--
Larry R. Glazerman, MD
Ob-Gyn at Trexlertown, PC
610-402-0161
l.glazerman@rcn.com
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod,
Darryl G MAJ 48 MDOS/SGOBO
Sent: Tuesday, January 31, 2006 3:01 AM
To: Multiple recipients of list OB-GYN-L
Subject: 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
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-----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).
