Cerebral Desaturation Events in Beach Chair Position: Optimizing the Quality of Care

Date
2018
Authors
mzumara, Ettinas T.
Ware, Sheneka
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Abstract
Positioning is one of many responsibilities required of anesthesia providers. A standard position utilized in surgery is called the beach chair position (BCP), an upright position. Sitting upright has many benefits such as the ability to provide the surgeon with an optimal view of the operative site; however, it has been associated with neurological complications and has been growing out of favor. The downfall of this position is with using conventional monitoring devices. The vital signs portrayed on standard monitors may not reflect actual oxygen saturation in the brain. This may lead to cerebral ischemia and neurological deficiencies. A reliable source of monitoring cerebral oxygenation is a necessity when performing anesthesia on patients at high risk for cerebral desaturation, such as with BCP. An extensive literature review was completed on fourteen articles. Research asserted positive outcomes when using cerebral oximetry in patients having surgery in BCP, among many other methods to optimize care for this patient population. The investigators aimed to explore possible monitoring solutions to provide a more reliable way of detecting and treating cerebral desaturation during surgeries in the BCP. Furthermore, the goal was to increase the knowledge base for the student registered nurse anesthetists (SRNAs) in the Nurse Anesthesia Program (NAP) at the Adventist University of Health Sciences (ADU) regarding physiological effects caused by BCP. To evaluate the response, a 30-minute evidence-based PowerPoint presentation was given to these students. Results from pre- and post-testing was analyzed utilizing a paired t-test procedure and revealed a significant increase in the students’ knowledge base following the presentation. It was concluded that the PowerPoint presentation was effective in increasing this knowledge base, which can lead to safer clinical conditions by increasing caregiver competence.
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