scholarly journals An audit of orthopedic operation notes: what are we missing?

2010 ◽  
pp. 37 ◽  
Author(s):  
Ghosh
Keyword(s):  
Orthopedic Operation

scholarly journals Intrathecal baclofen infusion and subsequent orthopedic surgery in patients with spastic cerebral palsy

1998 ◽  
Vol 4 (1) ◽  
pp. E7 ◽  
Author(s):  
Peter C. Gerszten ◽  
A. Leland Albright ◽  
Graham F. Johnstone
Keyword(s):  
Cerebral Palsy ◽  
Lower Extremity ◽  
Orthopedic Surgery ◽  
Intrathecal Baclofen ◽  
Orthopedic Procedures ◽  
Spastic Cerebral Palsy ◽  
Spastic Diplegia ◽  
Spastic Quadriplegia ◽  
Orthopedic Operation ◽  
The Mean

Intrathecal baclofen infusion (IBI) is an effective treatment for spasticity secondary to cerebral palsy (CP). The authors retrospectively reviewed the need for orthopedic surgery of the lower extremities in 48 patients with spastic CP who were treated with IBI. Forty pumps were placed in patients suffering from spastic quadriplegia (84%) and eight (16%) in patients with spastic diplegia. The patients' ages ranged from 5 to 43 years (mean 15 years). The mean follow-up period was 53 months (range 22-94 months). The mean baclofen dosage was 306 μg/day (range 25-1350 μg/day). At the time of pump placement, subsequent orthopedic surgery was planned in 28 patients (58%); however, only 10 (21%) underwent orthopedic surgery after IBI therapy. In all 10 cases, the surgical procedure was planned at the time of initial evaluation for IBI therapy. In the remaining 18 patients, who did not subsequently undergo their planned orthopedic operation, it was believed that their lower-extremity spasticity had improved to the degree that orthopedic intervention was no longer indicated. In addition, although six patients had undergone multiple orthopedic operations before their spasticity was treated, no patient required more than one orthopedic operation after IBI treatment for their spasticity. The authors conclude that IBI for treatment of spastic CP reduces the need for subsequent orthopedic surgery for the effects of lower-extremity spasticity. In patients with spastic CP and lower-extremity contractures, spasticity should be treated before orthopedic procedures are performed.

scholarly journals The Analysis of the Preventive Nursing of Infection after Orthopedic Operation

2015 ◽  
Vol 4 (1) ◽  
pp. 9
Author(s):  
Min Ai
Keyword(s):  
Spinal Cord ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Isolation System ◽  
Clinical Nursing ◽  
Factors Influencing ◽  
Orthopedic Operation

<p><strong>Objective:</strong> To explore the preventive nursing methods of infection after orthopedic operation and provide some basis for clinical nursing. <strong>Method: </strong>1000 patients who have received orthopedic operations are selected randomly from our hospital from September 2009 to September 2014, then we make follow-up and survey, analyze the factors influencing infection and implement corresponding nursing measures. <strong>Result:</strong> Among the 1000 patients, 26 patients have incision infection of sterile operation and the infected positions are on spinal cord, upper limbs and lower limbs. Surveys find that after orthopedic operation, infection patients are mostly infected 3-4 weeks after being hospitalized with the earliest infection occurring after one week after being hospitalized. We can find that the longer patients are hospitalized for, the higher the occurrence of infection is. <strong>Conclusion: </strong>In the preventive nursing of infection after orthopedic operation, sterile operation and preoperative, intraoperative and postoperative nursing should be remembered. And the most important one is to adopt sterilization and isolation system after orthopedic operation to lower the occurrence of infection to the lowest.</p>

Postoperative cognitive dysfunction in geriatric patients after orthopedic surgery

2012 ◽  
Vol 19 (3) ◽  
pp. 108-114
Author(s):  
Arūnas Gelmanas ◽  
Tomas Bukauskas ◽  
Andrius Macas ◽  
Giedrė Žarskienė ◽  
Ainius Žarskus
Keyword(s):  
Orthopedic Surgery ◽  
Older Patients ◽  
Geriatric Patients ◽  
Neuropsychological Test ◽  
Postoperative Cognitive Dysfunction ◽  
The Elderly ◽  
Mental Activity ◽  
Younger Patients ◽  
Orthopedic Operation ◽  
Group B

The aim of our study was to find out the changes of cognitive functions of geriatric patients after orthopedic surgery and when these differen­ ces are marked. We also tried to find out factors, which have influence on the results of common mental activity, to estimate the dynamics of mental activity and to choose the most optimal intervals of estimation. The population of our investigation consisted of 25 consecutive adult patients, undergoing orthopedic operation, applying regional anesthesia. Neurophysiological assessment where all patients underwent neurophysiological tests consisted of the Mini-mental State Examination (MMSE), 6 Item Cognitive Impairment test (6CIT), Trail-making test  –  a neuropsychological test of visual attention and task switching. Patients were tested the day before the surgery (MMSE1, 6CIT1, TMT1), on the day of the surgery (MMSE2, 6CIT2, TMT2) and on the third day after the surgery (MMSE3, 6CIT3, TMT3). The day before the surgery reveals that results of MMSE1, 6CIT1 tests were better in a group of younger patients. We found that the results of the MMSE test were significantly worse 3 days after the surgery than those before the procedure in the A group, p = 0.016. The biggest digression was fixed in “copying” and “repeating” after the surgery intervention, p = 0.01, p = 0.04. The orientation in time significantly decreased in the group B after the surgery, p = 0.00. MMSE, 6CIT, TMT test results were significantlt worse in older patients rather than younger ones 3 days after the surgery. We set that the elderly have a significantly shorter duration of education. Younger patients and patients with a longer studying period achieved better results of tests. The results mean that age and lasting of education are significant predictors of POCD. Our pilot study confirmed that POCD develops for older patients, undergoing neuroaxial anesthesia for orthopedic surgery. It is very important to continue studies and reveal how to decrease POCD events, keep the quality of life.

scholarly journals P008: Evaluation of outcomes after implementation of a provincial prehospital bypass standard for trauma patients – an Eastern Ontario experience

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S65-S66
Author(s):  
M. Austin ◽  
J. Sinclair ◽  
S. Leduc ◽  
S. Duncan ◽  
J. Rouleau ◽  
...  
Keyword(s):  
Injury Severity ◽  
Univariate Analysis ◽  
Vital Signs ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Level Of Consciousness ◽  
Orthopedic Operation ◽  
Eastern Ontario ◽  
Record Review ◽  
The Impact

Introduction: Trauma and injury play a significant role in the population's burden of disease. Limited research exists evaluating the role of trauma bypass protocols. The objective of this study was to assess the impact and effectiveness of a newly introduced prehospital field trauma triage (FTT) standard, allowing paramedics to bypass a closer hospital and directly transport to a trauma centre (TC) provided transport times were within 30 minutes. Methods: We conducted a 12-month multi-centred health record review of paramedic call reports and emergency department health records following the implementation of the 4 step FTT standard (step 1: vital signs and level of consciousness, step 2: anatomical injury, step 3: mechanism and step 4: special considerations) in nine paramedic services across Eastern Ontario. We included adult trauma patients transported as an urgent transport to hospital, that met one of the 4 steps of the FTT standard and would allow for a bypass consideration. We developed and piloted a standardized data collection tool and obtained consensus on all data definitions. The primary outcome was the rate of appropriate triage to a TC, defined as any of the following: injury severity score ≥12, admitted to an intensive care unit, underwent non-orthopedic operation, or death. We report descriptive and univariate analysis where appropriate. Results: 570 adult patients were included with the following characteristics: mean age 48.8, male 68.9%, attended by Advanced Care Paramedic 71.8%, mechanisms of injury: MVC 20.2%, falls 29.6%, stab wounds 10.5%, median initial GCS 14, mean initial BP 132, prehospital fluid administered 26.8%, prehospital intubation 3.5%, transported to a TC 74.6%. Of those transported to a TC, 308 (72.5%) had bypassed a closer hospital prior to TC arrival. Of those that bypassed a closer hospital, 136 (44.2%) were determined to be “appropriate triage to TC”. Bypassed patients more often met the step 1 or step 2 of the standard (186, 66.9%) compared to the step 3 or step 4 (122, 39.6%). An appropriate triage to TC occurred in 104 (55.9%) patients who had met step 1 or 2 and 32 (26.2%) patients meeting step 3 or 4 of the FTT standard. Conclusion: The FTT standard can identify patients who should be bypassed and transported to a TC. However, this is at a cost of potentially burdening the system with poor sensitivity. More work is needed to develop a FTT standard that will assist paramedics in appropriately identifying patients who require a trauma centre.

Blood Lost and Transfused in Patients Undergoing Elective Orthopedic Operation

1993 ◽  
Vol 39 (6) ◽  
pp. 355
Author(s):  
L. T. GOODNOUGH ◽  
K. VIZMEG ◽  
R. E. MARCUS
Keyword(s):  
Orthopedic Operation

scholarly journals Study on Psychological Influence of Nursing Intervention on Orthopedic Operation Patients during Perioperative Period

2015 ◽  
Vol 4 (2) ◽  
pp. 12
Author(s):  
Zeng Rong
Keyword(s):  
Intervention Group ◽  
Perioperative Period ◽  
Nursing Intervention ◽  
Psychological State ◽  
Control Group ◽  
Psychological Reactions ◽  
Psychological Reaction ◽  
Orthopedic Operation ◽  
Random Number Table ◽  
Psychological Influence

<p><strong>Objective</strong>: to discuss psychological influence of orthopedic operation patients with nursing intervention during perioperative period. <strong>Methods</strong>: 106 cases of orthopedic operation patients from August 2014 to March 2015 in our hospital were selected. According to the random number table, all cases were divided into two groups with principle of informed consent. The control group: 53 cases were treated with the conventional nursing; the intervention group: 53 cases were treated with the nursing intervention. Psychological reactions were compared in the two groups. <strong>Results</strong>: After nursing, the intervention group had the good rate of psychological reaction 86.8%, which was much higher than that in the control group (66.0%). Different results between the two groups were significant in Statistics (<em>p</em> &lt; 0.05); however, the intervention group had the rate of pain occurrence 54.7%, which was much lower than that in the control group (73.6%). Different results between the two groups were significant in Statistics (<em>p</em> &lt; 0.05). <strong>Conclusion</strong>: Nursing intervention could obviously improve psychological state of patients, reduce pain occurrence and accelerate recovery.</p>

PREVENTION OF DEEP VEIN THROMBOSIS (DVT) BY ENOXAPARINE (LOVENOXR) AFTER SURGERY FOR FRACTURE OF FEMORAL NECK. ONE DAILY INJECTION OF 40 MG VERSUS TWO DAILY INJECTIONS OF 20 MG

1987 ◽  
Author(s):  
J BARSOTTI ◽  
B DABO ◽  
J ANDREU ◽  
D ALISON ◽  
J LEROY ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Lower Limbs ◽  
Daily Injection ◽  
Bleeding Complications ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Orthopedic Operation ◽  
Group A ◽  
Group B

In a previous open study, a low-molecular-weight-heparinEnoxa-parine in a dose of 40 mg/24 hrs by subcutaneous (SC) injection, had been shown to be efficient and safe in preventing DVT after total hip replacement (THR), for a non traumatic hip disease. 103 patients (mean age : 82 years ± 10, mean weight : 52 kg ± 10) undergoing an orthopedic operation for fracture of femoral neck were included ina randomized, double blind study. These patients receivedSC Enoxaparine according to two different regimens : 54 patients received the treatment A (2 daily injections of 20 mg), 49 patients received the treatment B (1 daily injection of 40 mg).In both groups, administration of 40 mg of Enoxaparine was begun 12 hours before operation.Patients weretreated for 10-15 days, until bilateral ascending phlebography (BAP) had been completed.Lower limbs BAP were performed in 97 patients. The incidence of DVT is low and not significantly different betweenthe two regimens :a proximal DVT was detected in 6 patients of the group A and in 2 patients of the group B. This differenceis not significant(p = 0.28).3 patients of each group hada distal DVT. No clinical pulmonary embolism occurred.There was no serious bleeding complication, and the two groups are not significantly different on this point; 2 patients in each group had an important hematoma of the thigh.One hematoma, in a patient who received the treatment B, required a surgical treatment.Red cell transfusion requirementswere 2.6U+1.8 in the group A and 2.5 U ±1.4 in the group B (p = 0.84)There was no significant difference in the daily hemoglobinlevels between the two groups.This study shows that one daily SC injection of 40 mg of Enoxaparine is as efficient as two daily SC injections of20 mg of Enoxaparine in preventing DVT, in very elderly patients undergoing orthopedic operation for fracture of the femoral neck. The frequencies of bleeding complications in each group were not significantly different.Enoxaparine (LOVENOXR) - PHARMUKA S.F.

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