Consensus Paper on the Surveillance of Surgical Wound Infections

1992 ◽  
Vol 13 (10) ◽  
pp. 599-605 ◽  
Author(s):  
◽  
◽  
◽  
Keyword(s):  
Task Force ◽  
Outpatient Surgery ◽  
Case Finding ◽  
Surgical Wound ◽  
Optimal Method ◽  
Susceptibility To Infection ◽  
Routine Surveillance ◽  
Duration Of Surgery ◽  
American Society ◽  
Wound Class

AbstractA Surgical Wound Infection (SWI) Task Force was convened by The Society for Hospital Epidemiology of America (SHEA) to evaluate how SWI surveillance should be done and to identify where more information is needed. The Task Force reached consensus in the following areas. The Centers for Disease Control (CDC) definitions of SWI should be used for routine surveillance because of their current widespread acceptance and reproducibility. The CDC definitions have been clarified in an accompanying article (“Report From the CDC”). Direct observation of wounds and traditional infection control surveillance techniques are acceptable methods of case finding for hospitalized patients. The optimal method for case finding postdischarge or after outpatient surgery is unknown at this time. SWI rates should be stratified by surgical wound class plus a measure of patient susceptibility to infection, such as the American Society of Anesthesiology (ASA) class, and duration of surgery Surgeon-specific SWI rates should be calculated and reported to individual surgeons.

scholarly journals How Is Geriatric Assessment Used in Clinical Practice for Older Adults With Cancer? A Survey of Cancer Providers by the American Society of Clinical Oncology

2020 ◽  
pp. OP.20.00442
Author(s):  
William Dale ◽  
Grant R. Williams ◽  
Amy R. MacKenzie ◽  
Enrique Soto-Perez-de-Celis ◽  
Ronald J. Maggiore ◽  
...  
Keyword(s):  
Older Adults ◽  
Geriatric Assessment ◽  
Online Survey ◽  
Task Force ◽  
Statistical Significance ◽  
Geriatric Oncology ◽  
Perceived Barriers ◽  
Patients With Cancer ◽  
Change Behavior ◽  
American Society

PURPOSE: For patients with cancer who are older than 65 years, the 2018 ASCO Guideline recommends geriatric assessment (GA) be performed. However, there are limited data on providers’ practices using GA. Therefore, ASCO’s Geriatric Oncology Task Force conducted a survey of providers to assess practice patterns and barriers to GA. METHODS: Cancer providers treating adult patients including those ≥ 65 years completed an online survey. Questions included those asking about awareness of ASCO’s Geriatric Oncology Guideline (2018), use of validated GA tools, and perceived barriers to using GA. Descriptive statistics and statistical comparisons between those aware of the Guideline and those who were not were conducted. Statistical significance was set at P < .05. RESULTS: Participants (N = 1,277) responded between April 5 and June 5, 2019. Approximately half (53%) reported awareness of the Guideline. The most frequently used GA tools, among those aware of the Guideline and those who were not, assessed functional status (69% v 50%; P < .001) and falls (62% v 45%; P < .001). Remaining tools were used < 50% of the time, including tools assessing weight loss, comorbidities, cognition, life expectancy, chemotherapy toxicity, mood, and noncancer mortality risk. GA use was two to four times higher among those who are aware of the Guideline. The most frequent barriers for those who reported being Guideline aware were lack of resources, specifically time (81.7%) and staff (77.0%). In comparison, those who were unaware of the Guideline most often reported the following barriers: lack of knowledge or training (78.4%), lack of awareness about tools (75.2%), and uncertainty about use of tools (75.0%). CONCLUSION: Among providers caring for older adults, 52% were aware of the ASCO Guideline. Some domains were assessed frequently (eg, function, falls), whereas other domains were assessed rarely (eg, mood, cognition). Guideline awareness was associated with two to four times increased use of GA and differing perceived barriers. Interventions facilitating Guideline-consistent implementation will require various strategies to change behavior.

scholarly journals NORMATIZAÇÃO PARA USO DO ÓXIDO NITROSO NA CLINICA ODONTOLÓGICA

DENS ◽  
2007 ◽  
Vol 15 (2) ◽  
Author(s):  
Grasielle KARPSTEIN ◽  
Wilson Kenji SHIROMA
Keyword(s):  
Nitrous Oxide ◽  
Practice Guidelines ◽  
Task Force ◽  
Sao Paulo ◽  
São Paulo ◽  
Very Old ◽  
Nitrous Oxide Oxygen ◽  
Sedation And Analgesia ◽  
American Society ◽  
New Look

Apesar do oxido nitroso ser usado há mais de cem anos no mundo inteiro, seu uso no Brasil ainda é restrito a poucos profissionais, a falta de informação causa receio por parte do profissional e também por parte dos pacientes, pois pela pouca divulgação ainda existem muitos mitos envolvendo essa técnica. Apenas há três anos o Conselho Federal de Odontologia baixou uma resolução estabelecendo normas para habilitação do Cirurgião Dentista na utilização de oxido nitroso em consultório na sedação consciente. Antes disso muitos cirurgiões dentistas se beneficiavam de lacunas na Legislação, utilizando-o, não raras vezes, de forma indiscriminada. O presente trabalho tem por objetivo trazer ao conhecimento dos acadêmicos e profissionais de odontologia as novas legislações para utilização do oxido nitroso, promovendo a discussão através de comparação da Resolução do CFO de 2004 e das normas que a secretaria de Saúde do Estado de São Paulo implementou em 2005.  Palavras-chave: Oxido Nitroso; Odontologia; Sedação Consciente  Referencias Bibliográficas 1. Brasil. Lei nº 5.081, de 24 de agosto de 1966. Regula o exercício da profissão odontológica. Diário Oficial da União, Poder Executivo, Brasília, DF, 26 ago. 1966.2. Ranali J. Óxido nitroso: por que usar. J Assoc Paul Cir Dent. 2001; 36(529):32-5.3. São Paulo (Estado). Secretaria de Estado da Saúde. Portaria CVS nº 11, de 03 de junho de 2003. Dispõe sobre proibição ao cirurgião-dentista em aplicar anestesia geral em consultório, ou qualquer tipo de analgesia, empregando fármacos com potencialidade de anestesia geral. Diário Oficial do Estado, Poder Executivo 2003a; 113(104): 23. Seção 1.4. São Paulo. Secretaria de Estado da Saúde. Portaria CVS nº 14, de 01 de agosto de 2003. Dispõe sobre a revogação da Portaria CVS 11, de 03/06/03 e cria grupo de trabalho para regulamentar o uso de anestésicos inalatórios em odontologia. Diário Oficial do Estado, Poder Executivo  2003b; 113(144): 23. Seção 1.5. Moura, L. C. L;  A utilização da sedação consciente com oxido nitroso/oxigenio (N20/02) em Odontologia. 20056. AMERICAN SOCIETY OF ANESTHESIOLOGY TASK FORCE: Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 96(4):1004, 2002.7. ANDRADE, E.D. (1999). Terapêutica medicamentosa em Odontologia. 1ªed, São Paulo, Artes Médicas.8. ANDRADE, E.D. & RANALI, J. (2004). Emergências Médicas em Odontologia. 2ªed, São Paulo, Artes Médicas.9. MALAMED, S. F. & CLARK, M. (2003). Nitrous Oxide-Oxygen: A new look at a very old technique. Journal of the California Dental Association, 31(5):397-403.10. RANALI, J., RAMACCIATO, J.C., MOTTA, R.H.L. (2004). Biossegurança na sedação inalatória com óxido nitroso e oxigênio. Revista da Associação Paulista de Cirurgiões Dentistas, 58(5): 374-378 

Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration

2016 ◽  
Vol 124 (3) ◽  
pp. 535-552 ◽  
Keyword(s):  
Respiratory Depression ◽  
Regional Anesthesia ◽  
Practice Guidelines ◽  
Task Force ◽  
Digital Content ◽  
Pain Medicine ◽  
Practice Parameters ◽  
Opioid Administration ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract The American Society of Anesthesiologists Committee on Standards and Practice Parameters and the Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine present an updated report of the Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration. Supplemental Digital Content is available in the text.

Practice Guidelines for Obstetric Anesthesia

2016 ◽  
Vol 124 (2) ◽  
pp. 270-300 ◽  
Keyword(s):  
Practice Guidelines ◽  
Task Force ◽  
Obstetric Anesthesia ◽  
Supplemental Digital Content ◽  
Digital Content ◽  
Practice Parameters ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract The American Society of Anesthesiologists Committee on Standards and Practice Parameters and the Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology present an updated report of the Practice Guidelines for Obstetric Anesthesia. Supplemental Digital Content is available in the text.

scholarly journals Cardiac Patients for Non-Cardiac Surgery: Anesthetic Considerations in Patients with Permanent Pacemaker

2020 ◽  
Author(s):  
Eva Oktavia
Keyword(s):  
Cardiac Surgery ◽  
Surgical Procedure ◽  
Permanent Pacemaker ◽  
Anesthetic Technique ◽  
Device Implantation ◽  
Duration Of Surgery ◽  
Anesthetic Considerations ◽  
Safe Anesthesia ◽  
Anesthesia Technique ◽  
American Society

Permanent pacemaker (PPM) are being used in greater frequency in managing patients with electrophysiology disorders. These patients can be presented for either cardiac or non-cardiac surgery after their device implantation. They also will undergo either general or regional anesthesia to facilitate the surgical procedure. As an anesthesiologist, understanding patients’ condition, pacemaker care and safe anesthetic technique of choice are very important to provide safe patient management.  Therefore, this literature reviewed and summarized a systematic approach which can be followed in managing these patients. Various approach and guidelines have been discussed in the literature on how to manage patients with PPM who will undergo anesthesia. In this literature, the American Society of Anesthesiology (ASA) standard was used as a framework for managing patients with PPM. Meanwhile, the decision of anesthesia technique that being chosen should be based on patients’ clinical condition, the surgical procedure itself, the duration of surgery, and the convenience of the surgeon. Overall, patients with PPM require special attention in perioperative management. Both anticipations of the patient’s condition and the performance of PPM must always be considered to provide safe anesthesia practice.

scholarly journals A study of preoperative, intra-operative and postoperative factors responsible for postoperative wound infection

2017 ◽  
Vol 4 (5) ◽  
pp. 1569
Author(s):  
Shobha S. Nisale ◽  
Meghraj Chawada ◽  
Ganesh K. Kharkate ◽  
Sudhir B. Deshmukh
Keyword(s):  
Wound Infection ◽  
Care Center ◽  
Hospital Environment ◽  
Initial Assessment ◽  
Postoperative Wound Infection ◽  
Surgical Wound ◽  
Postoperative Wound ◽  
Health Care Center ◽  
Duration Of Surgery ◽  
Operative Findings

Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay increased, the occurrence of SSIs also increased. The occurrence of SSI increased as the quality of surgical wound deteriorated. As the duration of surgery increased, the occurrence of SSIs increased. It was found that the order of surgery was not related to occurrence of SSIs. It was found that the rate of SSI was more (21.55%) when the drain was used in comparison to only 8.04% when the drain was not used. The most common organism found to cause SSIs was staphylococcus aureus in 33.07% of cases.Conclusions: Slightly low incidence of SSIs in our study may be attributed to the better infection control practices though it must be concluded that more stringent aseptic measures including rational antibiotic policy will be contributory in lowering the SSI rate further.

scholarly journals Prevention of Shivering during Spinal Anesthesia: Comparison between Tramadol, Ketamine and Ondansetron

2017 ◽  
Vol 56 (208) ◽  
pp. 395-400 ◽  
Author(s):  
Gajal Lakhe ◽  
Krishna Murari Adhikari ◽  
Kiran Khatri ◽  
Anil Maharjan ◽  
Akriti Bajracharya ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Controlled Study ◽  
Sensory Blockade ◽  
Duration Of Surgery ◽  
Keywords Anesthesia ◽  
Baseline Temperature ◽  
Recorded Data ◽  
Prophylactic Use ◽  
American Society ◽  
Group 1

Introduction: Shivering is an unpleasant experience after spinal anesthesia. We conducted this study to evaluate the efficacy of ondansetron, ketamine and tramadol for prevention of shivering. Methods: In this prospective, randomized controlled study, 120 patients aged 18-65 years of American Society of Anesthesiologist (ASA) physical status I&II undergoing various surgical procedures were included and allocated alternately to one of the 4 groups; Normal saline (Group1), Ondansetron 4mg (Group2), Ketamine 0.25mg/kg (Group3) and Tramadol 0.5mg/kg (Group4). Incidence of shivering, effect on hemodynamics, nausea, vomiting, sedation and emergence reactions were recorded. Data was analyzed using SPSS (The Statistical Package for Social Sciences) version 20.0 software. Results: The patients were comparable in terms of demographic variables, baseline temperature, type of surgery, median level of sensory blockade, duration of surgery and anesthesia. Shivering was present in 17 (56.7%), 5 (16.7%), 3 (10%) and 3 (10%) patients respectively in Group 1, 2, 3 and 4 which was statistically significant when compared to Group 1 (P=0.00) The odds of NS and ondansetron, NS and ketamine, NS and tramadol was 6.53, 11.76 and 11.76 respectively which showed that study drugs were effective in preventing shivering. None of the patients were sedated in Group 1 and 2. Mild to moderate sedation was present in Group 3 and 4 (P=0.00). None of the patients had drug related adverse reactions. Conclusions: Prophylactic use of ondansetron, low doses of ketamine and tramadol is effective in preventing shivering post spinal anesthesia without untoward effects. Keywords:  Anesthesia spinal; Ketamine; Ondansetron; Shivering; Tramadol.

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