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The Indispensable Role of the Circulating Nurse in Robotic Cardiac Surgery
If cardiac surgeons were asked to rank the key people in the OR that help create good outcomes for their cases, most would first mention their PA or the anesthesiologist. […]
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Why the Cardiac Team Fails to Speak Up
When people on the cardiac team (OR staff, ICU nurses, PAs, etc) fail to speak up, it almost always is a signal of an underlying problem The most effective way […]
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Losing Situational Awareness During Heart Surgery
Imagine that you are alone and walking in the woods on a beautiful sunny day. Your map indicates that there is a lake off the trail you are taking so […]
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Cardiac Surgery with a Robot: It Benefits Patients, But Can Harm Surgeons
Patients, motivated by their fear of large and morbid surgical incisions, view robot heart surgery as an incredibly good idea. The lay public is now well aware of laparoscopy and […]
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Hospital Leadership: An Underappreciated Culprit of Patient Harm
In the 1970’s, the rate of commercial airline crashes had plateaued at an unacceptably high level of about one every few months. Investigations determined the safety attitude of pilots was […]
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Use coaching to tame the politics of robotic cardiac surgery
No one questions that the technical challenges of using robotics in cardiothoracic surgery make it a team sport. An experienced team that makes excellent decisions in the OR is necessary for […]
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Robotic Heart Surgery Needs a Pragmatic Visionary
Two reasonable assumptions gave birth to the field of robotic heart surgery. First, patients don’t want their incisions to be any larger than is necessary for a surgical procedure to […]
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Share the Decision to Avoid Regret
Sometimes there is only one appropriate treatment option for a patient. Consider someone with a knife stuck in their carotid artery. Nothing other than surgery is discussed. Many clinical problems […]
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Shifting the Curve for Stroke after CABG
Heart surgery in the early days (1970’s) was a very dangerous proposition. The heart lung machines were rudimentary, with risks of complications that were dramatically higher than what we see […]
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The Complex Story of Pain with Less Invasive Surgery
It is self-evident that less invasive surgery reduces trauma to the body’s tissues compared to conventional open chest surgery. Tissue damage is what triggers pain as patients recover from surgery, […]
