Health Scan: Pre-op briefings can prevent accidents

Surgical staffers in many medical centers still don't make such preparations before the 1st incision.

By JUDY SIEGEL-ITZKOVICH
A preoperative briefing in the operating room is one of the best ways to prevent medical errors. It would seem obvious, but surgical staffers in many medical centers around the world still do not make such preparations before the first incision. Now doctors and nurses at the Hadassah University Medical Center and industrial engineers at the Technion-Israel Institute of Technology have published a controlled study that proves investing time in such a briefing prevents most “nonroutine events” (situations that, if not corrected, might lead to patient harm).
Writing in the latest issue of Chest, Prof. Yoel Donchin of the Jerusalem medical center’s department of anesthesiology and critical care medicine and colleagues write that about half of all adverse events in hospitals are associated with surgical procedures.
“Surgical complications and adverse outcomes have been linked to lack of communication and coordination among surgical teams,” the article says. “Communication breakdowns may lead to conditions in which team members are uninformed or misinformed.”
The oral briefing relevant to each patient is based on a large, colorful poster hung in very visible place in the surgical theater. While the patient is awake, the surgeons, anesthesiologist, nurses and others rehearse what will be done, noting which organ and side the surgery involves, the surgical approach, patient information such as blood type, drug sensitivities and other details.
They compared the number of nonroutine events in 130 orthopedics and gynecology operations conducted without briefings (but in which the surgeons and anesthesiologists were familiar with each medical file and patient) and 102 operations of the same types in which the briefings were conducted. The results clearly showed that the short briefings significantly improve patient safety.
The authors wrote that the surgical teams did not regard the briefing as a burden, but rather that it gave hospital management “highly positive feedback and testimonies of prevented accidents.” The Hadassah Medical Center is “now preparing to implement the briefings in all operating rooms in the hospital.”
MAGNESIUM FOR MEMORY Researchers at the Massachusetts Institute of Technology – including an Israeli on sabbatical from her work at Tel Aviv University’s Sackler Faculty of Medicine – and Tsinghua University in Beijing show that boosting brain magnesium with a new compound enhances learning abilities, working memory, and short-and long-term memory in rats. The dietary supplement also boosted older rats’ ability to perform a variety of learning tests, they said. Dr. Inna Slutsky of the medical school’s physiology and pharmacology department did much of her work on the discovery when at MIT.
Magnesium, an essential element, is found in dark, leafy vegetables such as spinach and in some fruits. Those who get less than 400 milligrams daily are at risk for allergies, asthma and heart disease, among other conditions. In 2004, Guosong Liu and colleagues at MIT discovered that magnesium might also have a positive influence on learning and memory. They followed up by developing a new magnesium compound – magnesium-Lthreonate (MgT) – that is more effective than conventional oral supplements at boosting magnesium in the brain, and tested it on rats.
The team, who have just published their findings in the prestigious journal Neuron, found that elevating brain magnesium led to significant enhancement of spatial and associative memory in both young and aged rats. They believe that if found safe and effective in humans, the compound could have a significant impact on public health.
Half the people in industrialized countries have a magnesium deficit, which increases with aging. If normal or even higher levels of magnesium can be maintained, it may be possible to significantly slow age-related loss of cognitive function, and perhaps prevent or treat diseases that affect cognitive function, the team suggested.
As the study not only highlighted the importance of sufficient daily magnesium but also suggests the usefulness of magnesium-based treatments for agingassociated memory decline, clinical studies in Beijing are now investigating the relationship between body magnesium and cognitive functions in older humans and Alzheimer’s patients.
NEVER TOO LATE TO DONATE One is almost never too old to donate organs. A liver donated by the family of a 75-year-old woman has saved the life of a 30-year-old man in critical condition. A few weeks ago, after the elderly woman, Lisa Lubovsky, died at Emek Medical Center in Afula from a brain hemorrhage, her family – including her only son Baruch – agreed to donate any organs that were suitable for transplant.
Arteum Saleyeb, who suffered from severe liver failure and was in critical condition at Hadassah University Medical Center in Jerusalem, was chosen to receive the organ. His mother Marina said she feared she was about to lose her son. “We want to say ‘Thank you!’ to the family that gave our son a new chance to live. We would be happy to meet them. They have saved the life of a young man who is just starting out and almost died.”
The liver arrived from Afula at the last possible minute, said Israel Transplant spokeswoman Dvora Sherer, which noted that his organization is often asked until what age one can donate organs. “Here is our answer --organs can be donated at any age. When organs become available, the doctors and others in the transplant team examine them and decide whether they can be used.”
TASTY GOOD FOR YOU Eating chocolate may lower your risk of stroke, according to an analysis to be presented at the American Academy of Neurology’s 62nd Annual Meeting in Toronto. The meta-analysis reviewed three studies on chocolate and stroke. “More research is needed to determine whether chocolate truly lowers stroke risk, or whether healthier people are simply more likely to eat chocolate than others,” said study author Sarah Sahib from McMaster University in Ontario, Canada. Chocolate, especially the dark, non-dairy type, is rich in antioxidants called , which may have a protective effect against stroke. However, more research is needed.
The first study found that 44,489 people who ate one serving ofchocolate per week were 22 percent less likely to have a stroke thanpeople who ate no chocolate. The second study found that 1,169 peoplewho ate 50 grams of chocolate once a week were 46% less likely to diefollowing a stroke than people who did not eat chocolate. Theresearchers found only one additional relevant study in their search.That study found no link between eating chocolate and risk of stroke ordeath.