Billie Fernsebner

Patients at risk for nosocomial infections

The perioperative nurse plans interventions that will supplement the patients body defense mechanisms against infection. While not all risks can be eliminated, they can be reduced.

Antimicrobial therapy for surgical patients

The operating room nurse plays a critical role in the administration of antimicrobial therapy for prophylaxis and for treatment. When aminoglycosides are given, the fine line between a therapeutic and toxic dose presents an additional challenge. Timing is equally critical in administering a prophylactic dose of a cephalosporin; too early and it will be ineffective and too late, it may necessitate a full course of treatment rather than the one dose. Armed with the proper knowledge and skills, the operating room nurse will be able to provide the safe competent care that patients receiving antimicrobials should expect.

A protocol for malignant hyperthermia

Malignant hyperthermia (MH) syndrome is a frightening emergency both for patient and staff. The mortality rate of 53% to 60% is unchanged in recent years despite aggressive therapy and the introduction of dantrolene sodium as a pharmaceutical treatment.’ Early cessation of anesthesia and treatment according to protocol appear to improve patients’ chances for recovery. Establishing a written protocol should be the first step in treating MH at any hospital. Despite the rarity of MH, two patients at Mount Auburn Hospital, Cambridge, Mass, developed the syndrome in a nine-month period. The patients re-