Take a Smooth, Close Look at Neurosurgery
Leica's new microscope for neurosurgical procedures provides new level of ergonomics and maneuverability.

If you're considering hosting neurosurgical cases, you'll need a surgical microscope that gives your surgeons a clear picture and is easy to move. The M525 OH4 from Leica Microsystems offers these features and more. Its superior image quality offers a constant, clear, sharply focused image through the entire system, says the company. It offers more overhead space than any instrument on the market and the longest reach to give more room for the OR team to maneuver, says Leica. Its movement is precise yet harmoniously smooth, keeping it vibration-free at all magnification levels. Here are a few of the M525 OH4's illumination features:

• Constant illumination. A 300W xenon arc lamp illumination system features two independent illumination systems. The backup system automatically and immediately switches on in the event of the first lamp system's failure.
• Light intensity within safe levels. A working-distance-controlled light intensity ensures that the light intensity does not surpass safe levels, especially in short working distances.
• Safety for the patient. The magnification-controlled illumination diameter provides a field of illumination that is just as wide as the field of view.

Leica declined to disclose a price. For more information, go to www.leica-microsystems.com, call (800) 248-0123 or circle number 167 on your Reader Service Card.

New Pads Reduce Risk of Dental Damage During Intubation
Every anesthesia provider can remember flinching at the sound of metal cracking against teeth as he watched interns intubate patients. Administrators also flinch when they see the costs of a claim for dental damage caused during this procedure. But now there is a device that can alleviate this uneasy sensation for everyone, including patients who are worried about their smiles.

Salmon Medical Innovations introduced the Dentasafe intubating dental guard at the 2006 annual meeting of the American Society of Anesthesiologists. These pads are designed to fit onto the steel laryngoscope blade so the instrument won't chip the patient's tooth enamel. Unlike block guards, Dentasafe stays in place and doesn't obstruct the anesthesiologist's view of the patient's airway, says the company.

A pack of two Dentasafe strips costs $2.99. For more information, go to www.salmonmedical.com, call (866) 268-3376, e-mail [email protected] or circle 168 on your Reader Service Card.

Who's Going Where? The Answer Could Be in Your Palm
You can't be everywhere at once, but now there's a way to see where everyone else is in your facility at any given moment. Larger practices and hospitals that want to get something more advanced than radios and paper notes to control patient flow may want to look at TransQuest, which manufacturer MDA Technologies describes as a real-time wireless patient transport system. With this system, everyone involved in moving patients can find any given person by glancing at a PDA's screen.

The system works by having all of the PDAs interconnected via an intranet. When a transporter accepts a dispatch and completes the task, he notes it on his PDA and all the other PDAs are instantly updated. Everyone knows where the patients are, where they're going and who's ready to receive them, so nobody has to go searching through the facility. Best of all, no one has to remember the last note they read or worry about mishearing a radio announcement. The hospitals that used this system in pilot studies reported increased efficiency, reduced costs, improved employee satisfaction and better patient experiences, says the company.

The price for a TransQuest network depends on the size of the center. For more information, visit www.mdatransquest.com, e-mail [email protected], call (703) 730-9444 or circle number 169 on your Reader Service Card.

Medigenic Keyboard Keeps Medical Computer Work Clean and Accurate
Healthcare workers constantly have to wash their hands, especially if they have to type in some data between seeing patients or use a computer in the OR. Advanced Medical Systems has found a solution to the problem by creating an infection control keyboard with a mouse that monitors its own cleaning status. Not only is it clean, it also has excellent tactile key response so you don't miss a keystroke, says the company.

The keyboard was designed for clinical settings. It has a flat surface so it's easy to wipe clean with hospital-grade disinfectants and features an indicator that will flash at defined intervals and turns off when the keyboard is cleaned to monitor and promote infection control practices. The keys are backlit so it can be used in a low-light environment without compromising data entry.

Keyboards range from $250 to $300. For more information, go to www.advanced-input.com/medigenic, e-mail [email protected], call (800) 444-5923 or circle 170 on your Reader Service Card.

SabreSource Targeting System Gets You Right to the Point
Accuracy is extremely important when you're trying to find something as small as a nerve or administer an epidural. Those who want to take advantage of fluroscopically guided technology without buying a whole separate surgical suite for it may want to consider Minrad's SabreSource Targeting System. This portable device easily attaches to a C-arm fluoroscope, and is easily removed. Its targeting system puts a crosshair on the image and can be easily positioned to find the right subsurface structure to give the surgeon a needle's eye view of the area. When used with Light Sabre Instruments, the system aligns with the instruments' tube lights to glow when the device is directly above the correct site.

The product's manufacturer prides itself in calculating the SabreSource's accuracy to plus or minus one millimeter at one meter from the x-ray source. The Light Sabre Instruments are reported to be accurate to plus or minus three millimeters to a depth of up to 100mm.

A full SabreSource platform with battery charger costs just less than $20,000. For more information, go to www.minrad.com, call (800) 832-3303, e-mail [email protected] or circle number 171 on your Reader Service Card.

Diamond Knife Gives You More Control Over Your Cuts
The 1.4mm-wide diamond blade on the E0118 Brown Tri-facet Diamond Knife from Storz has a unique universal tri-facet shape. It provides excellent control when used in sweeping motions during scleral tunneling, says the company. The two sharp sides ensure straight tunnel incisions for lens implantation, side port and groove and wound extension.

The cost is $2,153. For more information, go to www.storz.com, call (800) 338-2020 or circle number 172 on your Reader Service Card.

Warm Patients for the Price of Powering a Light Bulb
A new patient warming system from Inditherm Medical promises to be gentler to your electric bill. The device's design makes keeping it warm as inexpensive as powering a light bulb, so it can be turned on at 7 a.m. and turned off at closing time without being too expensive, says the company. This way, every patient can be automatically warmed as soon as they're put on the operating table. Systems are available in a full range of sizes, ranging from pediatric to full-size adult, to suit any operating table. The accompanying mattresses and blankets are durable and reusable. The control unit is compact and silent while running.

Inditherm declined to disclose the price. For more information, go to www.inditherm.com/medical, call 44 (0)1709 761000, e-mail [email protected] or circle number 173 on your Reader Service Card.

What's In Your Turnover Kits?
A well-stocked kit can cut your clean-up time and keep the schedule humming.

You can call them turnover kits, environmental cleaning kits or infection control kits. Whatever name you give them, you need one of them for two things: to sanitize the OR between procedures and to get the room ready for the next patient. A well-stocked kit should contain everything you need to eliminate potentially infectious microorganisms while making the suite look clinically clean. Exactly what they contain is often up to you.

There are so many choices on the market (some of which we highlight on these pages) because your facility's needs may differ from the center's across town. Much of it depends on surgical specialties: For example, a kit designed for ENT may not have enough wipes and disposal bags to handle orthopedic surgery.

Room for everyone's input
The surgical administrator's charge is to always consider her customers when making a purchase. In this situation, your customers include your patients, your OR staff and your physicians. You're going to have to pick turnover kits that protect patients and also make potentially hazardous waste materials easy for staff to dispose of. Always consider the request of the staff using the product.

According to the current guidelines from AORN, OSHA and the Joint Commission, here are the very basics that should be in your kit:

• impervious disposable patient sheet,
• disposable lift sheet,
• disposable arm board sheets with straps,
• disposable mop head,
• linen disposal bag,
• clear trash bag for clean waste,
• red biohazard bag,
• clear bag for anesthesia waste,
• kick bucket liner and
• lint-free wipes.

The disposable linens must be impervious to protect both the patient and the OR bed by keeping pathogens from transferring in either direction. The disposable lift sheets easily replace and serve the same purpose as traditional linen sheets without requiring the staff to launder, fold, package and handle them.

The disposable mop head is very important. Before mop heads were put into common use in OR suites, mops weren't always changed as frequently as standards dictate. This created a breeding ground for pathogens. The disposable heads should be easy to use, efficient, durable for a variety of cases and inexpensive. Traditional requirements hold that the floors are mopped in a three-to-five foot perimeter around the OR table, under the table, in traffic areas and wherever visible soil is present.

Whether they use draw tapes or strings, the trash and linen bags must be self-sealing and easily secured to allow for fast and safe handling. Since some facilities require the bags to be marked for case identification, the material should be durable and easy to write on. As an incentive, companies that offer pre-made turnover kits usually provide the hampers for the included disposal bags.

Saving time or money?
Pricing is also an important factor to consider, and when you're looking at pre-assembled products you have to consider the actual cost of the kit. This means looking beyond the dollars and cents at how easy the materials are to use, how specific they are for your needs and how staff-friendly they are in the OR.

When looking for a kit, you may want to ask yourself the following questions:

• Will it meet the cleaning and turnover needs of my staff?
• Is it compliant with AORN, OSHA and Joint Commission infection control standards?
• Will it provide a safe patient and staff environment?
• Will it decrease the amount of linen products we use?
• Does it provide high-quality, durable, disposable bags?
• Will it save enough in time and supplies to pay for itself?
• Will it give us more OR time by decreasing turnover?
• Does the company offer free hampers or other incentives?

You can make your own
Despite the plethora of turnover kits out there, you may decide the best option is not to buy a kit but rather to make your own. It may take more time to assemble the products at the front-end, but for a smaller or more specialized facility the extra freedom of ordering the products on your own can help you create the best kit for your staff. OSM

Reference:
Neil JA, Nye PF and Toven LA. "Environmental surveillance in the operating room." AORN Journal 82:1 (July 2005): 43-50.

Cardinal Health
Presource Operating Room and Birthing Room Clean-up Packs
(800) 964-5227
www.cardinal.com
Price: Not disclosed
FYI: Presource clean-up packs make it easy to standardize all the supplies you need for procedure clean-up making OR turnover faster, according to the company. Each kit includes products to help eliminate fluid contact with the table pad and arm boards as well as the handling of potentially hazardous materials. As an added benefit, these products also have non-linting properties.

CareLine Inc.
OR Clean-up Kits
(800) 251-1157
www.carelineinc.com
Price: Varies by distributor
FYI: These kits provide all the components necessary for room turnover for less than the price of collecting the individual components, according to the company. Each piece is individually wrapped to reduce the risk of cross-contamination. You can ask to have more or fewer components in your kits depending on your needs.

Medline, Inc.
QuickSuite Clean-Up Kit
(800) 633-5463
www.medline.com
Price: $81 retail (less based on quantity)
FYI: Everything you need to clean up an OR is in the self-contained QuickSuite Clean-up Kit. According to the company, each kit comes with a table sheet, a draw/lift sheet, armboard covers, a head positioner cover, two washcloths and a lint-free mop head as well as four drawtape bags in three colors (clear, red and blue) and four kickbuckets (two red, two clear) for easy disposal.

Microtek Medical, Inc.
Mojave Linens
(800) 274-1863
www.cleanop.com
Price: Varies by distributor
FYI: Mojave linens are made from super absorbent polymers woven into a high-performance fabric designed to wick moisture away from patients' skin, says the company. This helps prevent cross contamination from fluid runoff, which can reduce room turnover time and reduce the risk of exposure for the staff. These are included in all of the company's room turnover kits, which can include many other components of your choosing.

SRI Surgical
Operating Room Turnover Kits
(813) 891-9550
www.srisurgical.com
Price: Varies by chosen components
FYI: SRI Surgical lets you design your own turnover kit by choosing what goes into it. According to the company, each component provides effective infection control, and its table sheets, armboard covers and headrest covers are designed to prevent damage to bedding or positioners.