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. Mon, 30 Nov 2009 13:44:04 +0100 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 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 and sweeping the ETC to the left. We were prepared to use bougie-assisted intubation but could not identify any airway anatomy. After removal of the ETC, we unsuccessfully attemp... 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 http://www.medworm.com/index.php?rid=1571191&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%3D18567322%26dopt%3DAbstract Authors: Schultz TE The obligatory use of fluoroscopy for placement of epidural steroids is controversial. Proponents of the use of fluoroscopy cite studies that report up to 35% rates of inaccurate placement of epidural needles without the aid of fluoroscopic imaging. This case study presents a situation in which a loss-of-resistance technique resulted in an inadvertent discogram. PMID: 18567322 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571191 Sun, 01 Jun 2008 04:00:00 +0100 1571191 http://www.medworm.com/index.php?rid=1571190&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%3D18567323%26dopt%3DAbstract This article explores the application of Paivio's Dual Coding Theory (DCT) as a scientifically sound rationale for the effects of multimedia learning in programs of nurse anesthesia. We explore and highlight this theory as a practical infrastructure for programs that work with dispersed students (ie, distance education models). Exploring the work of Paivio and others, we are engaged in an ongoing outcome study using audiovisual teaching interventions (SBVTIs) that we have applied to a range of healthcare providers in a quasiexperimental model. The early results of that study are reported in this article. In addition, we have observed powerful and sustained learning in a wide range of healthcare providers with our SBVTIs and suggest that this is likely explained by DCT. PMID: 18567323 [... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571190 Sun, 01 Jun 2008 04:00:00 +0100 1571190 http://www.medworm.com/index.php?rid=1571189&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%3D18567324%26dopt%3DAbstract Authors: Goodrich M, Keatley V, Norwood B Wilms tumor (WT), also called nephroblastoma, is a solid, malignant renal mass that can sometimes grow so large it spreads outside the kidney and invades other structures. Most experts recommend complete tumor resection as a primary intervention. The clinical manifestations caused by the WT most significantly hypertension, can appear as a barrage of pathophysiological events to the nurse anesthetist. The case presented involves an 8-week-old infant who underwent a radical nephrectomy because of a WT. The occurrence, symptoms, pathophysiology, and intraoperative anesthetic management of WT are discussed. PMID: 18567324 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571189 Sun, 01 Jun 2008 04:00:00 +0100 1571189 http://www.medworm.com/index.php?rid=1571188&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%3D18567325%26dopt%3DAbstract Authors: Brewer D, Baxter S, Marsh D, Saraceno D, Barber KR, Lebeck LL Cost containment is a critical factor in today's healthcare industry, so finding ways to decrease length of stay is essential in anesthesia practice. We rely on rapid induction, recovery, and discharge to control cost in outpatient surgery. Subarachnoid block (SAB) is an acceptable anesthetic choice for many outpatient procedures. It is often underused because it may result in delayed discharge. The purpose of this study was to determine if orientation of the spinal needle during administration of SAB affects the time required to meet discharge criteria in a same-day surgical unit. Patients undergoing surgical procedures deemed appropriate for short-acting lidocaine spinal anesthetic were recruited for this randomiz... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571188 Sun, 01 Jun 2008 04:00:00 +0100 1571188 http://www.medworm.com/index.php?rid=1571187&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%3D18567326%26dopt%3DAbstract Authors: Perkins PE High-frequency jet ventilation (HFJV) has been used in emergency airway scenarios and various surgical procedures. Although substantial literature is available regarding HFJV in these situations, there is only 1 publication to date concerning its use for cardiac radiofrequency ablation procedures. The following case study describes a 49-year-old man undergoing radiofrequency ablation in which HFJV was used. This method has been used for these procedures for months in our institution with great success. Its effectiveness is attributed to the lack of significant heart movement as compared with conventional intermittent positive-pressure ventilation, which, in turn, has improved surgical conditions and resulted in decreased procedure times. In this case, a newly introd... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571187 Sun, 01 Jun 2008 04:00:00 +0100 1571187 http://www.medworm.com/index.php?rid=1571186&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%3D18567327%26dopt%3DAbstract This article reports the results of a study in which 25 long-time nurse anesthesia program directors were interviewed to gain insights into faculty retention. The interviews revealed reasons for becoming an anesthesia educator, positive and negative aspects of the job, changes over time, and reasons for longevity in their positions. PMID: 18567327 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571186 Sun, 01 Jun 2008 04:00:00 +0100 1571186 http://www.medworm.com/index.php?rid=1571185&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%3D18567328%26dopt%3DAbstract Authors: Osborne L, Snyder M, Villecco D, Jacob A, Pyle S, Crum-Cianflone N The safety of neuraxial analgesia in febrile patients is controversial. We performed an evidenced-based project in an effort to establish a guideline for our active obstetric clinical practice. Neuraxial anesthesia is generally safe for parturients, and complications are rare; however, serious adverse outcomes can result. Because of the devastating nature of the morbidity, the decision to proceed with a neuraxial anesthetic in the face of infection may be contentious. Fever and sepsis are considered relative contraindications to regional anesthesia; however, epidural anesthesia is a superior method of management of pain during labor. One must also consider that 30% to 40% of patients with chorioamnionitis requi... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571185 Sun, 01 Jun 2008 04:00:00 +0100 1571185 http://www.medworm.com/index.php?rid=1571206&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%3D18478810%26dopt%3DAbstract Authors: Blumenreich GA PMID: 18478810 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571206 Tue, 01 Apr 2008 04:00:00 +0100 1571206 http://www.medworm.com/index.php?rid=1571205&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%3D18478811%26dopt%3DAbstract Authors: Merwin E, Stem S, Jordan LM PMID: 18478811 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571205 Tue, 01 Apr 2008 04:00:00 +0100 1571205 http://www.medworm.com/index.php?rid=1571204&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%3D18478812%26dopt%3DAbstract This article also reviews the physiology of the neuromuscular junction and the autonomic nervous system receptors that nerve agent toxicity affects. PMID: 18478812 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571204 Tue, 01 Apr 2008 04:00:00 +0100 1571204 http://www.medworm.com/index.php?rid=1571203&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%3D18478813%26dopt%3DAbstract Authors: Young B A 27-year-old man who had 2 admissions 1 month apart for abdominal surgery had a high methemoglobin (MHb) level secondary to liberal use of benzocaine oral spray. A co-oximetry level for MHb of greater than 0.30 proportion of total hemoglobin (30.1%) was detected intraoperatively. The patient was successfully treated with methylene blue intravenously and recovered uneventfully. When the arterial blood gas with a normal partial pressure of oxygen is inconsistent with a low pulse oximeter reading and with the physical appearance of the patient, methemoglobinemia should be considered as a differential diagnosis. This case illustrates the acquired form of methemoglobinemia. Adequate oxygen delivery to the tissues in the body is compromised when MHb overwhelms the capacity ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571203 Tue, 01 Apr 2008 04:00:00 +0100 1571203 http://www.medworm.com/index.php?rid=1571202&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%3D18478814%26dopt%3DAbstract This study was a randomized, double blind, posttest-only design that included 38 patients. Investigators recruited the subjects, obtained consent, and provided a syringe containing 5 mL of 4% lidocaine or 5 mL of saline to the anesthesia provider. At time of intubation, the provider injected the contents of the syringe into the endotracheal tube cuff. The control group received 5 mL of saline, and the experimental group received 5 mL of 4% lidocaine. On emergence, the anesthesia provider counted and recorded the number of coughs before awake extubation. This study did not show a correlation between use of intracuff lidocaine and a decrease in emergence coughing in procedures lasting less than 1.5 hours in patients who smoke. PMID: 18478814 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571202 Tue, 01 Apr 2008 04:00:00 +0100 1571202 http://www.medworm.com/index.php?rid=1571201&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%3D18478815%26dopt%3DAbstract Authors: Kier LB This review article presents 3 theories related to ligand diffusion, general anesthesia and sleep. The first theory describes the diffusion of molecules across a protein surface to a receptor. It is based on the effect of the amino acid side chains on the protein surface on the structure of bulk water nearby. This influence creates pathways, called chreodes, through the water near the protein surface, permitting a rapid diffusion of molecules to the receptors. A second theory involving the role of chreodes presents a mechanism of action of nonspecific anesthetic agents. These agents interrupt the diffusion of neurotransmitter molecules to their receptors, bringing on the anesthetic effects. Finally, building on the similarities of anesthesia and sleep, a theory is pres... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571201 Tue, 01 Apr 2008 04:00:00 +0100 1571201 http://www.medworm.com/index.php?rid=1571200&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%3D18478816%26dopt%3DAbstract Authors: Beaumont DM, Mark TM, Hills R, Dixon P, Veit B, Garrett N Chrysin, a passion flower extract, may be beneficial because of its potential to attenuate surgical suppression of natural killer (NK) cell activity. We divided 37 male Sprague-Dawley rats into 3 treatment groups: (1) rats undergoing abdominal surgery and administered isoflurane and a 5% solution of dimethyl sulfoxide in saline (vehicle), (2) rats undergoing abdominal surgery and administered isoflurane and chrysin solubilized in 5% dimethyl sulfoxide, and (3) rats not undergoing surgery but administered isoflurane and chrysin. Natural killer cell activity was measured before and 24 hours after the experiment. Analysis of covariance, with preoperative NK cell activity as the covariate, was used to compare differences in... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571200 Tue, 01 Apr 2008 04:00:00 +0100 1571200 http://www.medworm.com/index.php?rid=1571199&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%3D18478817%26dopt%3DAbstract Authors: Trudell J, McMurdy N The use of antifibrinolytic therapy is commonplace in coronary artery revascularization procedures. Cardiac surgery accounts for more than 700,000 surgeries per year, with approximately 70% of these cases requiring antifibrinolytic therapy for coronary artery bypass graft (CABG) procedures. Two main classes of antifibrinolytics are used in CABG procedures: synthetic lysine analogues and serine protease inhibitors. Both classes of antifibrinolytics have been shown to decrease the incidence of blood transfusions. However, new data have emerged regarding an increase in adverse outcomes associated with serine protease inhibitors. The purpose of this review article is to describe the clinical significance of antifibrinolytic therapy and the current implications... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571199 Tue, 01 Apr 2008 04:00:00 +0100 1571199 http://www.medworm.com/index.php?rid=1571198&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%3D18478818%26dopt%3DAbstract Authors: Reckard D, Cipcic E, Mackin C Mitral regurgitation is commonly encountered in anesthesia clinical practice. Knowledge of the pathophysiology and proper anesthetic management is crucial to achieving optimal outcomes. Surgical advancements and early intervention have led to improved outcomes. An ASA class III, 58-year-old woman with mitral regurgitation secondary to rheumatic fever, presented for repair or replacement of the mitral valve. A graded induction with low-dose narcotic, isoflurane, and phenylephrine was required to maintain acceptable cardiovascular parameters during induction and throughout the case. Additional interventions included adequate preload, normal heart rate, and decreased afterload, to maintain a mean arterial pressure of 65 mm Hg. Ampicillin and gentamic... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571198 Tue, 01 Apr 2008 04:00:00 +0100 1571198 http://www.medworm.com/index.php?rid=1571197&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%3D18478819%26dopt%3DAbstract Authors: Joyce JA Even though the supply of blood products has never been safer, disease transmission remains the chief patient concern about transfusions. The primary concerns for anesthetists center on risks associated with blood transfusions, such as transfusion-related acute lung injury, anaphylactic transfusion reaction, clerical errors resulting in ABO incompatibility, and blood products contaminated with infectious organisms. These concerns, combined with patients' religious tenets and other factors, have contributed to renewed efforts to minimize blood transfusion without negative patient consequences. Achieving this goal requires a concerted effort by surgeons, perioperative nurses, and anesthesia providers. PMID: 18478819 [PubMed - in process] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571197 Tue, 01 Apr 2008 04:00:00 +0100 1571197 http://www.medworm.com/index.php?rid=1571216&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%3D18323313%26dopt%3DAbstract Authors: Strube P, Jarvis J PMID: 18323313 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571216 Fri, 01 Feb 2008 05:00:00 +0100 1571216 http://www.medworm.com/index.php?rid=1571215&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%3D18323314%26dopt%3DAbstract Authors: Kremer M, Fallacaro M PMID: 18323314 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571215 Fri, 01 Feb 2008 05:00:00 +0100 1571215 http://www.medworm.com/index.php?rid=1571214&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%3D18323315%26dopt%3DAbstract This article reviews the techniques for removal of tongue jewelry and options for maintaining oral piercing patency. To remove or not to remove...that is the question. In the emergency medicine and anesthesia literature, there are arguments both for and against the routine removal of oral jewelry for intubation. Some practitioners feel that if people can eat, drink, talk, and sleep with the jewelry in place, they probably can be intubated safely without removing it. Most case reports present the opinion that tongue jewelry should be removed before oral intubation to minimize jewelry aspiration, bleeding, and medical-legal risks to the anesthetist. This article's focus is to illustrate suggested tongue jewelry removal techniques for awake and unconscious patients from the health practitione... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571214 Fri, 01 Feb 2008 05:00:00 +0100 1571214 http://www.medworm.com/index.php?rid=1571213&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%3D18323316%26dopt%3DAbstract Authors: Geisz-Everson MA, Wren K, Kennedy L A 53-year-old woman presented to the operating room for surgical correction of pericardial and pleural effusions. Her history included stage IV breast cancer, well-controlled hypertension, and diverticulitis. Although her baseline blood pressure, heart rate, and respirations were normal, she was short of breath with diminished breath sounds on the left side of the lungs and required oxygen, 2 L/min via nasal cannula. The nurse anesthesia student, under the direction of the Certified Registered Nurse Anesthetist (CRNA) and anesthesiologist, induced general anesthesia with etomidate, fentanyl, lidocaine, and succinylcholine. During placement of a double-lumen endotracheal tube, the patient became asystolic. The nurse anesthesia student immedia... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571213 Fri, 01 Feb 2008 05:00:00 +0100 1571213 http://www.medworm.com/index.php?rid=1571212&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%3D18323317%26dopt%3DAbstract Authors: Coopmans VC, Biddle C Directives to improve patient outcomes and enhance safety within the healthcare system have led to development of technologies to assist practitioners in a variety of activities. The purpose of this study was to explore and evaluate a method for examining the effect of computer-assisted decision making (CADM) using a handheld device on the accuracy (ie, correct diagnosis and treatment) and speed of problem solving by Certified Registered Nurse Anesthetists (CRNAs) during simulated critical patient-care events. A randomized crossover design with matched-pair sampling was used. In a high-fidelity human simulation environment, 4 CRNAs participated in 2 plausible critical anesthesia case scenarios. CRNA performance with and without CADM technology, environmen... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571212 Fri, 01 Feb 2008 05:00:00 +0100 1571212 http://www.medworm.com/index.php?rid=1571211&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%3D18323318%26dopt%3DAbstract Authors: Fischer R During the past 3 years, the US Food and Drug Administration (FDA) has received a growing number of adverse event reports on the breakage or fracturing and retention of anesthetic conduction device tips with associated complications. Serious injuries and other problems such as spinal stenosis, nerve root compression, and subcutaneous effusion can result. Several case reports demonstrate how the problems occur; some illustrate the severity of the problem. All cases are from adverse event reports in the FDA Center for Devices and Radiological Health (CDRH) Manufacturer and User Facility Device Experience database. Frequently, in the interest of not causing patient harm, a device fragment might not be removed as long as the patient is not neurologically compromised or a... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571211 Fri, 01 Feb 2008 05:00:00 +0100 1571211 http://www.medworm.com/index.php?rid=1571210&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%3D18323319%26dopt%3DAbstract Authors: Shields JA Heart block and Q-Tc interval prolongation have been reported with several agents used in anesthesia, and the US Food and Drug Administration mandates evaluation of the Q-T interval with new drugs. Drug-induced Q-T interval prolongation may precipitate life-threatening arrhythmias, is considered a precursor for torsades de pointes, and may predict cardiovascular complications. In the patient described in this article, heart block occurred and the Q-Tc interval became prolonged after muscle relaxant reversal with neostigmine; both were considered to be related to the combination of agents used in the case, as well as to other predisposing factors such as morbid obesity. The agents used that affected cardiac conduction were neostigmine, desflurane, droperidol, dolaset... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571210 Fri, 01 Feb 2008 05:00:00 +0100 1571210 http://www.medworm.com/index.php?rid=1571209&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%3D18323320%26dopt%3DAbstract Authors: Cline M, Taylor JE, Flores J, Bracken S, McCall S, Ceremuga TE The purpose of our study was to investigate the anxiolytic effects of linalool and its potential interaction with the GABAA receptor in Sprague-Dawley rats. Lavender has been used traditionally as an herbal remedy in the treatment of many medical conditions, including anxiety. Linalool is a major component of the essential oil of lavender. Forty-four rats were divided into 4 groups: control, linalool, midazolam (positive control), and flumazenil and linalool. The behavioral and the neurohormonal/physiological components of anxiety were evaluated. The behavioral component was examined by using the elevated plus maze (open arm time/total time) and the neurohormonal/physiological component by measuring serum catechola... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571209 Fri, 01 Feb 2008 05:00:00 +0100 1571209 http://www.medworm.com/index.php?rid=1571208&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%3D18323321%26dopt%3DAbstract This article describes the pathogenesis of AFE, including theories of its immunological mediation available in the literature. The most current diagnostic and treatment modalities are discussed, including several novel therapies. A case report of a 40-year-old parturient who suffered probable AFE following amniotomy, with the development of cardiopulmonary compromise, neurologic involvement, fetal distress, and coagulopathy, is outlined. The patient survived emergency cesarean delivery and hysterectomy with no residual physiologic deficits. PMID: 18323321 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571208 Fri, 01 Feb 2008 05:00:00 +0100 1571208 http://www.medworm.com/index.php?rid=1571207&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%3D18323322%26dopt%3DAbstract Authors: Biddle C Take a moment and consider our planet without oxygen. Imagine the earth some 2.5 billion years ago when oxygen first appeared as a waste product of early anaerobes. Oxygen, as we know it today, is essential for life. Abundant and relatively inexpensive to manufacture, oxygen has widespread use in industry and healthcare. Anesthesia providers routinely administer oxygen in concentrations exceeding that in ambient air to ensure clinical safety and to offset the predictable sequelae associated with patient, drug-related, and procedural factors. Understanding the history of this unique element is critical in evaluating the often contentious body of contemporary research that has illuminated its efficacy (as elixir) and its attendant complications (its "two-faced" nature).... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571207 Fri, 01 Feb 2008 05:00:00 +0100 1571207 http://www.medworm.com/index.php?rid=1571222&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%3D18178999%26dopt%3DAbstract Authors: Garey TD PMID: 18178999 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571222 Sat, 01 Dec 2007 05:00:00 +0100 1571222 http://www.medworm.com/index.php?rid=1571221&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%3D18179000%26dopt%3DAbstract This article discusses appropriate preoperative patient selection and intraoperative airway management plans for the modified use of one-lung anesthesia airway devices with an emphasis on use with tracheostomies. PMID: 18179000 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571221 Sat, 01 Dec 2007 05:00:00 +0100 1571221 http://www.medworm.com/index.php?rid=1571220&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%3D18179001%26dopt%3DAbstract Authors: Teran L, Hawkins JK We evaluated preemptive treatment for postoperative nausea and vomiting (PONV) with intravenous (IV) granisetron, 0.1 mg, introoperatively as compared with the use of 70% inhalation isopropyl alcohol and a control group for the prevention of PONV. We randomly assigned 57 women, 18 to 50 years old, undergoing laparoscopic procedures to 1 of 3 groups: (1) inhalation of 70% isopropyl alcohol, (2) 0.1 mg granisetron IV, and (3) no prophylactic treatment control. Participants were asked to rate their nausea and vomiting preoperatively, on arrival to postanesthesia care unit (PACU), at discharge from PACU, 6 hours after extubation, and 24 hours after extubation and any occurrence of nausea and vomiting using the numeric rating scale (NRS), 0 to 10. Group 1 experi... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571220 Sat, 01 Dec 2007 05:00:00 +0100 1571220 http://www.medworm.com/index.php?rid=1571219&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%3D18179002%26dopt%3DAbstract Authors: Eshkevari L, Baker BM The challenge of treating older, obese patients with various comorbidities has become a mainstay of anesthetic practice. In order to monitor and provide anesthesia safely, the nurse anesthetist must weigh the risks and benefits of all types of monitoring when these patients undergo major invasive procedures. One such option is the Swan-Ganz pulmonary artery catheter. During the last decade an estimated 2 million pulmonary artery (Swan-Ganz) catheters were sold annually in the United States. Although the pulmonary artery catheter is a useful and popular monitoring tool, the potential for complications does exist, with some estimates suggesting a mortality rate of 0.02% to 1.5%. These figures, along with other complications, warrant consideration when evalu... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571219 Sat, 01 Dec 2007 05:00:00 +0100 1571219 http://www.medworm.com/index.php?rid=1571218&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%3D18179003%26dopt%3DAbstract Authors: Chaplin RL, Jedynak J, Johnson D, Heiter D, Shovelton L, Garrett N Herbal use may be associated with increased morbidity and mortality as a consequence of interactions with anesthetic agents. The purpose of this study was to investigate the effects on emergence from isoflurane anesthesia using a combination of the herb valerian and midazolam compared with valerian alone, midazolam alone, and no additional drug-herb treatment in Sprague-Dawley rats. We assigned 32 male Sprague-Dawley rats to 1 of 4 groups: (1) isoflurane alone, (2) isoflurane plus valerian, (3) isoflurane plus midazolam, and (4) isoflurane plus a combination of valerian and midazolam. Thirty minutes after treatment, animals underwent a standard laparotomy. The time in seconds from discontinuation of isoflurane ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571218 Sat, 01 Dec 2007 05:00:00 +0100 1571218 http://www.medworm.com/index.php?rid=1571217&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%3D18179004%26dopt%3DAbstract Authors: Joyce JA Acute onset of dyspnea, fever, hypotension, and cough during or soon after a blood or blood-product transfusion has been described in the literature since the early 1950s. Between 2003 and 2005, transfusion-related acute lung injury (TRALI) surpassed ABO incompatibility as the number one cause of transfusion-related mortality in the United States, as reported to the Food and Drug Administration. Prompt recognition and appropriate intervention are required to reduce mortality. Prevention of TRALI represents a complex challenge. There is no single intervention that will prevent every case of TRALI, but several interventions have been proposed to reduce the risk. PMID: 18179004 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571217 Sat, 01 Dec 2007 05:00:00 +0100 1571217 http://www.medworm.com/index.php?rid=1571229&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%3D17966673%26dopt%3DAbstract Authors: Potter DG PMID: 17966673 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571229 Mon, 01 Oct 2007 04:00:00 +0100 1571229 http://www.medworm.com/index.php?rid=1571228&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%3D17966674%26dopt%3DAbstract Authors: Ray TD PMID: 17966674 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571228 Mon, 01 Oct 2007 04:00:00 +0100 1571228 http://www.medworm.com/index.php?rid=1571227&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%3D17966675%26dopt%3DAbstract Authors: Incollingo F, Shevchenko Y Penetrating foreign bodies of the oropharynx are encountered in children of all ages, although more frequently between the ages of 3 to 5 years. A thorough preanesthetic evaluation of these patients, including type and extent of injury, must be performed if time allows. As a result of the often emergent nature of these cases, poor patient cooperation, and great potential for airway compromise, special considerations are given to management of the airway. The use of nontraditional equipment may greatly facilitate laryngoscopy and intubation. PMID: 17966675 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571227 Mon, 01 Oct 2007 04:00:00 +0100 1571227 http://www.medworm.com/index.php?rid=1571226&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%3D17966676%26dopt%3DAbstract Authors: Brown E, Hurd NS, McCall S, Ceremuga TE The definitive anxiolytic effects of Passiflora incarnata are unknown. We studied the potential anxiolytic effects of chrysin, a Passiflora extract, and the purported modulation of the benzodiazepine receptor on the GABA(A) receptor in laboratory rats. We hypothesized that chrysin decreases anxiety via interaction with the GABA(A) receptor in laboratory rats as measured by elevated plus-maze (EPM), corticosterone, and catecholamine assays. We randomized 44 male Sprague-Dawley rats in a double-blind, placebo-controlled, between-subjects experimental design. Each animal received an intraperitoneal injection of (1) vehicle (DMSO 4%), (2) chrysin, 2 mg/kg, (3) midazolam, 1.5 mg/kg, or (4) flumazenil, 3 mg/kg and chrysin, 2 mg/kg. The EPM was... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571226 Mon, 01 Oct 2007 04:00:00 +0100 1571226 http://www.medworm.com/index.php?rid=1571225&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%3D17966677%26dopt%3DAbstract Authors: Hulse JA, Chenowith T, Lebedovych L, Dickinson P, Cavanaugh GB, Garrett N The primary objective of this research was to identify cognitive and noncognitive factors that may predict student success in the US Army Graduate Program in Anesthesia Nursing. Second, the results of this study will help identify students possibly at risk for failure so that interventional measures can be developed and implemented to promote success and reduce attrition. Participants in this 3-year longitudinal, nonexperimental, prospective, descriptive study were 42 students. Cognitive and noncognitive assessment tools were used to identify predictors of success. The measure of success was defined as graduation from the program and withdrawal or relief as nonsuccess. All data were analyzed using logist... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571225 Mon, 01 Oct 2007 04:00:00 +0100 1571225 http://www.medworm.com/index.php?rid=1571224&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%3D17966678%26dopt%3DAbstract Authors: Aker J, Biddle C Complex biological systems are often shaped and maintained by opposing forces. A relevant biological example is the delicate balance between proteases and their inhibitors. Serine proteases contain a serine residue in the active site of the molecule that is essential to the activity of the enzyme. Protease inhibitors limit the activity of proteases in the body. As examples, aprotinin (Trasylol), a serine protease inhibitor, and aminocaproic acid (Amicar), a lysine protease inhibitor, are used to decrease the rate of fibrinolysis and have recently been the subject of considerable controversy in the literature regarding safety and efficacy. This AANA journal course reviews 2 common examples of protease inhibitor disorders, angioedema and a form of emphysema, tha... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571224 Mon, 01 Oct 2007 04:00:00 +0100 1571224 http://www.medworm.com/index.php?rid=1571223&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%3D17969250%26dopt%3DAbstract Authors: Huang J PMID: 17969250 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571223 Mon, 01 Oct 2007 04:00:00 +0100 1571223 http://www.medworm.com/index.php?rid=1571235&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%3D17711154%26dopt%3DAbstract Authors: Horton BJ PMID: 17711154 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571235 Wed, 01 Aug 2007 04:00:00 +0100 1571235 http://www.medworm.com/index.php?rid=1571234&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%3D17711155%26dopt%3DAbstract Authors: Ales R, May D, Whitney L A prospective, double-blind, mixed, crossover study was conducted to determine the perception of pain associated with intradermal lidocaine and chloroprocaine for insertion of an 18-gauge intravenous catheter. A convenience sample of 64 healthy, adult volunteers was used. Each participant received an intradermal injection of lidocaine or chloroprocaine on the dorsum of one hand followed by insertion of an 18-gauge intravenous catheter. The procedure was repeated on the opposite hand with the other anesthetic. Half of the subjects received lidocaine first, and half received chloroprocaine first. Subjects were asked to rate their pain on a 100-mm visual analogue scale immediately after injection of each local anesthetic and immediately after insertion of... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571234 Wed, 01 Aug 2007 04:00:00 +0100 1571234 http://www.medworm.com/index.php?rid=1571233&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%3D17711156%26dopt%3DAbstract Authors: Macksey LF, White B This case report describes anesthetic considerations for a 6-year-old boy, admitted for adenoidectomy under general anesthesia, who had a complicated medical history, including mastocytosis, Noonan syndrome, and von Willebrand disease. Each affected the anesthetic plan and was addressed preoperatively among all surgical and anesthesia providers. Mastocytosis created a major concern, with its increased numbers of histamine-filled mast cells. Each drug that was added or eliminated from the anesthetic plan, to prevent histamine release by the activation of triggers, was considered. Patient handling and temperature control were also concerns. One of Noonan syndrome's characteristics is heart anomalies. This patient had a history of a patent foramen ovale and pu... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571233 Wed, 01 Aug 2007 04:00:00 +0100 1571233 http://www.medworm.com/index.php?rid=1571232&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%3D17711157%26dopt%3DAbstract Authors: MacRae MG Historically, closed malpractice claims have been used to identify and examine potential causes for adverse anesthesia outcomes. In the United States, the American Association of Nurse Anesthetists and the American Society of Anesthesiologists have compiled and analyzed such data. In all claims filed, respiratory events were most common, and the most common outcome class was brain damage or death. These findings and others led to improved practice standards, including end-tidal carbon dioxide and pulse oximetry monitoring. Although some researchers have cited closed claims studies as evidence of anesthesia risk trends, the nature of the data makes it inappropriate for calculation or comparison of risk. Further work is needed to elucidate some mechanisms of injury and... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571232 Wed, 01 Aug 2007 04:00:00 +0100 1571232 http://www.medworm.com/index.php?rid=1571231&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%3D17711158%26dopt%3DAbstract Authors: Gambrall MA Patients undergoing surgical correction of scoliosis present many challenges to anesthetists because of the pathophysiologic derangements caused by the disease and the demanding nature of the anesthetic care that is required. A thorough understanding of the pathophysiology of the disease, intraoperative concerns specific to the procedure, and the efficacy of various anesthetic management techniques is required by anesthetists to optimally care for patients undergoing surgical correction of scoliosis. This literature review focuses on key considerations for anesthetists, including common comorbidities in patients with scoliosis, the need for induced hypotension, large surgical blood loss, the need for transfusion of blood and blood products, possible autologous bloo... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571231 Wed, 01 Aug 2007 04:00:00 +0100 1571231 http://www.medworm.com/index.php?rid=1571230&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%3D17711159%26dopt%3DAbstract Authors: Welliver M Cyclodextrins, some of the select molecules exhibiting properties that are beneficial across multiple industries, are naturally occurring cyclical oligosaccharides with a lipophilic inner cavity and a hydrophilic exterior. These characteristics enable cyclodextrins to surround and bind lipophilic molecules while maintaining aqueous solubility. Agrochemistry, analytical chemistry, food, nutraceutical, and pharmaceutical industries have benefited and continue to benefit from these unique molecular properties. Though known and studied for more than 100 years, cyclodextrins have only recently been explored for specific application to anesthesia. Numerous studies exploring cyclodextrin-improved anesthetic delivery are underway. This new class of enabling molecules will e... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571230 Wed, 01 Aug 2007 04:00:00 +0100 1571230 http://www.medworm.com/index.php?rid=1571245&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%3D17591295%26dopt%3DAbstract Authors: Taylor K PMID: 17591295 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571245 Fri, 01 Jun 2007 04:00:00 +0100 1571245 http://www.medworm.com/index.php?rid=1571244&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%3D17591296%26dopt%3DAbstract Authors: Horton BJ PMID: 17591296 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571244 Fri, 01 Jun 2007 04:00:00 +0100 1571244 http://www.medworm.com/index.php?rid=1571243&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%3D17591297%26dopt%3DAbstract Authors: Hester CE, Dietrich SA, White SW, Secrest JA, Lindgren KR, Smith T The purpose of this study was to compare the preoperative anesthetic airway evaluation methods of the modified Mallamapti test (MMT) and upper lip bite test (ULBT) with the direct laryngoscopic views obtained during tracheal intubation. Positive relationships were predicted for the MMT and ULBT with direct laryngoscopic view and between the MMT and ULBT. We assessed 50 patients' airways preoperatively by MMT and ULBT. Intraoperatively, laryngoscopic views were graded on the Cormack and Lehane scale. Descriptive statistics and correlations were computed. There was no relationship between the MMT and the ULBT and the Cormack and Lehane scale. There was a significant relationship between the ULBT and the Cormack a... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571243 Fri, 01 Jun 2007 04:00:00 +0100 1571243 http://www.medworm.com/index.php?rid=1571242&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%3D17591298%26dopt%3DAbstract Authors: Snarr J Acute low back pain, radiculopathy, and associated disabilities have a prevalence of 2% in the United States, which represents a significant health problem and a major cause of workplace absence. The condition primarily affects 25- to 45-year-old men and women. Epidural steroid injections (ESIs) are commonly administered to relieve this pain and improve mobility without surgery. This case report presents issues related to the treatment of an epidural hematoma in an 87-year-old man receiving long-term anticoagulant therapy. It reviews the risks, benefits, side effects, complications, and contraindications to ESI and the American Society of Regional Anesthesia consensus recommendations for the performance of neuraxial procedures in patients receiving anticoagulant therap... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571242 Fri, 01 Jun 2007 04:00:00 +0100 1571242 http://www.medworm.com/index.php?rid=1571241&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%3D17591299%26dopt%3DAbstract This article discusses the initial treatment attempted at resolving the bronchospasm, as well as the use of heliox in the ultimate resolution of the bronchospasm. Although heliox has been used foryears to treat patients with various respiratory complications, it is not currently a common treatment instituted by anesthesia practitioners for the treatment of bronchospasm. Consideration of the use of heliox may provide another option for the treatment of a patient suffering from refractory bronchospasm. PMID: 17591299 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571241 Fri, 01 Jun 2007 04:00:00 +0100 1571241 http://www.medworm.com/index.php?rid=1571240&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%3D17591300%26dopt%3DAbstract Authors: Meitzner MC, Skurnowicz JA, Mitchell A An extensive literature review was undertaken to evaluate the best anesthetic practice for carotid endarterectomy surgery. Two anesthetic techniques were evaluated: general anesthetic with an endotracheal tube and regional anesthetic block. Three variables were reviewed with respect to significant clinical outcomes based on anesthetic technique. Relevant literature was obtained through multiple sources that included professional journals, a professional website, and textbooks. According to the literature, there is an advantage to performing regional anesthesia with respect to cost and neurologic status. Information analyzed was inconclusive with respect to hemodynamic stability and anesthetic technique. We conclude that regional anesthesi... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571240 Fri, 01 Jun 2007 04:00:00 +0100 1571240 http://www.medworm.com/index.php?rid=1571239&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%3D17591301%26dopt%3DAbstract Authors: Worrell J, Lane S This case report reviews anesthetic management and medical considerations for a pregnant patient with a history of pseudotumor cerebri (PTC). The 24-year-old woman, gravida 2, paragravida 0, spontaneous abortion 1, was in active labor at an estimated 38 weeks' gestation and had been given a diagnosis of PTC 4 years earlier. This patient first experienced global headaches and blurred vision at age 20 years. At the time of onset of her headache symptoms, she underwent a full diagnostic workup and detailed neurologic examination, including magnetic resonance imaging (MRI) of the brain and a lumbar puncture. The MRI was normal. Her lumbar puncture showed elevated cerebral spinal fluid (CSF) pressures and normal CSF composition. The patient's initial symptoms of h... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571239 Fri, 01 Jun 2007 04:00:00 +0100 1571239 http://www.medworm.com/index.php?rid=1571238&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%3D17591302%26dopt%3DAbstract Authors: Henkel-Honke T, Oleck M Artificial oxygen carriers are not blood substitutes. They serve to carry oxygen to tissues and are either hemoglobin based or perfluorocarbon based. Driving the development of artificial oxygen carriers are concerns involving both the safety and quantity of the blood supply. No artificial oxygen carriers are currently approved for clinical use in the United States. Hemopure has been approved for use in South Africa. The companies producing Hemopure and PolyHeme, both of which are hemoglobin-based oxygen carriers, have filed a Biologic License Application in the United States. Phase III trials have been completed for Hemopure, while PolyHeme is currently undergoing phase III trials in the PolyHeme Urban Ambulance Trial. No North American trials are unde... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571238 Fri, 01 Jun 2007 04:00:00 +0100 1571238 http://www.medworm.com/index.php?rid=1571237&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%3D17591303%26dopt%3DAbstract Authors: Aponte H, Acosta S, Rigamonti D, Sylvia B, Austin P, Samolitis T Ultrasound has been used to aid cannulation of veins of the neck, chest, antecubital fossa, and femoral vein. This investigation compared the traditional method of peripheral intravenous (IV) cannulation of veins of the hands and forearms with ultrasound-guided IV cannulation of these veins. After obtaining institutional review board approval and written informed consent, 35 adult subjects with a history or suspicion of difficult IV cannulation were prospectively enrolled with 16 subjects randomly assigned to the traditional group and 19 to the ultrasound group. Time taken for successful venous cannulation and number of attempts between the groups were compared using a Mann-Whitney U test. The number of subjects ... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571237 Fri, 01 Jun 2007 04:00:00 +0100 1571237 http://www.medworm.com/index.php?rid=1571236&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%3D17591304%26dopt%3DAbstract Authors: Maracic L, Van Nostrand J, Beach D Cancer is one of the most prevalent disease processes affecting people of all ages. Cancer is the second most common cause of death in the United States, exceeded only by heart disease. Cancer survival is dependent on treatment options that may include surgery, radiation, and chemotherapy. Chemotherapy, or systemic cancer therapy, is designed to promote cell death during different phases of cell growth and division. Unfortunately, chemotherapeutic agents cannot differentiate between malignant and normal cells. Therefore, the toxic effects of chemotherapy are also seen in healthy organs and tissues. In addition, chemotherapeutic agents can interact with other medications. The effects of chemotherapy may be acute and self-limiting or chronic an... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571236 Fri, 01 Jun 2007 04:00:00 +0100 1571236 http://www.medworm.com/index.php?rid=1571255&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%3D17471876%26dopt%3DAbstract Authors: Kuczkowski KM, Hastings BH PMID: 17471876 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571255 Sun, 01 Apr 2007 04:00:00 +0100 1571255 http://www.medworm.com/index.php?rid=1571254&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%3D17471877%26dopt%3DAbstract Authors: Blumenreich GA PMID: 17471877 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571254 Sun, 01 Apr 2007 04:00:00 +0100 1571254 http://www.medworm.com/index.php?rid=1571253&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%3D17471878%26dopt%3DAbstract Authors: Gaffey V PMID: 17471878 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571253 Sun, 01 Apr 2007 04:00:00 +0100 1571253 http://www.medworm.com/index.php?rid=1571252&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%3D17471879%26dopt%3DAbstract Authors: Baker KR, Landriscina D, Kartchner H, Mirkes DM Prompt administration of intravenous (i.v.) dantrolene sodium (DS) is the primary determinant of successful treatment of malignant hyperthermia (MH) syndrome. Because DS has a long reconstitution time for use in treating an MH crisis, we evaluated an alternative technique for hastening the reconstitution. Simulating real-world conditions, with equipment common to the operating room environment, we conducted a randomized, controlled, single-blind study dividing 16 DS vials into 2 equal groups: warm (41 degrees C) and ambient temperature (22 degrees C). With an i.. fluid warmer at 41 degrees C, primed with a 1-L bag of preservative-free sterile water, attached to a 60-mL syringe via a 3-way stopcock, we aspirated and injected the d... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571252 Sun, 01 Apr 2007 04:00:00 +0100 1571252 http://www.medworm.com/index.php?rid=1571251&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%3D17471880%26dopt%3DAbstract Authors: Howie WO PMID: 17471880 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571251 Sun, 01 Apr 2007 04:00:00 +0100 1571251 http://www.medworm.com/index.php?rid=1571250&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%3D17471881%26dopt%3DAbstract Authors: O'Connor G, Gingrich R, Moffat M Postdural puncture headache (PDPH) is a debilitating side effect of spinal anesthesia, the result of dural puncture and cerebrospinal fluid (CSF) leakage with an incidence of 3% to 75% in patient populations. Despite numerous in vitro and in viva studies that have identified predictors associated with PDPH, debate continues on the best technique to reduce CSF leak after dural puncture. The purpose of this in vitro study was to evaluate the relationship between spinal needle type (pencil tipped or cutting), needle size (22 or 25 gauge), and dura penetration angle from perpendicular (90 or 30 degrees), with the resulting CSF leak measured after dural puncture. Spinal needle designs continue to be studied and modified to reduce the incidence of PD... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571250 Sun, 01 Apr 2007 04:00:00 +0100 1571250 http://www.medworm.com/index.php?rid=1571249&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%3D17471882%26dopt%3DAbstract Authors: Adams L, Malcotti C, Petrunak E Aneurysms that extend from the descending thoracic aorta into the abdomen, which can also involve the visceral segments of the upper abdominal aorta, are traditionally classified as thoracoabdominal. Thoracoabdominal aortic aneurysm reconstruction is very complex vascular surgery associated with high postoperative morbidity and mortality and related postoperative complications. In addition to the surgical complexity associated with repair of these aneurysms, the temporary interruption of blood flow distal to the clamp introduces multiple considerations for the anesthetic practitioner to consider for the reduction of potential complications. This case report involves an 80-year-old female presenting for elective repair of a type IV thoracoabdomin... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571249 Sun, 01 Apr 2007 04:00:00 +0100 1571249 http://www.medworm.com/index.php?rid=1571248&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%3D17471883%26dopt%3DAbstract This study aimed to determine whether the PAXpress airway (Vital Signs, Totawa, NJ) should replace the standard laryngeal mask airway (LMA Classic) in our practice. Records of patients who had been ventilated with a PAXpress airway or an LMA were examined. Responses of patients in the postanesthesia care unit (PACU) or from routine postoperative calls the following day were noted. Insertion of the airway was easy in all of the LMA patients but in only 20% of the PAXpress patients. Blood was noticed on 27% (4/15) of the PAXpress airways but on none of the LMAs. None of the LMA patients complained of pharyngeal soreness in the PACU, whereas 33% (5/15) in the PAXpress group had a sore throat. The next day, only 2 patients in the LMA group (13%) complained of a slightly sore throat. In the PAX... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571248 Sun, 01 Apr 2007 04:00:00 +0100 1571248 http://www.medworm.com/index.php?rid=1571247&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%3D17471884%26dopt%3DAbstract Authors: Burns SM, Meland NB PMID: 17471884 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571247 Sun, 01 Apr 2007 04:00:00 +0100 1571247 http://www.medworm.com/index.php?rid=1571246&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%3D17471885%26dopt%3DAbstract Authors: Smally A A rescue airway device is used when conventional methods of intubation fail to achieve control of the airway. Although the laryngeal mask airway is often used in the operating room should endotracheal intubation fail, the esophageal-tracheal double-lumen airway represents another alternative rescue airway device. Nurse anesthetists may encounter patients with an in situ esophageal-tracheal double-lumen airway placed in the field; in some locales, it is used as the primary approach to airway management by emergency services personnel. The most commonly used esophageal-tracheal double-lumen airway device is the Combitube (TYCO Healthcare, Pleasanton, Calif), which will be used to illustrate insertion techniques needed in the use of esophageal-tracheal double-lumen airwa... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571246 Sun, 01 Apr 2007 04:00:00 +0100 1571246 http://www.medworm.com/index.php?rid=1571266&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%3D17304776%26dopt%3DAbstract Authors: Cady RF Although the reported incidence of surgical fires indicates they are rare occurrences, any Certified Registered Nurse Anesthetist (CRNA) who is involved in one will most likely end up in court defending a malpractice suit. This column discusses one such case with an emphasis on the CRNA's deposition testimony and its impact on the need to settle the case. The column also will discuss how surgical fires can be prevented and provide sources of further information on this important risk management issue for CRNAs. PMID: 17304776 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571266 Thu, 01 Feb 2007 05:00:00 +0100 1571266 http://www.medworm.com/index.php?rid=1571265&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%3D17304777%26dopt%3DAbstract Authors: Pearson JA, Van Nest RL PMID: 17304777 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571265 Thu, 01 Feb 2007 05:00:00 +0100 1571265 http://www.medworm.com/index.php?rid=1571264&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%3D17304778%26dopt%3DAbstract Authors: Starnes-Ott K, Kremer MJ PMID: 17304778 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571264 Thu, 01 Feb 2007 05:00:00 +0100 1571264 http://www.medworm.com/index.php?rid=1571263&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%3D17304779%26dopt%3DAbstract Authors: Cotton JW, Rowell LR, Hood RR, Pellegrini JE We compared the efficacy of inhaled isopropyl alcohol (IPA) with ondansetron for the control of postoperative nausea and vomiting (PONV) during a 24-hour period in 100 ASA class I-III women undergoing laparoscopic surgery. Nausea was measured postoperatively using a 0 to 10 verbal numeric rating scale (VNRS). The control group received ondansetron, 4 mg intravenously, and the experimental group inhaled IPA vapors. Breakthrough PONV was treated with 25-mg promethazine suppositories. Demographic and anesthesia characteristics were similar between groups. There was a significant difference between groups in mean +/- SD time to alleviation of PONV symptoms: for a 50% reduction in VNRS scores, 15.00 +/- 10.6 vs. 33.88 +/- 23.2 minutes wa... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571263 Thu, 01 Feb 2007 05:00:00 +0100 1571263 http://www.medworm.com/index.php?rid=1571262&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%3D17304780%26dopt%3DAbstract Authors: Forrester CM, Benfield DA, Matern CE, Kelly JA, Pellegrini JE Postoperative nausea and vomiting (PONV) is prevalent in surgical patients with known risk factors: general anesthesia, female, nonsmoker, motion sickness history, and PONV history. Common treatment involves ondansetron; however, the effects are short-lived, and supplemental medication may be required. Meclizine, a long-acting drug with a low side-effect profile, may be ideal in combination with ondansetron for at-risk patients. We randomized 77 subjects scheduled for general anesthesia and screened for 4 of 5 PONV risk factors for experimental or control group assignment. Severity of PONV was measured using a 0 to 10 verbal numeric rating scale (VNRS). Other measured variables included time to onset and incidence o... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571262 Thu, 01 Feb 2007 05:00:00 +0100 1571262 http://www.medworm.com/index.php?rid=1571261&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%3D17304781%26dopt%3DAbstract This article describes a case of myocardial ischemia detected in the postanesthesia care unit following an excision of a facial/neck hematoma in an 83-year-old male. The patient had undergone extensive facial reconstructive surgery for squamous cell carcinoma the previous day. Marked ST-elevation in lead II and T-wave inversion in lead V5 were noted and the patient was treated promptly. Cardiac complications can occur in 1% to 5% of patients who have major noncardiac surgery. PMID: 17304781 [PubMed - indexed for MEDLINE] (Source: AANA Journal) AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571261 Thu, 01 Feb 2007 05:00:00 +0100 1571261 http://www.medworm.com/index.php?rid=1571260&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%3D17304782%26dopt%3DAbstract Authors: Kaplan L, Brown MA, Andrilla H, Hart LG The purposes of this study were to describe the Washington State Certified Registered Nurse Anesthetist (CRNA) workforce and analyze selected dimensions of their clinical practice. We developed the 31-item CRNA Practice Questionnaire. After receiving institutional review board approval, the questionnaire was mailed in 2003 to CRNAs licensed in Washington with an address in Washington, Oregon, and Idaho. Statistical analysis included descriptive statistics for all variables and was performed by University of Washington Center for Health Workforce Studies staff. Results indicate that the typical Washington State CRNA is 50.7 years old, white, and equally likely to be a man or woman. More than half of the Washington State CRNAs are master's... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571260 Thu, 01 Feb 2007 05:00:00 +0100 1571260 http://www.medworm.com/index.php?rid=1571259&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%3D17304783%26dopt%3DAbstract Authors: O'Sullivan CT, Dexter F, Lubarsky DA, Vigoda MM A systematic and comprehensive review of the scientific literature revealed 4 evidence-based methods that contribute to a positive return on investment from anesthesia information management systems (AIMS): reducing anesthetic-related drug costs, improving staff scheduling and reducing staffing costs, increasing anesthesia billing and capture of anesthesia-related charges, and increased hospital reimbursement through improved hospital coding. There were common features to these interventions. Whereas an AIMS may be the ideal choice to achieve these cost reductions and revenue increases, alternative existing systems may be satisfactory for the studied applications (i.e., the incremental advantage to the AIMS may be less than predi... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571259 Thu, 01 Feb 2007 05:00:00 +0100 1571259 http://www.medworm.com/index.php?rid=1571258&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%3D17304784%26dopt%3DAbstract Authors: Anderson NK, Jones AD, Martin EE, Thies RF, Baxter D, Marienau ME, Elliott BA Adequate preparation by anesthesia providers promotes quality care and decreases the likelihood of morbidity and mortality. Unfortunately, many trauma cases occur after hours when support resources are less readily available. At a large midwest academic medical center, it was determined that a website on the institution's Intranet relating to anesthetic care of trauma patients would be a readily accessible, user-friendly resource for improved care. In recent years, media tools such as computers have become increasingly popular and accessible as effective learning tools. A comprehensive literature search was completed on anesthetic care of trauma patients and on adult and Web-based learning principles... AANA Journal journals http://www.medworm.com/rss/comments.php?id=1571258 Thu, 01 Feb 2007 05:00:00 +0100 1571258