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August 2021 Issue
This August issue includes a CE article on the pathophysiology and treatment options for hydrocephalus and the laparoscopic-assisted VPS placement procedure and related perioperative care considerations; and a CE article on implementing a virtual preoperative huddle. The Clinical Issues column explores using antiseptic solutions in surgical wound irrigation, use of powered air-purifying respirators in the OR, surgical wound classification of cesarean delivery procedures, management and documentation of foam dressings used in open wounds, and gastric lavage during a malignant hyperthermia crisis.
Featured CE Articles
1. Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement: A Less Invasive Approach to Treating Hydrocephalus
Hydrocephalus is caused by the disruption of the normal flow of cerebrospinal fluid (CSF), which results in a buildup of CSF. Normal-pressure hydrocephalus currently has no cure; the main treatment option is ventriculoperitoneal shunt (VPS) placement surgery. This procedure is performed to reestablish the balance between CSF production, flow, and absorption. Recently, general surgeons have begun assisting the neurosurgeon by placing the distal or abdominal end of the shunt using a laparoscopic technique. This article briefly reviews the pathophysiology and treatment options for hydrocephalus and presents a thorough review of the laparoscopic-assisted VPS placement procedure.
2. Safety First: Encouraging Interdisciplinary Preoperative Communication With a Virtual Huddle
Perioperative personnel can use preoperative huddles to integrate verbal communication and EHR information when planning patient care. Penn Presbyterian Medical Center perioperative leaders decided to initiate a virtual preoperative huddle to support the participation of all required team members wherever they might be located. To implement the initiative, the perioperative leadership team worked with stakeholders from other entities in the Penn Medicine organization to embed a huddle guide checklist that incorporated parts of the World Health Organization Surgical Safety Checklist into the EHR.
- Using antiseptic solutions in surgical wound irrigation
- Use of powered air-purifying respirators in the OR
- Surgical wound classification of cesarean delivery procedures
- Management and documentation of foam dressings used in open wounds
- Gastric lavage during a malignant hyperthermia crisis