Same-day slush preparation

I am writing in reference to an article appear- ing in the February 1977 AORN Journal, “Slush technique in renal surgery.”

We have been using slush for many years in open heart surgery and renal transplanta- tion. Our method of obtaining slush is quite simple and requires no preparation the day preceding surgery.

We place the required number of 1,000 cc bottles of solution, which have been pre- cooled in the refrigerator overnight, into the freezer with a temperature of -8 C. It takes approximately one hour for the solution to become supercooled. Remove the bottle from freezer gently, making certain not to jar the solution. Let it stand at room temperature

for four minutes. Very gently remove top and pour carefully into a sterile bowl provided by the scrub nurse. We use stainless steel bowls with a 2,000 cc capacity. The super- cooled solution turns to slush as it hits the bowl. If we anticipate needing slush over a long period of time, we place solution into the freezer from the refrigerator at staggered time intervals. We check the freezer periodi- cally to remove the bottles that have frozen and replace with one from the refrigerator.

This method of preparing slush prevents the formation of large ice crystals, which cause tissue burns. It also makes it un- necessary to pour sterile solutions prior to surgery.

Marilyn Blake, RN Presbyterian Hospital of Pacific

Medical Center San Francisco

Program to improve health care in jails The American Medical Association (AMA), in cooperation with six state medical societies, has instituted a three-year nationwide pilot program to improve medical care and health services in 30 jails. More than 1,000 prisoners have been given physical examinations and have had health histories taken to provide inmate-patient profiles. These profiles will give the incidences of disease in the randomly drawn sample of jails.

completed and is being implemented in the 30 jails. Experimental medical care delivery systems have been installed in certain jails, and it is expected that some systems may prove transferable to other jails.

of $25,000 from the Law Enforcement Assistance Administration of the US Department of Justice. The six state medical societies were chosen by an AMA advisory committee of physicians, clergymen, and US correctional systems experts. The state medical societies of Georgia, Indiana, Maryland, Michigan, Washington, and Wisconsin were chosen from among 22

A draft of medical care standards has been

Each state program is financed by a grant

societies on the basis of remedial programs they submitted.

In a report published in the Journal of the American Medical Association, Lambert King, MD, PhD, and George Geis, MD, traced the spread of undetected tuberculosis (TB) through Cook County Jail ( I l l ) and discovered that a majority of inmates exposed to the first patient became infected. The two physicians, both members of the Cook County Jail Medical Department, believe the report substantiates the need for appropriate medical facilities and supports AMAs concern over the lack of medical facilities in US jails.

They reported that after diagnosis of the first patient (who had been incarcerated several months), skin tests were conducted on 107 inmates who had cells in close proximity to him. Twenty-three percent showed positive reactions to the TB tests.

Three months later, skin tests were again conducted on all inmates of the same jail tier. Ten of the fourteen inmates originally exposed to the first patient had positive reactions.

AORN Journal, May 1977, Vol25, No 6 1045