--
Myer S. Bornstein, MD, MMM, FACOG, FACPE
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Larry
Glazerman
Sent: Tuesday, January 31, 2006 7:06 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Gyn H/S Fluid Management
With non-ionic media (glycine, sorbitol), I'd start to be concerned at
around 500 ml, and probably stop at a liter.
Twice that with saline.
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
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).
