Patient Safety News

August 2021

Magnets Deactivating Pyxis Machines

Magnets and electronics don’t play nice! ….Please keep this in mind when placing them onto something.

The standard place to store them is in the top drawer of the anesthesia machine.

Broadcast Anesthesia Help

• Used to obtain rapid help for intraoperative events – unanticipated difficult airway, sudden massive blood loss, etc.
• How to do it:
  • Press grey button on Vocera and say “Broadcast Anesthesia Help” (note it doesn’t say “call”)
    • Connects to everyone signed into the role.
    • Effectively turns devices into walkie talkies.
    • Initiator can talk freely.
    • Responders press and hold grey button to talk.
    • Initiator ends the conversation by pressing their grey button again.

M&M Process Being Reviewed and Updated

• Patrick Farmer, Michael Greenberg, and Laura Niday-Madison are working on standardizing how cases are selected, how presentations are prepared/delivered, and the roles of all involved.
• Christine McKenzie, Angela Robertson, and Sally Stander are working on establishing standard work for identifying action items, assigning them to people to complete, and ensuring feedback upon completion.
• More detail regarding the updated process will be sent out as soon as it is ready

When you finish your case, please press END CASE on the monitor, rather than MONITOR STANDBY.

This will reset the monitor to standard settings, including alarm limits, BP cycle frequency, etc.

Local Anesthetics with and without Epinephrine

• Local anesthetics are in short supply nationwide including bupivacaine, lidocaine, chloroprocaine, and mepivacaine.
• We have run out of the following products:
  • Bupivacaine 0.25% w/ epinephrine 1:200,000; 30 mL vial
  • Bupivacaine 0.5% w/ epinephrine 1:200,000; 30 mL vial
• Should OR’s need to combine epinephrine with plain bupivacaine/lidocaine, please feel free to call OR Pharmacy for Calculations Tip Sheet or assistance.

Plain bupivacaine

• Most worrisome supply, at the moment.
• Setting some stock aside for L&D cases.
• Discussing restrictions and other options, with more information to come.

Cisatracurium

• Reserve for patients with poor renal/liver function.
• Stock centralized in MAIN-OR Pyxis fridge for extended expiration dating.

Fat emulsion (Intralipid)

• May begin stocking alternative sized bags (e.g. 250 mL, 1000 mL) if 100 mL supply worsens.
• Could see interchangeable Nutralipid formulation as well.

Bacitracin ophthalmic ointment

• Sole manufacturer has temporarily discontinued.
• If product remains unavailable, consider alternate therapies:
  • Bacitracin/polymyxin B eye ointment
  • Erythromycin eye ointment

Lidocaine 2%, 5mL SYRINGES

• Nephron reports production and distribution delays.
• May see substitution with lidocaine 2%, 5 mL VIALS if supply worsens.

Drug Shortage information can also be found on the PSQI SharePoint site (available only when connected to the hospital’s secure network/wifi).