Minnesota medicine
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Since the 1980s, minimally invasive procedures have made inroads into gynecologic surgery. This article describes the progression of technological developments that have led gynecologists to attempt and master more and more minimally invasive surgical techniques over the last 30 years. It describes the minimally invasive gynecologic surgeries that are done today and reviews evidence that shows these procedures lead to faster recovery, fewer complications, and better outcomes.
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Although some women want to experience childbirth without medications, most women in the United States labor with an epidural or spinal analgesic. Epidurals provide relatively consistent pain relief, are long-lasting, can be titrated according to the analgesic needs of the mother, and can be bolused for procedures such as forceps, vacuum, or cesarean delivery. But they can have undesirable side effects including lower-extremity motor block, hypotension, urinary retention, and pruritus, and they may increase the risk for a slightly prolonged labor, a forceps or vacuum delivery, and fever during labor. This article describes the current thinking regarding labor analgesia and how anesthesiologists and obstetricians can help women have a birth experience that is both safe and satisfying.
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A handoff is the transfer of a patient's care from one provider to another. It usually involves both a verbal and written exchange of information. Although written handoff sheets are critical to good patient care, there is little data on the quality of information they contain. ⋯ The most common error was one of omission on the medication list (69% of the handoff sheets contained a medication omission). The percentage of patient handoff sheets with code-status errors was 5.7%, and the percentage with medication allergy errors was 2.8%. Important problems were omitted from the problem list in 22% of cases.