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CVPR 371 Techniques II > Shabel Paper on (10 common Perfusion Problems) Prevention and treatment protocols > Flashcards

Shabel Paper on (10 common Perfusion Problems) Prevention and treatment protocols Flashcards

1
Q

How many perfusion accidents occur during CPB procedures?

How many end up in death or injury?

A

1 out of 300

1 out of 1000

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2
Q

What percent of patients that undergo CPB will have at least transient neurological dysfunction ?

A

60 - 70%

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3
Q

What percentage of perfusionist do not use protocols ?

A

> 50%

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4
Q

What are the (2) number 1 causes of morbidity and mortality in bypass procedures?

A

Protamine Reaction

DIC

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5
Q

An important step in developing protocols is to be able to apply the 4 steps of probelm solving theory. What are the 4 steps of problem solving theory ?

A
  • Identification
  • Evaluation
  • Resolution
  • Reassessment
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6
Q

In what way can you approach identifying a particular perfusion problem ?

A
  • Case Presentations
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7
Q

After completing what 2 steps can you develop a protocol?

A

Identification

Evaluation

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8
Q

What are variances ?

A

Failure to meet the standards required for a procedure or a task.

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9
Q

Variances often occur when ?

A

Protocols are not used

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10
Q

Protocols should be used to prevent variances of all types ?

A

Uncertainties
Unexpected events
Failures
Human Error

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11
Q

Human error accounts for what percentage of variances ?

A

72%

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12
Q

The purpose of this paper is to discuss 10 of the most common perfusion perfusion problems and give an outline for ____ and ____ of these problems.

A

Prevention

Treatment

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13
Q

The purpose of this paper is to discuss 10 of the most common perfusion problems and give an
outline for what ?

A

Prevention and treatment

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14
Q

The lack of a disciplined method of openly attacking problems ?

A

Breeds more problems

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15
Q

Protocols are answers to what?

A

Problems

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16
Q

Emergency protocols should be?

A

short, to the point, and limited to 1 page.

17
Q

How should protocols be written?

A

In a form that is easy to read, implement and follow.

18
Q

To ensure everyone has read and understands the existing protocol, __________ should be performed on
a regular basis.

A

drills

19
Q

What are the stated 4 benefits of practice drills?

A
  • Educating the surgical team on new techniques and procedures.
  • Shortening reaction time in emergencies
  • Evaluating the existing protocol
  • Enhancing communication between different members of the surgical team.
20
Q

What should be utilized prior to bypass.

A

Checklist

21
Q

Designing and implementing protocols should not be considered merely a legal issue
but also a ?

A

Ethical

22
Q

What do the authors contend are the first and one of the more important steps in making quality perfusion possible?

A

Doing the right thing the first time

23
Q

What period of time the Mejak Survey cover?

A

2 yrs

96-98

24
Q

Between the 1980 Stony survey and the 1986 Kurusz survey the was an increase in the use of what
device?

A

ALF

81.1 % to 98.5%

25
Q

How many perfusionists did Kurusz find to be using arterial line filters in 1986?

A

81%

26
Q

In Stony and Kurusz, what were the perfusion accident rates that resulted in serious injury of death?

A

1 : 1000

27
Q

In the Jenkins study, what was the incident rate?

What was the rate of serious injury or death?

A

1 : 1288

28
Q

The Mejak Survey was divided into 4 sections, what were they ?

A
  • Perfusionist info
  • Hospital Information
  • Equipment Info
  • Perfusion incident
29
Q

In the Mejak survey, What is the most commonly used safety device?

A

Hand Crank 99.2%

30
Q

In the Mejak survey, How many respondents cite the use of one-way pressure relief valves in the vent line?

A

83%

31
Q

In the Mejak survey, The most common perfusion incidents were ?

This occured at a rate of ?

A

Coagulation disorders such as DIC

1 : 857

32
Q

In the Mejak survey, How was a protamine reaction defined?

A

1 : 871

Resulting in re-heparinizartion and restarting of CPB.

33
Q

In the Mejak survey,
How many oxygenator failures were reported?

Of these, how many required change-out?

A

273

144

34
Q

In the Mejak survey, How many medication errors were reported?

A

78

35
Q

How many incorrect blood units were reported?

Any serious injury?

Any deaths?

A

11

0

2

36
Q

Comparing this study with the 1986 Kurusz study, how have incident resulting in serious injury or death changed?

To what may we attribute this decline?

A

Decreased

Safety devices

37
Q

What was the overall incident rate of the Mejak study?

A

1 : 138 CPB procedures

38
Q

Because of the difficulty in predicting arterial related incidents in clinical practice, what do the authors
recommend perfusionist do?

A

Prepare a plan of action for yourself and the operating room in case this occurs.

CVPR 371 Techniques II (6 decks)

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