Freethought & Rationalism Archive

Dr Rick · 01-19-2003, 11:13 AM

Quote:

Originally posted by gilly54
An easy way to check for hardware or sponges in the patient is to do a quick fluoro or x-ray. These units are always at the ready in the OR. I would think that the cost of an x-ray will be a lot cheaper than a lawsuit. I'm surprised this quick check isn't routine.

The total cost of routine X-ray or fluoroscopy after every single one of the 29 million surgeries performed each year in the US would be well in excess of $2 billion per year plus indirect costs such as prolonged time in the OR and installation of additional fluroscopy equipment. The overall radiation exposure to patients from such a policy would be mininmal, but the exposure risks to the OR staff and doctors would be much higher.

The authors of the article I cited recommended consideration of post-op imaging in high risk cases such as emergency surgeries (in which the risk of a retained foreign body is increased 9 fold).

Rick

Dark Jedi · 01-19-2003, 08:18 PM

Quote:

Originally posted by Ernest Sparks
Performance of surgical procedures needs to be changed to add one more team member: a detail logger. This person has the responsibility of logging each action taken on an OR event logging computer. Date/time is automatically generated. Everyone must announce what they are doing while they do it. This is logged immediately, regardless of outcome. At closing time, the logger keys a read out request. Everything used on the patient during the procedure is listed (in inverse order), so the team can be sure nothing is left in the patient that should not be left in the patient. To cover the semi-chaos of emergency procedures, perhaps artificial intelligence software with a microphone system could be used for the logging.

Yes, we can have the designers of the Apple Newton write the software.

Dr. Bob: "Ok, the log says we used two elephants and a Ford transmission. Anyone account for those?"

gilly54 · 01-19-2003, 09:58 PM

The total cost of routine X-ray or fluoroscopy after every single one of the 29 million surgeries performed each year in the US would be well in excess of $2 billion per year plus indirect costs such as prolonged time in the OR and installation of additional fluroscopy equipment. The overall radiation exposure to patients from such a policy would be mininmal, but the exposure risks to the OR staff and doctors would be much higher.

I should have been more clear in my post. I didn't mean for x-rays to be taken after EVERY surgery, just the major ones where a lot of instrumentation and sponges were used and there is the increased chance of something being left behind. In laparoscopic surgical procedures, there would be no need, for example.

If sound radiation protection practices are employed , the amount of exposure should be well below the NCRP (National Council on Radiation Protection) limits. I've monitored the film badges for busy OR and radiology depts and the readings have always been way low. ( FYI: It's the cardiac cath doctors that have a heavy foot on the fluoro unit that get the most exposure).

Maybe a better solution IS to wave one of those metal detectors over the patient, as suggested in an earlier post. But that won't detect the gauze sponges left behind. The makers of those sponges (at least the ones we use) purposely weave a radio-opaque thread in them so that they can be seen on x-ray.

Ernest Sparks · 01-20-2003, 08:02 AM

Dark Jedi,

Quote:

Yes, we can have the designers of the Apple Newton write the software.

I am guessing that this is an "IN" joke. It goes over my head. But here from Wired News:

"Apple marketed the Newton poorly, and it was widely ridiculed; a memorable Doonesbury strip by Garry Trudeau effectively doomed the device."
"Apple finally killed the Newton in February 1998 after Steve Jobs returned to the company..."

I found nothing about the quality of the Newton's software, however.

Quote:

Dr. Bob: "Ok, the log says we used two elephants and a Ford transmission. Anyone account for those?"

Time for upgrade to version 6, I reckon.

Mad Kally · 01-22-2003, 10:25 AM

Maybe the nurses should do a better job of counting.

01-23-2003, 10:51 PM

Quote:

Originally posted by Ernest Sparks
Dark Jedi,

I am guessing that this is an "IN" joke. It goes over my head. But here from Wired News:

"Apple marketed the Newton poorly, and it was widely ridiculed; a memorable Doonesbury strip by Garry Trudeau effectively doomed the device."
"Apple finally killed the Newton in February 1998 after Steve Jobs returned to the company..."

I found nothing about the quality of the Newton's software, however.

Time for upgrade to version 6, I reckon.

My guess would be that he is referring to the quality of the handwriting recognition software.

If the logging device used AI to process speech recognition the same way, I can imagine there would be some funny entries.

It's interesting to note that even today the Newton has a cult-like following with some people.

Ernest Sparks · 01-24-2003, 04:58 PM

HeatherD,

Thanks! I get it!

Ernie

Jackalope · 01-25-2003, 03:42 AM

Yeah, some folks I know who worked at Apple when the Newton came out used to call that writing recognition software the "random poetry mode." Apple's voice recognition software is considerably better...probably because the guy that wrote the code core knows what he's doing. But it's mostly that machines have considerably more computing power than they did even 5 years ago. Hell, my old desktop machine was dumber than the various PDAs you can buy today. I think my iPod might be smarter than my old mac...

--Lee
[Who'll be even more freaked out by the thought of surgery after this thread...]

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01-19-2003, 09:58 PM	#23
gilly54 Senior Member Join Date: Jan 2002 Location: New Almaden, California Posts: 917	The total cost of routine X-ray or fluoroscopy after every single one of the 29 million surgeries performed each year in the US would be well in excess of $2 billion per year plus indirect costs such as prolonged time in the OR and installation of additional fluroscopy equipment. The overall radiation exposure to patients from such a policy would be mininmal, but the exposure risks to the OR staff and doctors would be much higher. I should have been more clear in my post. I didn't mean for x-rays to be taken after EVERY surgery, just the major ones where a lot of instrumentation and sponges were used and there is the increased chance of something being left behind. In laparoscopic surgical procedures, there would be no need, for example. If sound radiation protection practices are employed , the amount of exposure should be well below the NCRP (National Council on Radiation Protection) limits. I've monitored the film badges for busy OR and radiology depts and the readings have always been way low. ( FYI: It's the cardiac cath doctors that have a heavy foot on the fluoro unit that get the most exposure). Maybe a better solution IS to wave one of those metal detectors over the patient, as suggested in an earlier post. But that won't detect the gauze sponges left behind. The makers of those sponges (at least the ones we use) purposely weave a radio-opaque thread in them so that they can be seen on x-ray.

01-22-2003, 10:25 AM	#25
Mad Kally Banned Join Date: May 2001 Location: LALA Land in California Posts: 3,764	Maybe the nurses should do a better job of counting.

01-24-2003, 04:58 PM	#27
Ernest Sparks Veteran Member Join Date: Jun 2000 Location: Portland, OR USA Posts: 1,248	HeatherD, Thanks! I get it! Ernie

01-25-2003, 03:42 AM	#28
Jackalope Veteran Member Join Date: Oct 2002 Location: Hayward, CA, USA Posts: 1,675	Yeah, some folks I know who worked at Apple when the Newton came out used to call that writing recognition software the "random poetry mode." Apple's voice recognition software is considerably better...probably because the guy that wrote the code core knows what he's doing. But it's mostly that machines have considerably more computing power than they did even 5 years ago. Hell, my old desktop machine was dumber than the various PDAs you can buy today. I think my iPod might be smarter than my old mac... --Lee [Who'll be even more freaked out by the thought of surgery after this thread...]

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