were prolonged (&gt; 15 min beyond mean) and that occurred during specified hours of the day. Confidence intervals for the proportions corrected for the effect of multiple comparisons. Statistical assumptions were satisfied at the two studied hospitals. The confidence intervals achieved family-wise type I error rates accurate to within 0.5% when applied to between five and nineteen 4-week periods of data. The diurnal pattern in the proportions of all turnovers that were prolonged provided different, more managerially relevant information than the time course throughout the day in the percentage of turnovers at each hour that were prolonged. Conclusions Benchmarking sample mean turnover times among hospitals, without the use of confidence intervals, can be valid and useful. The authors successfully developed and validated a statistical method to estimate the percentage of turnover times at a surgical suite that are prolonged and occur at specified times of the day. Managers can target their quality improvement efforts on times of the day with the largest percentages of prolonged turnovers.

Simulation of a Multiple Operating Room Surgical Suite

2006 ◽  
Author(s):  
Brian Denton ◽  
Ahmed Rahman ◽  
Heidi Nelson ◽  
Angela Bailey
Keyword(s):  
Operating Room ◽  
Surgical Suite

Biomedical applications: Pitfalls in the practice

1994 ◽  
Vol 52 ◽  
pp. 378-379
Author(s):  
J. D. Shelburne ◽  
Peter Ingram ◽  
Victor L. Roggli ◽  
Ann LeFurgey
Keyword(s):  
Operating Room ◽  
Liquid Nitrogen ◽  
Lung Tissue ◽  
Biomedical Applications ◽  
Microprobe Analysis ◽  
Tissue Sample ◽  
Cellular Level ◽  
Tissue Samples ◽  
Asbestos Fibers

At present most medical microprobe analysis is conducted on insoluble particulates such as asbestos fibers in lung tissue. Cryotechniques are not necessary for this type of specimen. Insoluble particulates can be processed conventionally. Nevertheless, it is important to emphasize that conventional processing is unacceptable for specimens in which electrolyte distributions in tissues are sought. It is necessary to flash-freeze in order to preserve the integrity of electrolyte distributions at the subcellular and cellular level. Ideally, biopsies should be flash-frozen in the operating room rather than being frozen several minutes later in a histology laboratory. Electrolytes will move during such a long delay. While flammable cryogens such as propane obviously cannot be used in an operating room, liquid nitrogen-cooled slam-freezing devices or guns may be permitted, and are the best way to achieve an artifact-free, accurate tissue sample which truly reflects the in vivo state. Unfortunately, the importance of cryofixation is often not understood. Investigators bring tissue samples fixed in glutaraldehyde to a microprobe laboratory with a request for microprobe analysis for electrolytes.

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