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P O S T- O P
M A N A G E M E N T
of potential risk.
cotics and have a
In addition to
history of PONV
— statistically
young, female, non-
speaking, the
smoking, narco-
patients most
tized patients, indi-
likely to suffer it?
viduals with a his-
That's not a great
tory of motion sick-
way to run a sur-
ness are also fre-
gical facility, how-
quently at risk.
ever. So instead
Using my aptly
focus on proven
named "Sinha's
ways to reduce
Indirect test of
incidence of
PONV from the
KNOW AND GO Pre-op assessments often provide clues to patients' susceptibility to PONV.
Motion Sickness"
(a.k.a. "SIMS"), I'll
ask patients if they
moment patients
enter your facility to when they're
enjoy theme-park rides. The popula-
heading home after surgery.
tion cleanly divides into those who
Pre-op precautions
love them ("SIMS negative") and those
It's reasonable to assume that, for
who hate them ("SIMS positive"), with
patients, the only thing worse than suf-
very little middle ground. I've found
fering PONV is not expecting it as a
that "SIMS positive" patients are prob-
possible outcome. In the interest of
ably at a higher risk of PONV.
keeping patients informed and pre-
Granted, this is entirely anecdotal and
pared, candidly discuss the potential
based on personal observation. But it's
problem during pre-op assessment
a fairly accurate test that lets you be
interviews. Mention that it's the most
more proactive with a potentially
common significant side effect of anes-
high-risk group.
thesia (about 30% of surgical patients
Consider giving at-risk patients a
reportedly suffer PONV). Then ask
scopolamine patch or aprepitant
patients to help you identify their level
(Emend) tablets pre-operatively.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E
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