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DBE prevent pneumonia by increasing lung expansion and preventing the accumulation of secretions. DBE also initiate the coughing reflex; voluntary coughing in conjunction with DBE facilitates the expectoration of respiratory tract secretions. A physiotherapist will often provide pre/postoperative advice and/or assessment for DBE. Note that the patient will require adequate analgesia and support for the wound to enable DBE and mobilization.

Discharge planning

All patients, whether short- or long-stay, those with few needs or those with complex needs, should receive comprehensive discharge planning. Postoperatively, discharge planning needs to be tailored to the individual needs of the patients, particularly in relation to advice and information on recovery and self-management (DH 2004) (see Chapter 2).

Websites

www.nhs.uk/Conditions/Toxic-shock-syndrome/Pages/Introduction.aspx

www.nhs.uk/conditions/toxic-shock-syndrome/pages/prevention.aspx

References

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AAGBI (2010) Pre-Operative Assessment and Patient Preparation: The Role of the Anaesthetist: AAGBI Guideline 2. Association of Anaesthetists of Great Britain and Ireland, London. www.aagbi.org/publications/guidelines/docs/preop2010.pdf.

Allaert, S.E., Carlier, S.P., Weyne, L.P. et al. (2007) First trimester anesthesia exposure and fetal outcome: a review. Acta Anaesthesiologica Belgica, 58 (2), 119–123.

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AORN (2001) Recommended practices for positioning the patient in the perioperative practice setting. AORN Journal, 73 (1), 231–235, 237–238.

AORN (2004) AORN latex guideline. AORN Journal, 79 (3), 653–672.

AORN (2008) Perioperative Standards, Recommended Practices and Guidelines. AORN, Denver, CO.

Armstrong, M. (1998) Obesity as an intrinsic factor affecting wound healing. Journal of Wound Care, 7 (5), 220–221.

Asai, T. (2004) Editorial II: who is at increased risk of pulmonary aspiration? British Journal of Anaesthesia, 93 (4), 497–500.

Atkinson, R.S., Rushman, G.B. and Lee, J.A. (1982) A Synopsis of Anaesthesia, 9th edn. Wright-PSG, Bristol.

Baig, M.K. and Wexner, S.D. (2004) Postoperative ileus: a review. Diseases of the Colon and Rectum, 47 (4), 516–526.

Bale, S. and Jones, V. (2006) Wound Care Nursing: a Patient-Centred Approach, 2nd edn. Mosby Elsevier, Edinburgh.

Barker, S.G.E. and Hollingsworth, S.J. (2004) Wearing graduated compression stockings: the reality of everyday deep vein thrombosis prophylaxis. Phlebology, 19 (1), 52–53.

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Beths, T. (2006) Setting up the Anesthesia Machine and Scavenging System. Ross University, Dominica, West Indies. www.rossvet.edu.kn/safetyweb/docs/Setting%20up%20the%20Anesthesia%20Machine%20and%20Scavenging%20System.pdf.

Bickley, L.S., Bates, B. and Szilagyi, P.G. (2009) Bates’ Pocket Guide to Physical Examination and History Taking, 6th edn. Wolters Kluwer Health(Lippincott Williams and Wilkins, Philadelphia.

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