Technological advances in safety and the performance of electrosurgical units (ESUs) have made the ESU the most common piece of electrical equipment in the OR. The constant presence of the ESU in the OR increases the potential for patient injury that is associated with the use of any piece of electrical equipment. To prevent injuries related to the use of an ESU, the perioperative nurse must understand the types of current used, types of ESUs available, and potential complications and have a working knowledge of safe practices for using this equipment in the perioperative setting.
Enzymatic detergents are widely used to clean gastrointestinal endoscopes before high-level disinfection. Although proper use of enzymatic detergents may appear straightforward, common misuses include failure to dilute the enzymatic detergent, overdilution of enzymatic detergent, use of expired enzymatic detergent, inadequate exposure time, and failure to rinse the enzymatic detergent from the instrument being cleaned. Each type of misuse has its own rationale. In these studies, the authors show by high-performance liquid chromatography that the type of enzymatic detergent and the dilution and rinsing of enzymatic detergents affect the amount of residual high-level disinfectant (ortho-phthalaldehyde) left on test segments of flexible endoscope insertion tubes. The authors also qualitatively demonstrate that proteinaceous material, which is stained a dark color by ortho-phthalaldehyde (OPA), remains on colonoscopes that have been cleaned with improperly diluted or rinsed enzymatic detergents. These findings emphasize the importance of diluting and using enzymatic detergents exactly as directed by their manufacturers to reduce bioburden and residual amounts of high-level disinfectant on flexible endoscopes.
Patients undergoing cataract surgery with the use of topical anesthesia experience less pain, can return home faster, and avoid the need for an eye patch, which can cause depth perception problems. Patient education performed by the perioperative nurse significantly affects patients' experience and recovery. This article discusses the history of cataract surgery, etiology of cataract formation, and traditional anesthetic choices. The patient selection process relative to topical anesthesia is defined, and the patient's experience throughout the perioperative phases of cataract extraction is described.
A basic understanding of electrocardiogram (EKG) interpretation is necessary for all perioperative nurses. This includes knowledge of the conduction system of the heart and skill at identification of normal and abnormal EKG rhythms. This article discusses basic EKG interpretation for OR nurses.
Cardiac explantation and autotransplantation is a procedure by which the heart is removed from the chest and replaced. Explantation of the heart for tumor removal has been documented six times in the literature; however, with this aggressive approach, the median patient survival rate is only eight months. This article presents a case study in which this procedure was used to treat a patient with malignant fibrous histiocytoma.
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