RSS-Feed abonnieren
DOI: 10.1055/s-2006-951578
Patient Safety in the Operating Room
Publikationsverlauf
Publikationsdatum:
18. Oktober 2006 (online)
![](https://www.thieme-connect.de/media/sps/200604/lookinside/thumbnails/10.1055-s-2006-951578-1.jpg)
ABSTRACT
Maintaining patient safety in the operating room is a major concern of surgeons, hospitals, and surgical facilities. Circumventing preventable complications is essential, and the pressure to avoid these complications during elective cosmetic surgery is especially important. Traditionally, nursing and anesthesia staff have managed patient positioning and most safety issues in the operating room. As the number of office-based procedures in the plastic surgeon's practice increases, understanding and implementation of patient safety guidelines by the plastic surgeon is of increasing importance.
Key aspects of patient safety in the operating room include thoughtful patient positioning, ocular protection, proper handling of electrocautery, and airway management. If performed correctly with attention to certain anatomic landmarks, preoperative positioning of the patient can prevent nerve injury and postoperative joint or muscle pain. In this article we discuss proper patient positioning with attention to protection against nerve palsy. Further, we discuss common patient positions on the operative table and highlight special concerns associated with each position. Other safety issues including prevention of ocular injury and proper management of electrocautery are discussed.
Responsibility of postoperative complications ultimately lies with the surgeon. Careful attention to patient safety guidelines is of paramount importance to surgeons, especially during elective cosmetic procedures. Attention to detail in patient positioning, eye protection, and bovie use can help avoid unnecessary perioperative complications and significantly improve the patient's cosmetic surgery experience.
KEYWORDS
Patient safety - operating room - patient positioning - ocular injury - electrosurgery - nerve injury
REFERENCES
- 1 Kohn L T, Corrigan J M, Donnaldson M S. To Err Is Human: Building a Safer Health System. National Institute of Medicine, Committee on Quality of Health Care in America. Washington, DC; National Academy Press 1999
-
2 Vandam L D.
Positioning of patients for operation. Stiefel RH, Electricity, electrical safety, and instrumentation in the operating room . In: Rogers MC Principles and Practice of Anesthesiology. Baltimore, MD; Mosby Year Book 1993: 703-745 -
3 Cucchiara R F, Faust R J.
Patient positioning . In: Miller RD Anesthesia. New York, NY; Churchill Livingstone 1994: 1057-1073 - 4 Fritzlen T, Kremer M, Biddle C. The AANA Foundation Closed Malpractice Claims Study on nerve injuries during anesthesia care. AANA J. 2003; 71 347-352
- 5 Akinbingol G, Borman H, Maral T. Bilateral brachial plexus palsy after a prolonged surgical procedure of reduction mammoplasty, abdominoplasty, and liposuction. Ann Plast Surg. 2002; 49 219-220
- 6 Bund M, Heine J, Jaeger K. Complications due to patient positioning. Anesthesiological considerations. Anasthesiol Intensivmed Notfallmed Schmerzther. 2005; 40 329-339
- 7 Shermak M, Shoo B, Deune E G. Prone positioning precautions in plastic surgery. Plast Reconstr Surg. 2006; 117 1584-1589
- 8 Roth S, Thisted R A, Erickson J P et al.. Eye injuries after nonocular surgery. A study of 60,965 anesthetics from 1988 to 1992. Anesthesiology. 1996; 85 1020-1027
- 9 Principles of Electrosurgery .Online. Valleylab 2006 Available at: http://www.valleylab.com/education/poes/index.html
- 10 Mann D. Reducing the hazard of burns and bovie pads. Plast Reconstr Surg. 2000; 106 947
- 11 Chen K T, Tzeng J I, Lu C L et al.. Risk factors associated with postoperative sore throat after tracheal intubation: an evaluation in the postanesthetic recovery room. Acta Anaesthesiol Taiwan.. 2004; 42 3-8
- 12 Altintas F, Bozkurt P, Kaya G et al.. Lidocaine 10% in the endotracheal tube cuff: blood concentrations, hemodynamic and clinical effects. Eur J Anaesthesiol. 2000; 17 436-442
Warren A Ellsworth IVM.D.
Division of Plastic Surgery, Baylor College of Medicine
1709 Dryden, Suite 1600, BCM Mail Stop: 630, Houston, TX 77030