Aye Poppy!
This medication is used in TIVA because of it's short context-sensitive half-life.
What is Remifentanil?
During Ocular Surgery this can cause a severe bradycardia and should be initially treated with this.
What is the oculocardiac reflex treated with stopping surgical manipulation and/or atropine (glycopyrrolate)?
This is a retroactive process, focusing on finding system or process causes. One technique used is the "5 Whys".
What is Root Cause Analysis
"Tran"sfusion with pRBCs can result in this causing decreased cardiac contractility, vasodilation, and coagulopathy due to this.
What is hypocalcemia and binding with Citrate?
Xarelto should be stopped for this long for high-risk bleeding surgery.
What is 48-72hrs (2-3 days)?
This common opioid should be used in caution with pts with ESRD due to this.
What is morphine and active metabolite (morphine 6)?
Dilaudid may be better choice.
If bradycardia that returns with surgical stimulation during eye surgery may be treated effectively with this.
What is local anesthetic infiltration by the surgeon?
In conducting a QI project the iterative testing acronym PDSA stands for this.
What is plan-do-study-act?
This medication can be used in treatment of intraoperative bleeding in C-Sections.
What is Tranexamic Acid?
Pts on Plavix with surgical oozing should be treated with this
What are Platelets?
This medication given neuraxially requires pts be monitored due to this possible delayed complication.
What is Duramorph and delayed respiratory depression?
This often painless cause of unilateral vision loss, sometimes described as a curtain coming down and on fundoscopic exam this may be present.
What is Central Retinal Artery Occlusion and Cherry Red Spot?
Voluntarily reported to Joint Commission, serious events focusing on patient safety and quality.
What is a sentinel event?
After Significant "Tran"sfusion with pRBCs pts may develop Vfib due to this and should be treated with these measures, the first being.
What is Hyperkalemia and Calcium, hyperventilation, Insulin (+/- glucose), albuterol, bicarb?
Calcium first (preferably Calcium Chloride, greater bioavailability)
After Epidural removal Lovenox can be restarted after this time.
What is 4 hours?
ASRA and Stanford Recommendations
This medication used for treating shivering, should be avoided or used with caution in children because of this potential side effect
What is Demerol and seizure (neurotoxicity)?
The most likely diagnosis in a patient with painless visual loss following prolonged prone surgery with papilledema on fundoscopic exam.
What is AION?
Most common not PION!
In the state of Florida this is concerned more with legal liability regarding medical events such as unanticipated surgical foreign objects and is required to be reported within 15 days.
What is a Code 15?
"Tran"examic acid should be avoided in pts with this in the past or present
What are clotting issues and active thromboembolic issues?
Epidural catheters can be removed this long after the last dose of Lovenox if prophylactic and if treatment dose?
What is 12 hrs and 24 hrs?
Buprenorphine/Naloxone (Suboxone) in the periop period should be handled in this way and as a result they may need this dose adjustment with opioid medications.
What is continue and increased opioid dosage?
The most likely diagnosis in a patient with painless visual loss following prolonged prone surgery with normal fundoscopic exam.
What is PION?
Medication Errors and Near Misses are also considered to fall under this event.
What is a sentinel event?
While a recent study concluded that "Tran"examic acid is safe for pts with ESRD undergoing surgery in addition to ureteral clots a potential concern is this.
What is neurotoxicity/seizures?
Rapid reversal of Xarelto is best accomplished with this.
What is PCC?