Blood clots after surgery – call to action

September 26, 2008

Deep vein thrombosis (DVT) and pulmonary embolism (PE) – “blood clots” – kill about 100,000 Americans each year. Many blood clots occur after routine elective surgery – especially spine surgery and major surgery on the hip or knee.

An excellent consumer guide to the risks, prevention and treatment of blood clots can be found here.

The Office of the Surgeon General in the US recently called for action to address this major public health problem. The Surgeon General’s Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism documents the problems DVT and PE pose, as well as strategies to reduce the risk of developing the conditions. Clearly we need to improve public knowledge about risk factors, triggering events, and symptoms of the disease, which is often silent.

Before any surgical procedure, particularly those requiring more than a day or so in hospital, you should be evaluated for any risk factors for a blood clot. People at risk need preventive measures, which can include anticoagulants, like heparin, special stockings, or the use of automated calf compression devices.

Rapid mobilisation – i.e. getting out of bed – is one of the best ways to avoid blood clots and is one of the reasons why patients having outpatient or day surgery very seldom need specific preventive treatments. Read the rest of this entry »


The Cost of Anesthetic (Anaesthetic) Gases

January 8, 2008

In South Africa, controversy has arisen over the cost of anesthetic gases charged by private hospitals.

According to the Board of Healthcare Funders (BHF), which represents medical schemes (insurers), hospitals are overcharging for anesthetic gases because they charge by the minute rather than for each milliliter of anesthetic agent consumed.

For those unfamiliar with the intricacies of anesthetic pharmacology I will attempt to explain the problem, without delving into the political aspects of this issue.

Read the rest of this entry »