Journal of perioperative practice
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Surgical smoke is produced when tissues are dissected or cauterised by heat generating devices. Perioperative personnel and patients are routinely exposed to this smoke, and the use of smoke evacuation devices in operating theatres is not mandatory. This review will examine the most recent literature relating to surgical smoke in an attempt to discover guidelines for best practice and thereby provide recommendations for future practice.
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Up to 70% of surgical patients develop hypothermia perioperatively. Inadvertent hypothermia can be caused by a cold operating theatre, anaesthetic effects, exposure to the environment and administration of cold intravenous or irrigation fluids. ⋯ Preventing unplanned hypothermia increases patient comfort and prevents associated complications. It can be achieved by simple preventative measures (Burger & Fitzpatrick 2009, Lynch et al 2010).
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Tracheal intubation constitutes a routine part of anaesthetic practice both in the operating theatre as well as in the care of critically ill patients. The procedure is estimated to be performed 13-20 million times annually in the United States alone. There has been a recent renewal of interest in the morbidity associated with endotracheal tube cuff overinflation, particularly regarding the rationale and requirement for endotracheal tube cuff monitoring intra-operatively.
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Safe surgery is a world-wide recognised issue. The World Health Organization statistics show that the occurrence of major complications is between 3 and 16%, and the occurrence of disability and death is between 0.4 and 0.8% (WHO 2009). ⋯ The National Patient Safety Agency (NPSA) has collated over 1 million reports of surgical incidences in England and Wales between October 2006 and September 2007. Weiser et al (2008) quote a world-wide figure of 7 million individuals affected with a disabling complication, and a death rate of 1 million.
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Hip fracture is a major cause of morbidity, mortality and loss of independence for the elderly. Surgical fixation of the fractured hip remains the standard of care to allow for early mobilisation and a return to independence. ⋯ The altered physiological state of the older person, often coupled with significant comorbidity, can present challenges for the anaesthetist, the surgeon and the rest of the perioperative team. This article provides an evidence-based review of the important perioperative factors associated with hip fractures in the older person and their management.