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E N T
Attack PONV in every
3 PONV is an inherent concern inpatient
ENT procedures, because (1)
there's a lot of work on the airway, which causes swelling around the
tonsil beds (which in turn leads to gagging and nausea issues), and (2)
there's a lot of work in the ear canal, which can cause inner-ear issues
(which in turn leads to nausea). A scopolamine patch is a must for some
ENT patients. In higher-risk patients — those who meet at least a couple
of the "overweight, fair, over 40, fertile, female" criteria — we use a
propofol drip instead of anesthetic gases, so these patients wake up with
the smallest possible chance they'll experience and be delayed by PONV
issues. For patients with known PONV, our surgeons will prescribe 1
dose of aprepitant (Emend) to be taken the day before surgery. We also
dose them on the day of surgery. These patients are always amazed to
not be sick after surgery, and our PACU nurses are happy because delays
are minimized.
Involve
4 Parents or caregivers to comfort childrento the pre-op
guardians accompany pediatric patients
area, where they assist with changing into surgical attire and listen in
on the post-op teaching. We rarely allow a parent into the surgery suite
for induction as it can be very stressful for the patient and parent— it
may even have a negative impact on the surgical experience. When a
child goes to sleep holding his parent's hand, he'll hold the parent
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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 O N L I N E | D E C E M B E R 2012
