Outpatient Surgery Magazine

Queasy Feeling - April 2017 - Subscribe to 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 40 of 154

No. 1 priority apart from preserving the patient's safety and comfort during the surgery. Here's my 5-point plan designed to make sure patients get discharged with their stomachs settled — and your facility's reputation intact. 1 Know your patient. PONV affects as many as 40% of patients. Preventing it is all about ameliorating the risk based on the patient's history, the nature of the surgery and gender. Young women are more prone to PONV — as much as 3 times more likely than men, in fact. Nonsmokers and anyone with a history of migraines or motion sickness tend to be more at risk, too. Ask patients if they have a history of PONV, but some patients might not remember or might not even know that they're prone to PONV. So do some legwork on the patient to see if you can learn more. You'll learn more when you speak with the patient directly, so use your pre- operative introduction as an opportunity to uncover more informa- tion. When I contact a patient the night before surgery, I'll answer any questions they might have and also ask a few of my own so I can com- plete a formal assessment to gauge the likelihood of PONV. If the patient is anxious and has a history of PONV, administer an antiemet- ic like aprepitant or ondansetron. I'll also remind the patient of NPO fasting guidelines, but if their case is later in the day I'll encourage them to take some PO water or, if they have reason to think they might suffer from withdrawal, some coffee. 2 Know the risks associated with the surgery. As a gen- eral rule, the longer the surgery, the higher the risk of PONV, though some surgeries by their very nature are more likely to trigger PONV. GYN surgery, like a bilateral tubal ligation, or a breast surgery, or anything that manipulates the equilibrium centers, like an A P R I L 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 4 1

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