"One of the most
difficult problems in
tendon transfer has
always been the
problem of getting
the tension just
right, not too tight or
too loose," he
explains. "Doing
these operations
while patients are
wide awake has real-
ly improved our abil-
ity to do this."
Jodi L. Pelkey, BSN, RN, CNOR, an educator at the Flagstaff (Ariz.)
Medical Center, helped set up a successful WALANT program after a
surgical colleague proposed the idea. Now, she says, they have
WALANT days roughly once a week at their affiliated ASC, during
which they can do upwards of 15 patients with just one surgeon work-
ing because the procedure is very fast-paced.
The full numbing effect of the anesthetic typically takes 15 to 20
minutes to set in, so they use 2 ORs, and the surgeon moves back and
forth at appropriate intervals. By the time one patient's surgery is
complete, the next patient is ready to go.
"The surgical time doesn't change much, but we can get started
quicker, and afterward we don't have to wait for the patient to be
less sedated or to wake up from general anesthesia," says Ms.
Pelkey. "Things move quickly on both ends of surgery."
There's also a cost savings, she says, because although supply costs
A U G U S T 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 6 1
• FULLY AWARE Performing hand and wrist surgeries while patients are awake is a
safe, efficient and cost-effective practice.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
