MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'AANA Journal' source. Sat, 30 Jul 2011 15:55:49 +0100 http://www.medworm.com/index.php?rid=5058926&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21751687%26dopt%3DAbstract Authors: Bradbury B, Cohen F Takotsubo cardiomyopathy (TC), also called stress-induced cardiomyopathy, is a rare type of nonischemic cardiomyopathy accompanied by a transient ballooning and akinesis of the left ventricle. It has been reported mainly in the Japanese literature, although awareness is increasing in the United States and Europe. The reason for the increased incidence in postmenopausal women remains unclear, as does why the apex and left ventricular midcavity are commonly affected. The degree of symptom presentation and severity varies widely and is usually accompanied by an unremarkable medical history. The most frequent presentation is left ventricular dysfunction with or without pulmonary edema. Identifying signs and symptoms and its correlation with physical or emotiona... AANA Journal journals http://www.medworm.com/rss/comments.php?id=5058926 Tue, 31 May 2011 23:00:00 +0100 5058926 http://www.medworm.com/index.php?rid=5058925&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21751688%26dopt%3DAbstract Authors: Burns SM In order to foster academic progression and improve retention in nurse anesthesia programs, admission selection criteria require attention. With the escalating cost of graduate education coupled with the current economic crisis, efforts by educational leaders to minimize attrition remain pivotal. Selecting potential candidates who are most likely to succeed, aligned with data-driven evidence, offers the greatest potential for academic success for student registered nurse anesthetists. The purpose of this quantitative correlational study was to determine if a relationship existed between admission criteria (grade point average [GPA], science grade point average [SGPA], Graduate Record Examination scores, and critical care experience) and academic progression (current a... AANA Journal journals http://www.medworm.com/rss/comments.php?id=5058925 Tue, 31 May 2011 23:00:00 +0100 5058925 http://www.medworm.com/index.php?rid=5058924&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21751689%26dopt%3DAbstract Authors: Kline JP Sonography addresses a variety of concerns, such as patient safety and comfort, cost-effectiveness, time to complete a procedure, and success rates associated with invasive anesthesia procedures. Ultrasound guidance is commonly being used for the placement of nerve blocks, placement of peripheral and central lines, and arterial catheterization. Recently, it has been applied to preprocedural and imaged-guided spinal and epidural placement. The general terms and application of ultrasound to the practice of anesthesia are discussed in this article, as well as the general principles and the interpretation of basic images. Common procedures that include its use are also reviewed. PMID: 21751689 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=5058924 Tue, 31 May 2011 23:00:00 +0100 5058924 http://www.medworm.com/index.php?rid=5058923&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21751690%26dopt%3DAbstract This study investigated the role of preoperative dexmedetomidine on parental separation anxiety and acceptance of wearing an anesthesia mask, and its effectiveness in reducing the incidence and severity of ED. A double-blind study was conducted in 41 children, aged 1 to 6 years, undergoing dental restoration and/or extractions. Subjects received 4 microg/kg of dexmedetomidine or 0.5 mg/kg of midazolam orally prior to anesthesia induction. Subjects' anxiety over parental separation, acceptance of anesthesia masks, and presence and severity of ED were evaluated. There were no statistically significant differences in parental separation anxiety or mask acceptance between the 2 groups. There were also no significant differences in ED occurrence. In this study, dexmedetomidine produced no commo... AANA Journal journals http://www.medworm.com/rss/comments.php?id=5058923 Tue, 31 May 2011 23:00:00 +0100 5058923 http://www.medworm.com/index.php?rid=5058922&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21751691%26dopt%3DAbstract Authors: Wong E, Li Q A review of the literature revealed that nurse anesthesia educational program (NAEP) faculty members perceive certain personality characteristics and clinical awareness as the most important traits needed for clinical success in an NAEP. Clinical success in an NAEP is equated with safe nurse anesthesia practice. The purpose of this study is for NAEP academic faculty and expert Certified Registered Nurse Anesthetist (CRNA) clinical faculty to discern which of the 63 intrapersonal and 15 interpersonal characteristics that student registered nurse anesthetists (SRNAs) exhibit contribute to safe or unsafe nurse anesthesia practice. A pilot study of expert CRNA clinical faculty (n = 10) was undertaken, followed by a prospective randomized survey of NAEP academic facult... AANA Journal journals http://www.medworm.com/rss/comments.php?id=5058922 Tue, 31 May 2011 23:00:00 +0100 5058922 http://www.medworm.com/index.php?rid=5058921&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21751692%26dopt%3DAbstract Authors: Anghelescu DL, Rakes LC, Shearer JR, Bikhazi GB Emergence agitation (EA) can be a distressing side effect of pediatric anesthesia. We retrospectively reviewed the records of 7 pediatric oncology patients who received low-dose ketamine in conjunction with propofol for total intravenous anesthesia (TIVA) repeatedly for radiation therapy. EA signs were observed in all 7 patients in association with propofol TIVA but did not recur in any of 123 subsequent anesthetics sessions during which low-dose ketamine was added to propofol. Based on this experience, we suggest that low-dose ketamine added to propofol may be associated with prevention of EA in children with a history of EA with propofol TIVA. PMID: 21751692 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=5058921 Tue, 31 May 2011 23:00:00 +0100 5058921 http://www.medworm.com/index.php?rid=5058920&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21751693%26dopt%3DAbstract Authors: Choleva AJ A patient with McArdle disease underwent bowel surgery with general anesthesia and was successfully managed. McArdle disease is a rare skeletal muscle disorder affecting approximately 1 in 100,000 people. McArdle disease, also known as type V glycogen storage disease, is an autosomal recessive inherited condition caused by a missing or nonfunctioning enzyme called myophosphorylase C. This phosphorylase is the enzyme responsible for making glucose for energy. Individuals suffering from McArdle disease have muscles that cannot properly metabolize energy and may experience fatigue and failure during strenuous activities. When a patient with McArdle disease presents for any surgical procedure, a variety of anesthesia implications should be discussed and incorporated int... AANA Journal journals http://www.medworm.com/rss/comments.php?id=5058920 Tue, 31 May 2011 23:00:00 +0100 5058920 http://www.medworm.com/index.php?rid=5058919&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21751694%26dopt%3DAbstract This report describes the presentation and anesthetic management of a parturient who was admitted with a diagnosis of severe preeclampsia in whom pulmonary edema and heart failure developed, necessitating emergency cesarean delivery under general anesthesia. The patient was subsequently given a diagnosis of PPCM. PMID: 21751694 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=5058919 Tue, 31 May 2011 23:00:00 +0100 5058919 http://www.medworm.com/index.php?rid=5058918&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21751695%26dopt%3DAbstract Authors: Phillips G, Monaghan WP Many modern diagnostic and surgical procedures rely heavily on the use of ionizing radiation. These procedures include computed tomography, nuclear medicine procedures, interventional radiology, and cardiac catheterization and electrophysiology procedures. Recent trends toward increased patient visits and patients with multiple challenging comorbidities have meant that anesthesia providers are increasingly required to provide services in the ancillary areas using ionizing radiation. As a result, anesthesia providers are at a greater-than-ever risk for excessive radiation doses. An overview of some of the basic principles of radiation biology, radiation physics, and radiation protection and specific guidelines related to radiation exposure and pregnancy ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=5058918 Tue, 31 May 2011 23:00:00 +0100 5058918 http://www.medworm.com/index.php?rid=4816319&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560970%26dopt%3DAbstract Authors: Brennen K, König M, Mahmoud M PMID: 21560970 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4816319 Thu, 31 Mar 2011 23:00:00 +0100 4816319 http://www.medworm.com/index.php?rid=4816310&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560971%26dopt%3DAbstract Authors: Jordan L Recent research reaffirms that Certified Registered Nurse Anesthetists (CRNAs) are critical to the delivery of anesthesia in the United States and argues persuasively for the removal of barriers-including supervision requirements--that prevent CRNAs and other advanced practice registered nurses (APRNs) from practicing to the full extent of their education and training. As we as a nation strive to make healthcare accessible, ever safer, and affordable, the health system must use anesthesia professionals as efficiently as possible. Repealing the federal Medicare physician supervision requirement for nurse anesthetists is an important step toward achieving this goal. PMID: 21560971 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4816310 Thu, 31 Mar 2011 23:00:00 +0100 4816310 http://www.medworm.com/index.php?rid=4816308&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560972%26dopt%3DAbstract This article discusses the preventive measures that were taken to avoid angioedema secondary to pressure related to anesthesia. Because of the rarity of the disease, anesthetic implications have not been addressed in the literature. Consideration of the symptoms and preoperative preventive measures may be of great benefit to all practitioners. PMID: 21560972 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4816308 Thu, 31 Mar 2011 23:00:00 +0100 4816308 http://www.medworm.com/index.php?rid=4816307&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560973%26dopt%3DAbstract Authors: Leiter E, Hitchcock G, Godwin S, Johnson M, Sedgwick W, Jones W, McCall S, Ceremuga TE The purpose of this study was to investigate the anxiolytic effects of myristicin, a major compound found in nutmeg, and its potential interaction with the gamma-aminobutyric acid (GABA(A)) receptor in male Sprague-Dawley rats. Nutmeg has traditionally been used as a spice in food preparation and as an herbal remedy in the treatment of many medical conditions, including anxiety. Fifty-five rats were divided equally into 5 groups: control (vehicle); myristicin; midazolam (positive control); flumazenil and myristicin; and midazolam and myristicin. The behavioral component of anxiety was examined by using the elevated plus-maze (open-arm and closed-arm times) along with analysis of gross and fi... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4816307 Thu, 31 Mar 2011 23:00:00 +0100 4816307 http://www.medworm.com/index.php?rid=4816305&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560974%26dopt%3DAbstract Authors: Molloy BL Postoperative visual loss (POVL) is a rare but catastrophic complication after nonocular surgery. Previously POVL has been reported in lengthy, prone, lateral, or cardiopulmonary cases, with extreme blood loss, hemodilution, and hypotension. The author's index case of POVL following a lengthy operation in steep Trendelenburg position (ST) prompted study of the relationship between intraocular pressure (IOP), mean arterial pressure (MAP), and time spent in ST. A 3-year investigation of the relationship between IOP and ST procedures is reported. Ocular perfusion pressure (OPP) was calculated from IOP and MAP in supine position and at 30-minute intervals during ST. At start of surgery, IOP of 37 patients ranged from 9 to 28 mm Hg. At 120 minutes, IOP ranged from 25 to 5... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4816305 Thu, 31 Mar 2011 23:00:00 +0100 4816305 http://www.medworm.com/index.php?rid=4816304&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560975%26dopt%3DAbstract This study was designed to determine the current level of stress and its physical manifestations in Certified Registered Nurse Anesthetists (CRNAs) and student registered nurse anesthetists. It also looked at coping mechanisms individuals commonly employ to combat the effects of stress. The study used data collected between February and May 2008 using a Stress and Burnout Survey on an online survey tool (SurveyMonkey). The fiscal year 2008 president of the American Association of Nurse Anesthetists, Wanda Wilson, CRNA, PhD, distributed a link to this survey in 2 electronic requests to approximately 28,000 nurse anesthesia providers. The response rate was 26.9% (N = 7,537). Based on responses and comments, recommendations can be made for future wellness interventions for the Association and... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4816304 Thu, 31 Mar 2011 23:00:00 +0100 4816304 http://www.medworm.com/index.php?rid=4816294&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560976%26dopt%3DAbstract This study examined whether combining lipid emulsion and advanced cardiac life support (ACLS) improves survival in an unanesthetized swine model of bupivacaine- and hypoxia-induced cardiovascular collapse. Arterial and venous catheters and a tracheostomy were surgically placed in 26 swine receiving inhalation anesthesia. After a 1-hour recovery period, bupivacaine (5 mg/kg) was administered intravenously over 15 seconds. Following 1 minute of observation and 3 minutes of mechanical airway obstruction, during which all animals exhibited complete cardiovascular collapse, ACLS was initiated. Animals were randomized to receive either intravenous saline or 20% lipid emulsion commencing with the initiation ofACLS. Survival was defined as a return of spontaneous circulation (ROSC) with unsupporte... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4816294 Thu, 31 Mar 2011 23:00:00 +0100 4816294 http://www.medworm.com/index.php?rid=4816293&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560977%26dopt%3DAbstract Authors: Thompson J, Bordi S, Boytim M, Elisha S, Heiner J, Nagelhout J An increasing number of bariatric surgeries are performed every year. A thorough understanding of the pathophysiologic changes, surgical procedure, and anesthesia case management for morbidly obese patients and of the pharmacology of weight-reduction and anesthetic drugs is essential to provide high-quality anesthetic care. The various comorbidities associated with obesity may complicate anesthetic management. Anesthetists must perform a thorough preoperative assessment to identify potential risk factors related to anesthesia and adequately prepare for intraoperative management. Intubation, maintenance of oxygenation, and pain management may be particularly challenging, and various strategies are presented. In addi... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4816293 Thu, 31 Mar 2011 23:00:00 +0100 4816293 http://www.medworm.com/index.php?rid=4711012&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473219%26dopt%3DAbstract Authors: Gabot M, Morris SE, Liao A PMID: 21473219 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711012 Tue, 01 Feb 2011 00:00:00 +0100 4711012 http://www.medworm.com/index.php?rid=4711011&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473220%26dopt%3DAbstract Authors: Ouellette SM, Horton BJ The International Federation of Nurse Anesthetists [IFNA] has been striving to promote quality education and practice standards since it began in 1989. Many organizations throughout the world have recognized these efforts including the International Council of Nurses. This Guest Editorial summarizes IFNA's achievements and introduces IFNA's new initiative to enhance the quality of anesthesia care worldwide through an approval process for education programs. PMID: 21473220 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711011 Tue, 01 Feb 2011 00:00:00 +0100 4711011 http://www.medworm.com/index.php?rid=4711010&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473221%26dopt%3DAbstract Authors: Kiser M, Wakim JA, Hill L There have been many contradicting studies as to how well preoperative airway assessments predict difficult intubation. One of these measures, thyromental distance (TMD), has often been called into question. However, there have been no published studies evaluating whether anesthesia practitioners are measuring TMD accurately, especially if they use fingerbreadths as opposed to a centimeter ruler. A convenience sample of 60 anesthesia providers were asked to participate in a brief study. The subjects were asked a series of questions, including the type of anesthesia provider they were, how often they used TMD, and their estimates in centimeters of the following fingerbreadth combinations: index finger, index and second finger, index plus second and thi... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711010 Tue, 01 Feb 2011 00:00:00 +0100 4711010 http://www.medworm.com/index.php?rid=4711009&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473222%26dopt%3DAbstract Authors: Lyons A In 2005, the World Health Organization estimated that 572% of children were exposed to environmental tobacco smoke (ETS) in the home. Studies show that children who are exposed to ETS are more prone to airway and pulmonary complications perioperatively. A 4-year-old healthy girl, weighing 12.7 kg, who had dental caries presented for general anesthesia for a full mouth restoration. Pertinent history included a remote history of bronchitis after an upper respiratory tract infection, with no current use of inhalers or other medications. Further assessment revealed that the patient had been exposed to cigarette smoke in the home since birth by both parents. After induction of general anesthesia, the patient experienced a respiratory complication and the surgical procedure ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711009 Tue, 01 Feb 2011 00:00:00 +0100 4711009 http://www.medworm.com/index.php?rid=4711008&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473223%26dopt%3DAbstract Authors: Kaplan L, Brown MA, Simonson D One year after implementation of a 2005 Washington State law that granted Certified Registered Nurse Anesthetists (CRNAs) authority to prescribe schedule II through IV controlled substances, only 30% of CRNAs held prescriptive authority. The purpose of this study was to describe Washington State CRNA prescribing practices and workforce and practice characteristics. A questionnaire was mailed in 2006 to CRNAs licensed in Washington with addresses in Washington, Oregon, and Idaho. A typical respondent was 51 years old, white, and equally likely to be male or female, with 19 years of experience. More than half (52.2%) of the CRNAs were employed by hospitals, and 22% were in solo practice. Forty-one percent of the sample had prescriptive authority; h... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711008 Tue, 01 Feb 2011 00:00:00 +0100 4711008 http://www.medworm.com/index.php?rid=4711007&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473224%26dopt%3DAbstract This article presents the recently proposed contributions of neuroimmune activation to the maintenance of chronic pain. The theory of neuroimmune activation postulates a pathway that links peripheral neuronal injury/inflammation with the activation of central nervous system neuroglial cells, which contributes to sustained neuronal hyperexcitability. Literature generated by the emerging field of central nervous system glial cell research, including genetic therapies, was reviewed to provide empirical support for this pathway. The clinical implications of neuroimmune activation to improved treatment of chronic pain states are discussed. PMID: 21473224 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711007 Tue, 01 Feb 2011 00:00:00 +0100 4711007 http://www.medworm.com/index.php?rid=4711006&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473225%26dopt%3DAbstract Authors: Radzvin LC Registered nurses are frequently confronted with ethical dilemmas in their nursing practice. As a consequence of their decisions regarding ethical challenges, nurses report experiencing moral distress. This experience is often manifested by such feelings as anger, guilt, and sadness, and has been identified as a contributing factor to burnout and turnover in nursing. The purpose of this exploratory, descriptive study was to determine if Certified Registered Nurse Anesthetists (CRNAs) experience moral distress in their nursing practice. A random sample of 800 CRNAs from the registry of the American Association of Nurse Anesthetists was selected to participate in this study. Participating nurses were asked to complete a demographic data survey and the Ethics Stress Sc... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711006 Tue, 01 Feb 2011 00:00:00 +0100 4711006 http://www.medworm.com/index.php?rid=4711005&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473226%26dopt%3DAbstract Authors: Schirle L Polyuria has been reported as a side effect of sevoflurane administration, but because of its relative rarity, many practitioners are not aware of this potential phenomenon. Polyuria in its extreme form can cause undesirable hemodynamic changes. A case study, in an 18-year-old man, is presented highlighting polyuria as a probable side effect of sevoflurane administration. PMID: 21473226 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711005 Tue, 01 Feb 2011 00:00:00 +0100 4711005 http://www.medworm.com/index.php?rid=4711003&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473227%26dopt%3DAbstract Authors: Björkelund KB, Hommel A, Thorngren KG, Lundberg D, Larsson S The purpose of this descriptive cohort study was to identify perioperative risk factors associated with postoperative outcome up to 4 months after surgery in elderly patients with hip fracture. Data were collected prospectively through the Swedish National Hip Fracture, the local Acute and Emergency, and Anesthesia registers, and retrospectively from medical and nursing records. The 428 patients (aged > or = 65 years) with hip fracture were consecutively included. Multiple logistic regression analyses were used to identify factors predicting each of 4 outcomes. Perioperative risk factors predicting death within 4 months after surgery were fasting time of 12 or more hours and blood transfusion of 1 U or more. Risk... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711003 Tue, 01 Feb 2011 00:00:00 +0100 4711003 http://www.medworm.com/index.php?rid=4711001&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473228%26dopt%3DAbstract Authors: Meeusen VC, van Dam K, Brown-Mahoney C, van Zundert AA, Knape HT Finding ways to retain nurse anesthetists in the profession to meet the increasing demands of the healthcare system is of paramount importance. The present study investigates the relationship between work climate and job satisfaction among Dutch nurse anesthetists. A questionnaire was distributed to Dutch nurse anesthetists to assess their perceptions of their work climates, and their levels of job satisfaction. Multiple regression analyses were performed to obtain the predictive value of work climate for job satisfaction. All of the work climate characteristics had statistically significant correlations to job satisfaction, and explained 20% of the variance in job satisfaction. To achieve a higher level of job s... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4711001 Tue, 01 Feb 2011 00:00:00 +0100 4711001 http://www.medworm.com/index.php?rid=4710998&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21473229%26dopt%3DAbstract Authors: Henrichs B, Walsh RP Intraoperative magnetic resonance imaging (IMRI) for tumor resection allows a neurosurgeon to pinpoint the exact location of the tumor before resection and to navigate to the tumor after the incision is made. Although the anesthetic management is not substantially different from that for other neurosurgical procedures, strategies to keep the patient and operating room personnel safe can be challenging. Because of the risk of injury by the strong force of the magnet, safety precautions with respect to anesthetic delivery must be taken. Ferrous objects must be removed and kept outside the operating room. Only MRI-compatible equipment is allowed in the MRI operating room. This includes the anesthesia machine, anesthesia cart, intubating equipment, monitors, s... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4710998 Tue, 01 Feb 2011 00:00:00 +0100 4710998 http://www.medworm.com/index.php?rid=4481196&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21309289%26dopt%3DAbstract Authors: Hodson C Little was known about 1LT Kenneth R. Shoemaker Jr, 1 of 2 nurse anesthetists killed during the Vietnam War, outside of his family and friends. This column examines the life, death, and legacy of Shoemaker as seen through the eyes of his family, former classmates, and fellow nurse anesthetists who served in Vietnam. PMID: 21309289 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4481196 Wed, 01 Dec 2010 00:00:00 +0100 4481196 http://www.medworm.com/index.php?rid=4481192&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21309290%26dopt%3DAbstract Authors: Jones TS PMID: 21309290 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4481192 Wed, 01 Dec 2010 00:00:00 +0100 4481192 http://www.medworm.com/index.php?rid=4481190&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21309291%26dopt%3DAbstract Authors: Penney R Dexmedetomidine and ketamine infusions were the main anesthetic for a 15-year-old girl, who underwent scoliosis repair surgery with intraoperative wake-up test, somatosensory evoked potential (SSEP), and motor-evoked potential (MEP) monitoring. To achieve maintenance of anesthesia, dexmedetomidine and ketamine were administered concomitantly. The dexmedetomidine dose ranged from 0.9 to 1.2 microg/kg per hour throughout the case, and the ketamine dose ranged from 0.4 to 0.6 mg/kg per hour. The analgesic properties of dexmedetomidine and ketamine were complimented by the continuous fentanyl infusion at 1 to 2 microg/kg per hour. The sympatholytic properties of dexmedetomidine were balanced with the sympathomimetic properties of ketamine, and the patient required minimal... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4481190 Wed, 01 Dec 2010 00:00:00 +0100 4481190 http://www.medworm.com/index.php?rid=4481189&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21309292%26dopt%3DAbstract Authors: Attilio P, Merritt C, Sims J, Kane N, O'Sullivan J The purpose of this study was to investigate the effects of ellagic acid on platelet expression via the cyclooxygenase (COX) pathway by examining its effects on platelet activation and comparing them with known COX inhibitors in male Sprague-Dawley rats. Ellagic acid is a major compound found in certain fruits and nuts. It has been attributed as having anti-inflammatory, free radical scavenging, and coagulation properties as well as effects on tumor genesis in multiple forms of cancer. We assessed the similarities of ellagic acid to known COX-2 specific and nonspecific COX inhibitors by examining their effects on platelet activation via use of P-selectin flow cytometry. Compared with the vehicle group, both the ellagic acid (P... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4481189 Wed, 01 Dec 2010 00:00:00 +0100 4481189 http://www.medworm.com/index.php?rid=4481187&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21309293%26dopt%3DAbstract Authors: Kipple JC A 78-year-old man presented preoperatively with severe abdominal pain, dyspnea, and subcutaneous emphysema in his face, neck, and chest approximately 8 hours after colonoscopy with a sigmoid polypectomy. A pneumoperitoneum, free air in the mesentery, pneumoretroperitoneum, pneumomediastinum, and bilateral pneumothoraces were diagnosed using radiography and computed axial tomography. He emergently underwent an exploratory laparotomy with colostomy following bilateral chest tube placement. At laparotomy, a perforation of the posterior sigmoid colon was identified at the site of earlier polypectomy. The patient remained intubated and mechanically ventilated for 3 days postoperatively. Perforations of the colon during colonoscopies are the most serious complication of th... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4481187 Wed, 01 Dec 2010 00:00:00 +0100 4481187 http://www.medworm.com/index.php?rid=4481184&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21309294%26dopt%3DAbstract Authors: Key KL, Rich C, DeCristofaro C, Collins S Emergence agitation (EA) is an important issue in pediatric anesthesia. This phenomenon arises more frequently with the use of inhalational agents. Three commonly used general anesthesia techniques in children were evaluated as to the associated incidence of emergence reactions. An extensive literature review was performed to evaluate these anesthetic practices and the occurrence of EA in young children. Relevant literature was obtained from multiple sources, including professional journals, professional websites, and textbooks. Three categories of anesthesia techniques were reviewed: sevoflurane inhalational general anesthetic, Emerpropofol as an adjunct to sevoflurane general anesthetic, and propofol total intravenous anesthesia (TIV... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4481184 Wed, 01 Dec 2010 00:00:00 +0100 4481184 http://www.medworm.com/index.php?rid=4481181&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21309295%26dopt%3DAbstract Authors: Phillips JK The purpose of this qualitative study was to examine the challenges that recent graduates of nurse anesthesia programs coped with during their anesthesia curriculum from their perspective. The initial research questions for this study were: From the graduates'perspective, what were the stressors that they encountered during their nurse anesthesia program? And how did they successfully negotiate those stressors in order to graduate from their program? This phenomenon was studied using grounded theory methodology. The data were collected by individual, semistructured, in-depth interviews with 12 recent nurse anesthesia program graduates, from 5 different nurse anesthesia programs, who have been out of school for less than 2 years. This exploration into student nurse ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4481181 Wed, 01 Dec 2010 00:00:00 +0100 4481181 http://www.medworm.com/index.php?rid=4481174&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21309296%26dopt%3DAbstract Authors: Khoo KA Approximately 5 million Americans experience heart failure, which affects 10 in every 1000 people older than 65 years. Ventricular assist devices (VADs) are a type of mechanical circulatory support that aids in systemic perfusion by maintaining unidirectional flow while reducing the oxygen demand of the failing ventricle. There are 3 generations of VADs in circulation used as a bridge to transplantation, a bridge to recovery, or as destination therapy. Due to the increasing use of these devices, it is likely that anesthetists will encounter patients with these devices more frequently, which requires adequate preoperative discussion with the care team. Intraoperatively, it is important to realize that patients with VADs are at higher risk for aspiration, to recognize el... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4481174 Wed, 01 Dec 2010 00:00:00 +0100 4481174 http://www.medworm.com/index.php?rid=4170445&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21067082%26dopt%3DAbstract Authors: Varela H, Bums SM Local anesthetic toxicity remains a clinical concern when performing regional anesthesia. Because signs and symptoms of toxicity may not appear for 20 to 30 minutes after administration of local anesthetic, vigilance is crucial. When signs and symptoms of local anesthetic toxicity appear, traditional standards mandate resuscitative measures, including maintenance of oxygenation, elimination of seizures, and treatment of cardiac arrhythmias. However, intravenous administration of lipid emulsions may offer a viable adjunctive treatment of local anesthetic toxicity. The number of case reports demonstrating successful use of lipid emulsions is growing. Continued research remains pivotal to improve understanding of the theory of lipid emulsion pharmacology and app... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4170445 Fri, 01 Oct 2010 00:00:00 +0100 4170445 http://www.medworm.com/index.php?rid=4170444&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21067083%26dopt%3DAbstract Authors: Crowley RL, Haas RE Diastrophic dwarfism is an autosomal recessive disease that predominantly occurs in the Finnish population (1 in 33,000) but has been known to occur worldwide. Affected patients present with multiple cartilaginous anomalies and early degeneration of weight-bearing joints. Once past infancy, life expectancy is favorable and patients may undergo multiple surgical procedures throughout their lifetime to repair .or replace affected joints. The characteristic short trunk of these patients in addition to scoliosis, cervical kyphosis, and involvement of articular cartilages can create unique ventilation and airway challenges for anesthesia providers involved in their care. PMID: 21067083 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4170444 Fri, 01 Oct 2010 00:00:00 +0100 4170444 http://www.medworm.com/index.php?rid=4170441&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21067084%26dopt%3DAbstract Authors: Franson HE An exciting revolution in pediatric pain control has evolved in anesthesia during the past 2 decades. The creative use of systemic analgesic techniques has dramatically improved the quality of postoperative pain management. The postsurgical pediatric population is reaping the benefits of such advancements in acute pain management, as there is an increasing use of patient-controlled analgesia (PCA). The goal of PCA is to provide safe and effective postoperative pain control by achieving a continuous level of analgesia in the body, along with the opportunity for Nursbolus doses as requested by the patient. The aim of this analgesic technique is optimal pain relief and a high level of patient and parent satisfaction. This review of the literature addresses safety issue... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4170441 Fri, 01 Oct 2010 00:00:00 +0100 4170441 http://www.medworm.com/index.php?rid=4170440&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21067085%26dopt%3DAbstract Authors: Bergakker SA The rate of cesarean delivery in the United States is at an all-time high. With the increased rate of primary and repeated cesarean delivery, a corresponding increase in the occurrence rate of placenta previa and placenta accreta has been observed. The purpose of this case report is to discuss the obstetric disorder of placenta previa with the concurrent occurrence of placenta accreta. A review of the actual management and course of a patient undergoing elective cesarean delivery with the aforementioned concurrent disorders will be undertaken. This will be followed by a general discussion related to the management of an obstetric patient undergoing elective cesarean delivery with known placenta previa and placenta accreta. PMID: 21067085 [PubMed - in process] ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4170440 Fri, 01 Oct 2010 00:00:00 +0100 4170440 http://www.medworm.com/index.php?rid=4170439&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21067086%26dopt%3DAbstract This article reviews the anesthetic properties of xenon and current and potential research about the gas. PMID: 21067086 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4170439 Fri, 01 Oct 2010 00:00:00 +0100 4170439 http://www.medworm.com/index.php?rid=4170438&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21067087%26dopt%3DAbstract Authors: Ama T, Bounmythavong S, Blaze J, Weismann M, Marienau MS, Nicholson WT The practice of anesthesia has long been considered an art and a science, with interpatient variability in drug response being the rule, rather than the exception. Pharmacogenomics, which studies the role of genetics in drug response, is emerging as a discipline that may impact anesthetic management. The purpose of this review is to provide clinicians with basic knowledge related to pharmacogenomics and its implications in anesthesia. This review focuses on pharmacogenomics related to commonly used drugs in anesthesia. Pharmacogenomics as a predictor of drug response is increasingly used in medicine and drug development. By expanding the knowledge base of anesthesia providers, pharmacogenomic considerations... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4170438 Fri, 01 Oct 2010 00:00:00 +0100 4170438 http://www.medworm.com/index.php?rid=4170437&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21067088%26dopt%3DAbstract Authors: Austin RD Tracheal dissection is an uncommon complication of endotracheal intubation. A large source of morbidity and mortality in anesthesia is associated with airway issues. Several airway complications can be avoided or minimized by proper technique and vigilance. Emergency thoracotomy surgery is required in patients who suffer lower tracheal trauma. A tracheal tear poses additional challenges to traditional airway management, demanding vigilant planning and collaboration among the entire operative team. This case report details the airway management strategies employed during an emergent thoracotomy for a patient who suffered tracheal perforation during endotracheal intubation. A discussion of airway anatomy, airway considerations, intubation complications, and one-lung ve... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4170437 Fri, 01 Oct 2010 00:00:00 +0100 4170437 http://www.medworm.com/index.php?rid=4170436&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21067089%26dopt%3DAbstract Authors: Pfister S, Wagar P, Casserly IP Stress-related cardiomyopathy (SRC), initially referred to as Tako-Tsubo cardiomyopathy and later as apical ballooning syndrome, has been largely observed in postmenopausal women. It is frequently precipitated by a stressful event. This is a case report of a 31-year-old woman who experienced SRC immediately after a bilateral mastectomy. PMID: 21067089 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4170436 Fri, 01 Oct 2010 00:00:00 +0100 4170436 http://www.medworm.com/index.php?rid=4170435&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21067090%26dopt%3DAbstract Authors: Kirsner KM, Sarkiss M, Brydges GJ Tumors of and trauma to the trachea and bronchi can result in loss of integrity of the airway and death. Once treated primarily with thoracic surgery, these conditions are increasingly being managed with interventional pulmonary procedures outside the operating room but requiring the assistance of anesthetists. These interventional procedures require airway instrumentation, necessitating anesthesia care for ventilation and obtundation of airway reflexes. A thorough preoperative assessment and consultation with the pulmonologist or surgeon performing the procedure are essential for successful completion of the tumor and scar reduction and subsequent stent placement. In addition, anesthetists may care for patients undergoing nonpulmonary surgery... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4170435 Fri, 01 Oct 2010 00:00:00 +0100 4170435 http://www.medworm.com/index.php?rid=4027880&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879625%26dopt%3DAbstract Authors: Thomas S The devastating earthquake in Haiti on January 12, 2010, resulted in massive destruction and human suffering that captured attention worldwide. This column details the experiences shared by the anesthesia department aboard the USNS Comfort. A total of 843 urgent and emergent surgical cases were completed. The mission included cooperation of both military and civilian anesthesia providers. The level of devastation and trauma provided an experience unparalleled by most trauma units and will forever be etched in the minds of those who responded. PMID: 20879625 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027880 Sat, 31 Jul 2010 23:00:00 +0100 4027880 http://www.medworm.com/index.php?rid=4027879&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879626%26dopt%3DAbstract Authors: Hader AL, Brown ED Healthcare providers using social media must remain mindful of professional boundaries and patients' privacy rights. Facebook and other online postings must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), applicable facility policy, state law, and AANA's Code of Ethics. PMID: 20879626 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027879 Sat, 31 Jul 2010 23:00:00 +0100 4027879 http://www.medworm.com/index.php?rid=4027878&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879627%26dopt%3DAbstract Authors: Thiemann LJ, McFadden JJ The American Association of Nurse Anesthetists (AANA) is committed to advancing evidence-based nurse anesthesia practice. This determination is evident across multiple activities within the Association. This editorial describes the AANA's evidence-based policy and process for the development of those practice-related documents that require approval from the AANA Board of Directors. Additionally, several of the Association's initiatives geared toward fostering the advancement of evidence-based nurse anesthesia practice are described. PMID: 20879627 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027878 Sat, 31 Jul 2010 23:00:00 +0100 4027878 http://www.medworm.com/index.php?rid=4027877&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879628%26dopt%3DAbstract Authors: Prielipp RC, Magro M, Morell RC, Brull SJ There are many elements that contribute to errors within an industry or profession. Several human factors associated with safety breakdowns are outlined in Table 2. Experience and root-cause analyses usually document that 2 or more of these factors coalesce to form a "perfect storm" leading to a mishap. For example, expecting a fatigued provider to care for an emergency patient with concurrent production pressure to maintain the elective schedule, while using new and unfamiliar equipment, is a potent mix of risk factors. As Gaba et al. pointed out, production pressure "is a reality for many anesthesiologists and is perceived in some cases to have resulted in unsafe actions." One solution is to integrate standard protocols and expectati... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027877 Sat, 31 Jul 2010 23:00:00 +0100 4027877 http://www.medworm.com/index.php?rid=4027876&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879629%26dopt%3DAbstract This article reports what the author believes to be the first case study in which clevidipine (Cleviprex) was successfully used to treat a suspected, and later diagnosed, pheochromocytoma. PMID: 20879629 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027876 Sat, 31 Jul 2010 23:00:00 +0100 4027876 http://www.medworm.com/index.php?rid=4027875&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879630%26dopt%3DAbstract Authors: Elkins LJ Organs needed for transplantation far outweigh their availability. There is minimal research regarding perioperative care of the brain-dead organ donor during the procurement procedure. Current research attributes a great deal of organ damage to autonomic or sympathetic storm that occurs during brain death. Literature searches were performed with the terms brain death, organ donor, organ procurement, anesthesia and organ donor, anesthesia and brain death, anesthesia and organ procurement, inhalational anesthetics and organ procurement, and inhalational anesthetics and brain dead. Additional resources were obtained from reference lists of published articles. The literature review showed there is a lack of published studies researching the use of inhalational anestheti... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027875 Sat, 31 Jul 2010 23:00:00 +0100 4027875 http://www.medworm.com/index.php?rid=4027874&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879631%26dopt%3DAbstract Authors: McKay KA, Buen JE, Bohan KJ, Maye JP Managing stress for student nurse anesthetists represents a multifaceted educational concern for anesthesia educators. Our purpose was to determine the relationship between physiologic measures of stress and performance of student nurse anesthetists during anesthesia simulator training. Following institutional review board approval, 78 students were enrolled from a nurse anesthesia program. A prospective descriptive design was used to compare baseline, acute, and recovery measurements of stress with performance scores of students during an induction and intubation sequence in a patient simulator. Performance scores were stratified into low-, moderate-, and high-performing groups based on scores received from trained observers. A statistical... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027874 Sat, 31 Jul 2010 23:00:00 +0100 4027874 http://www.medworm.com/index.php?rid=4027873&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879632%26dopt%3DAbstract Authors: Soliday FK, Conley YP, Henker R Pseudocholinesterase deficiency is an inherited or acquired condition in which the metabolism of succinylcholine, mivacurium, or ester local anesthetics is potentially impaired. In this review, genetic inheritance, variants, and testing are examined. Additionally, acquired conditions and drugs that influence enzyme activity, as well as possible treatments of the condition, are reviewed. The review of the literature was conducted by searching PubMed and Ovid Medline databases, with no limitation on date of publication. The search was limited to English-language journals only. Additional articles of relevance were obtained from reference lists of previously searched articles and via Internet searches. Numerous keywords were used in the search, and... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027873 Sat, 31 Jul 2010 23:00:00 +0100 4027873 http://www.medworm.com/index.php?rid=4027872&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879633%26dopt%3DAbstract Authors: Choleva AJ Coccidioidomycosis is a fungal disease with a wide variety of manifestations. The systemic infection is a product of airborne spore inhalation released from the soil. This once-endemic disease is steadily increasing in incidence, geographic location, and severity. The rare coccidioidomycosis cases requiring surgical intervention present unique challenges to anesthesia providers. This case report describes a 45-year-old woman with no relevant medical history admitted for lobec-occidi tomy with decortication because of aggressive coccidioidomycosis. Anesthetic considerations included attention to fungal sepsis, acute tubular necrosis related to amphotericin B therapy, and airway challenges. Careful attention to perioperative fungal therapies, invasive monitoring, and ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027872 Sat, 31 Jul 2010 23:00:00 +0100 4027872 http://www.medworm.com/index.php?rid=4027871&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879634%26dopt%3DAbstract Authors: Lindstrom E, Johnstone R Patients who are Jehovah's Witnesses refuse blood transfusions and blood products as a matter of faith. For surgical procedures during which substantial blood loss is possible, their refusal presents a challenge. 'Anesthetists must generally respect the requests of adults not to receive blood and thus should have a clear understanding of how they will respond in the event of bleeding. Several blood conservation techniques are available for consideration, including acute normovolemic hemodilution. This technique entails the preoperative phlebotomy of whole blood that contains a high concentration of red blood cells and coagulation Patiefactors, while replacing the lost volume with a crystalloid and/or colloid infusion. The procured whole blood can then ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027871 Sat, 31 Jul 2010 23:00:00 +0100 4027871 http://www.medworm.com/index.php?rid=4027870&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20879635%26dopt%3DAbstract Authors: Falyar CR The use of ultrasound as an adjunct to invasive anesthesia procedures is becoming commonplace. The U.S. Agency for Health Care Quality and the United Kingdom National Institute for Clinical Excellence have identified the role of ultrasound in improving patient safety. Numerous studies have demonstrated the benefits of ultrasound, yet there have also been articles inferring it may not offer additional benefits to traditional landmark techniques. The major disadvantage often cited is that success is user-dependent, and using ultrasound is a unique skill that requires training and experience to become proficient. Modern ultrasound systems incorporate 2 sound technologies to provide users with specific information about what is being viewed. Brightness mode imaging and p... AANA Journal journals http://www.medworm.com/rss/comments.php?id=4027870 Sat, 31 Jul 2010 23:00:00 +0100 4027870 http://www.medworm.com/index.php?rid=3702235&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572403%26dopt%3DAbstract Authors: Gonzales EA, Ledesma RJ, McAllister DJ, Perry SM, Dyer CA, Maye JP The purpose of this investigation was to evaluate the effects of guided imagery on postoperative outcomes in patients undergoing same-day surgical procedures. Forty-four adults scheduled for head and neck procedures were randomly assigned into 2 groups for this single-blind investigation. Anxiety and baseline pain levels were documented preoperatively. Both groups received 28 minutes of privacy, during which subjects in the experimental group listened to a guided imagery compact disk (CD), but control group patients received no intervention. Data were collected on pain and narcotic consumption at 1- and 2-hour postoperative intervals. In addition, discharge times from the postoperative anesthesia care unit (PAC... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702235 Mon, 31 May 2010 23:00:00 +0100 3702235 http://www.medworm.com/index.php?rid=3702234&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572404%26dopt%3DAbstract Authors: Barker MC Familial hyperkalemic periodic paralysis (HYPP) is a rare genetic disorder in which the sodium channels in skeletal muscle cells have altered structure and function. Small elevations in serum potassium lead to inactivation of sodium channels, causing episodic weakness or paralysis. Exposure to cold, anesthesia, fasting, emotional stress, potassium ingestion, and rest after exercise can stimulate an attack. This case report describes a 65-year-old man with HYPP who was admitted for a right total knee arthroplasty. He had a history of arteriosclerotic heart disease and stenting 8 years earlier, previous inferior wall myocardial infarction with ejection fraction of 65%, anxiety, degenerative joint disease, well-controlled type 2 diabetes mellitus, and a body mass index ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702234 Mon, 31 May 2010 23:00:00 +0100 3702234 http://www.medworm.com/index.php?rid=3702233&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572405%26dopt%3DAbstract Authors: Welliver D, Welliver M, Carroll T, James P Current fashion in body art includes low back tattoos of varying designs and colors, a trend that presents unique concerns for anesthesia providers. Does the placement of epidural catheters risk the introduction of tattoo pigment dyes into the epidural space through the process of coring? Are there specific risks associated with tattoo dyes and epidural needle placement? We performed a comprehensive review of the literature using multiple search databases with the intent to form guidelines for practice using a level of evidence taxonomy. The available evidence does not identify any specific risks associated with epidural catheter placement through low back tattoos, although tissue coring with tissue transport to deeper sites has been ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702233 Mon, 31 May 2010 23:00:00 +0100 3702233 http://www.medworm.com/index.php?rid=3702232&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572406%26dopt%3DAbstract Authors: Ly DT Delivery of anesthesia to patients with severe pulmonary hypertension can be extremely challenging. The profound hemodynamic alterations of the disease can often be exacerbated by alterations in circulatory function brought about by anesthetic and surgical interventions. High perioperative morbidity and mortality rates have been reported. Minimizing adverse outcomes in these patients requires careful perioperative evaluation and planning. Selection of an anesthetic technique suitable for the surgery without causing major hemodynamic alterations, which can lead to cardiac failure and death, is a unique consideration of the anesthesia provider. As shown in this case report, caudal anesthesia, when appropriate, can offer a safe anesthetic for these patients. PMID: 20572... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702232 Mon, 31 May 2010 23:00:00 +0100 3702232 http://www.medworm.com/index.php?rid=3702231&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572407%26dopt%3DAbstract Authors: Hyatt KA Complex regional pain syndrome (CRPS) is an enigmatic disease process affecting the upper and lower extremities. It consists of various combinations of sensory, autonomic, and motor abnormalities, the pathogenesis of which is unclear. Formally known as reflex sympathetic dystrophy or causalgia, CRPS has a revised taxonomy since 1994. The International Association for the Study of Pain established 2 categories, type I and type II, based on precipitating events. This syndrome manifests in 3 progressive stages, displaying peripheral and central neurologic aberrancies. The exact triggering mechanism is unclear but appears to involve neurogenic inflammation from axonal damage to small-fiber distal nerves. Central sensitization independent of afferent input and central soma... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702231 Mon, 31 May 2010 23:00:00 +0100 3702231 http://www.medworm.com/index.php?rid=3702230&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572408%26dopt%3DAbstract Authors: Yauger YJ, Bryngelson JA, Donohue K, Lawhorn LA, Pitcher BM, Schoneboom BA, Watts DD We compared outcomes between patients receiving general anesthesia (GA) vs regional block (RB) in a military same-day surgery unit (SDSU), where Certified Registered Nurse Anesthetists (CRNAs) delivered all RBs and GA. All patient charts from 2003 through 2006 were reviewed. Patients were included if they were 18 years or older, had an ASA physical status I or II, and underwent a shoulder or knee arthroscopy that used either RB or GA. Overall, 342 patients met inclusion criteria: 161 GA and 181 RB. With GA, mean anesthesia time was shorter (109.6 vs 135.5 minutes, P < .001), but recovery times were longer (56.7 vs 36.4 minutes, P < .001). SDSU times were nearly identical (GA vs RB, 71.5 ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702230 Mon, 31 May 2010 23:00:00 +0100 3702230 http://www.medworm.com/index.php?rid=3702228&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572409%26dopt%3DAbstract Authors: Spence D Acute fatty liver of pregnancy (AFLP) is a potentially fatal metabolic disorder that manifests during the third trimester. Early diagnosis, termination of pregnancy, and treatment of complications associated with AFLP significantly reduce maternal morbidity and mortality. While most cases of AFLP occur before delivery, some may occur after vaginal delivery. Anesthesia providers should have a high level of suspicion for AFLP in a patient with altered mental status and elevated liver function test results in the postpartum period. Anesthetic implications include early recognition of liver dysfunction and aggressive resuscitation and treatment of hypoglycemia, disseminated intravascular coagulopathy, and other associated complications and reduction or avoidance of medica... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702228 Mon, 31 May 2010 23:00:00 +0100 3702228 http://www.medworm.com/index.php?rid=3702226&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572410%26dopt%3DAbstract This study was designed to identify the systolic blood pressure (SBP) and mean arterial pressure (MAP) at which rebleeding occurs when a clot is formed by a hemostatic agent, Celox or TraumaDEX, compared with a standard dressing. Fifteen pigs (5 each) were assigned randomly to 1 of 3 groups: Celox, TraumaDEX, or standard pressure dressing as a control. In all animals, the femoral artery and vein were transected to simulate traumatic injury. Subjects were allowed to hemorrhage 1 minute before treatment. Direct pressure was held 5 minutes followed by application of elastic dressings for 30 minutes. Dressings were removed after 30 minutes, and the wound was observed for rebleeding. Animals demonstrating hemostasis received phenylephrine infusion to increase SBP in 10-mm Hg increments until SB... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702226 Mon, 31 May 2010 23:00:00 +0100 3702226 http://www.medworm.com/index.php?rid=3702224&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572411%26dopt%3DAbstract Authors: Bennetts PS, Pierce JD Apoptosis, or programmed cell death, is a physiologic mechanism employed by most multicellular organisms to maintain homeostasis of body tissues. In balance with the production of new cells by mitosis, apoptosis provides for the orderly destruction and removal of cells that are no longer needed by the organism. Apoptosis occurs by complex pathways involving multiple biochemical signals and processes. Dysfunctional apoptotic mechanisms are the pathologic basis for many human diseases, including common disorders of the heart, lungs, brain, and endocrine systems. Researchers have demonstrated in animal models that neurodegenerative changes after the administration of anesthetic drugs are related to apoptosis. Anesthesia drugs have been found to induce apopt... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702224 Mon, 31 May 2010 23:00:00 +0100 3702224 http://www.medworm.com/index.php?rid=3702220&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20572412%26dopt%3DAbstract Authors: Wiehe M, Arndt K Cystic fibrosis (CF) is a fatal genetic disorder that affects many organ systems in the body. Historically, few patients with CF lived beyond early childhood, but with continuous improvement in treatment modalities, quality of life and the life span of persons with CF has greatly improved. As the surviving population of people with CF increases, a greater chance of encountering them in anesthesia practice exists. Comorbidities associated with the disease, such as diabetes mellitus and osteopenia, may also contribute to an increased frequency of surgical and anesthetic encounters. An understanding of the pathophysiology of the disease, as well as anesthetic implications and management, is crucial to the safe administration of anesthesia in this population. Cyst... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3702220 Mon, 31 May 2010 23:00:00 +0100 3702220 http://www.medworm.com/index.php?rid=3225146&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20108726%26dopt%3DAbstract Authors: Johnson TW PMID: 20108726 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=3225146 Tue, 01 Dec 2009 00:00:00 +0100 3225146 http://www.medworm.com/index.php?rid=3225145&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20108727%26dopt%3DAbstract Authors: McFadden JJ, Thiemann LJ PMID: 20108727 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=3225145 Tue, 01 Dec 2009 00:00:00 +0100 3225145 http://www.medworm.com/index.php?rid=3225144&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20108728%26dopt%3DAbstract Authors: Brar MS A 37-year-old morbidly obese man with a history of obstructive sleep apnea underwent elective tonsillectomy. The patient was successfully intubated with an 8.0-mm regular cuffed endotracheal tube. A large video laryngoscope (GlideScope, Verathon Inc, Bothell, Washington) was used for intubation, as airway assessment indicated a potentially difficult airway. The surgery was uneventful, but active bleeding was noticed in the oropharynx after extubation. The patient was reintubated, again with the use of a GlideScope. The bleeding site was cauterized, and the patient was extubated after meeting the criteria for an awake extubation. He was discharged home the following day. Eight days postoperatively, the patient returned to the emergency center with spontaneous bleeding f... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3225144 Tue, 01 Dec 2009 00:00:00 +0100 3225144 http://www.medworm.com/index.php?rid=3225143&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20108729%26dopt%3DAbstract Authors: Jones TS, Fitzpatrick JJ The benefits of collaboration in healthcare have been linked positively with higher patient satisfaction, improved patient outcomes, enhanced nursing staff satisfaction, and decreased hospital costs. A sample of nurse anesthetists and anesthesiologists affiliated with postgraduate training programs in the state of Texas responded to a survey designed to gather attitudes toward physician-nurse collaboration using an adaptation of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. Two-hundred seventy surveys were completed by 62 anesthesiologists and 208 nurse anesthetists. The mean for the total scores on attitudes toward collaboration for anesthesiologists was 44.4 (+/- SD 8.7) and 51.8 (+/- SD 2.7) for nurse anesthetists. Mean scor... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3225143 Tue, 01 Dec 2009 00:00:00 +0100 3225143 http://www.medworm.com/index.php?rid=3225142&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20108730%26dopt%3DAbstract Authors: Hartman MT, Lang J Inadvertent deflation of the endotracheal tube cuff during a tracheotomy can complicate the surgical procedure, especially in a morbidly obese patient. Also, the anesthesia provider may lose control of the airway, with the inability to reintubate in case of airway edema, airway secretions, or airway fire. The use of the GlideScope video laryngoscope (Verathon Inc, Bothell, Washington) in the morbidly obese patient undergoing a tracheotomy has clinical benefits. This device allowed the visualization of the airway anatomy in 2 patients and the manipulation of the punctured endotracheal tube cuff in one case. PMID: 20108730 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=3225142 Tue, 01 Dec 2009 00:00:00 +0100 3225142 http://www.medworm.com/index.php?rid=3225141&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20108731%26dopt%3DAbstract This article provides facts about the current system of health insurance in the United States and government reform efforts. PMID: 20108731 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=3225141 Tue, 01 Dec 2009 00:00:00 +0100 3225141 http://www.medworm.com/index.php?rid=3225140&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20108732%26dopt%3DAbstract Authors: Heese T, Jenkinson J, Love C, Milam R, Perkins L, Adams C, McCall S, Ceremuga TE The purpose of the study was to investigate the anxiolytic effects of L-theanine and its potential interaction with the GABAA receptor in Sprague-Dawley rats. L-theanine is a major component of green tea, which has traditionally been used as an herbal remedy in the treatment of many medical conditions, including anxiety. Herbals and supplements and their potential interactions perioperatively are a concern to anesthetists. Fifty-five rats were divided into 5 groups: control (saline); L-theanine (positive control); flumazenil (a known benzodiazepine receptor antagonist) and L-theanine; and midazolam and L-theanine. The behavioral component of anxiety was evaluated using the elevated plus-maze and c... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3225140 Tue, 01 Dec 2009 00:00:00 +0100 3225140 http://www.medworm.com/index.php?rid=3225139&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20108733%26dopt%3DAbstract Authors: Talley HC, Talley CH As life expectancy increases, the anesthetic management of older surgical patients has received increased attention. Current estimates suggest that approximately 20% or more of the surgical procedures performed in the United States are on persons 65 years or older, and if current trends continue, the number of older patients requiring anesthesia for surgical procedures is likely to increase. A thorough evaluation is required when planning for the anesthetic management of older adults. Older adults have specific management needs, and these demands continue to pose challenges to anesthesia providers. These challenges relate to the accrual of numerous and diverse anatomic and physiologic changes that occur in older adults throughout the course of aging. P... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3225139 Tue, 01 Dec 2009 00:00:00 +0100 3225139 http://www.medworm.com/index.php?rid=3225138&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20112450%26dopt%3DAbstract Authors: Schwartz A PMID: 20112450 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=3225138 Tue, 01 Dec 2009 00:00:00 +0100 3225138 http://www.medworm.com/index.php?rid=3004292&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19911640%26dopt%3DAbstract Authors: Jirgl RR PMID: 19911640 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=3004292 Thu, 01 Oct 2009 00:00:00 +0100 3004292 http://www.medworm.com/index.php?rid=3004291&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19911641%26dopt%3DAbstract Authors: Brock M, Guinn C, Jones M Additional documentation of regional anesthesia in patients with Charcot-Marie-Tooth disease (CMT) is needed to guide practitioners and patients in exploring appropriate options for anesthesia and analgesia management. This case report describes the successful use of a combined spinal-epidural technique for labor progressing to cesarean delivery in a patient with CMT. Previous similar case reports were reviewed and an extensive literature search was conducted to organize the limited body of research regarding use of regional anesthesia in patients with CMT. Opinions regarding regional anesthesia in patients with neuromuscular diseases such as CMT are often contradictory and based on theory rather than documented practice. This case report confirms wha... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3004291 Thu, 01 Oct 2009 00:00:00 +0100 3004291 http://www.medworm.com/index.php?rid=3004290&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19911642%26dopt%3DAbstract Rescue ventilation: resolving a "cannot mask ventilate, cannot intubate" situation during exchange of a Combitube for a definitive airway. AANA J. 2009 Oct;77(5):339-42 Authors: Rich JM, Mason AM, Tillmann HA, Foreman M Our anesthesia care team was called to care for a patient who was admitted to the emergency department with the esophageal-tracheal double-lumen airway device (Combitube, Tyco Healthcare, Nellcor, Pleasanton, California) in place, which needed to be exchanged for a definitive airway because the patient required an extended period of mechanical ventilation. Several techniques were attempted to exchange the esophageal-tracheal Combitube (ETC) without success. First, we attempted direct laryngoscopy with the ETC in place after deflation of the No. 1 proximal cuff a... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3004290 Thu, 01 Oct 2009 00:00:00 +0100 3004290 http://www.medworm.com/index.php?rid=3004289&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19911643%26dopt%3DAbstract This study provided no support for the supposition that gender contributes to the differences in attitude toward collaboration between physicians and nurses. PMID: 19911643 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=3004289 Thu, 01 Oct 2009 00:00:00 +0100 3004289 http://www.medworm.com/index.php?rid=3004288&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19911644%26dopt%3DAbstract Authors: Schmidt NR, Donofrio JA, England DA, McDonald LB, Motyka CL, Mileto LA The purpose of this study was to compare the efficacy and safety of extended-release epidural morphine (EREM) and perineural infusion (PNI) to control pain after total knee arthroplasty. A convenience sample of 200 patients was obtained using a retrospective chart review of patients who underwent a total knee arthroplasty. Institutional review board approval was obtained, and 100 charts of patients who received EREM and 100 patient charts for PNI were reviewed. The main end points were pain scores up to 48 hours postoperatively, and the ancillary end points were supplemental opioid requirements and adverse effects. Data were analyzed using the Pearson chi2 where appropriate or the Fisher exact test, and all... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3004288 Thu, 01 Oct 2009 00:00:00 +0100 3004288 http://www.medworm.com/index.php?rid=3004287&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19911645%26dopt%3DAbstract Authors: Burgert JM A 79-year-old woman presented in the postanesthesia care unit with hematemesis following replacement of a jejunostomy tube. Her medical history included recurrent stage IIIC ovarian cancer. The patient rapidly decompensated despite blood products administered through the patient's implanted medication port. The anesthesia service was consulted for resuscitative support. Examination revealed an alert, hypotensive elderly female in hemorrhagic shock. While peripheral intravenous (IV) access was sought, her condition further deteriorated. Attempts at peripheral access were determined futile and central venous access would be required. An intraosseous (IO) catheter was placed in the proximal medial aspect of the left tibia using the EZ-IO device (Vidacare Corp, San Anto... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3004287 Thu, 01 Oct 2009 00:00:00 +0100 3004287 http://www.medworm.com/index.php?rid=3004286&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19911646%26dopt%3DAbstract Authors: Thompson J A 52-year-old patient, ASA physical status IV, undergoing a radical prostatectomy for cancer with a robotic system had a cardiac arrest 3 hours into the case. All attempts to resuscitate were unsuccessful, and several hours later he was pronounced dead. Underlying patient comorbidity and procedural issues contributed to the patient's death. The patient had a history of coronary artery disease that required the placement of drug-eluting stents 2 years before this surgical procedure. The preoperative cardiac evaluation and pharmacological management of patients with drug-eluting coronary stents are reviewed. There are a number of positional and technical considerations for patients undergoing robotic surgical procedures, especially in relation to the requirement of lo... AANA Journal journals http://www.medworm.com/rss/comments.php?id=3004286 Thu, 01 Oct 2009 00:00:00 +0100 3004286 http://www.medworm.com/index.php?rid=2775597&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19731841%26dopt%3DAbstract Authors: Fanelle J PMID: 19731841 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2775597 Fri, 31 Jul 2009 23:00:00 +0100 2775597 http://www.medworm.com/index.php?rid=2775596&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19731842%26dopt%3DAbstract Authors: Quinlan D This column traces the history of the efforts of the American Association of Nurse Anesthetists to provide assistance to members struggling with addiction. The work of the Ad Hoc Committee on Chemical Dependency, the Peer Assistance Advisors, Anesthetists in Recovery, the Council on Public Interest in Anesthesia, and the Wellness Program are examined. PMID: 19731842 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2775596 Fri, 31 Jul 2009 23:00:00 +0100 2775596 http://www.medworm.com/index.php?rid=2775595&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19731843%26dopt%3DAbstract Authors: Moskowitz M A patient had a fire in his chest cavity during dissection of the left internal mammary artery before coronary artery bypass graft. The electrosurgical unit indirectly ignited gauze, resulting in a fire. It was determined that oxygen was being entrained into the surgical field through open pulmonary blebs. This case identifies the need for continued fire training and prevention strategies, persistent vigilance, and quick intervention to prevent injury whenever electrosurgical units are used in an oxygen-enriched environment. PMID: 19731843 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2775595 Fri, 31 Jul 2009 23:00:00 +0100 2775595 http://www.medworm.com/index.php?rid=2775594&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19731844%26dopt%3DAbstract Authors: Fink GE Certified Registered Nurse Anesthetists (CRNAs) perform epidural steroid injections for chronic back and extremity pain. Placing epidural needles using fluoroscopy and confirming the needle placement by epidurogram has been suggested as a means to increase the efficacy of epidural injections while decreasing complications. Because of the risk of radiation injury to patients and staff when using fluoroscopy, the purpose of this article is to review the concepts of fluoroscopy and radiation safety for CRNAs. Following a literature search using keywords such as fluoroscopy, radiation injury, and radiation safety, relevant articles were identified. In addition, the reference lists of these articles were reviewed to identify other pertinent sources regarding this topic. The... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2775594 Fri, 31 Jul 2009 23:00:00 +0100 2775594 http://www.medworm.com/index.php?rid=2775593&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19731845%26dopt%3DAbstract Authors: Nissen P, van Lieshout JJ, Nielsen HB, Secher NH Near-infrared spectroscopy (NIRS) assesses cerebral oxygen saturation (Sco2) as a balance between cerebral oxygen delivery and consumption. In 71 patients, we evaluated whether marked reduction in mean arterial pressure (MAP) during propofol-fentanyl anesthesia induction affects frontal lobe Sco2. The NIRS-determined arm muscle oxygenation (Smo2), heart rate (HR), and cardiac output (CO) were monitored, endtidal carbon dioxide tension was controlled at 3.5 to 4.5 kPa, and central blood volume was maintained. Before anesthesia, the median (range) MAP, HR, and CO were 93 mm Hg (61-126 mm Hg), 76 beats/min (50-96 beats/min), and 5.3 L/min (2.4-9.0 L/min), respectively, but immediately following intravenous administration of fentany... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2775593 Fri, 31 Jul 2009 23:00:00 +0100 2775593 http://www.medworm.com/index.php?rid=2775592&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19731846%26dopt%3DAbstract This article reviews commonly used intraoperative monitoring techniques and discusses their potential limitations as they relate to hypovolemia and hemorrhagic shock. PMID: 19731846 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2775592 Fri, 31 Jul 2009 23:00:00 +0100 2775592 http://www.medworm.com/index.php?rid=2775591&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19731847%26dopt%3DAbstract This article reviews the effects of various anesthetics and analgesics on NK cell activity and suggests techniques to attenuate the suppressive effects of these compounds. PMID: 19731847 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2775591 Fri, 31 Jul 2009 23:00:00 +0100 2775591 http://www.medworm.com/index.php?rid=2775590&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19731848%26dopt%3DAbstract Authors: Pellegrini J, DeLoge J, Bennett J, Kelly J Frequently, patients identified as high risk for postoperative nausea and vomiting (PONV) are treated prophylactically with intravenous (IV) ondansetron and postoperatively with IV promethazine. The purpose of this study was to determine if using an aromatic therapy of 70% isopropyl alcohol (IPA) would be more effective than promethazine in resolution of breakthrough PONV symptoms in groups of high-risk patients administered prophylactic ondansetron. All subjects enrolled were identified as high risk for PONV, administered general anesthesia and a prophylactic antiemetic of 4 mg of IV ondansetron, and randomized to receive IPA or promethazine for treatment of breakthrough PONV Demographics, verbal numeric rating scale (VNRS) scores fo... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2775590 Fri, 31 Jul 2009 23:00:00 +0100 2775590 http://www.medworm.com/index.php?rid=2775589&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19731849%26dopt%3DAbstract Authors: Welliver M, Rugari SM The use of propofol presents chemical and clinical concerns, including pain on injection, allergy risks, possible bacteria growth, and hyperlipidemia. These concerns have encouraged the search for alternative propofol formulations. Elimination of the soybean oil and lecithin carrier agents is difficult because the highly lipophilic diisopropyl phenol molecule does not dissolve in water. Propofol in aqueous solution would be a preferable alternative to lipid-based emulsions. One formulation of propofol is fospropofol disodium (Lusedra, Eisai Corporation of North America, Woodcliff Lake, New Jersey), previously known as Aquavan (MGI Pharma, Bloomington, Minnesota). Fospropofol is an aqueous solution of a propofol prodrug intended for injection. The discover... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2775589 Fri, 31 Jul 2009 23:00:00 +0100 2775589 http://www.medworm.com/index.php?rid=2671202&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645165%26dopt%3DAbstract Authors: Schwartz A PMID: 19645165 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2671202 Sun, 31 May 2009 23:00:00 +0100 2671202 http://www.medworm.com/index.php?rid=2671201&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645166%26dopt%3DAbstract Authors: Galvin S, Dewan J, Rockoff MA Many noted clinicians and educators led the development of nurse anesthesia as a profession during the first half of the 20th century. Betty E. Lank, CRNA, a nurse anesthetist at Children's Hospital Boston, Massachusetts, for 34 years, devoted her professional life to the delivery and advancement of pediatric anesthesia. She is credited with many contributions including the first use of cyclopropane for infant anesthesia, developing pediatric-sized anesthesia masks and ventilation bags, and instituting standards for specialized postanesthesia recovery areas. Lank recorded her anesthesia experiences in various nursing publications and shared her knowledge with colleagues at professional meetings. Her accomplishments make her a notable figure in the... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2671201 Sun, 31 May 2009 23:00:00 +0100 2671201 http://www.medworm.com/index.php?rid=2671200&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645167%26dopt%3DAbstract Authors: Muckle TJ, Apatov NM, Plaus K The purpose of this column is to present the results of the 2007 Professional Practice Analysis (PPA) of the field of nurse anesthesia, conducted by the Council on Certification of Nurse Anesthetists. The PPA used survey and rating scale methodologies to collect data regarding the relative emphasis of various aspects of the nurse anesthesia knowledge domain and competencies. A total of 3,805 survey responses were analyzed using the Rasch rating scale model, which aggregates and transforms ordinal (rating scale) responses into linear measures of relative importance and frequency. Summaries of respondent demographics and educational and professional background are provided, as well as descriptions of how the survey results are used to develop test s... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2671200 Sun, 31 May 2009 23:00:00 +0100 2671200 http://www.medworm.com/index.php?rid=2671199&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645168%26dopt%3DAbstract Authors: Smith J, Wakim JH, Hill L Student nurse anesthetists are often required to purchase an auscultatory earpiece device for use in the clinical setting. Although the device is required, students have observed that many anesthesia providers in the clinical setting no longer use this piece of equipment. The purpose of this project was to determine the number of anesthesia programs that required mandatory purchase of the auscultatory earpiece by student nurse anesthetists. A brief survey was developed to collect data from the directors of all 105 accredited nurse anesthesia programs in the United States. The survey was completed by 63 (60%) of the program directors, and 62 completed surveys were used in the analysis. Results revealed that 95% of the responding nurse anesthesia progra... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2671199 Sun, 31 May 2009 23:00:00 +0100 2671199 http://www.medworm.com/index.php?rid=2671198&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645169%26dopt%3DAbstract Authors: Libby A Inguinal hernias are the most common diagnosis requiring surgical repair in children of all ages. Anesthetic management of premature infants is often difficult due to their comorbidities and propensity for apnea and bradycardia. General anesthesia has been shown to be associated with an increased incidence of postoperative adverse events. The purpose of this review is to determine the benefits and risks of spinal anesthesia in preterm infants undergoing herniorrhaphy. The use of spinal anesthesia in this population has been shown to decrease the incidence of postoperative adverse events. PMID: 19645169 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2671198 Sun, 31 May 2009 23:00:00 +0100 2671198 http://www.medworm.com/index.php?rid=2671197&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645170%26dopt%3DAbstract Authors: Conti ME The minimally invasive Nuss procedure has become the standard of care for surgical correction of pectus excavatum. Pectus excavatum is the most common congenital deformity of the chest wall. Historically, surgical correction was limited to the Ravitch procedure, an invasive procedure associated with significant drawbacks, where abnormal cartilage was removed and the sternum elevated and stabilized. Patients typically experienced a prolonged recovery period, from 6 to 9 months and significant postoperative pain. The Nuss procedure, invented in 1998, is much less invasive and has a success rate of 90% compared with the Ravitch procedure with a success rate of 70% to 80%. This more recent procedure normally has an exceedingly low complication rate, reported to be 8% to 1... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2671197 Sun, 31 May 2009 23:00:00 +0100 2671197 http://www.medworm.com/index.php?rid=2671196&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645171%26dopt%3DAbstract Authors: Jansen TK, Miller BE, Arretche N, Pellegrini JE Two common forms of postoperative analgesia used in patients following an anterior cruciate ligament repair (ACLR) are the femoral nerve block (FNB) and the combined femoral-sciatic nerve block (FSB). The purpose of this study was to determine if the addition of the sciatic nerve block to the FNB is truly beneficial in ACLR patients requesting regional anesthesia for postoperative pain control. All subjects scheduled for an ACLR, requesting general anesthesia and preoperative placement of a peripheral nerve block (PNB), were randomized to receive an FNB or an FSB. Analgesic requirements, pain scores, and overall postoperative analgesic satisfaction were the primary outcomes measured. The data for 56 subjects (FNB, 27; FSB, 29) we... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2671196 Sun, 31 May 2009 23:00:00 +0100 2671196 http://www.medworm.com/index.php?rid=2671195&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645172%26dopt%3DAbstract Authors: Welliver M, Cheek D Sugammadex sodium is the generic drug name for the novel modified gamma cyclodextrin that terminates neuromuscular blockade induced by aminosteroidal neuromuscular blocking agents. Published phase II and phase III clinical data support preclinical and clinical phase I study findings of fast, safe, and efficacious reversal of all levels of neuromuscular blockade induced by rocuronium and vecuronium. Low levels of neuromuscular blockade induced by pancuronium have also been successfully reversed by sugammadex. This agent does not reverse the bis-isoquinoline neuromuscular blocking agents. Special patient populations, including pediatric, elderly, cardiac, and renal-compromised subjects, have been studied in phase III. This update focuses on the most recent fi... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2671195 Sun, 31 May 2009 23:00:00 +0100 2671195 http://www.medworm.com/index.php?rid=2671194&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645173%26dopt%3DAbstract Authors: Biddle C Hospital-acquired infections occur at an alarmingly high frequency, possibly affecting as many as 1 in 10 patients, resulting in a staggering morbidity and an annual mortality of many tens of thousands of patients. Appropriate hand hygiene is highly effective and represents the simplest approach that we have to preventing nosocomial infections. The Agency for Healthcare Research and Quality has targeted hand-washing compliance as a top research agenda item for patient safety. Recent research has identified inadequate hand washing and contaminated anesthesia workstation issues as likely contributors to nosocomial infections, finding aseptic practices highly variable among providers. It is vital that all healthcare providers, including anesthesia providers, appreciate t... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2671194 Sun, 31 May 2009 23:00:00 +0100 2671194 http://www.medworm.com/index.php?rid=2528699&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19388501%26dopt%3DAbstract Authors: Koch E PMID: 19388501 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528699 Tue, 31 Mar 2009 23:00:00 +0100 2528699 http://www.medworm.com/index.php?rid=2528697&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19388502%26dopt%3DAbstract Authors: Hawkins R, Nezat G PMID: 19388502 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528697 Tue, 31 Mar 2009 23:00:00 +0100 2528697 http://www.medworm.com/index.php?rid=2528695&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19388503%26dopt%3DAbstract Authors: Scharine JD These 2 case reports describe the use of transversus abdominis plane (TAP) nerve blocks for analgesia following emergency cesarean delivery. Bilateral single shot TAP blocks provided prolonged and extremely effective analgesia. Patients displayed early oral intake, early ambulation, and low pain scores. No postoperative narcotics were used by either patient throughout their hospital stay. A technique for TAP blocks is described with discussion of risks and suggested uses. PMID: 19388503 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528695 Tue, 31 Mar 2009 23:00:00 +0100 2528695 http://www.medworm.com/index.php?rid=2528693&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19388504%26dopt%3DAbstract Authors: Chalikonda SA Alpha2-adrenergic agonists have been shown to reduce the incidence of perioperative myocardial morbidity and mortality. The purpose of this review article is to summarize the current data pertaining to alpha2-adrenergic agonists and their role in the prevention of perioperative adverse cardiac events. The MEDLINE and Cochrane databases were searched for randomized trials from 1980 to 2006 that assessed perioperative alpha2-agonists and myocardial ischemia, myocardial infarction, and mortality. All recently published studies were reviewed and the data summarized. The currently published randomized controlled trials indicate that alpha2-agonists reduce the incidence of myocardial ischemic episodes in patients with known or suspected coronary artery disease undergoi... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528693 Tue, 31 Mar 2009 23:00:00 +0100 2528693 http://www.medworm.com/index.php?rid=2528691&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19388505%26dopt%3DAbstract Authors: Lambert KG, Wakim JH, Lambert NE We conducted a randomized clinical trial of patients undergoing laparoscopic gynecologic surgery to determine the effect of a calculated preoperative fluid bolus on postoperative nausea and vomiting (PONV). For the study, 46 women were randomly assigned to an experimental group, group 1, or a control group, group 2. Group 1 received up to 1,000 mL of replacement fluid preoperatively, using the 4-2-1 formula. Group 2 received the anesthesia provider's routine replacement fluids. Neither group received antiemetics preoperatively or intraoperatively. All patients were assessed for PONV by nurses blinded to patient group assignment. Group 1 patients experienced significantly lower occurrences of PONV than did group 2 patients (P = .046). The preope... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528691 Tue, 31 Mar 2009 23:00:00 +0100 2528691 http://www.medworm.com/index.php?rid=2528689&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19388506%26dopt%3DAbstract Authors: Peiffer KM Hereditary hemorrhagic telangiectasia (HHT), Osler-Weber-Rendu Syndrome, is an uncommon disease but may be present in many people who remain undiagnosed. It is an autosomal dominant disorder characterized by multiple arteriovenous malformations (AVMs) and telangiectases that affect multiple organ systems. Hereditary hemorrhagic telangiectasia patients have a propensity for bleeding, especially from the oropharynx, nasopharynx and gastrointestinal tract, as well as from rupture of AVMs of other organ systems. Anesthetic care of patients with HHT involves very specific interventions with regard to control of bleeding, maintaining adequate oxygenation, and balancing hemodynamic values to optimize perfusion without compromising anesthetic depth. PMID: 19388506 [PubM... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528689 Tue, 31 Mar 2009 23:00:00 +0100 2528689 http://www.medworm.com/index.php?rid=2528687&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19388507%26dopt%3DAbstract Authors: Merwin E, Stern S, Jordan LM, Bucci M A national survey to estimate vacancy rates of Certified Registered Nurse Anesthetists (CRNAs) in hospitals and ambulatory surgical centers was conducted in 2007. Poisson regression methods were used to improve the precision of the estimates. A significant increase in the estimated vacancy rate was reported for hospitals relative to an earlier study from 2002, although it is important to note that there were some methodological differences between the 2 surveys explaining part of the increase. Results from this study found the vacancy rate was higher in rural hospitals than in nonrural hospitals, and it was lower in ambulatory surgical centers. A number of simulations were run to predict the effects of relevant changes in the market for su... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528687 Tue, 31 Mar 2009 23:00:00 +0100 2528687 http://www.medworm.com/index.php?rid=2528683&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19388508%26dopt%3DAbstract Authors: Williamson W, Burks D, Pipkin J, Burkard JF, Osborne LA, Pellegrini JE Spinal-induced hypotension remains the most common complication associated with spinal anesthesia for cesarean delivery. Recent evidence indicates that a 20-mL/kg bolus via pressurized infusion system administered at the time of subarachnoid block (SAB) (coload) may provide better prophylaxis than the traditional administration of a 20-mL/kg crystalloid infusion (preload) approximately 20 minutes before SAB; however, this method raises some concerns. We hypothesized that administering half of the fluid bolus (10 mL/kg) before and half immediately following injection of the SAB would provide benefit. Variables included demographics, spinal anesthetic dermatome level obtained, additional intravenous (IV) flui... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528683 Tue, 31 Mar 2009 23:00:00 +0100 2528683 http://www.medworm.com/index.php?rid=2528680&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19388509%26dopt%3DAbstract Authors: Bruns AR, Norwood BR, Bosworth GA, Hill L Patients having surgical procedures are at risk for anoxia that may cause cognitive impairment. Continuous monitoring of cerebral oxygenation and perfusion with an instrument such as a cerebral oximeter is desirable. The data it provides give insight into the cause of the cerebral insults along with the cerebral response to specific interventions, all of which could help prevent damage to the brain. This critical review of the literature on the efficacy, mechanics, and usefulness of the cerebral oximeter will be helpful to anesthesia providers in evaluating the controversy surrounding its use. A comprehensive understanding of the factors involved in cerebral perfusion and available equipment, such as the cerebral oximeter to monitor ce... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528680 Tue, 31 Mar 2009 23:00:00 +0100 2528680 http://www.medworm.com/index.php?rid=2528679&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19391247%26dopt%3DAbstract Authors: Huang J, German T PMID: 19391247 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2528679 Tue, 31 Mar 2009 23:00:00 +0100 2528679 http://www.medworm.com/index.php?rid=2242412&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19263822%26dopt%3DAbstract Authors: Jirgl RR PMID: 19263822 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2242412 Sun, 01 Feb 2009 05:00:00 +0100 2242412 http://www.medworm.com/index.php?rid=2242410&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19263823%26dopt%3DAbstract Authors: Nelson JE, Wilstead SF Alice Magaw (Kessel) was a pioneer in nursing research and the practice of nurse anesthesia through the publication of her clinical findings. This historical review will consolidate and preserve existing information and document new findings pertaining to this outstanding anesthetist. Primary historical sources, newspapers, legal documents, and other forms of information will be utilized, as well as correspondence with individuals who had some relative association with Magaw. PMID: 19263823 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2242410 Sun, 01 Feb 2009 05:00:00 +0100 2242410 http://www.medworm.com/index.php?rid=2242408&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19263824%26dopt%3DAbstract Authors: Phelps MR, Gerbasi F PMID: 19263824 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2242408 Sun, 01 Feb 2009 05:00:00 +0100 2242408 http://www.medworm.com/index.php?rid=2242406&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19263825%26dopt%3DAbstract Authors: Yost S, McDonald B, Vallejo M There is little data currently available for the obstetric anesthetist to use as a reference for the anesthetic management of laboring women with automatic implantable cardioverter-defibrillators (AICDs). This case report involves a parturient with an AICD and a history of serious cardiac events. The information contained in this case report may be used by anesthesia providers in the obstetric suite confronted with this unique subset of patients that require in-depth anesthetic management. The parturient presented to our labor suite in active labor. The choice of anesthetics used to provide her with analgesia for labor is described, including the rationale for this anesthetic plan. A review of the literature that contains information on safe and e... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2242406 Sun, 01 Feb 2009 05:00:00 +0100 2242406 http://www.medworm.com/index.php?rid=2242404&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19263826%26dopt%3DAbstract Authors: Raines T, Jones P, Moe N, Duncan R, McCall S, Ceremuga TE The purpose of this study was to investigate the anxiolytic effects of luteolin and its potential interaction with the gamma-aminobutyric acid (GABAA) receptor in male Sprague-Dawley rats. Lemon balm has traditionally been used as an herbal remedy in the treatment of many medical conditions, including anxiety. Luteolin is a major component of the essential oil lemon balm. We divided 55 rats into 5 groups: (1) control (negative control), (2) luteolin, (3) midazolam (positive control), (4) flumazenil and luteolin, and (5) midazolam and luteolin. The behavioral component of anxiety was examined by using the elevated plus-maze (open arm time/total time) and motor movements. Data analyses were performed using a 2-tailed mult... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2242404 Sun, 01 Feb 2009 05:00:00 +0100 2242404 http://www.medworm.com/index.php?rid=2242402&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19263827%26dopt%3DAbstract Authors: Cann DF Hypotension should be vigilantly prevented in patients with spinal cord injury. Recent advances in neurological, intraoperative monitoring techniques have allowed Certified Registered Nurse Anesthetists to assess the effects of spinal cord ischemia and compression as they occur. This case report describes a young, healthy man who sustained a cervical spine fracture and was scheduled for anterior spinal fusion with somatosensory and motor-evoked potential (MEP) monitoring while under total intravenous anesthesia. This patient experienced a brief period of intraoperative hypotension with evidence of abnormal MEPs. A wake-up test was performed, which showed normal functioning, and the case resumed an uneventful course. Although this scenario resulted in no neurological se... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2242402 Sun, 01 Feb 2009 05:00:00 +0100 2242402 http://www.medworm.com/index.php?rid=2242400&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19263828%26dopt%3DAbstract Authors: Pearson JA, Fallacaro MD, Pellegrini JE There is a shortage of military Certified Registered Nurse Anesthetists (CRNAs). Relative deprivation is a perception of unfairness due to discrepancies between what one has and what one could or should have that is dependent on feelings (subjective data) and facts (objective data). Feelings of relative deprivation could contribute to the military CRNA shortage. The purposes of this study were to measure relative deprivation in active-duty military CRNAs and explore variables that correlate with relative deprivation. The descriptive, correlational study was conducted using a self-administered survey sent to 435 active-duty Army, Navy, and Air Force CRNAs. Surveys were distributed to subjects by mail and could be answered by mail or by se... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2242400 Sun, 01 Feb 2009 05:00:00 +0100 2242400 http://www.medworm.com/index.php?rid=2242398&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19263829%26dopt%3DAbstract Authors: Björkelund KB, Hommel A, Thorngren KG, Lundberg D, Larsson S The purpose of this descriptive cohort study was to describe patients with hip fracture on the basis of ASA physical status and to identify preoperative risk factors associated with postoperative outcome up to 4 months after surgery. Data were collected prospectively through the Swedish National Hip Fracture and Anesthetic registers and retrospectively from medical and nursing records. The 428 patients (aged > or = 65 years) with hip fracture were consecutively included. Multiple logistic regression analyses were used to identify factors predicting each of 4 outcomes. Risk factors for a poorer 4-month survival after hip fracture were ASA physical status 3 and 4, more extensive fractures, 85 years or older, ma... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2242398 Sun, 01 Feb 2009 05:00:00 +0100 2242398 http://www.medworm.com/index.php?rid=2242396&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19263830%26dopt%3DAbstract Authors: Nagelhout J, Elisha S, Waters E Patients are admitted for surgery while taking a wide array of medications, and nurse anesthetists must evaluate their effectiveness and compatibility with anesthesia. Anesthetists must be familiar with the basic pharmacology of each drug and the potential adverse effects and possible drug interactions that may occur when anesthetic drugs are administered. If a medication requires discontinuation, we must ensure that the patient's disease remains controlled throughout the perioperative period. It is estimated that up to 50% of patients admitted for surgery will be taking some of type of medication preoperatively. The most common types are the drugs used to treat cardiovascular, central nervous system, and gastrointestinal disorders. There are fe... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2242396 Sun, 01 Feb 2009 05:00:00 +0100 2242396 http://www.medworm.com/index.php?rid=2054228&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19090307%26dopt%3DAbstract Authors: Huang J, Wilson S PMID: 19090307 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054228 Mon, 01 Dec 2008 05:00:00 +0100 2054228 http://www.medworm.com/index.php?rid=2054227&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19090308%26dopt%3DAbstract Authors: Johnson KW The case of Brase v Rees was presented before the US Supreme Court to consider the constitutionality of death by lethal injection as practiced in the state of Kentucky. The 3-drug combination of sodium thiopental, pancuronium bromide, and potassium chloride is a key aspect in question. Capital punishment conflicts with medical and nursing code of ethics preventing providers who are skilled at difficult intravenous (IV) access, assessment of appropriate sedation, and involvement without fear of disciplinary action. Therefore, untrained or undertrained personnel from the prison have been delegated these duties. Cases in which failure to establish or maintain IV access has led to executions lasting up to 90 minutes before the execution was complete. Participation by sk... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054227 Mon, 01 Dec 2008 05:00:00 +0100 2054227 http://www.medworm.com/index.php?rid=2054226&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19090309%26dopt%3DAbstract Authors: Wright SM PMID: 19090309 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054226 Mon, 01 Dec 2008 05:00:00 +0100 2054226 http://www.medworm.com/index.php?rid=2054225&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19090310%26dopt%3DAbstract Authors: Crerar C, Weldon E, Salazar J, Gann K, Kelly JA, Pellegrini JE Endotracheal intubation (ETT) can cause emergence phenomena (EP) including coughing, sore throat, and dysphonia. Two methods used to prevent EP are the administration of local anesthetics directly onto airway structures using a specialized laryngotracheal instillation of topical anesthesia (LITA) tube (Sheridan Catheter Corporation, Argyle, New York) or the placement of a local anesthetic into the ETT cuff. The purpose of this study was to determine which method was better at preventing ERl In this prospective, randomized, comparative analysis, a sample of 160 ASA class I through III patients were randomly assigned to receive their EP prophylaxes either by placement of alkalinized lidocaine directly into the ETT cu... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054225 Mon, 01 Dec 2008 05:00:00 +0100 2054225 http://www.medworm.com/index.php?rid=2054224&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19090311%26dopt%3DAbstract We report a case in a pediatric patient with pyruvate dehydrogenase deficiency who presented for a left foot tendon transfer with an Achilles tendon lengthening secondary to left ankle equinus. The pathophysiology of pyruvate dehydrogenase deficiency is discussed as well as anesthetic management in patients with pyruvate dehydrogenase deficiency. PMID: 19090311 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054224 Mon, 01 Dec 2008 05:00:00 +0100 2054224 http://www.medworm.com/index.php?rid=2054223&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19090312%26dopt%3DAbstract Authors: Huang J, Babins N There are more than 100 different types of dwarfism. Achondroplasia is the most common form of this rare condition. The incidence of achondroplasia in the United States is about 15 per 1 million births. Although inherited as an autosomal dominant condition, 80% of cases result from spontaneous mutation. Underdevelopment and premature ossification of bones result in characteristic craniofacial and spinal abnormalities. Limited neck extension, foramen magnum stenosis, a large tongue, large mandible, and atlanto-axial instability can lead to increased difficulty of airway management. Severe kyphosis, scoliosis, spinal stenosis, and unpredictable spread of local anesthetics in the epidural space and subarachnoid space lead to reluctance to apply regional anesthes... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054223 Mon, 01 Dec 2008 05:00:00 +0100 2054223 http://www.medworm.com/index.php?rid=2054222&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19090313%26dopt%3DAbstract This article describes the genesis and evolution of the collaboration as well as the impact of this ongoing educational effort. PMID: 19090313 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054222 Mon, 01 Dec 2008 05:00:00 +0100 2054222 http://www.medworm.com/index.php?rid=2054221&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19090314%26dopt%3DAbstract Authors: Shannon-Cain J, Hunt E, Cain BS Peripartum cardiomyopathy is a potentially fatal form of heart failure associated with pregnancy. A 29-year-old African American woman, gravida 3, para 2, at 36 weeks' gestation had a history of cardiomyopathy, morbid obesity (body mass index > 70 kg/m2), uncontrolled hypertension, obstructive sleep apnea, and required a repeat cesarean delivery. The patient was admitted to the hospital several times throughout her pregnancy for congestive heart failure, pulmonary edema, and headaches. Two years previously the patient received a diagnosis of peripartum cardiomyopathy 3 weeks after the delivery of her second child. This case report illustrates the recognition of peripartum cardiomyopathy and the risks early in pregnancy. It also describes the ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054221 Mon, 01 Dec 2008 05:00:00 +0100 2054221 http://www.medworm.com/index.php?rid=2054220&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19090315%26dopt%3DAbstract Authors: Griffis CA, Page G, Kremer M, Yermal S Multiple aspects of perianesthesia care and the perioperative environment can influence the functions of the immune system. This course reviews basic immune system functions and potential sources of immune system-altering perioperative stress. The effects of commonly used anesthesia drugs, opioids, and adjunct drugs on immune function are discussed. Patient populations at risk for increased morbidity due to perioperative immune depression are identified, along with patient-specific measures nurse anesthetists can take to reduce postoperative immune dysfunction. PMID: 19090315 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054220 Mon, 01 Dec 2008 05:00:00 +0100 2054220 http://www.medworm.com/index.php?rid=2054219&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19093300%26dopt%3DAbstract Authors: Butterweck V PMID: 19093300 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=2054219 Mon, 01 Dec 2008 05:00:00 +0100 2054219 http://www.medworm.com/index.php?rid=1906699&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18947157%26dopt%3DAbstract Authors: Shire L PMID: 18947157 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1906699 Wed, 01 Oct 2008 04:00:00 +0100 1906699 http://www.medworm.com/index.php?rid=1906698&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18947158%26dopt%3DAbstract Authors: Cox GH PMID: 18947158 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1906698 Wed, 01 Oct 2008 04:00:00 +0100 1906698 http://www.medworm.com/index.php?rid=1906697&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18947159%26dopt%3DAbstract Authors: Henry CT PMID: 18947159 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1906697 Wed, 01 Oct 2008 04:00:00 +0100 1906697 http://www.medworm.com/index.php?rid=1906696&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18947160%26dopt%3DAbstract This article will provide the reader with a comprehensive review of the pharmacology, pharmacokinetics, and adverse effects of dexmedetomidine. A thorough understanding of this drug will enable the anesthesia provider to determine situations in which dexmedetomidine may be a useful drug to consider, whether as an adjunct or as a sole agent. PMID: 18947160 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1906696 Wed, 01 Oct 2008 04:00:00 +0100 1906696 http://www.medworm.com/index.php?rid=1906695&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18947161%26dopt%3DAbstract This study was performed to determine if a 20-mg dose of ketorolac is effective in providing prolonged postoperative analgesia without adverse effects. A total of 55 patients (29 lidocaine-ketorolac, 26 lidocaine-placebo) were enrolled in this randomized, double-blind, placebo controlled study. Pain was measured using a 0 to 10 visual analogue scale and analysis of postoperative analgesic requirements. Incidence of bruising and postoperative analgesic satisfaction scores were determined 48 hours following discharge. No difference in demographic variables, adverse effect profiles, or satisfaction scores was noted between groups. Visual analogue scale scores were increased in the placebo group in the hospital but not following discharge to home. There was also a prolonged time to postoperati... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1906695 Wed, 01 Oct 2008 04:00:00 +0100 1906695 http://www.medworm.com/index.php?rid=1906694&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18947162%26dopt%3DAbstract Authors: Fitzpatrick LR This case report details the onset of masseter muscle rigidity, elevated creatine kinase levels, and rhabdomyolysis following a sevoflurane mask induction and succinylcholine administration in a 12-year-old boy. The patient had no family or personal history of neuromuscular disease or malignant hyperthermia. Hyperkalemia, metabolic acidosis, and rhabdomyolysis occurred within 75 minutes of masseter muscle rigidity. Subsequent to this event, it was recommended that the patient undergo a workup for neuromuscular disease and malignant hyperthermia with muscle biopsy. Until this workup is completed, the family should advise anesthesia providers that the patient is "malignant hyperthermia susceptible." Masseter muscle rigidity, elevated creatine kinase levels, and rh... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1906694 Wed, 01 Oct 2008 04:00:00 +0100 1906694 http://www.medworm.com/index.php?rid=1906693&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18947163%26dopt%3DAbstract Authors: Toomey M Increasing evidence suggests that men and women differ in their responses to pain. Women report intense pain more often than men afflicted with similar ailments. A variety of psychological, cellular, and hormonal modulations have important roles in the experience of pain. The aims of this course are to update anesthesia providers about the differences between genders in pain sensitivity and treatment and to elucidate the complex aspects of the biology of such differences. Providers need to understand and anticipate gender as a potential factor in pain response and opioid requirements. Continued research in this area may someday provide gender-specific medications for pain treatment and a better understanding of certain prevalent pain conditions between genders. PM... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1906693 Wed, 01 Oct 2008 04:00:00 +0100 1906693 http://www.medworm.com/index.php?rid=1780386&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18777807%26dopt%3DAbstract Authors: Yurina G PMID: 18777807 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1780386 Fri, 01 Aug 2008 04:00:00 +0100 1780386 http://www.medworm.com/index.php?rid=1780385&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18777808%26dopt%3DAbstract Authors: Wilson WO PMID: 18777808 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1780385 Fri, 01 Aug 2008 04:00:00 +0100 1780385 http://www.medworm.com/index.php?rid=1780384&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18777809%26dopt%3DAbstract Authors: Turcato N, Roberson C, Covert K PMID: 18777809 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1780384 Fri, 01 Aug 2008 04:00:00 +0100 1780384 http://www.medworm.com/index.php?rid=1780383&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18777810%26dopt%3DAbstract Authors: Spain K Use of the Bullard laryngoscope has been fraught with difficulties, especially for inexperienced users who often end up placing the instrument on the back shelf of the airway cart without further use. A recent hypothesis suggests that the use of a flexible tip tube on the Bullard stylet might facilitate intubation. Initially, the Fastrach laryngeal mask airway (LMA North America, Inc, San Diego, California) flexible tip endotracheal tube was loaded on the Bullard laryngoscope stylet (Circon ACMI, Stamford, Connecticut) and used for intubation. The ease of intubation was noteworthy. Intubations on 6 patients assessed as difficult to intubate were performed on the first attempt without any difficulty. In fact, the effortlessness of these potentially difficult intubations... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1780383 Fri, 01 Aug 2008 04:00:00 +0100 1780383 http://www.medworm.com/index.php?rid=1780382&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18777811%26dopt%3DAbstract Authors: Weissgerber AJ Methylene blue has multiple indications for use, but recently it has been shown to be useful in treating refractory hypotension. Anaphylaxis results in widespread vasodilation and hypotension. Epinephrine has been described as the drug of choice in the treatment of hypotension for anaphylaxis, but the increased heart rate may be poorly tolerated by some patients. This case report describes a 79-year-old man with a history of diastolic dysfunction who was admitted for elective coronary artery bypass graft surgery. After induction of general anesthesia, symptoms of anaphylaxis developed with urticaria and decreased mean arterial pressure. The hypotension was refractory to vasoactive agents and volume repletion. Methylene blue was primed in the cardiopulmonary bypa... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1780382 Fri, 01 Aug 2008 04:00:00 +0100 1780382 http://www.medworm.com/index.php?rid=1780381&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18777812%26dopt%3DAbstract This study reports the beliefs of program directors about the rate of and reasons for attrition in the cohort graduating in 2005. A survey tool was distributed online to all 101 nurse anesthesia educational program directors. Eight programs were excluded because they had no graduates in 2005. Of the remaining 93 programs, 62 (67%) responded. Of 1,499 students enrolled with a projected graduation in 2005, 135 (9%) did not complete the program. The most common reason for attrition was withdrawal (n = 48), followed by academic dismissal (n = 41), and clinical dismissal (n = 21). The attrition rate for individual programs was 7% +/- 9.1 % (mean +/- 1 SD), ranging from 0% to 41.3%. The median value for program attrition rate was 5.41%. The rate for individual programs was not related to the siz... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1780381 Fri, 01 Aug 2008 04:00:00 +0100 1780381 http://www.medworm.com/index.php?rid=1780380&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18777813%26dopt%3DAbstract Authors: Lindsey S Multiple patient and economic benefits have contributed to the widespread popularity of laparoscopic surgery. Although the laparoscopic approach is safe, it is not without potential complications. The following case study describes a patient undergoing a laparoscopic salpingo-oophorectomy who had a sudden rise in end-tidal carbon dioxide to 65 mm Hg and was found to have developed subcutaneous emphysema. Hyperventilation, close monitoring, and mechanical ventilation for 4 hours postoperatively resulted in a positive patient outcome. The mechanisms of carbon dioxide absorption, as well as risk factors, complications, treatment, and prevention of subcutaneous emphysema will be described. PMID: 18777813 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1780380 Fri, 01 Aug 2008 04:00:00 +0100 1780380 http://www.medworm.com/index.php?rid=1780379&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18777814%26dopt%3DAbstract Authors: Elisha S An educational curriculum using adult learning principles in an active learning format was developed for Certified Registered Nurse Anesthetist clinical educators (CRNACEs) to help improve the quality of the clinical learning experiences for student nurse anesthetists (SNAs). This exploratory study sought to determine the extent to which an 8-hour educational course modified the behavioral perceptions and the knowledge of CRNACEs. The effects of the CRNACE course were measured using a questionnaire that consisted of 22 Likert scale items and 8 open-ended questions. The study population included 33 CRNACEs. Their responses were assessed before the course, after the course, and during a 2-month follow-up. It was determined that the CRNACE course positively modified part... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1780379 Fri, 01 Aug 2008 04:00:00 +0100 1780379 http://www.medworm.com/index.php?rid=1780378&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18777815%26dopt%3DAbstract Authors: Aker J The use of a cuffed endotracheal tube (ET) has been discouraged in children up to 8 years of age. Recent literature suggests that this age-old argument is empirical rather than scientifically based. This AANA Journal course will examine the history of pediatric endotracheal intubation, suggested methods for choosing the appropriately sized ET emerging literature describing the advantages and disadvantages of the use of the cuffed ET in young children, and potential clinical problems that develop with the use of the currently available, manufactured, cuffed pediatric ETs. PMID: 18777815 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1780378 Fri, 01 Aug 2008 04:00:00 +0100 1780378 http://www.medworm.com/index.php?rid=1571196&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18567317%26dopt%3DAbstract Authors: Syverud G PMID: 18567317 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571196 Sun, 01 Jun 2008 04:00:00 +0100 1571196 http://www.medworm.com/index.php?rid=1571195&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18567318%26dopt%3DAbstract Authors: Merwin E, Stem S, Jordan LM PMID: 18567318 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571195 Sun, 01 Jun 2008 04:00:00 +0100 1571195 http://www.medworm.com/index.php?rid=1571194&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18567319%26dopt%3DAbstract Discussion includes Gertrude Fife's and Helen Lamb's work in organizing the meeting and the program, a day-by-day look at the meeting events and speakers, and the response to first Annual Meeting. PMID: 18567319 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571194 Sun, 01 Jun 2008 04:00:00 +0100 1571194 http://www.medworm.com/index.php?rid=1571193&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18567320%26dopt%3DAbstract Authors: Rutledge C Airway evaluation and management are of critical importance to providing safe and effective anesthesia. Burn injuries in and around the airway are of particular concern to anesthesia providers. The following is a case report of a 5-year-old patient who had neck contractures and a large hypertrophic scar on his chin secondary to a burn injury. The patient initially was easy to mask ventilate, but ventilation became difficult when muscle relaxants were given and positive-pressure ventilation was attempted. An alteration of conventional hand placement during mask ventilation enabled the anesthesia provider to maintain a patent airway and the surgical procedure to proceed. PMID: 18567320 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571193 Sun, 01 Jun 2008 04:00:00 +0100 1571193 http://www.medworm.com/index.php?rid=1571192&cid=s_37336_5_f&fid=37336&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18567321%26dopt%3DAbstract Authors: Gegel BT The Ohmeda Universal Portable Anesthesia Complete (U-PAC) draw-over anesthetic system is active in the US Army inventory. It is standard equipment for Certified Registered Nurse Anesthetists assigned to US Army Forward Surgical Teams and Joint Special Operations Command. The purpose of this article is to describe a practical and field-expedient U-PAC draw-over vaporizer setup used during Operation Iraqi Freedom I (February 2003 to July 2003). During the deployment, general anesthesia was administered to 25 patients with penetrating trauma using the Gegel-Mercado setup without system malfunction. This setup strengthens the standard U-PAC draw-over system delivery because it increases fractional inspired oxygen concentrations, promotes hands-free operation, enhances cir... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571192 Sun, 01 Jun 2008 04:00:00 +0100 1571192