Jean A. Simonson MD
Situation: Patients with pacemakers and/or ICDs are frequently scheduled for procedures, including MRIs. Background: There is a Nebraska Medicine policy, NM MS49 Surgical Patients with Cardiac Implantable Electronic Devices (CIEDs), and an order available for pacemaker and/or ICD interrogation. Assessment: All patients with a CIED are to be identified preoperatively and the device clinic and […]
Apr 19, 2023
Capnography during PACU sedation procedures
Safety Tip – Capnography during PACU Sedation Procedures During moderate or deep sedation, the adequacy of ventilation shall be evaluated by continual observation of qualitative clinical signs and monitoring for the presence of exhaled carbon dioxide unless precluded or invalidated by the nature of the patient, procedure, or equipment. (ASA Standards for Basic Anesthetic Monitoring, […]
Mar 14, 2023
Situation: Positioning a patient’s arms safely and securely can be challenging. Background: All patients are vulnerable to injury. For many procedures, the surgeon’s preference is for “tucking” a patient’s arms. The width of OR surgical beds/tables is 20 inches. By comparison, seat widths at Memorial Stadium at the University of Nebraska Lincoln range from 18 […]
Feb 21, 2023
Single-dose or multi-dose vials of injectable medication: “one patient and done”
Situation: Medication supply issues have resulted in single-dose and multi-dose vials of parenteral medications and local anesthetics available to anesthesia providers. This can present confusion with regard to the utilization and wasting of unused medication. Background: Medication vials are labeled by the manufacturer based on the intended use. Assessment: Single-dose vials are preferred over multi-dose vials whenever available. Anesthesia […]
Jan 31, 2023
QIPS Terminology: Failure Mode and Effects Analysis (FMEA) vs. Root Cause Analysis (RCA)
Do you:consider what might go wrong in a situation and how you might prevent it from happening or minimize the effects?have backup airway equipment and vasopressors available for an anesthesia case?check the winter weather before traveling and adjust your travel route or departure time if there are icy roads forecasted?If you answered “yes” to any […]
Dec 5, 2022