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Standardizing Spontaneous Awakening And Breathing Trials In Critical Care: A Pilot Project, Lynzy Elzinga, Deirdre Mcnally, Eddie Montes

Books, Presentations, Posters, Etc.

No abstract provided.

Neostigmine Versus Sugammadex And The Relationship To Reintubation Rates In The Pacu, Delanie Urrutia, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Findings Discussion Reintubation in the post-anesthesia care unit (PACU) is a complication that may be related to residual neuromuscular blockade. Neostigmine and sugammadex have different pharmacokinetics that effect speed and completeness of reversal of paralysis. According to Tillquist et al. (2016) reintubation following general anesthesia in the PACU is associated with a 50% increased risk of mortality. Few studies have investigated the incidence rate of PACU reintubation and its possible relationship and choice of reversal medication.

Methods • Retrospective Observational Research Study. • This project was approved by the PSHMC Clinical Innovation and Research Council and deemed human subjects …

Prophylactic Phenylephrine Infusion To Mitigate Intraoperative Hypotension After Spinal Anesthesia Among Orthopedic Patients, David Nelson, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background

Intraoperative Hypotension (IOH) is common after spinal anesthesia (SA) and is associated with an increased risk of end organ damage.1 2 3 The treatment regimen for IOH after SA varies in the orthopedic population. However, the current research literature suggests that a prophylactic infusion of phenylephrine significantly reduces the number of episodes and duration of hypotension.1 This EBP project aims to report the proportion of patients receiving prophylactic phenylephrine infusions and the incidence of hypotension following SA among orthopedic surgery patients at Providence Sacred Heart Medical Center (PSHMC) in Spokane, WA.

Methods

• A retrospective, observational EBP project was …

Opioid Consumption After Scheduled Cesarean Delivery Following Implementation Of Enhanced Recovery After Surgery, Mindy Woodruff, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background With 47,600 opioid overdose related deaths in the U.S. in 2017, the opioid crisis is of national concern.1 Cesarean delivery is the most common surgery worldwide, with over 1.2 million in the U.S. in 2018 alone.2,3 As cesarean delivery is a highly prevalent surgery it has a large capacity to influence the opioid epidemic. Literature is showing that Enhanced Recovery after Surgery (ERAS) and multimodal analgesia are effective means of managing postoperative pain while minimizing opioid use.4,5,6,7,8 This project aims to help discover if introduction of ERAS, and more specifically it’s multimodal analgesia aspect, has helped decrease oral morphine …

Intratracheal Lidocaine And Postoperative Sore Throat At Providence Sacred Heart Medical Center And Providence Holy Family Hospital, Jennifer Cowgill, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative sore throat (POST) is a common side effect from general anesthesia (GA) and has a prevalence of 14.4-50%.1 The experience of POST contributes to patient discomfort during recovery from surgery. The etiology of this is thought to be from tracheal mucosal erosion from the cuff of the endotracheal tube (ETT), trauma from intubation, coughing and bucking, and friction between the ETT and the tracheal mucosa during general anesthesia.2 Risk factors shown to contribute to the development of POST include, but are not limited to, elderly age, smoking history, patient positioning, ETT cuff pressure, and movement of ETT during …

Rates Of Ondansetron Administration Prior To Spinal Anesthesia: Evaluating The Practice Of Prophylactic Attenuation Of Spinal-Induced Hypotension And Bradycardia, Clare Santana, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Hypotension and bradycardia are common complications of spinal anesthesia. Intraoperative hypotension and bradycardia may lead to complications that require additional treatment and increase cost. The literature identifies intervention strategies to attenuate spinalinduced hypotension (SIH) and bradycardia.1 Prophylactic administration of ondansetron, a serotonin 5-hydroxytryptamine receptor antagonist, prior to spinal anesthesia is associated with reduced SIH and bradycardia.1,2,3,4,6 The objective of this scholarly project was to report the practice of ondansetron prophylaxis for SIH and bradycardia and the rate of rescue interventions in patients who received ondansetron prior to spinal anesthesia.

Methods Retrospective, multi-center observational evidence-based practice project conducted at Providence …

Postoperative Length Of Stay Following Enhanced Recovery After Surgery Protocol Implementation For Scheduled Cesarean Deliveries, Hannah Zimmerman, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Cesarean delivery is the most common major surgery worldwide. 1 In 2018, 1.2 million cesarean deliveries occurred in the United States, accounting for nearly 32% of all deliveries.2 Research has shown ERAS benefits include decreased length of stay, improved pain control, and improved patient satisfaction.2,3 Despite its use in numerous surgical specialties, ERAS implementation within obstetrics has been slow.2 The ERAS Society released a three-part guideline specific to cesarean deliveries in 2018 and 2019,4,5,6 yet few studies have assessed the impact of ERAS on cesarean postoperative outcomes.2 An improved perioperative course would be particularly beneficial for mothers undergoing cesarean …

Postoperative Nausea And Vomiting With Low-Dose Propofol Infusions In Patients Undergoing Gynecological Surgeries With Volatile Anesthetics At Providence Sacred Heart Medical Center And Providence Holy Family Hospital, Adrianna Silva, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative nausea and vomiting (PONV) is a common complication following surgery. It remains the most important determinant of length of stay and leading cause of dissatisfaction in anesthesia.4 Females undergoing gynecological laparoscopic surgery have the highest rates.8 Apfel’s baseline risk factors for PONV include female gender, history of motion sickness and/or PONV, non-smoking status and administration of postoperative opioids.1 Propofol has antiemetic properties and Gan’s evidence supports the use of an intraoperative low-dose infusion to reduce baseline risk factors for PONV.6 This project aims to describe the rates of intraoperative low-dose propofol infusions in female patients undergoing gynecological surgery …

Rate Of Unscheduled Administration Of An Epidural Bolus Among Pregnant Women Receiving Labor Epidurals, Aleksandr A. Lyakhov, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background The labor and delivery process is a painful experience that pregnant women undergo and while various medical options are available for managing labor pain, labor epidurals are the most common.1,3 Breakthrough pain, or inadequate analgesia, is a significant complication of labor epidurals that is typically managed with the administration of an unscheduled epidural bolus. The purpose of this evidence-based practice (EBP) project is to describe the rate of unscheduled epidural bolus administration in pregnant women receiving continuous labor epidurals (CLE) at Providence Sacred Heart Medical Center (PSHMC) and Providence Holy Family Hospital (PHFH).

Methods • Design: Retrospective, observational, EBP …