Course Content 9. Postoperative Complications. Postoperative complications are a constant threat to the millions of people undergoing surgical interventions. Whether patients are managed in a hospital setting, an ambulatory care facility, or in a free standing operating suite, the development of postoperative complications can lead to long term disability and possibly death. Healthcare professionals caring for patients during the postoperative period should be alert to complication risks and institute measures for risk reduction. Hospital discharge statistics demonstrate changes in hospitalization and trends. While many patients are being treated in the outpatient setting, the elderly population is increasingly using inpatient resources 1. With the advent of new technology, new medications, and minimally invasive procedures, the frequency of surgical operations continues to increase. The procedure with one of the greatest increases in frequency is knee replacements. The rate of knee replacements for patients between 4. While knee replacements were originally considered an elderly persons procedure, younger patients have chosen to have the procedure done to enhance their lifestyle. Patients are no longer willing to live with pain and disability when the problem can be fixed. However, with this increase in procedures comes an increase in complications. One of the greatest risks for the knee replacement patient is the development of a deep vein thrombosis DVT. The good news is that it is possible to anticipate who is at risk and institute risk reduction measures earlier in the course of care. In 2. 01. 0, approximately 3. The patients varied in age from infants to adults older than 1. In 2. 00. 7, procedures on the cardiovascular system were common, with 4 million procedures performed. Procedure rates varied by sex men were more likely to have a cardiovascular procedure, while women were more likely to have an operation on the digestive system 2. Approximately 2. 6 of all procedures performed on women were obstetrical in nature 2. Management of postoperative complications requires astute assessment throughout the operative cycle. Preoperative assessment is critical to ascertain which patients are at risk for complication development. Preoperative personnel should evaluate each patient for their medical history, medication use, physical limitations or disabilities, previous surgical andor anesthesia history, and psychosocial and emotional status. Operating room personnel should be vigilant for those factors that increase the risk for postoperative complications, including positioning of the patient, the temperature of the operating suite and equipment used, and the length of the surgical intervention. Certain measures can be instituted while the patient is under anesthesia to prevent complication development in the postoperative phase of care. The staff caring for the patient in the postoperative environment may have the greatest impact on preventing complication development. Awareness of complication development is the first step in risk reduction. Complications can occur at various periods in the recovery phase. Risk of developing hypotension, myocardial infarction, and respiratory depression is greatest in the first postoperative day.
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November 2017
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