Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Bringing brain health awareness into the operating room

Katie J. Schenning, MD, MPH and Stacie Deiner, MD
Physician
June 17, 2022
Share
Tweet
Share

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.

“I am so ashamed. I am truly sorry to anyone I hurt or offended.”

These were the first words Beverly said when I met her in the preoperative holding area before surgery. She was referring to her recent behavior during an episode of postoperative delirium. Beverly could barely make eye contact as she described how she didn’t remember anything she said, but her son and some of her health care providers had told her parts of the story. She had pulled out her lines, thrown them across the room, and accused health care providers of physically abusing her, screaming paranoid accusations at anyone who walked into her room. “Please don’t let that happen to me again,” Beverly begged me as we prepared to go back to the operating room for another washout of her infection.

Unfortunately, with her medical history, Beverly was at an elevated risk for developing postoperative delirium again. So, we talked together about postoperative delirium. I let her know that she was not alone and that postoperative delirium is common in older patients. We discussed that I would avoid administering medications that might increase the risk of delirium. We also discussed that her family could help reduce the risk by coming to visit and that she should ask to have her hearing aids and glasses right away to help her reorient to her environment.

This June, during Alzheimer’s and Brain Awareness Month, we want to empower health care professionals to promote brain health in the perioperative period. Here are two crucial steps to promote brain health before, during, and after surgery:

1. Education. Invite relevant stakeholders, including surgeons, geriatricians, hospitalists, and nurses, to learn more about perioperative cognitive disorders. Delirium and longer-lasting postoperative neurocognitive disorder after surgery and anesthesia are the most common complications in adults 65 and older undergoing surgery, and are associated with increased morbidity, departure from the workforce, decreased independence, and mortality. It is easier to implement best practices for delirium risk stratification, prevention, identification, and treatment with stakeholder buy-in. For example, risk stratification often includes a brief preoperative cognitive and frailty screening to identify patients at the highest risk.

2. Communication. It is essential for health care professionals to have conversations about perioperative brain health with at-risk patients and their loved ones and caregivers. Ideally, these conversations would first occur with the surgeon at the time the surgery is booked or during a preoperative anesthesia (or medicine) clinic visit. With enough time before surgery, patients can prepare to bring their hearing aids, glasses, and other assistive devices to the hospital. Family members can also be prepared to help promote sleep hygiene and keep calendars, clocks, and photos to help orient the patient after surgery. These conversations are much more productive when they occur preoperatively rather than when a family member hears the term “delirium” for the first time when the patient is delirious after surgery.

After Beverly was discharged from the hospital, we kept in touch. I had the opportunity to meet her adult son. He expressed how grateful he was to learn about postoperative delirium. His mom had several operations over the past few years, and unfortunately, this was not the first time this family had to witness her experience postoperative delirium. However, no one had ever explained to him that this was a common postoperative complication in older adults. He expressed that he and other family members had blamed his mother for her out-of-character behavior.

Anesthesiologists are proud to play an important role in preventing, identifying, and treating perioperative cognitive disorders like delirium. We ask other health care professionals to raise awareness of perioperative brain health by discussing postoperative delirium and other perioperative cognitive disorders with your colleagues, patients, their caregivers, and their loved ones. Tools and resources, such as clinical guides, key actions for care teams, and case studies can help you do just that.

Katie J. Schenning and Stacie Deiner are anesthesiologists.

Image credit: Shutterstock.com

Prev

The epidemic of work dread

June 17, 2022 Kevin 0
…
Next

It’s time to flip the script on peer evaluations [PODCAST]

June 17, 2022 Kevin 0
…

Tagged as: Anesthesiology, Surgery

Post navigation

< Previous Post
The epidemic of work dread
Next Post >
It’s time to flip the script on peer evaluations [PODCAST]

ADVERTISEMENT

Related Posts

  • Are negative news cycles and social media injurious to our health?

    Rabia Jalal, MD
  • How social media can help or hurt your health care career

    Health eCareers
  • Sharing mental health issues on social media

    Tarena Lofton
  • 3 ways to advance the credibility of online health information

    Robert Pearl, MD
  • Digital health equity is an emerging gap in health

    Joshua W. Elder, MD, MPH and Tamara Scott
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD

More in Physician

  • The shocking risk every smart student faces when applying to medical school

    Curtis G. Graham, MD
  • The physician who turned burnout into a mission for change

    Jessie Mahoney, MD
  • Time theft: the unseen harm of abusive oversight

    Kayvan Haddadan, MD
  • Why more doctors are leaving clinical practice and how it helps health care

    Arlen Meyers, MD, MBA
  • Harassment and overreach are driving physicians to quit

    Olumuyiwa Bamgbade, MD
  • Why starting with why can transform your medical practice

    Neil Baum, MD
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...