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Re: Gyn H/S Fluid Management From: Elrod, Darryl G MAJ 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL) Tue Jan 31 01:00:22 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Larry Glazerman: "Re: Gyn H/S Fluid Management" Previous message: Harrison Sheld: "Preeclampsia Solved" Maybe in reply to: Joanne Bulley, MD: "Gyn H/S Fluid Management" Next in thread: Larry Glazerman: "Re: Gyn H/S Fluid Management" Reply: Larry Glazerman: "Re: Gyn H/S Fluid Management" Joanne, I remember being asked at my oral boards at what level of discrepancy would I stop a case. Obviously 9 liters is a no brainer, but what is your usual breaking point? (I think I finally settled on 2 liters as my final answer) Glen //SIGNED// D. Glen Elrod, Maj., USAF, MC Obstetrician/Gynecologist Chief of Obstetrics 48 MDOS/SGOBO RAF Lakenheath, England Telephone DSN: 314-226-8130 Comm: +44 (0) 1638 52 8130 Notice of Confidentiality Under the Privacy Act of 1974, you must safeguard all information reflected on this e-mail and, if applicable, all attachments. Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI 37-132, AFI 33-219, and PL 93-579" This e-mail message including any attachments is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. Any questions pertaining to disclosure should be directed to the privacy officer. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joanne Bulley, MD Sent: Tuesday, January 31, 2006 4:17 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Gyn H/S Fluid Management I would definitely use the eyeball method for the short diagnostic 'scopes - but I really want this for the operative H/S. I had a patient see me with records (OR and office) from elsewhere ... there had been a fluid deficit of 9L (yes that is 9 liters) before someone said "stop" ... That was before filing a case and that one settled out of court ... She is pretty much back to her pre - surgical status according to both her and her husband. Sodium was down about 109 when she was in the PACU and then trasferred to the ICU. The OR knows that I am really really testy when the "fluid management RN" is not giving me moment by moment numbers. I just stop the procedure and get the person back on the ball. I refuse to run the fluid without the person doing his / her job! Joanne At Mon, 30 Jan 2006, Garry E. Siegel, M.D. wrote: > >I think that ours is Wolf and a bit older and cumbersome for the staff, >but it does the job. > >Agree that you must use this for glycine. > >For simple diagnostic scopes with LR, we frequently start with a bag >under pressure and the eyeball system (no opening of expensive tubing, >etc.) and then convert if it will be a longer procedure. > >Garry > >At Mon, 30 Jan 2006, Joanne Bulley, MD wrote: >> >>Thanks Myer and Larry. It was my understanding that we are really an >>outlier at this point and must change .... good to have someone else >>say it for me to take back to the OR! >> >>Joanne >> >>At Mon, 30 Jan 2006, Myer S. Bornstein wrote: >>> >>>I have been using the Gynecare system since it was FemRx and it has kept me >>>out of fluid trouble. I had seen a 3 liter change in 15 minutes with the >>>eyeball system. Tell your hospital a fluid collection system is the >>>standard of care and if a patient develops hyponatremia with the way they >>>are doing it now there is BIG liability >>>Myer >>> >>>-- > -- Joanne Bulley, MD Keene, NH, USA "Love is indescribable and unconditional. I could tell you a thousand things that it is not, but not one that it is." - Duke Ellington, American jazz artist (1899-1974). Next message: Larry Glazerman: "Re: Gyn H/S Fluid Management" Previous message: Harrison Sheld: "Preeclampsia Solved" Maybe in reply to: Joanne Bulley, MD: "Gyn H/S Fluid Management" Next in thread: Larry Glazerman: "Re: Gyn H/S Fluid Management" Reply: Larry Glazerman: "Re: Gyn H/S Fluid Management"

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