3. Accreditation Manual for Hospitals 7982(Chi- cago: Joint Commission on Accreditation of Hospi- tals, 1982) 76.

4. "Recommended practices for documentation of perioperative nursing care," AORN Standards and Recommended Practices for Perioperative Nursing (Denver: Association of Operating Room Nurses, 1982) Part 111, section 3, 1.

Suggested readings Alexander, J P. "Reflex disturbance of cardiac

rhythm during ophthalmic surgery." British Jour- nal of Ophthalmology59 (September 1975) 518- 524.

Baida. M R. "Nursing care in use of local anesthe- sia." AORN Journal 28 (November 1978) 855- 858.

Barkin, M; Middleton. R. "ECG monitoring of oral surgery patients receiving a local anesthetic." Journal of Oral Surgery36 (October 1978) 779- 780.

Castillo, P. "Care of the patient under local anes-

thesia." AORNJournall8 (August 1973) 283-285. Dahle, J. "Caring for the patient with local anesthe-

sia." AORN Journal 27 (April 1978) 985-990. Lilley, J; Russell, C; Walter, R 0; Waterhouse, J A.

"Use and misuse of equipment for dental local anesthesia." Journal of Dental Surgery 6 (June

McCall, M. "Monitoring patients in the operating room." AORN Journal 13 (June 1971) 65-68.

Natof, H. "Complications associated with ambula- tory surgery." Journal of the American Medicel Association 244 (Sept 5. 1980) 11 16-1 118.

Regan, W A. "OR nursing law." AORN Journal 2:s (May 1977) 1184-1186.

Robertson, P. "Respiratory care in local anesthe- sia." AORN Journal 21 (April 1975) 797-805.

Thiery, M. "lntracervical block with needle and syr- inge." (Letter) American Journal of Obstetrics 4 Gynecology 132 (Nov 15, 1978) 705.

Young, T. "A throat spray." (Letter) Anesthesia 33 (September 1978) 759-760.

1978) 133-146.

Audiovisual review: Defibrillators This slide/sound program written by Alan Fleeter for Medi-films uses graphics and cartoon stills to present an overview of defibrillation. It is designed to assist instructors of life-support techniques.

The audiovisual portion provides a simple explanation of the pacing system of the heart, the steps taken to prepare the defibrillator for use, and the common errors that can make defibrillation ineffective or hazardous.

The excellent instructional guide that accompanies the slide/sound program contains notes that explain the how and why of defibrillation to assist instructors in preparing a program. A pretest, posttest, and references are also provided.

a review for those already schooled in defibrillation, providing a basis for discussion. The target audience is health care personnel who may have to operate a defibrillator in an emergency.

U-matic videocassette as well as slide/cassette (41 slides and one audiocassette). It can be purchased from

The slidelsound portion can be used as

This program is available on 3/4 in

Medi-films, 5632 E Third St, Tucson, Ariz 8571 1. The videocassette costs $1 60, and the slide/cassette costs $1 25. Both come with an unconditional 30-day money back guarantee.

Patricia Ball, RN, CNOlR Audiovisual Committee

Dilution reverses stroke symptoms A dilution technique improved the status of patients experiencing early symptoms of stroke, such as partial paralysis or loss of speech, in a preliminary clinical study. A neurosurgeon at Emory University Clinic, Atlanta, successfully reversed the symptoms in eight of nine patients by administrating simple agents to dilute the blood.

The technique allows better blood flow in the collateral blood vessels. The rate of improvement was better than expected, but until another study is done with a control group, no conclusions can be made. The study was published in the Journal of the American Medical Association.

712 AORN Journal, March 1983, Vol37, No 4

Infection risks identified for hysterectomy pa tien ts Why is infection so common after hysterec- tomies? A new study by Mervyn Shapiro and his colleagues in Boston has identified factors associated with a higher risk. The report was published in the New England Journal of Medicine. The risk factors for infection at the operative site were:

increased duration of the operation 0 lack of prophylactic antibiotic 0 being a younger patient 0 being a clinic patient instead of a

0 having an abdominal operation rather private patient

than a vaginal one. A particularly interesting finding was that the protective effect of the antibiotic diminished rapidly with the length of the surgery. Antibiotics had a statistically significant effect in preventing infection for 1 -hour procedures. But by the time operations had extended to 3 hours and 20 minutes, the protective effect was gone. The protective effect did not seem to have any relationship to how long the drug had been given before surgery began.

The authors comment that they do not believe the passage of time in itself leads to increased infection risk. Rather, they think other factors that tend to be associated with a lengthy operation are to blame. Examples might be the general difficulty of the procedure and a surgeon’s dexterity.

In an accompanying editorial, Ronald Lee Nichols, MD, comments that the study adds to what is already known about the value of prophylactic antibiotics. Previous researchers have learned that the drugs are most effective for clean-contaminated procedures. In using these agents properly, physicians must also consider the type of microorganism usually causing infection, the administration route, the proper dose, and the time for administration.

Discussing other risk factors, the researchers thought that younger age might be associated with previous findings about menopausal status. Earlier studies have established that premenopausal women have a higher infection risk than postmenopausal patients.

B m O N C O M P A N Y P O BOX 1851 * MERIDIAN. MS 39302 - 6011693 6344

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