Asunto(s)
Actitud del Personal de Salud , Lista de Verificación , Adhesión a Directriz/estadística & datos numéricos , Errores Médicos/prevención & control , Personal de Enfermería en Hospital/psicología , Enfermería de Quirófano , Protocolos Clínicos , Humanos , Investigación en Administración de Enfermería , Investigación en Evaluación de Enfermería , Investigación Metodológica en Enfermería , Grupo de Atención al Paciente/organización & administración , Guías de Práctica Clínica como AsuntoRESUMEN
Serial cardiac arrests occurred during the induction of a 3-year-old boy for elective 1-sided orchiopexy surgery and evaluation under anesthesia of previously placed ear tympanoplasty tubes. The child's history included Williams syndrome along with hypercalcemia and mild supravalvular aortic stenosis. The initial arrests included significant ST wave changes along with profound brodycardia, hypotension, and pulseless electrical activity requiring full resuscitation twice. The patient was transferred on an emergency basis to the intensive care unit (the surgery was cancelled), and a heart catheterization was scheduled for the following morning. The patient experienced several cardiac arrests during the cardiac catheterization procedure, necessitating emergency extracorporeal membrane oxygenation cannulation and immediate transfer to the operating room for emergency cardiac surgery. A thorough preoperative cardiac workup, including cardiac catheterization, electrocardiogram, and echocardiogram, may decrease mortality and morbidity in patients with Williams syndrome. However, cardiac catheterization has been associated with increased risk in this patient population.
Asunto(s)
Anestesia General/efectos adversos , Estenosis Aórtica Subvalvular , Estenosis Coronaria/etiología , Paro Cardíaco/etiología , Síndrome de Williams , Estenosis Aórtica Subvalvular/complicaciones , Preescolar , Humanos , MasculinoRESUMEN
Health care costs in the United States are climbing annually at a staggering rate. Technology often is blamed for rising health care costs; however, some medical advances, such as minimally invasive surgery (MIS), are critical to improving health care efficiency, enhancing the quality of care provided, and decreasing overall expenses. Savings or profits relating to technology may be difficult to measure quantitatively, but when surgeons and perioperative personnel have reached the peak of the learning curve for performing MIS procedures, complication rates drop significantly. Patients are experiencing the benefits of MIS (eg, decreased postoperative pain, shorter hospital stays and often no need for an overnight stay, ability to return to work sooner), all of which encourage technologically savvy consumers to seek MIS options.