Intercom Duke University Medical Center VOLUME 24, NUMBER 11 MARCH 18,1977 DURHAM, NORTH CAROLINA 1 m Outpatient Pediatric Surgery Saves Time, Money, Anxiety SNOOPY, THIS WON’T HL/Rr—Two-year-old David Schwartz learned about stethoscopes and hospitals when he was the first patient in a new program here that allows routine surgery for children without overnight hospitalization. The system should cause less anxiety to the child and less disruption to the family, according to Dr. Howard C. Filston, chief of the pediatric surgical service. David recovered so quickly that he wanted to visit the people at the hospital again the day after surgery. (Photo by Jim Wallace) By Ina Fried As many parents know, strange faces and strange places are often upsetting to young children, and hospitals are no exception. D^ke Hospital has developed a new system designed to alleviate the anxiety of many young patients by allowing them to undergo routine surgery without remaining overnight. The service, called the Ambulatory General Anesthesia Program (AGAP), also is expected to save time and money. The system is organized to speed up cdl the red tape associated with hospitalization so that all of the child's time in the hospital is used constructively, says Dr. Howard C. Filston, associate professor and chief of the pediatric surgical service. First Patient The first patient in the program, 2-year-old David Schwartz, underwent surgery for hernia repair earlier this month. David, the son of Mr. and Mrs. Michael Schwartz of Durham, visited the hospital the day before surgery to complete his lab work and meet the pediatric nurses and recreation therapists. He and his parents completed pre-admission paper work and consultation with Filston. His parents received instructions on preparing him for the surgery. C)rdinarily the family wotdd go on a tour of the hospital, but that was not necessary since Schwartz is an assistant administrative director and Mrs. Schwartz works in the blood bank at the hospital. Home that Afternoon David was admitted to the hospital early the next morning. He underwent surgery under a general anesthetic, remained in the recovery room about an hour, and then went to a regular pediatrics room. His parents were encouraged to remain with him except during the actual surgical procedure. David left for New Diving Study To Focus on Bone Death By David Williamson As the search for the black gold petroleum intensifies, commercial deep sea divers can travel to exotic lands, get plenty of sunshine and ocean air and earn wages that run upwards of $50,000 for six months work. But before you kiss yotu" spouse good-bye, slip on your swim fins and promise to write at every opportunity, consider that diving is one of the most dangerous professions there is outside a municipal bomb squad. Accidents, angry fish, cold temperatures, decompression sickness ("the bends") and high pressure nervous syndrome that can cause vomiting, tremors and brain wave irregularities are just a few of the dangers to which underwater explorers are exposed. Combatting 'Bone Death' In an effort to combat still another of the health hazards associated with deep saturation dives — osteonecrosis or "bone death" — a tecim of 24 professional divers from Caiuida arrived here yesterday to participate in three weeks of experiments at the medical center's^ F.G. Hall Laboratory for Environmental Research, more commonly called the hyperbaric chamber. A series of four simulated dives, each involving six divers, will be made to the equivalent of 60 feet beneath the sea to test how well two drugs can prevent the conditions that lead to bone death, according to Dr. Peter B. Bennett, professor of anesthesiology at Duke. Each dive last 48 hours in the pressurized atmosphere of the hyperbaric chamber. (Continued on page 2) home in the early afternoon. "We're not taking an)rthing away that the patient needs," Filston emphasized. "The patient receives the same muring care, the same anesthesia care, the same surgical and recovery room care. All we're doing is eliminating a lot of extraneous time." "The less time the mother and father have to miss work, the less loss of income they have," he said. "Most children don't come as isolated entities. Parents have to find a place to leave their other children while they're at the hospital," the physician added. From Simple Procedure To Major Upset "What starts as a simple surgical procedure can turn into a major upset in time; resources and emotions." Before AGAP, a child might be admitted to the hospital one day for preliminary lab and paper work, have surgery sometime the next day (Continued on page 4) He Talks about Us^ And Ifs Good! (From an article written by Dale E. Baker in the Feb. 14, 1977, issue of The Centre Times in State College, Pa. The headline was “On People Helping People.") Howard Smith, a State College barber, has been telling me for years about the great people at Durham, N.C., and E>uke University Hospital. My visit there last week reminded me of the important goal of life in the South — people helping others. For example, I arrived at the Durham-Raleigh Airport at 10 p.m. A round trip limousine fare to Durham (16 miles) was $6. What help was available! The driver made three phone calls to find me a motel room; took me to the motel; the motel used their coiutesy car to take me to the hospital the next morning. The X-ray technician started work within 5 minutes after receiving a request from Dr. Boyce Cole, who missed lunch to check the X-rays; another doctor came in for consultation during the lunch hour; I was through the administrative red-tape by 1:30; the secretary called the limousine service and by 1:50 I was on my way back to the airport and home. Maybe the attitude and happiness exhibited by these people is contagious. How might we start an epidemic in State College? As Arnold Glasgow said "there's still time to be what you might have been."