Topic Of The Week

A new opportunity for volunteering has emerged.  As the need for qualified anesthesia providers in developing areas of the world increases, there is a great need for anesthesia education in Sierra Leone (western Africa).  I am working with Johns Hopkins University and Health Volunteers Overseas with this project to educate CRNAs.  If you are motivated to […]

CRNA Topic: Volunteer Your Time and Talent.

by admin on November 11, 2012 · 0 comments

Hello everyone.  I want to tell all of you about another exciting opportunity for us to pay it forward.  Earlier in the year, I wrote an article about volunteerism.  My first opportunity to teach other nurses anesthesia education outside of the United States was in Eritrea (Eastern Africa).  Now I am honored to have another […]

In the Army, one is often tasked to do a job that most consider undesirable (i.e. 20 push-ups in full combat gear, pulling weeds in the parking lot in full combat gear, or painting the commander’s office in full combat gear); at the completion of said task the assigning officer or Drill Sergeant may state […]

Clinical Topic: Handwashing Standards

by admin on April 29, 2012 · 1 comment

New patient safety guidelines require increased vigilance in handwashing by healthcare providers.  Previous guidelines established by OSHA required soap and water handwashing between every patient contact.  Over the past few years, alcohol based handwashing agents have been introduced to the hospital setting raising the question about their efficacy and risk. An article By Gina Pugliese, […]

Legal Topic: Documentation

by admin on March 21, 2012 · 0 comments

Same Song Different Verse – If It Wasn’t Documented….. Consider for a moment, that you or a colleague is facing legal action that, on the face of things, appears absurd.  How absurd? Well, think for a moment about the first time that you learned how to place an intravenous (IV) line.  The first thing that […]

Clinical Topic: Defenses to Negligence

by admin on February 7, 2012 · 1 comment

In earlier articles, I discussed some basics about medical malpractice. Now I want to briefly review some defenses to negligence.  Keep in mind that all negligence claims are not credible; and even if a credible claim exists, there are many avenues to resolution.  If the required elements of negligence are present and cannot be contested, […]

Every year the last full week in January is designated as National Nurse Anesthetist week.  This is our opportunity to capture media coverage and let the world know who we are and what we do.   PROCRNA.com encourages you to offer “CRNA for a day” to your local nursing school.  Welcome students at the head of […]

Standards, the Expert Witness

by admin on December 24, 2011 · 3 comments

Submitted by Pamela Chambers, MSN, CRNA, EJD Click here for Lex Terrae consulting As we all know, legislative bodies enact the laws that we must all abide by – whether we are aware of them or not.  Ignorance of the law is rarely a defense to violating it, whereas professions set their own standards of […]

Radiation Exposure to Anesthetists

by admin on December 21, 2011 · 7 comments

Radiation exposure has long been a concern to Radiologists and their assistants.  Lead aprons, thyroid shields and more recently leaded eyeware have reduced their exposure to radiation.  Anesthetists are frequently assigned to sedate / anesthetize patients in the interventional radiology suite.  Like the Radiologist, the anesthetist is exposed to radiation danger. In a study by […]

Opioid-Induced Respiratory Depression

by admin on November 28, 2011 · 6 comments

The Anesthesia Patient Safety Foundation is committed to the safe and reliable administration of every anesthetic.  An area of concern has been respiratory depression in the immediate postoperative period secondary to narcotic administration.  The following information comes directly from the foundation; The APSF believes that clinically significant, drug-induced respiratory depression in the postoperative period remains […]

Ketamine Supplement for Anesthesia

November 17, 2011

Ketamine is an old drug which has come in and out of favor many times over the past decades.  Currently, articles are emerging touting the advantages of Ketamine as a supplement for  both general anesthesia and monitored anesthesia care.  Below is a description by Pamela Chambers, CRNA regarding her clinical experience using Ketamine as a […]

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The Sticky Situation of Adhesion

November 4, 2011

Submitted by Pamela Chambers, MSN, CRNA, EJD Click here for Lex Terrae consulting Two years ago, Joe Sixpack was admitted to your facility to undergo vasectomy.  His clinical course in your fine medical center was uneventful. Today, you are seated in the office of the facility mediator and all relevant parties are present: Joe Sixpack, […]

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DNR in the Operating Room

October 28, 2011

You are scheduled to do a patient coming from the ward with Do Not Resuscitate orders.  What does that mean and what do you do?  Some would argue that General Anesthesia is a controlled resuscitation on every case, and, therefore either the DNR orders should be suspended or the case should be canceled.   Does that […]

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LMA in the Prone Position

October 23, 2011

The LMA (Laryngeal Mask Airway) has been a common airway management device used by the Anesthesia community for two decades.  Because the device does not “secure” the airway like a cuffed endotracheal tube would, anesthetists are selective about the patient population and type of surgery when deciding whether or not to use the LMA.  Our […]

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Res Ipsa Loquitur

October 15, 2011

This is a theory of liability that basically states “the thing speaks for itself”.  This doctrine is applied in medical malpractice usually in cases where the injury is in a location of the body distinct from the proposed procedure or operation.  The classic case is Ybarra v. Spangard, 25 Cal.2d 486, 154 P.2d 687 (1944), […]

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Strictly Speaking

September 28, 2011

Most of us take comfort in the fact that each day that we come to work to serve our patients, we intend to perform at our very highest caliber.  We hope that our stellar reputations will shield us from liability if anything unplanned should occur and injury befalls a patient.  Well, strictly speaking – this […]

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Prevention of Intraoperative Awareness in a High-Risk Surgical Population

August 17, 2011

To Bis or not to Bis….the controversy continues.  A study reported in the New England Journal of Medicine (Avidan et al, August 18,2011) evaluated using BIS versus end tidal agent concentration in the prevention of intraoperative awareness. In this study, 6041 patients were randomly assigned to either have BIS or end tidal agent to determine […]

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Risks of Anesthesia Care in Remote Locations

June 19, 2011

From the ASPF Newsletter Patients receiving anesthesia in remote locations tend to be older and sicker than those in the Main OR.  In addition, they tend to receive MAC anesthesia more frequently.  Below is a case scenario.  Read the entire article from the ASPF newsletter and add your comments. A 75-year-old, 100-kg, ASA 2 man […]

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Cost Effectiveness Evaluation of Anesthesia Providers

June 18, 2011

Anesthesiologists and certified registered nurse anesthetists provide high-quality, efficacious anesthesia care to the U.S. population. This research and analyses indicate that CRNAs are less costly to train than anesthesiologists and have the potential for providing anesthesia care efficiently. Anesthesiologists and CRNAs can perform the same set of anesthesia services, including relatively rare and difficult procedures […]

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