your fiberoptic scope leaves much to be desired, hook it up to a 2-liter
flow of oxygen. "This will blow all secretions away from your optics,"
says Dr. Chipas.
8. Your senses know more than the screen. New providers, espe-
cially, are trained to be very dependent on electronics. But if you're
too focused on a monitor, you may miss the subtle early warning signs
that something's gone wrong — like slight wheezing or cutaneous
manifestations of anaphylaxis. (Also be mindful that cyanosis is not
always blue, but can manifest as pale skin.) Is there a subtle rocking
chest motion or rib retraction? Are the nostrils subtly flaring? Even
your olfactory sense can aid you in identifying an oral abscess and
determining whether it will become problematic.
"The monitors in the OR are there to verify what you're seeing clini-
cally or to alert you to something unseen, but they don't solve the
problems," says Jeffrey Cazier, MD, medical director and chief of
anesthesia at The Surgery Center of Huntsville (Ala.). "You should be
looking at the patient, not staring at a screen."
9. It's dangerous to fumble the PACU handoff. The anesthesia
provider should give a verbal report to recovery room personnel, but
research shows that such handoffs are often characterized by poor
communication.
"Recovery room nurses should ask all the questions and get all the
information they need from an anesthesia provider before taking over
care of a patient," says Dr. Patane. "That care will vary depending on
what meds were given, what techniques were used and what procedure
was done in the OR."
10. You may be over-relying on the pulse oximeter. Some
recovery room personnel mistakenly think that a pulse oximeter veri-
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