Objectives: Discuss advantages and disadvantages of relocating IV pumps for coronavirus disease 2019 patients from bedside to outside the patient room and characterize reproducible details of an external infusion pump model. Design: Brief report. Setting: ICUs at a single-center teaching hospital. Patients: Critically ill coronavirus disease 2019 patients under contact and special droplet precautions. Interventions: Relocation of IV pumps for coronavirus disease 2019 patients from bedside to outside the patient room using extension tubing. Measurements and Main Results: Infusion pumps secured to a rolling IV pole are moved immediately outside the patient room with extension tubing, reaching the patient through a closed door. It is anticipated that this practice may reduce unnecessary coronavirus disease 2019 exposure for healthcare professionals, reduce the consumption of personal protective equipment, and promote patient safety by limiting delays of donning personal protective equipment to initiate or adjust medications. Conclusions: Risks of situating IV pumps outside the patient room must be carefully weighed against the benefits. Relocation of IV pumps outside the patient room may be considered given shortages of personal protective equipment and high risk of healthcare professional exposure. Institutional review-approved studies investigating the measured impact on decreased exposure, personal protective equipment usage, and patient safety are required.

Objectives: To quantify the impact of IV pump relocation for COVID-19 patients from the bedside to outside the patient room on nurse exposure to COVID-19 and conservation of PPE. Design: Original Article Setting: Intensive care units at a single-center teaching hospital. Patients: Critically ill COVID-19 patients under contact and special droplet precautions. Interventions: Relocation of intravenous pumps for COVID-19 patients from bedside to outside the patient room using extension tubing. Measurements and Main Results: The primary objective of the study was to measure the impact of this strategy on COVID-19 exposure, utilizing the number of nurse entries into the patient room as a surrogate endpoint, and extrapolation of this data to determine the reduction or PPE usage. Secondary endpoints included incidence of extravasation, hyperglycemia, hypotension, and diagnosis of CLABSI/bacteremia. A statistically significant reduction in the primary endpoint of the study was observed as room entries prior to pump relocation averaged 15.36 (± 4.10) as opposed to an average of 7.92 (± 2.19) following pump relocation (p < 0.0001). In both pre- and post-pump relocation groups, there was no incidence of extravasation or CLABSI. No significant differences were noted in number of patients experiencing hyperglycemia, hypotensive episodes, or bacteremia. Conclusions: There was a significant decrease in COVID-19 exposure based on the number of nurse entries following the relocation of intravenous pumps from inside to outside of the patient room. These results may be cautiously extrapolated to suggest a decrease in personal protective equipment utilization. Future prospective, randomized controlled trials investigating the impact of this strategy are required.

OBJECTIVES: Adequate pain control in the post-anesthesia care unit (PACU) has been directly associated to overall patient satisfaction. Identifying which patients are at increased risk for elevated narcotic use after surgery would allow for targeted multimodal preemptive interventions to reduce the need for narcotics. The objective of this study was to determine if an elevated body mass index (BMI) in patients undergoing laparoscopic hysterectomy increases narcotic requirements in the PACU. MATERIALS AND METHODS: A retrospective chart review of all surgical cases between 2018 and 2020 performed by 4 fellowship trained MIS surgeons with similar operative techniques was completed. We included patients who were between 18 and 60 years of age that had undergone a laparoscopic hysterectomy. Patients who received concomitant procedures such as pelvic floor repair, interventions for urinary incontinence, or excision of endometriosis were excluded. Data collected included age, uterine weight, estimated blood loss, operative time, and narcotics received in the PACU. Total dose of administered narcotics was converted to intravenous morphine milligram equivalents (MME) based on the American Pain Society guidelines and critical review papers. T-Student was used to compare means between groups. RESULTS: One hundred eighty-five patients were included for analysis. Patients were divided into 2 groups depending on whether their BMI was less than 30 kg/m 2 (n ¼ 60) or equal to or greater than 30 kg/m 2 (n ¼ 125). Statistical analysis revealed that the two groups were similar in regards to age (44.48 vs. 43.58, P ¼ 0.38), operative time (170.5 minutes vs. 177.05 minutes, P ¼ 0.46), EBL (91.92 mL vs. 88.88 mL, P ¼ 0.80), and uterine weight (221.6 g vs. 214.9 g, P ¼ 0.80). Total narcotic use in the PACU was significantly higher in the BMI greater than or equal to 30 kg/m 2 group at 6.76 MME (SD¼6.98) compared to the BMI less than 30 kg/m 2 group at 4.15 MME (SD ¼ 5.22) (P ¼ 0.01). CONCLUSION: These findings suggest that obese patients undergoing laparoscopic hysterectomy are at a risk for increased narcotic requirements in the PACU and are potential targets for further nonnarcotic postoperative pain reduction interventions.

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