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Melt Your Job Stress Away - January 2014 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 74 O U T P A T I E N T E V O L U T I O N CLINICAL EVIDENCE Few Complications Following Adenotonsillectomy A denotonsillectomy can safely be performed in young children with minimal complications, so it's time to start reevaluating the need for mandatory admission of all children younger than 3 years old, study results show. DAY CARE Children who receive For research published in the April 2012 expert perioperative care can be sent home safely. issue of JAMA Otolaryngology-Head & Neck Surgery (tinyurl.com/p9jacpg), I reviewed the outcomes of 86 pediatric patients I operated on between January 2003 and October 2009 at New York–Presbyterian Hospital, a tertiary care medical center in New York City. There were minimal post-op complications, and notably no respiratory issues — no one required intubation or significant supplemental oxygen. None of the patients had post-op problems that necessitated admission. Dehydration was the most common complication. Recent studies, including mine, have proven the safety of outpatient adenotonsillectomy, but the American Academy of Pediatrics and the American Academy of Otolaryngology-Head and Neck Surgery hesitate to issue national recommendations for sending all children home the day of surgery. The groups must be certain the procedure can be completed safely in every type of facility, from my tertiary care facility in New York City to community hospitals in the rural Midwest. If more studies show that pediatric adenotonsillectomy patients can be discharged safely, the AAO-HNS and AAP would feel more comfortable making recommendations stating physicians can use discretion in deciding when patients can go home. In the meantime, rely on good clinical sense when determining who can be discharged on the day of — Jacqueline E. Jones, MD surgery and who can't.

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