Local Anesthetic Systemic Toxicity.

Local anesthetics are commonly used in the perioperative environment to facilitate surgical procedures or to provide postoperative pain management for patients. The use of local anesthetics, however, introduces the risk of complications resulting from local anesthetic systemic toxicity and the risks of increased morbidity and mortality for the surgical patient. Systemic toxicity from the injection or overdose of local anesthetics is a rare but potentially fatal complication that occurs in less than 1 in 1,000 patients. This article provides the perioperative nurse with information about local anesthetics, the signs and symptoms of local anesthetic systemic toxicity, and the information needed to manage a patient experiencing this complication.

ECG Interpretation Using the CRISP Method: A Guide for Nurses.

Nurses often struggle with identifying electrocardiogram (ECG) rhythms, but rapidly interpreting these rhythms is an essential skill that every nurse should master, especially in the perioperative setting. The CRISP (Cardiac Rhythm Identification for Simple People) method is an algorithm designed to help nurses rapidly interpret ECGs. Key aspects of assisting patients with suspected cardiac issues include the nursing assessment, correct three-lead ECG placement, and calculation of the heart rate. Then the perioperative nurse can use the steps of the CRISP method to identify nursing actions related to specific arrhythmias, including determining whether QRS complexes are present, P waves are present, and QRS complexes are wide or narrow or whether there are more P waves than QRS complexes.

Crisis Management of Hypotension in the OR.

Perioperative nurses play a pivotal role in coordinating care during crises, employing their nursing skills to foster a positive outcome and collaborating with their colleagues and peers to achieve the desired resolution. Whether caring for a patient during a liver transplantation or one undergoing removal of a cyst, perioperative nurses know that a drop in the blood pressure may signal a momentary phenomenon or a critical event that can become a crisis. It is important for nurses to understand how the color of the patient's tissue, the strength of a pulse, or the downward trending of blood pressure readings can affect how well blood is distributed throughout the body and eventually adversely affect cellular viability with prolonged hypotension. Integrating the patient's objective data (ie, blood pressure readings, pulse oximetry) and subjective cues (ie, skin color) are important perioperative nursing skills that demonstrate clinical patient advocacy and judgment and are crucial for the successful treatment of hypotension.

Meeting the challenge of IBS.

Irritable bowel syndrome is frustrating and debilitating for patients, and management of this disorder is a challenge for healthcare providers. IBS is a common, functional, gastrointestinal disorder, and is often characterized by crippling symptoms without any pathologic findings.

Prevention, recognition, and management of nursing complications in the intraoperative and postoperative surgical patient.

A review of the literature focusing on postoperative complications reveals that the best available tools to the medical and surgical teams are recognition and prevention. This article highlights the more common postsurgical adverse events and discusses methods for preventing and treating these occurrences.

Laparoscopy: risks, benefits and complications.

This article discusses the benefits and risks of laparoscopy. Also discussed are complications of laparoscopy and methods to avoid or treat these adversities.