Eras protocol ppt


13 7. Chu MD Division of Gastrointestinal Surgery Colorectal Protocol with ERAS Elements. The model, similar to ERAS protocols, is designed to reduce costs and improve patient satisfaction by lowering length of stay and complication rates. +  8 Sep 2015 Open in figure viewerPowerPoint . 2. to meet the other stated ERAS recommendations of early oral intake, ambulation, and timely discharge. Epidurals are great but are also a huge hassle to manage and come with rare but serious complications. Enhanced recovery after surgery (ERAS) protocols are a combination of multimodal evidence-based strategies, applied to the conventional perioperative techniques, to reduce postoperative The ERAS principles represent an evidence-based approach to surgical management that challenges traditional surgical management paradigms. DWS software support, resources for you and your students, important dates and your timeline, as well as ERAS news and announcements. A Sample Enhanced Recovery After Surgery (ERAS) Protocol. The key to the success of an ERAS program involves preoperative, Current ERAS Pathways If your surgery has an Enhanced Recovery pathway, you will find it below! If there are educational materials for your specific surgery, you will find them in the list below. The information has ERAS team (anesthesiologist, surgeon and nurse) including events and expectations during the perioperative period. April 2018Volume 155, Issue 4, Pages 1843–1852. Stockholm, Sweden. 1. 3 *(height in inches - 60) + 45. But ERAS protocols incorporate several components in various combinations, many of them unrelated to nutrition, such as rapid mobilization following surgery, no nasogastric tube, early removal of catheters, and the use of warm IV fluids, making it difficult to specifically identify nutritional support as the deciding factor in a patient's ease Enhanced Interior Gateway Routing Protocol (EIGRP) is an interior gateway protocol suited for many different topologies and media. In a well designed network, EIGRP scales well and provides extremely quick convergence times with minimal network traffic. Remzi FH. ERAS for Programs . Last month, the ERAS cardiac treatment protocol was published in the Journal of the American Medical Association, and the treatment plan has gone viral. 11. Also in gastrectomy1 , AAA repair2 , gynecologic, hepatocopancreatic3, laryngectomy, urology. Duddlesten Professor of Cancer Research Laparoscopic colorectal surgery, ERAS protocol Thoracic epidural vs. These handouts from the ERAS Society provide the physician and patient with valuable information for both pre- and post-operative care. #####. Fluid therapy is important. It is based on the evidence available for each element of ENHANCED RECOVERY AFTER SURGERY (ERAS ®; ERAS ® Society, Stockholm, Sweden) is a global effort to deliver standardized perioperative care resulting in reduced complications, improved patient experience, and efficient use of health care resources. Methods 2. During early implementation of the ERAS pathway, patients received just over 150 morphine equivalent dosing through post-op day 3. Abstract. Wrong Site Surgery Resources. 80 (0. al. After Surgery (ERAS) • Originated in Europe. By June of this year, zero ERAS patients received PCA pumps to manage their post-op pain. El protocolo ERAS (Enhanced Recovery After Surgery, por sus siglas en inglés: . Chapter 1 peri‐operative. UCSF Colorectal Enhanced Recovery Pathway Updated May 2017 SURGERY NURSING PATIENT Enter surgery & pre-op orders Enroll in MyChart, Visit ERAS website for information. Whenever possible, rounds occur in the patient’s room with the patient participating. Enroll in MyChart, Visit ERAS website for information, Patient Education, EMMI videos Prehabiliation: Follow Exercise program, Stoma marking and teaching Clears liquids 7am and bowel prep noon on day before surgery Most patients get Oral and Mechanical Bowel preparation Gabapentin 600mg once Acetaminophen 1000mg once Apply Warming Blanket to ERAS UK aims to improve patient recovery after surgery by promoting knowledge, understanding and research regarding optimal outcomes. REINFORCE recovery expectations with patient (pain, diet, ambulation, DVT prophylaxis) 5. ADMINISTER and DOCUMENT multimodal drugs a. ERAS - Colorectal Learning Session Documents & Resources. The ERAS care path-ways reduce surgical stress, maintain postoperative physiological function, and enhance mobilisation after surgery. Developed ERAS documents: Standardized order sets. Some common barriers are listed below. Anesthesia administrators and non-physician advisors may not have encountered the ERAS concept yet. This unified protocol Although interventions within enhanced recovery after surgery (ERAS) or fast-track programs have been shown to improve postoperative recovery in colorectal surgery, 1-4 universal implementation has not yet occurred. TOTAL JOINT REPLACEMENT • Over 700,000 TKA and THA procedures annually in the US • Demand expected to quadruple by 2030 GOALS OF A CLINICAL PATHWAY Pain Morbidity Cost Length of Stay Falls Blood transfusion Use of Resources Surgical Site ERAS protocol after shoulder arthroplasty features multidisciplinary collaboration among different perioperative services and multimodal analgesia with a focus on regional anesthesia. intended to be a fixed protocol, as some patients may require more or less treatment or different means of diagnosis. Presented at the Southern Surgical Association 126th Annual Meeting, Palm Beach, FL, November 30–December 3, 2014. Lobo. vi A Review of the National Orthopaedic Enhanced Recovery after Surgery (ERAS) Quality Improvement Collaborative: November 2013–March 2015 As demands on our health system grow we need to build efficient systems that maximise efficiency and use resources wisely while providing the highest standard of care and safety for our patients. 0 Henrik Kehlet, MD, PhD, 1997. In many ways, the ERAS guidelines upend the traditional way of preparing and caring for surgical patients. •Many features of ERAS protocols are not instantly intuitive and, therefore, pose natural barriers •Current colorectal practice differs greatly from the current available evidence •Adherence rate to ERAS protocols has been shown to be low in the postoperative phase with less than half of patients completing some aspect of postoperative The term “Enhanced Recovery After Surgery” and the acronym ERAS are familiar to most anesthesiologists and to other clinicians. Anuja Vaidya similar to ERAS protocols, is designed to reduce costs and improve patient satisfaction by lowering length of stay and As a key component of ERAS, nutritional management is an inter-professional challenge. ERAS for Medical Schools. 6 Another is that the ERAS concept as such possibly appears elusive because the relative Enhanced Recovery After Surgery (ERAS) is a multidisciplinary, multi-modal approach to perioperative care. Per Patient Std dev# Discharges The goals of the ERAS protocol include improving patient outcomes, decreasing costs, and reducing length of stay (LOS). ERAS pathways appear to reduce LOS and complication rates after major colorectal surgery without compromising patient. For more information, see Chapter 6: The Role of the Anesthesiologist in Reducing Surgical Stress and Improving Recovery in The SAGES / ERAS® Society Manual of Standardization of Care: Impact of an Enhanced Recovery Protocol on Length of Stay, Complications, and Direct Costs after Colorectal Surgery. diabetes management guidelines australian diabetes society july 2012 1 Patient-controlled analgesia pump use before implementation of the ERAS pathway was about 37%. Barr J. People recover faster and return home earlier to their normal life, work and Protocol Development •Gynecologic Oncology •Spring - Fall, 2016 Olle Ljungqvist, and Dileep N. “The biggest thing we were worried about was increasing the 30-day readmission rate, which had been pretty stable,” he says. - Early oral nutrition means early resumption of oral intake. • ERAS or modifications of it include up to 20 perioperative interventions1. ERAS 2. The goal of this article is to critically review existing evi-dence and make recommendations for elements of postoperative care. For ERAS implementation, an intraoperative opioid-sparing anesthetic protocol was followed that included lidocaine (2. 0 Cleveland Clinic, 2014 All reduced by instituting Enhanced Recovery protocols  9 May 2018 The role of ERAS in several surgical disciplines was reviewed. Multimodal Analgesia for Postoperative Pain Management 181 A lower incidence of adverse effects and impr oved analgesia has been demonstrated with multimodal analgesia techniques, which may provide for shorter hospitalization times, improved recovery and function , and possibly decreased heal thcare costs (Buvanendran & Kroin, 2009). RO 2. Patient care and treatment should always be based on a clinician’s independent medical judgment, given the individual patient’s clinical intended to be a fixed protocol, as some patients may require more or less treatment or different means of diagnosis. The Enhanced Recovery After Surgery (ERAS) Program is focused on improving surgical outcomes and enhancing the patient experience before, during and after surgery. Discuss components of an effective ERAS for our facility. A main reason for the effectiveness of the ERAS protocols is that many of the different treatments building  ERAS refers to patient-centered, evidence-based, multidisciplinary team developed ERAS Protocol Can Cut Opioid Use After Spine Surgery · ERAS Society  Background: The ERAS (enhanced recovery after surgery) care has been shown in randomized clinical trials to improve outcome after colorectal surgery  Provided ongoing education for surgical staff on the ERAS protocol. It is the inclusion of audit that most distinguishes an ERAS protocol from a clinical Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS ) Society recommendations and difference to protocol in colonic resection. Enhanced recovery after surgery (ERAS), first introduced in 2005 [], is a combination of various perioperative patient care methods based on a multimodal approach that integrates evidence-based interventions to reduce surgical stress, maintain postoperative physiological function, and accelerate recovery in patients undergoing major surgery. Drafted by: Alimorad G. Outline Disadvantages References What is Enhanced Recovery After Surgery? Any questions? Participants praised ERAS for motivating them (encourages the achievement of recovery goals), others suggest that the fixed regime of ERAS creates challenges when the focus of recovery is on Although not explicitly required by the ERAS, the following variables were also recorded: opioid-free pain control, the use of prophylactic medication for postoperative vomiting and nausea, and the use of epidural anaesthesia. April 2018. 6th ERAS World Congress. ** Audio PPT ** American Association for Thoracic Surgery: Enhanced Recovery After Cardiac Surgery. IDENTIFY ERAS patient and initiate protocol 2. Preop Enhanced Recovery After Surgery (ERAS) is a multidisciplinary, multi-modal approach to perioperative care. However, adherence to the ERAS protocol was not monitored continuously during the trial, leading to possible bias. Lawrence Safety Award We are pleased to announce that the ERAS team received the 2016 Enhancing Recovery After Surgery: Better Teamwork for Better Outcomes 2017 will be held Feb. The Journal of Thoracic and Cardiovascular Surgery. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations. Enhanced Recovery After Surgery (continued on page 50) Table 2. Briefly review the evolution of insulin therapy. Our new CrystalGraphics Chart and Diagram Slides for PowerPoint is a collection of over 1000 impressively designed data-driven chart and editable diagram s guaranteed to impress any audience. Joint effort between ERAS Society and the International Association of for Surgical Metabolism and Nutrition (IASMEN) and the European Society for Clinical Nutrition and Metabolism (ESPEN) Gustafson UO, et. wound infusion catheter (WIC) Outcome: Attenuating effect of epidural analgesia on stress response expressed by decreased plasma insulin and epinephrine levels Pain scores were similar, opioid consumption was higher in the WIC group. There was no significant difference in readmission and mortality rates. 001. Correspondencia: Jesús Velázquez Gutiérrez ERAS mentors are registered nurses who are trained in performance improvement. Some of the many advantages of EIGRP are: 1. This short historical overview explains the development of enhanced recovery from a small group of surgeons in European academic centers to the establishment of ERAS ® Society, a not-for-profit multiprofessional multidisciplinary medical-academic society, reaching all major continents and involving a wide range of surgical and anesthesia disciplines. Clinical patients may not necessarily be the same as those found in a clinical trial. 15) Varadhan, Clin Nutr 2010 ERAS Audit • Easy part –protocol creation • Hard part – audit/compliance • Hardest part – repeat ERAS Audit The Protocol of Enhanced Recovery After Surgery in Colorectal Surgery (ERAS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Despite the strength of the evidence-base in its support, the implementation of ERAS has been slow. We currently do not use buprenorphine in our TAP blocks but I will now look in to it. Adoption of enhanced recovery after surgery (ERAS) strategies for colorectal surgery at academic teaching hospitals and impact on total length of hospital stay. Provide time for discussion and  He devised a protocol- Surgery (ERAS) Society in 2005 by Fearon and colleagues for colorectal surgery. by a nurse protocol, including ordering dangerous drugs, medical treatments or diagnostic studies. Complejo Hospitalario “José Ignacio Baldó” Caracas, Venezuela. 6. 23, No. An ARDS protocol can serve as a guide to performing low tidal volume ventilation for mechanically ventilated patients: Start in any ventilator mode with initial tidal volumes of 8 mL/kg predicted body weight in kg, calculated by: [2. To minimize the stress of operations, improve the patient experience, reduce variability, and optimize resource utilization, we implemented a thoracic enhanced recovery after surgery (ERAS) protocol and evaluated progress after 1 year. Enhanced recovery after elective caesarean: protocol for a rapid review of clinical protocols, and an umbrella review of systematic reviews Ellena Corso1, Daniel Hind 2§, Matthew Wilson1, Ian Wrench3, Duncan Chambers4 1School of Medicine and Dentistry, University of Sheffield, UK Chart and Diagram Slides for PowerPoint - Beautifully designed chart and diagram s for PowerPoint with visually stunning graphics and animation effects. Bridging: Use of a short-acting anticoagulant to assist peri-procedure management of anticoagulation and the process for resuming the patient’s Department of Clinical Effectiveness V2 ** Audio PPT ** American Association for Thoracic Surgery: Enhanced Recovery After Cardiac Surgery. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining pre-operative organ function and reducing the profound stress response following surgery. Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Total knee replacement rehab protocol All times are to be considered approximate, with actual progression based upon clinical presentation. Webinar: ERAS in Thoracic Surgery - State of the Art Webinar: ERAS in Thoracic Surgery - State of the Art Thursday 9 November 2017 19:30 - 21:00 hours Faculty: Jalal Assouad, Tim Batchelor, Francis Bonnet, Rene Petersen Registration announced soon - Save the Date Clinical Pathways Lead to Better Surgical Care Glenn Whitman, left, on morning rounds at the foot of an intensive care unit bed, along with other members of the treatment team. In the meantime, it is important to emphasize that there are a range of elements in the ERAS protocol that will reduce insulin resistance and hence reduce the risk of hyperglycaemia and that should be employed. The Nurse's Perspective on Improving Patient care Through an ERAS Initiative by D. Enhanced Recovery after Surgery (ERAS) refers to patient-centered, evidence-based, interdisciplinary team developed pathways for a surgical specialty and facility culture to reduce the patient’s surgical stress response, optimize their physiologic function, and facilitate recovery. Period. Effective pain control in the early postoperative period is a key element in avoiding chronic post surgical pain, which has a reported rate as high as 18% in benign and oncologic State-of-the-Art Perioperative Care Refined to Improving Surgical Outomes. Define the elements of the ERAS and apply the protocol in the acute care setting. Br J Surg 2004; 91: 828–841. Morris MD and Daniel I. ERAS intervention As recommended in colon resection As recommended in rectal resection Difference in protocol Preoperative counselling and education Participant Information Package 2012 Implementation of an Enhanced Recovery after Surgery (ERAS) Program ARTIC Project In many ways, the ERAS guidelines upend the traditional way of preparing and caring for surgical patients. • Discuss elements of Early Recovery After Surgery (ERAS) programs for joint replacement surgery. ERAS is a multimodal perioperative approach aiming at promoting recovery after major colorectal surgery ERAS is both advantageous for the patient and for the hospital ERAS ↓↓↓↓ LOS and postoperative complications ERAS is spreading as standard of practice throughout Europe ANICOLAU. Describe the Enhanced Recover After Surgery (ERAS) pathway. 5 year transition period while the ERAS protocol evolved, and 342 patients during approximately 1. 1 x 1 Kehlet, H. Joshi, MB, BS, MD, FFARCSI Professor of Anesthesiology and Pain Management Enhanced Recovery After Surgery: Role of Anesthesiologist Eras ppt 1. Enhanced recovery after surgery (ERAS) programs aim to hasten functional recovery and improve postoperative outcomes. 98) • Mortality RR 0. Enhanced Recovery after Surgery (ERAS) protocols optimize perioperative care by utilizing concepts including preoperative counseling and limited fasting, early  . 1 team regarding perioperative protocol •No automated process in EPIC to document patients flow through perioperative pathway •No automated process for data and metric gathering from EPIC xxx00. The most common cause is infection by the bacterium Helicobacter pylori, which accounts for more than 60% of cases. Straughn says implementing the ERAS protocol has positively impacted outcomes. Paul’s Hospital, Providence Health Care The Enhanced Recovery After Surgery (ERAS) Committee has produced evidenced-based guidance on perioperative care for cesarean delivery. 1 2 Total Hip Replacement, Rehabilitation & Physical Therapy Protocols Rehabilitation Walkers, Crutches, Canes These devices provide support through your arms to limit the amount of Intravenous infusion of lidocaine starting at the time of surgery for reduction of pain and improvement of recovery after surgery A new ERAS® Protocol for Bariatric Surgical Application is Now Available in the ERAS® Interactive Audit System New ERAS® Protocol for Bariatric surgical application, based on the published ERAS® Society "Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations". com, find free presentations research about Enhanced Recovery After Surgery PPT UCSF’s Enhanced Recovery After Surgery (ERAS) pathways describe the preoperative, intraoperative and postoperative anesthetic management that is performed to optimize the perioperative period for qualifying patients undergoing certain surgical procedures. Tailoring to one’s own health system and environment of care is vital to success. Djalali MD This protocol intends to streamline the perioperative management of colorectal patients by preventing unnecessary variations. Deep neuromuscular blockade may help with exposure during laparoscopic surgery at lower pressures of pneumoperitoneum. Mariappan P, Sinclair SG & Dufus T. Opioid selection was standardized in the ERAS protocol. 5. aarhove. PDWS software support, new staff information, training and learning opportunities, how to join, and important news and announcements from ERAS. per ERAS protocol unless specific contraindication Major elective surgery November 2012 The BAPEN Principles of Good Nutritional Practice (Decision Trees) have been prepared to assist health care professionals in the decision making processes surrounding nutritional care. the scope of ERAS has gradually been expanded to other surgical sub- specialties. Deviation from the protocol is in discretion of the anesthesiologist. The biopsy sample is easily and quickly taken by your gynaecologist during your appointment. Compare and contrast the three eras of medicine. What is ERAS? Enhanced Recovery After Surgery (ERAS) standardizes care before, during and after surgery. Department of Anesthesia, Cooper University Hospital skin preparation, standard anesthetic protocol and intraoperative fluid management. Dr. The ERAS concept initiated for patients a week before surgery when the patient receives detailed information about the care process during a meeting with a nurse. The patient-centred Enhanced Recovery After Surgery (ERAS) pathway aims to ensure people: are in the best possible condition for surgery; have the best possible management during and after their operation; participate in the best possible rehabilitation after surgery. The goals of enhanced recovery after surgery (ERAS) protocols include attenuating the surgical stress response and reducing end organ dysfunction through integrated preoperative, intraoperative, and postoperative pathways. The impact of enhanced recovery after surgery (ERAS) protocol compliance on morbidity from resection for primary lung cancer. This effort forms the basis of the ERAS® Guideline for postoperative care in gynecologic/oncology surgery. Patients are weight bearing as tolerated with the use of crutches, a walker or a cane to assist walking until they are able to demonstrate good walking mechanics, then full weight bearing. 3. If you click it, it will be enlarge in new window. View filters (ERAS) Society Step-by-Step Analytical Methods Validation and Protocol in the Quality System Compliance Industry Introduction Methods Validation: Establishing documented evidence that provides a high degree of assurance that a specific method, and the ancillary instruments included in the method, will consistently yield results that accurately reflect The protocol, Enhanced Recovery After Surgery (ERAS), is a multi-step program that starts several days before the operation and helps prepare patients for surgery. Patients undergoing vascular operations face high rates of intraoperative and postoperative complications and delayed return to baseline. View Large Image | Download PowerPoint Slide  31 Jul 2015 ERAS is a set of measures employed in the perioperative setting information on actual adherence to treatment protocols in the single trials. ERAS was associated with a significantly reduced postoperative length of stay ERAS after cesarean was not associated with an increase in the number of women View Large Image | View Hi-Res Image | Download PowerPoint Slide. 0 Cleveland Clinic, 2014 •19 Elements of Enhanced Recovery •Increasing focus on the patient’s physical condition prior to surgery •Co-morbidities •Chronic or acute •ASA I-II or III-IV •Risk assessment •Frailty score ERAS and Preoperative Nutrition ERAS Collaborative: Learning Session 2 April 1st, 2015 Vanessa Lewis, RD, CNSC St. 32‐1. The anticipated date of protocol initiation is May 2018. Implementation of ERAS is “far from straightforward”. PERFORM CHG wipes and clipping according to policy 6. Parul Gupta Moderator : Dr. All ERAS programs have important anesthetic components, especially with respect to pain management. 6 Enhanced recovery after surgery (ERAS) is a programme that aims to improve the care of elective surgical patients. The PowerPoint PPT presentation: "Analgesic Aspects of ERAS" is the property of its rightful owner. From the Birth of Telecommunications to the Modern Era of Cellular Communications and Wireless Local Area Networks: a brief summary of the evolution of wireless communications from telegraph to radio, cellular communication, wireless local area networks, and beyond. per patient Std dev # Discharges Length of Stay 11. Fast track postoperative management protocol for patients. 5 years following full implementation of their ERAS protocol. Guidelines for perioperative care in elective colonic surgery:Enhanced recovery after surgery (EARS) society recommendations. All ERAS® Society Guidelines are available free at the ERAS® Society website. Saltwater AWQC are to be used in waters with salinity greater than or equal to 10 ppt, 95 percent or more of the time. The occurrence of one or more postoperative complications adversely effects both short-term and long-term survival and increases healthcare costs [1,2]. Engelman helped create a new standard procedure for post-op cardiac patient care: Enhanced Recovery After Surgery. View and Download PowerPoint Presentations on Enhanced Recovery After Surgery PPT. . A gift to the ERAS Program will improve the surgical care of patients, shorten hospital stays and lower the cost of healthcare. 5 May 2018 implementing an orthopedic ERAS protocol is to improve patient An ERAS powerpoint was compiled for the educational presentation  21 Nov 2018 New ERAS® Protocol for Bariatric surgical application, based on the published ERAS® Society "Guidelines for Perioperative Care in Bariatric. "The Enhanced Recovery after Surgery (ERAS) Pathway Optimal patient pathways for hip and knee arthroplasties: Use of Enhanced Recovery After Surgery principles - 2013 A Report from the Musculoskeletal Audit on behalf of the Scottish Government The information in this report is intended to be used for improvement purposes. et al, Tech Coloproctol 2015 Based on the evidence available for each element of perioperative care pathways, the Enhanced Recovery After Surgery (ERAS ®) Society presents a comprehensive consensus review, clinical considerations and recommendations for anaesthesia care in patients undergoing gastrointestinal surgery within an ERAS programme. The guidance covers practices from the time of decision making to hospital discharge. Paolo Millo Enhanced Recovery After Surgery (ERAS) Protocol Aosta experience 1999-2012 703 bariatric procedures BIB, Pacing, Banding VBG GBP BPD Sleeve Redo Surgery 90% laparoscopy Aosta experience Day -1 recovery Day 0 intervention Day 1 XRay for SAGB iv fluid for Sleeve and GBP Day 2 Discharge for SAGB Xray for SL eand GBP Day 3/4 nutritional ERAS protocols were compared before the start of the study, and most ERAS components were applied similarly in all hospitals. An enhanced recovery protocol (ERP) is a set of standard-ized perioperative procedures and practices that is applied to all patients undergoing a given elective surgery. ERAS protocols are multimodal perioperative care pathways  2 Apr 2016 ERAS stands for Enhanced Recovery After Surgery also Known as Fast Track Surgery ERAS consists of Enhanced Recovery Programs which  19 Oct 2017 Concepto FAST-TRACK/ERAS (Enhanced Recovery After Surgery) . "The Enhanced Recovery after Surgery (ERAS) Pathway PowerPoint Presentation Author: ERAS programs are a particularly effective way of providing improved surgical care. the ERAS protocols during the preoperative clinic education appointment and  8 Nov 2010 This approach has been used in many centres in the UK for different procedures, especially colorectal and orthopaedic surgery, and is now the  ERAS strategies are employed from the time a surgeon decides to operate to after a patient is discharged following a procedure. While early oral feeding is the preferred mode of nutrition, avoidance of any nutritional therapy bears the risk of Protocolo ERAS en pacientes sometidos a cirugía electiva ERAS protocol in patients undergoing elective surgery Yoslyn D Chalhoub Buccé,* Madelein A Álvarez Colmenares,*Jesús Velázquez Gutiérrez* *Departamento de Cirugía. Fast track in colorectal surgery Mr Amro Salem, MCh, FRCS Consultant Colorectal surgery King Fahd Specialist hopspital-Dmmam Scott MJ, Baldini G, Fearon KCH, Feldheiser A, Feldman LS, Gan TJ, Ljungqvist O, Lobo DN, Rockall TA, Schricker T, Carli F. Figure 1 Components of our ERAS (Enhanced Recovery After Surgery) protocol Table 1 Patient demographics and complications. Use of SV for GDFT protocol with FloTrac or NexFin Ketamine: 5 mcg/kg/min infusion after induction until fascial closure Lidocaine: 2 mg/kg/hr decreased to PACU dose by weight Ketorolac: 30mg IV at fascial closure; omit if h/o renal dysfunction or GI bleed PONV prophylaxis - ondansetron 4mg IV plus dexamethasone 8-10 mg (unless given in TAP blocks) Enhanced recovery pathways (ERP) are rapidly gaining acceptance and use in gynecologic surgery. Data Synthesis For most protocol items, recommendations are based on good-quality trials or meta-analyses of such trials. Evidence-based information on enhanced recovery in orthopaedics from hundreds of trustworthy sources for health and social care. • Mostly in colorectal surgery patients. ERAS protocol in patients undergoing radical cystectomy for bladder cancer – a prospective controlled study of surgical outcomes. Compared with traditional management, Enhanced Recovery After Surgery (ERAS ) represents a fundamen-tal shift in perioperative care [1–4]. within an ERAS pathway. Makay et al (sumbitted) Effect of Restricted Intra-op Fluids Plus Discontinuation of IV Fluids on Day 1 Makay et al (submitted) BALANCED IS BEST Postoperative early enteral nutrition Effect of ERAS on spontaneous oral diet Complications, length of stay and readmissions within 30 days of colorectal resection THE END KCH Fearon 2004 DEBATE? The Nurse's Perspective on Improving Patient care Through an ERAS Initiative by D. Facilitated by our regional business consultants, these subject matter experts developed clinical protocols and pathways to meet the program’s goals. 69 159 Variable Direct Cost Avg. Laparoscopic colorectal surgery, ERAS protocol Thoracic epidural vs. Epidural analgesia in gastrointestinal surgery. ERAS stands for Enhanced Recovery After Surgery also Known as Fast Track Surgery ERAS consists of Enhanced Recovery Programs which is a multimodal perioperative care pathway that aims at reducing stress response to surgery and acceleration of recovery. As the program continues to evolve, we are adapting our people, infrastructure, and processes to help meet the goal of enhanced recovery. In the event of Reduction of stress response after surgery. Correspondencia: Jesús Velázquez Gutiérrez ERAS for Medical Schools . 0 mg/min) and ketamine infusions (5 µg/kg/min) and goal-directed fluid therapy (Fig. ERAS Colorectal How to Guide (November 2010) Learning Session 1 Presentations ARDS Protocol for Mechanical Ventilation. The changes, pioneered in Europe in the early 1990s, include keeping patients hydrated by giving them a special carbohydrate-loaded drink up to two hours before surgery, controlling their pain better with nonnarcotic pain relievers taken before the operation begins, and letting them walk The ERAS group has published evidence-based consensus recommendations for colorectal surgery. This is a PDF file of an unedited manuscript that has been accepted for publication. Enhancing Recovery After Surgery: Better Teamwork for Better Outcomes 2017 will be held Feb. With input from all relevant stakeholders, the ERAS Cardiac team will quickly identify barriers to the implementation of a working protocol. The effectiveness of the analgesia should be recorded in the Nursing Progress notes; Observations following a bolus of ketamine infusion: Respiratory rate and sedation score: every 5 minutes for 15 minutes and then return to routine observations. ERAS protocols and programs lead to improved outcomes, reduced rates of complications, shorter inpatient stays and cost-savings, notes the article. First, it re-examines traditional practices, replacing them with evidence-based best practices when necessary. 2 Seventy five percent of surgical patients report The Universal Protocol is now accessible as part of the National Patient Safety Goal chapter from your accreditation manual. ELEMENTS OF ERAS. In general, these protocols are not intended for emergent cases, but components of them certainly could apply to the emergent/urgent patient. Combination of Oral Antibiotics and Mechanical Bowel Preparation Reduces Surgical Site Infection in Colorectal Surgery Kerri A Ohman, MD, Leping Wan, MPH, Tracey Guthrie, RN, Bonnie Johnston, ANP-BC, CWOCN, Download Presentation Eras An Image/Link below is provided (as is) to download presentation. v. Patients undergoing surgery have a decreased risk of complications if body temperature is maintained in normal range and they are not allowed to become hypothermic during the perioperative period (except for procedures where hypothermia is deliberately induced). N. Rawlinson A, Kang P, Evans J, Khanna A. The ERAS protocol for colonic surgery recommends no naso-gastric tube, oral fluid intake in the day of surgery more than 300ml fluids and stop of iv fluids on day 1. There is no internationally accepted definition of what constitutes a clinical pathway. Acceleration of Recovery. “In the scenario analysis where all outcomes (statistically significant and nonsignificant impacts of ERAS on HSU) were included, the net cost savings of ERAS was $3 019 000 or $2332 per Patients and health professionals working together Patients and health professionals working together Patients and health professionals working together Cardiac Background Enhanced Recovery principles and protocols are now considered to be a standard of care in many surgical specialties. Colorectal Protocol with ERAS Elements. 4. A Sample Enhanced Recovery After Surgery (ERAS) Protocol Period Enhanced Recovery Protocol (ERP) Conventional care Protocol (CCP) (key differences only) Pre-operative • Provide complete information about the protocol and take an informed consent ERAS is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing major surgery. Controlling the Perils of Change, 38-43 Does Nursing Workload increase with ERAS? Enhanced recovery pathways (ERP) are rapidly gaining acceptance and use in gynecologic surgery. 4 Like ERAS, clinical pathways ensure an evidence-based set of patient orders and interventions, so that the most important elements of care are consistently delivered. The role of n‐3 enriched oral supplements/enteral nutrition in upperncerGI ca Bowel Preparation Pre-Operative Instructions What is a bowel preparation? Bowel preparation (“bowel prep”) is done to prepare the bowel for surgery or a procedure. Fast track surgery versus conventional recovery strategies for colorectal surgery (Review) WR, J, F, van I. Controlling the Perils of Change, 38-43 Does Nursing Workload increase with ERAS? To investigate whether a bariatric specific ERAS protocol was effective at improving recovery after LSG A randomised controlled trial was conducted to investigate the efficacy and safety of an ERAS protocol Exposure arm (EG): Perioperative care according to ERAS Control arm (CG): Standard perioperative care Anesthesia Practice and ERAS Keyur Trivedi, MD . Enhanced Recovery Society 3 Please cite this article as: Wainwright TW, Immins T, Middleton RG, Enhanced Recovery after Surgery (ERAS) and its applicability for major spine surgery, Best Practice & Research Clinical Anaesthesiology (2015), doi: 10. lidocaine in the surgical wards without continuous ECG monitoring. • Five Essential ERAS 2. Users of these Page 3 of 22 OPIOID FREE ANAESTHESIA INTRODUCTION Pain is an important contributor to post-operative distress 1 and is reported as the primary concern for 56% of surgical patients. Oral information will be provided to each patient by the ERAS team during the the preadmission evaluation / counseling. Medical center leadership has given significant input as well. 1 HIPEC is a treatment option that may be appropriate for select patients with peritoneal carcinomatosis. Protocols include avoiding  Enhanced recovery after surgery (ERAS) protocols for radical cystectomy (RC) aim to improve Evaluate the ERAS protocol for 30-d global costs relative to standard management in the era . Patient education will be provided via personal consult, handouts or educational video. Do you have PowerPoint slides to share? If so, share your PPT presentation slides online with PowerShow. Clinical pathway & kardex. ERAS helps patients get back on their feet quicker while shortening hospital stays and reducing surgical complications. 3-4, 2017, at the Juanita Kious Waugh Auditorium, Mayo Clinic Hospital Campus, 5777 East Mayo Blvd. The investigators are implementing an enhanced recovery after surgery (ERAS) protocol for patients undergoing cesarean delivery. 1 The objective of this narrative review is to identify articles on enhanced recovery in cardiac surgery and highlight potential areas of interest Enhanced Recovery after Surgery (ERAS) in Patients Undergoing Colorectal Surgeries Altaf Ahmed Malik1,*, Sumat-ul-khurshid2, Nisar Ahmad Chowdhri1, Fazl Qadir Parray1 1Department of General and Minimal Access Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, J&K, 190011, India An anesthesia protocol allowing for rapid awakening is used. The length of stay in the ERAS group was 2. Read more here. Enhanced Recovery After Surgery is a collaborative, multidisciplinary initiative between the departments of Anesthesiology and Surgery to improve the perioperative care of patients at UNC. For waters with salinity between 1 and 10 ppt, the more stringent of the freshwater or saltwater AWQC is used, unless site-specific inform ation on species inhabiting There is good evidence that early post-operative feeding reduces post-operative complications and the Enhanced Recovery After Surgery (ERAS) protocol is designed to start post-operative feeding as soon as possible (coupled with early mobilisation to reduce muscle loss). These include colorectal, endocrine, gynaecological, urological, vascular and orthopaedic surgery, with further studies adding to the list. Patient Education, EMMI videos Prehabiliation: Follow Exercise program and have support at home in place for discharge. Identify the types of insulin currently available for treatment of Type 2 4 Aug 2017 + ERAS – Role of Anesthesiologist Presenter : Dr. Federal Government. Patient care and treatment should always be based on a clinician’s independent medical judgment, given the individual patient’s clinical (ppt), 95 percent or more of the time. Despite success, adoption is not universal because ERAS protocols are resource intensive. com. 55 days less and the relative risk complication rate was 53% reduced in the ERAS group compared to controls. Enhance Recovery After Surgery. Surg Endosc 2012; 26:442. The key to the success of an ERAS program involves preoperative, Enhanced recovery after surgery (ERAS) pathways are multimodal, evidence-based approaches to optimize patient outcome after surgery. Assistant Professor Cooper Medical School of Rowan University . Determine whether you have an integral worldview and approach in your clinical practice and other education, research, hos-pital policies, and community endeavors. Its purpose is to clear out the bowel of all solid matter. As a service to protocol ERAS k*Society ORIGINAL ARTICLE The Impact of Enhanced Recovery Protocol Compliance on Elective Colorectal Cancer Resection Results From an International Registry On behalfof the ERAS Compliance Group. ). W In 2009, the acute pain service (APS) of our tertiary level university hospital implemented a protocol for the use of lidocaine infusions for perioperative pain management (summarized in Table 1). Adherence to the enhanced recovery after surgery protocol and  ERAS 1. 6 Enhanced recovery after surgery to repair an abdominal aortic aneurysm (AAA) Enhanced recovery after surgery to repair an abdominal aortic aneurysm (AAA) 7 It’s important to remember that your surgeon will only recommend an UCSF also offers the scarless thyroidectomy to selected patients. Major surgery is a considerable physiologic insult that can be associated with significant morbidity and mortality. Impact of an enhanced recovery pathway on length of stay and complications in elective radical cystectomy: a before and after cohort study. View Large Image | View Hi-Res Image | Download PowerPoint Slide. A systematic review of enhanced recovery protocols in colorectal surgery. How multimodal anesthesia can enhance pain care of disciplines to help create ERAS. Click on Graphic to download file (20 KB) Click on Graphic to download file (52 KB) The images below are clickable. When implementing a new ERAS protocol, the length and detail of the recommendations can be overwhelming. Lobectomy? In general, at UCSF and most of the United States, when a diagnosis of cancer is known BEFORE the operation a total thyroidectomy is warranted. 2,3 Beneficial experiences with clinical pathway programmes after pancreaticoduodenectomy (PD, Whipple’s procedure) have been published,4e9 but the reported series employed different protocols, or no prospective protocol at all. 5 for women or + 50 for men]. Kamat, MD, MBBS, FACS Professor of Urologic Oncology Wayne B. highly effective, evidenced-based interventions and protocols that accelerate The ERAS process begins even before the patient has been seen by one of our Patients in the ERAS program thus receive state-of-the-art perioperative care  This is the first patient-led ERAS (Enhanced Recovery After Surgery) study, . 53 (0. et al, Tech Coloproctol 2015 The PowerPoint PPT presentation: "Analgesic Aspects of ERAS" is the property of its rightful owner. EIGRP Theory of Operation. ERAS programs are associated with shorter length of hospital stay, a reduction in overall health care costs, and improvements in patient satisfaction. DOCUMENT CHO drink (Clearfast) was taken and document time 3. Objectives 1. Listing a study does not mean it has been evaluated by the U. Thyroid Surgery: FAQ Why do I need a Total Thyroidectomy vs. In ERAS protocol for colonic Aarts MA, Okrainec A, Glicksman A, et al. Prior to the RN functioning under a nurse protocol, there should be written documentation that the RN has training, preparation and/or orientation relative to each medical act authorized by the specific nurse protocol and can perform such acts. Patient  ERAS involved multiple evidence-based interventions bundled into one protocol. If necessary colloid administration is encouraged. Patients were discharged following the criteria established by the ERAS protocol. Enhanced recovery after surgery (ERAS) pathways aim to standardize and integrate perioperative care, incorporating the best available evidence-based practice throughout the perioperative period targeted at att Fluid management in ERAS A continuum throughout the perioperative period Pre-operative—goal to the patient to arrive to the OR in a hydrated and euvolemic state Follow Modern fasting guidelines, pre-operative CHO loading beverage the night before and morning of surgery Avoid mechanical bowel preparation, if possible. skin preparation, standard anesthetic protocol and intraoperative fluid management. n COCHRANE Stomach cancer, also called gastric cancer, is a cancer that starts in the stomach. 1 our purpose/our aims in 2007-2008 we developed a post-op lumbar fusion exercise protocol this included: communicating with the surgeons/staff to find safe therapeutic exercises developing a protocol to include before surgery (pre-operation visit to pt) working with acute care rehab having the patient come back to outpatient pt at the voi this They retrospectively analyzed 2,886 patients from 2006 to 2016 at MD Anderson: 1,615 patients from the 6 years prior to ERAS implementation, 929 patients during an approximately 3. However, the use of ERAS protocols to improve morbidity and recovery time without compromising safety following pancreaticoduodenectomy (PD) remains to be elucidated. What will I need for bowel preparation? Gatorade Miralax Ducolax Neomycin Erythromycin Overview. Stoma marking and teaching Clears liquids 7am and bowel ERAS pathways with usual care in patients undergoing primary hip or knee replacement. Thanh conducted a ERAS economic impact study on over 1600 patients, over three years at multiple hospitals in Alberta. »The Enhanced Recovery After Surgery (ERAS) protocol was developed in 2001 by a group of academic surgeons in Europe »Emphasis is on the quality, not the speed, of recovery »It is a multimodal, multidisciplinary, evidence- based approach to the care of the surgical patient »Started with colorectal surgery, but has expanded and ERAS Committee • Surgical Attendings and Residents • Anesthesia Attendings and NPs • Nursing Leadership • Need “Buy In” • ERAS Protocols- Modify if Useful • Implement and Track Results • Goal of ERAS is to become Obsolete-Evidenced Based Practice= Standard Recovery Pathway Standardization of Care: Impact of an Enhanced Recovery Protocol on Length of Stay, Complications, and Direct Costs after Colorectal Surgery. The implementation of ERAS in Alberta is sponsored by the Surgery Strategic Clinical Network (Surgery SCN™). , Phoenix, Arizona 85054. IdentifyEnablers •Protocols for preoperative, intraoperative, and Dileep N. Using a small sample of endometrial tissue the ERA® test establishes the best day for transferring the embryo. Examine the Theory of Integral Nursing, and begin the process of integrating the theory into your clinical practice. The use of ERAS pathways has resulted in more rapid surgical recovery, shorter length of stay, greater patient satisfaction, and decreased costs when compared with traditional approaches. Protocolo ERAS en pacientes sometidos a cirugía electiva ERAS protocol in patients undergoing elective surgery Yoslyn D Chalhoub Buccé,* Madelein A Álvarez Colmenares,*Jesús Velázquez Gutiérrez* *Departamento de Cirugía. S. Discuss Lewin's Theory of Change. They coach local teams at the point of care. To understand stomach cancer, it helps to know about the normal structure and function of the stomach. Key Points Olsen, 2008, T&D. The enhanced recovery after surgery (ERAS) protocol is a perioperative care pathway adopted in health systems across the nation as part of quality  The concept of ERAS and protocols for patients undergoing thoracic surgery. The Guidelines are published by the ERAS®Society and in some cases also as a joint effort with other medical societies such as The European Society for Clinical Nutrition and Metabolism (ESPEN) and the International Association for Surgical Metabolism and Nutrition (IASMEN), part of the International Surgical Enhanced Recovery after Surgery. Girish P. Enhanced Recovery after Surgery (ERAS ®) refers to patient-centered, evidence-based, multidisciplinary team developed pathways for a surgical specialty and facility culture to reduce the patient’s surgical stress response, optimize their physiologic function, and facilitate recovery. Our members are welcome to join the new Knowledge Hub group, which has a growing library of useful documents, forums, event information plus more. Enhanced recovery after surgery (ERAS), with its aim of delivering high-quality perioperative care and accelerating recovery, appears well suited to address the needs of this population. Empower multidisciplinary teams to start building ERAS protocols. Watson R. The changes, pioneered in Europe in the early 1990s, include keeping patients hydrated by giving them a special carbohydrate-loaded drink up to two hours before surgery, controlling their pain better with nonnarcotic pain relievers taken before the operation begins, and letting them walk ERAS pathway meta‐analysis • 6 randomized trials; 452 patients • Mean of 9 (4‐12) ERAS elements used • Readmission RR 0. Acta Anaesthesiologica Scandinavica 2015. •Standardized anesthetic protocol •Normothermia maintainance •Skin to skin and breastfeeding in OR •Delayed cord clamping •Nausea prophylaxis •VTE prophylaxis Post-op •Daily medical review and daily HealthCheck with SeamlessMD app •Non-narcotic pain control •Early mobilization measured with FitBit •Early Foley removal 36 Cancer Control January 2016, Vol. Clinical trials evaluating various ERAS protocols have been published. This protocol allowed for the continuous infusion of i. Updated July, 2017 1 ANTIBIOTIC PROPHYLAXIS FOR SURGERY GUIDELINE BACKGROUND The goal of antibiotic surgical prophylaxis is to ensure adequate serum and tissue ERAS is a standardized, multimodal treatment program for elective colorectal surgery, leading to faster recovery and shorter hospital stays via inter-professional collaboration. Enhanced recovery after surgery. In colorectal surgery, ERAS protocol is currently well established as the best  9 Jun 2016 Adherence rate to ERAS protocols has been shown to be low in the postoperative phase with less than half of patients completing some aspect  Welcome to the. The purpose of the ERAS protocol is to optimize care provided to patients (patient education, nutrition, pain management, early ambulation, etc. and Wilmore, D. The best of evidence-based medicine is employed to optimize the patient’s post-operative course promoting early recovery while post-op complications and costs are reduced. ERAS programs were initiated by Professor Henrik Kehlet in Denmark in the 1990s, and they have become an important focus of perioperative management. Since The ERAS elements are shown in Fig. The 12 investigators who form the Enhanced Recovery Study Group began the article by stating, "Despite lack of evidence for preoperative bowel preparation in colorectal surgery, routine use of Enhanced Recovery after Surgery (ERAS) pathways include several preoperative, intraoperative, and postoperative interventions, which, when implemented together, have been shown to decrease the amount of stress and gut dysfunction in individuals undergoing elective colorectal surgery, and leads to enhanced recovery, decreased morbidity, and length of stay. Return to pre admission function or better… A happy patient at discharge who has felt well informed and involved in their care ** Audio PPT ** American Association for Thoracic Surgery: Enhanced Recovery After Cardiac Surgery. Clinical Awesome Blade! We have started to do the ERAS protocol at our institutions and I have thought that although well intentioned it is cumbersome and inefficient. The optimal post‐operative regimen in terms of type, preparation and access to normal food +/‐oral nutritional supplements for patients managed within an ERAS pathway. Series of perioperative protocols that aim to improve the patients ability to face major operations and facilitate In anticipation of full ERAS protocol ERAS is a multimodal perioperative approach aiming at promoting recovery after major colorectal surgery ERAS is both advantageous for the patient and for the hospital ERAS ↓↓↓↓ LOS and postoperative complications ERAS is spreading as standard of practice throughout Europe ANICOLAU. Every ERAS unit is able to customize the program to their specialty, while staying aligned to Enhanced Recovery After Surgery & how metabolism is key State of the art lecture Olle Ljungqvist MD, PhD Professor of Surgery Örebro University Hospital • Recommendations from ERAS® Society for adult gynecologic oncology surgery only • No known data available for ERAS protocols in pediatric and adolescent gynecology (PAG) • Purpose: To evaluate the safety and efficacy of ERAS protocols in Pediatric and Adolescent Gynecologic (PAG) Enhanced recovery after surgery (ERAS) programs aim to hasten functional recovery and improve postoperative outcomes. RO Enhanced Recovery After Surgery (ERAS) Radical Cystectomy and Urinary Diversion Ashish M. ERAS - Goals • Reduction of stress response to surgery • Acceleration of recovery. 1). This is the official website of the Enhanced Recovery After Surgery (“ERAS”) Program at UNC Chapel Hill. Initially, all patients in the ERAS protocol will be identified by the surgeon. 44 As Rusby and colleagues have argued, there is often a rapid turnover of surgical house staff, and this is likely to hinder progress and patients may receive care that deviates from the protocol. Working with a team, Dr. bpa. BJUI 101(suppl5):50, 2008. In a comparison of 1500 patients on an ERAS pathway with 3000 patients on a traditional protocol for hip or knee arthroplasty,12 ERAS effected significant reductions in both postoperative transfusion requirements and 90 day mor-tality. 186 These include preoperative carbohydrates, an active mid thoracic epidural, early feeding and good pain control. The ERAS Society has many valuable resources to help interested clinicians. 5 One reason could be that ERAS programs are considered complex and resource demanding. DOCUMENT if bowel prep completed or not 4. ERAS Committee • Surgical Attendings and Residents • Anesthesia Attendings and NPs • Nursing Leadership • Need “Buy In” • ERAS Protocols- Modify if Useful • Implement and Track Results • Goal of ERAS is to become Obsolete-Evidenced Based Practice= Standard Recovery Pathway ERAS Cardiac program. PACT faculty or resident will consent the patient for single shot spinal. • Use of protocols - earlier return of GI function and shorter LOS by 1-4 days. The ERAS programmes also include a metabolic strategy to reduce perioperative stress and improve outcomes [12]. - Preoperative nutritional status (MUST score) of the patient will be assessed. Objectives To collect data of randomised controlled trials (RCTs) and clinical controlled trials (CCTs) for evaluating the effects of enhanced recovery after surgery on postoperative recovery of patients who received total hip arthroplasty (THA) or total knee arthroplasty (TKA). The ERAS Society has issued recommendations for many surgical procedures that address best practices in pre-operative, intraoperative, and postoperative management. Care needs to be protocol driven and strict adherence is critical. Controlling the Perils of Change, 38-43 Does Nursing Workload increase with ERAS? Protocolo ERAS en pacientes sometidos a cirugía electiva ERAS protocol in patients undergoing elective surgery Yoslyn D Chalhoub Buccé,* Madelein A Álvarez Colmenares,*Jesús Velázquez Gutiérrez* *Departamento de Cirugía. Enhanced Recovery after Surgery (ERAS) in Patients Undergoing Colorectal Surgeries Altaf Ahmed Malik1,*, Sumat-ul-khurshid2, Nisar Ahmad Chowdhri1, Fazl Qadir Parray1 1Department of General and Minimal Access Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, J&K, 190011, India tive period and formulated into a standardised protocol. This paper specifically explores the utility of Normalization Process Theory (NPT) as a methodological framework to aid exploration of ERAS implementation, with a focus on the core NPT construct coherence. –Fundamental element of early ERAS protocols (mainly open surgery) –Analgesic effect –Attenuation of stress response –Risk of morbidity –High failure rate (~30%)1 1 Fotiadis RJ, Badvie S, Weston MD, Allen-Mersh TG. Accelerated care pathways are delivered using a multidisciplinary approach The New Standard for Surgical Recovery Enhanced Recovery After Surgery (ERAS) Melanie S. ppt 9/4/2018 2:22:00 PM PSH versus ERAS •Transition to ERAS –Focused perioperative protocols –Focused on more common metrics in children ERAS for Colorectal surgery-All Surgeons 2015/2016 Baseline 2014 Avg. ERAS represents a paradigm shift in perioperative care in two ways. ERAS. Anticoagulation Guidelines for Neuraxial Procedures Guidelines to Minimize Risk Spinal Hematoma with Neuraxial Procedures. . Conclusions The Enhanced Recovery After Surgery (ERAS) Group presents a comprehensive evidence-based consensus review of perioperative care for colorectal surgery. 09‐3. Find PowerPoint Presentations and Slides using the power of XPowerPoint. 2015. Compliance with number of ERAS protocols and (A) morbidity and (B) delayed discharge. 1016/j. The PACT will be the point of first contact between Anesthesia and ERAS patients. How a multimodal pain regimen can enhance ERAS protocols. eras protocol ppt

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