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IDEAS THAT WORK
gery cases, as these procedures are most commonly associated with
PONV.
• Add 1 point if the case is expected to last longer than 60 minutes.
• Subtract 1 point if propofol is being used to anesthetize the patient.
• Add up the patient's score. Scores of 1 to 2 are low risk, 3 to 5 points moderate risk and 6 to 9 high risk for experiencing PONV.
The pre-admissions nurse includes the form with the patient's chart for the anesthesiologist to review before the procedure. Based on the patient's score, the anesthesiologist may choose to pre-medicate a
high-risk patient.
For a score of 3 to 5, we offer a drug like aprepitant, and strongly recommend aprepitant for patients in the 6 to 9 range. It's important
to note that aprepitant costs $100 a pop and isn't covered by all insurance carriers.
But we've found most patients are willing to pay the price to reduce
their risk of post-op problems. And we've seen results. Since implementing the screening tool in 2008, the number of patients with
extended recoveries related to PONV has dropped from 0.64% to 0.33%, and we expect the number to keep going down.
Dee Weigel, RN, BS
Algonquin Road Surgery Center
Lake in the Hills, Ill.
dweigel@algonquinsurgerycenter.com
On the Web:
Download our "PONV Risk Scoring Tool" at www.outpatientsurgery.net/forms.
