2,147 results match your criteria AANA Journal[Journal]


In Defense of Values.

Authors:
Brad Verhulst

AANA J 2016 Oct;84(5):305-308

Research associate in statistical genetics at the Virginia Institute for Psychiatric and Behavioral Genetics in the Department of Psychiatry at Virginia Commonwealth University, Richmond, Virginia.

P values have become the scapegoat for a wide variety of problems in science. P values are generally over-emphasized, often incorrectly applied, and in some cases even abused. However, alternative methods of hypothesis testing will likely fall victim to the same criticisms currently leveled at P values if more fundamental changes are not made in the research process. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375179PMC
October 2016
80 Reads

A Tour of Autonomic Reflex Activity Relevant to Clinical Practice.

AANA J 2017 Apr;85(2):141-7

The reflex arc is the functional unit allowing the human body to continuously, and unconsciously, adapt to its internal and external milieus. We review a broad range of autonomic reflexes controlling blood pressure, ensuring tissue oxygenation, and otherwise acting in concert to maintain homeostasis. Normal activity, pathophysiologic insult, and pharmacologic impairment of this reflex activity are discussed, with special consideration to the care of the anesthetized patient. Read More

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April 2017
7 Reads

Considerations of Epidural Analgesia in a Patient With Suspected Uterine Rupture.

AANA J 2017 Apr;85(2):136-9

The practice of epidural analgesia in laboring women began to emerge in the 1970s. It is now a common method of pain relief for patients in labor and is used by 63% of women in the hospital setting. The patient who has had a previous cesarean delivery can benefit from having an epidural anesthetic placed early to expedite an emergency, such as a uterine rupture, if necessary. Read More

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April 2017
3 Reads

Laryngeal Mask Airway Use in Morbidly Obese Patients Undergoing General Anesthesia.

AANA J 2017 Apr;85(2):130-5

The use of laryngeal mask airways with morbidly obese patients remains controversial. A recent legal case involving the use of a laryngeal mask airway with a morbidly obese patient who aspirated during the anesthetic found the anesthesia providers negligent. We sought evidence examining the use of laryngeal mask airways with obese patients undergoing surgery. Read More

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April 2017
3 Reads

Development, Implementation, and Evaluation of a Nurse Anesthesia Program in Belize.

AANA J 2017 Apr;85(2):123-9

Because of a critical shortage of anesthesia providers in Belize, the Belize Ministry of Health initiated support for the creation of a nurse anesthesia education program. Developed in collaboration with Health Volunteers Overseas and the University of Belize, the nurse anesthesia education program graduated 10 nurse anesthetists. This article describes the 24-month nurse anesthesia education program’s design, implementation, and evaluation. Read More

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April 2017
2 Reads

Effects of Ondansetron on Attenuating Spinal Anesthesia–Induced Hypotension and Bradycardia in Obstetric and Nonobstetric Subjects: A Systematic Review and Meta-Analysis.

AANA J 2017 Apr;85(2):113-22

Hypotension and bradycardia are common adverse effects following spinal anesthesia. Ondansetron has been studied in the attenuation of spinal anesthesia– induced hypotension (SIH) and bradycardia because of its antagonistic effect on the Bezold-Jarisch reflex. The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to determine the efficacy of intravenous (IV) ondansetron in reducing the incidence of SIH and bradycardia. Read More

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April 2017
3 Reads

An Initiative to Optimize Waste Streams in the Operating Room: RECycling in the Operating Room (RECOR) Project.

AANA J 2017 Apr;85(2):108-12

The goal of this project was to optimally sort waste material in the operating room (OR) environment and divert waste such that streams of low-cost disposal, including recyclable material, could be maximized. Using the Lean Six Sigma method, we followed 5 steps to define, measure, analyze, improve, and control. Descriptive statistics were used to describe OR characteristics during the study period. Read More

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April 2017
4 Reads

Propofol: Review of Potential Risks During Administration.

Authors:
Adam C Adler

AANA J 2017 Apr;85(2):104-7

Propofol is one of the most commonly used agents by anesthesia providers. Despite its excellent safety profile, numerous drawbacks and patient safety issues remain. This article is a focused review of the common issues surrounding propofol administration as they relate to infection, pediatric sedation, and the propofol infusion syndrome. Read More

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April 2017
3 Reads

Effectiveness of Interventions to Increase Provider Monitoring of Endotracheal Tube and Laryngeal Mask Airway Cuff Pressures.

AANA J 2017 Apr;85(2):98-103

Previous research demonstrates that monitoring and adjusting pressures in endotracheal (ET) tubes 30 cm H2O or less and laryngeal mask airways (LMAs) 60 cm H2O or less decrease rates of postoperative pharyngolaryngeal complications. In this evidencebased practice project we examined whether a multistep intervention (departmental education plus reference cards in operating rooms plus addition of cuff pressure documentation variable in electronic anesthesia record) would increase the frequency of providers monitoring intracuff pressures and decrease the rate of high intracuff pressures. Before and after the intervention, we recorded intracuff pressures of 51 ET tubes and 51 LMAs in surgical patients, as well as providers’ self-reported incidence of monitoring and adjusting intracuff pressures. Read More

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April 2017
3 Reads

Pain Management Efficacy Study Between Continuous and Single-Administration Bupivacaine Following Lumbar Spinal Fusion.

AANA J 2017 Apr;85(2):91-7

Poorly managed postoperative pain decreases patient satisfaction, impedes early patient mobilization, lengthens inpatient hospital stay, and increases healthcare costs. Multimodal analgesia with local anesthetics is considered most effective for postoperative pain management. This study compared patients undergoing lumbar fusion who received plain bupivacaine from May 2011 until August 2012 with those who received liposomal bupivacaine from September 2012 until May 2013. Read More

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April 2017
3 Reads

AANA Journal Course: Update for Nurse Anesthetists-Part 5-Use of Tranexamic Acid in Preventing Postpartum Hemorrhage.

AANA J 2016 Dec;84(6):427-438

Department of Nurse Anesthetist Practice at Florida International University College of Nursing and Health Sciences, Miami, Florida.

Postpartum hemorrhage (PPH) continues to be a serious complication in both developed and underdeveloped countries. It remains the leading cause of maternal mortality in underdeveloped countries. Implementation of the World Health Organization guidelines of PPH treatment has reduced mortality. Read More

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December 2016
33 Reads

Laryngeal Mask Airway and Valsalva Maneuver During Ophthalmic Surgery: A Case Report.

AANA J 2016 Dec;84(6):423-425

Anesthesiology Department at Mayo Clinic in Jacksonville, Florida.

The use of a supraglottic airway, also called laryngeal mask airway (LMA), is gaining in popularity for delivery of general anesthesia in certain situations and is shown to be safe. Use of infraglottic airways (tracheal tubes) allows for positive pressure ventilation and maneuvers, such as holding continuous positive pressure in the airway to check for pleural and dural leaks. We describe the successful use of the LMA (Teleflex Inc) for general anesthesia, in which continuous positive airway pressure of 15 cm H2O held for 20 seconds allowed the neurosurgeon to identify the site of a cerebrospinal fluid (CSF) leak and successfully repair the leak. Read More

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December 2016
20 Reads

Laryngospasm as a Cause of Unsuccessful Placement of Laryngeal Mask Airway ProSeal: A Case Report.

AANA J 2016 Dec;84(6):420-422

Department of Anesthesiology and Critical Care at the University College of Medical Sciences.

Laryngospasm is a potential complication encountered during anesthesia using a laryngeal mask airway (LMA). We report a case in which laryngospasm resulted in unsuccessful placement of an LMA ProSeal Airway (Teleflex Inc), and we discuss the various causes of unsuccessful placement of this type of airway device. Laryngospasm causes increased resistance to gas flow by inducing closure of vocal cords, aryepiglottic fold, and periglottic tissue. Read More

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December 2016
25 Reads

Low-Dose Vasopressin and Analogues to Treat Intraoperative Refractory Hypotension in Patients Prescribed Angiotensin-Converting Enzyme Inhibitors Undergoing General Anesthesia: A Systematic Review.

AANA J 2016 Dec;84(6):413-419

University at Buffalo School of Nursing, Buffalo, New York.

This review assessed the utility of vasopressin and vasopressin analogues for the treatment of refractory hypotension associated with angiotensin-converting enzyme (ACE) inhibitors in the perioperative setting. A systematic review of the literature was conducted using MEDLINE, Embase, and ProQuest. Six randomized controlled trials met eligibility criteria. Read More

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December 2016
14 Reads

A Patient Safety Dilemma: Obesity in the Surgical Patient.

AANA J 2016 Dec;84(6):404-412

Duke University School of Nursing, Durham, North Carolina.

Patient safety and the delivery of quality care are major concerns for healthcare in the United States. Special populations (eg, obese patients) need study in order to support patient safety, quantify risks, advance education for healthcare-workers, and establish healthcare policy. Obesity is a complex chronic disease and is considered the second leading cause of preventable death in the United States with approximately 300,000 deaths per year. Read More

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December 2016
14 Reads

Exploring Strategies to Increase and Sustain Membership in the American Association of Nurse Anesthetists.

AANA J 2016 Dec;84(6):396-403

American Association of Nurse Anesthetists in Park Ridge, Illinois.

The total numbers of Certified Registered Nurse Anesthetists (CRNAs) in the United States and members of the American Association of Nurse Anesthetists (AANA) have risen to an all-time high. However, the percentage of CRNAs who are AANA members has been slowly declining since 2006, particularly among newly certified nurse anesthetists. To develop new strategies to increase and sustain CRNA membership, the AANA conducted a translational research project that explored evidence-based determinants of individuals' decisions to join professional associations, current membership practices and patterns, results of a recent member needs survey, and socialization of student registered nurse anesthetists (SRNAs) into the AANA. Read More

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December 2016
20 Reads

The Editor's Desk: Science and Clinical Potpourri for Your Life and Your Practice.

Authors:

AANA J 2016 Dec;84(6):395

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December 2016
14 Reads

Legal Briefs: Navigating the "Captain of the Ship" Argument.

Authors:
Mark J Silberman

AANA J 2016 Dec;84(6):392-394

Duane Morris LLP, Chicago, Illinois.

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December 2016
18 Reads

Guest Editorial: Active Shooter: Are We Complacent?

Authors:
Brenda Wands

AANA J 2016 Dec;84(6):388-390

Department of Nurse Anesthesia at Virginia Commonwealth University, Richmond, Virginia.

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December 2016
13 Reads

Consensus Bundle on Prevention of Surgical Site Infections After Major Gynecologic Surgery.

AANA J 2017 Feb 6;85(1):1-12. Epub 2017 Feb 6.

Health Policy and strategic Health Care Initiatives, American College of Obstetricians and Gynecologists, Washington, DC.

Surgical site infections are the most common complication of surgery in the United states. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. Read More

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February 2017
31 Reads

Tranexamic Acid in Anesthetic Management of Surgical Procedures.

AANA J 2016 Jun;84(3):201-9

Blood loss during surgical procedures poses a grave risk to the patient, but transfusion is costly and associated with adverse outcomes. Antifibrinolytics, however, offer an economical and effective means of decreasing blood loss associated with surgical procedures. Tranexamic acid (TXA) is an antifibrinolytic that blocks lysine-binding sites of fibrinogen and fibrin, preventing the breakdown of existing clots. Read More

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June 2016
13 Reads

Unknown Pseudocholinesterase Deficiency in a Patient Undergoing TIVA with Planned Motor Evoked Potential Monitoring: A Case Report.

Authors:
Candace Binkley

AANA J 2016 Jun;84(3):198-200

Pseudocholinesterase abnormalities are a genetic cause of aberrant metabolism of the depolarizing muscle relaxant succinylcholine. This article examines a case where succinylcholine was chosen to facilitate intubation due to its ultra short duration and the request of the surgeon to monitor motor evoked potentials. Following succinylcholine administration the neurophysiologist was unable to obtain motor evoked potentials. Read More

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June 2016
27 Reads

Preventive Dorzolamide-Timolol for Rising Intraocular Pressure During Steep Trendelenburg Position Surgery.

AANA J 2016 Jun;84(3):189-96

The study purpose was to evaluate preventive use of dorzolamide-timolol ophthalmic solution (Cosopt) during laparoscopic surgery with the patient in steep Trendelenburg (ST) position. Periorbital swelling, venous congestion, and elevated intraocular pressure (IOP) may produce low ocular perfusion. Prompt IOP reduction is important because 30- to 40-minute episodes of acute IOP elevations can result in retinal ganglion cell dysfunction. Read More

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June 2016
15 Reads

Anesthetic Considerations of Stiff-Person Syndrome: A Case Report.

AANA J 2016 Jun;84(3):181-7

Stiff-person syndrome (SPS) is a neurologic disorder characterized by painful involuntary episodes of severe muscle rigidity affecting the axial muscles and extremities. Although the etiology of SPS is unknown, it is suspected to involve the synthesis of γ-aminobutyric acid (GABA). Symptoms of SPS are precipitated by sudden unexpected movements, noises, and stress. Read More

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June 2016
26 Reads

The Jehovah's Witness Population: Considerations for Preoperative Optimization of Hemoglobin.

AANA J 2016 Jun;84(3):173-8

Most members of the Jehovah's Witness community refuse blood transfusions, and there are variations in what alternatives they will accept depending on their personal decisions. To provide culturally competent care, healthcare providers need to be knowledgeable about substitutions for blood administration as well as the risks and benefits of available alternatives so that they can inform their patients. It has been recognized in the literature that preoperative optimization of hemoglobin levels with alternative treatment modalities through a multidisciplinary approach can improve clinical outcomes in patients who refuse blood products. Read More

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June 2016
24 Reads

Venous Thromboembolism Prophylaxis in Plastic Surgery: A Literature Review.

AANA J 2016 Jun;84(3):167-72

Venous thromboembolism (VTE) is a major health concern because it increases morbidity and mortality after a surgical procedure. A number of well-defined, evidence-based guidelines are available delineating suitable use of prophylaxis to prevent deep vein thrombosis and pulmonary embolism. Despite the available literature, there are clear gaps between recommendations and clinical practice, affecting the incidence of VTE. Read More

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June 2016
20 Reads

Effects of a 30-mL Epidural Normal Saline Bolus on Time to Full Motor Recovery in Parturients Who Received Patient-Controlled Epidural Analgesia With 0.125% Bupivacaine With 2 µg/mL of Fentanyl.

AANA J 2016 Jun;84(3):159-65

Previous research suggests that an epidural bolus of 30 mL of normal saline after vaginal delivery may decrease the time for recovery from motor block. A double-blind, randomized controlled study was conducted in 46 parturients to determine if a 30-mL normal saline bolus or sham administered via epidural approach after delivery reduces the time to full motor recovery and the time to 2-dermatome regression. No significant difference was found in time to full motor recovery (saline group 83. Read More

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June 2016
14 Reads

Hazardous Intraoperative Behaviors: What's at Risk?.

Authors:
Joshua Philippon

AANA J 2016 Jun;84(3):155-6

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June 2016
11 Reads

Response.

AANA J 2016 Jun;84(3):155

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June 2016
10 Reads

On Combat Anesthesia.

Authors:
Karl Kammer

AANA J 2016 Jun;84(3):155

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June 2016
11 Reads

Awareness With Recall: A Systematic Review.

Authors:
Caitlin Sullivan

AANA J 2016 Aug;84(4):283-8

This article provides a systematic review of awareness with recall, also called intraoperative awareness. Major topics of this review include the incidence and causes of this phenomenon, in addition to an examination of current strategies for prevention of intraoperative awareness. Awareness with recall creates substantial physical and/or psychological distress for the patient, representing a continued threat to patient safety. Read More

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August 2016
2 Reads

Anesthetic Management of Unstable Cervical Spine: Is Intubating LMA CTrach a Right Choice? A Case Report.

AANA J 2016 Aug;84(4):280-2

The LMA (Laryngeal Mask Airway) CTrach (LMA North America Inc) is widely used for airway management in patients undergoing cervical spine immobilization. Three important concerns in these patients are stabilization of the neck, prevention of aspiration of regurgitated gastric contents, and hypoxia. The standard maneuver—down-up down maneuver—applied to the LMA CTrach to improve the glottis view has been reported to cause pulmonary aspiration in cases of regurgitation of gastric contents in predisposed patients. Read More

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August 2016
1 Read

Prolongation of Subarachnoid Block With Concomitant Use of Intravenous Dexmedetomidine: An Evidence-based Review.

AANA J 2016 Aug;84(4):271-8

A failed subarachnoid block due to prolonged surgical duration continues to be a challenging problem for anesthesia providers. This evidence-based review updates a 2013 systematic review describing the use of intravenous dexmedetomidine as an extrathecal spinal adjunct capable of extending the duration of a subarachnoid block. Eight randomized controlled trials published after the 2013 systematic review met the inclusion criteria. Read More

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August 2016
1 Read

Changing Endotracheal Tube Taping Practice: An Evidence-based Practice Project.

AANA J 2016 Aug;84(4):261-70

The purpose of this evidence-based, quality improvement practice project was to increase anesthesia providers’ knowledge and awareness of the taping practice for securing the endotracheal (ET) tube that increases the patient’s exposure to pathogens and the risk of nosocomial infections. A change in the taping practice by anesthesia providers was the desired outcome. Participants completed an anonymous questionnaire about their knowledge and use of a taping practice to secure the ET tube. Read More

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August 2016
1 Read

Pulse Perfusion Values to Predict Eye Opening After Intravenous Anesthesia: An Explorative Study.

AANA J 2016 Aug;84(4):255-9

Variables measured in modern pulse oximetry apparatuses include a graphic pulse curve and a specified perfusion value (PV) that could be a sensitive marker for detecting differences in sympathetic activity. We hypothesized that there is a correlation between a reduction of PV and the time to eye opening after anesthesia with propofol-remifentanil. This study includes 29 patients, ASA physical status 1 or 2, scheduled for elective thyroid surgery. Read More

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August 2016
1 Read

Laundering Methods for Reusable Surgical Scrubs: A Literature Review.

AANA J 2016 Aug;84(4):246-52

Surgical site infection is one of the most frequent and serious postoperative complications. Surgical site infections may be precipitated by high bacterial loads introduced into the operating room setting. The most common microorganisms contributing to infections are Staphylococcus, Streptococcus, and Pseudomonas. Read More

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August 2016
1 Read

Evaluation of Testing as a Method to Assess Continued Competency in Nurse Anesthesia Practice: A Systematic Review.

AANA J 2016 Aug;84(4):239-45

Competency in healthcare practice has become a priority for sustaining the goals of quality and safety in patient care delivery. Evaluating maintenance of competency for practitioners beyond their initial licensure and credentialing has become a topic of focus in recent years. A systematic review was conducted to evaluate testing as a method of assessing continued competency in nurse anesthesia practice. Read More

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August 2016
1 Read

Developing a Health Services Research Agenda in Nurse Anesthesia Using a Modified Delphi Method.

AANA J 2016 Aug;84(4):234-8

The authors sought to formalize a process and ascertain research priorities for nurse anesthesia, which resulted in a new Health Services Research (HSR) Agenda. After formation of an 8-member ad hoc committee (representing different stakeholders from the American Association of Nurse Anesthetists [AANA]), a modified Delphi technique was used to determine the top 3 HSR research priorities for the 2016 fiscal year. The committee identified 24 high-priority HSR questions/topics specific to policy, education, or practice. Read More

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August 2016
1 Read

Response

AANA J 2016 Aug;84(4):227-8

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August 2016
1 Read

Thromboelastography: Clinical Application, Interpretation, and Transfusion Management.

AANA J 2016 Apr;84(2):129-34

The coagulation cascade is a dynamic process dependent on many factors. It involves interaction between primary hemostasis, platelet clot formation, secondary hemostasis, thrombin generation, and fibrinolysis. The assessment of this process is particularly important in the surgical patient to properly manage hemostatic issues. Read More

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April 2016
61 Reads

Using a Structured Assessment Tool to Evaluate Nontechnical Skills of Nurse Anesthetists.

AANA J 2016 Apr;84(2):122-7

Nontechnical skills are critical for good anesthetic practice but are seldom addressed explicitly in clinical training. The purposes of this study were (1) to evaluate the reliability and validity of the observation-based assessment tool Nurse Anaesthetists' Non-Technical Skills system (N-ANTS) and (2) to evaluate the effect of training nurse anesthetist supervisors in the use of N-ANTS. This system comprises a global rating score, 4 categories, and 15 elements to rate nurse anesthetists' nontechnical skills. Read More

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April 2016
10 Reads

Use of Personal Electronic Devices by Nurse Anesthetists and the Effects on Patient Safety.

AANA J 2016 Apr;84(2):114-9

Certified Registered Nurse Anesthetists (CRNAs) provide high-quality patient care to ensure patient safety. Strict vigilance and prompt response is required of the CRNA to make critical decisions. Distractions during anesthesia delivery may threaten patient safety. Read More

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April 2016
14 Reads

Design of an Evidence-Based "Second Victim" Curriculum for Nurse Anesthetists.

AANA J 2016 Apr;84(2):107-13

The "second victim" phenomenon--when a healthcare provider experiences adverse events because of the adverse events of a patient--is not well known or understood among healthcare professionals, including Certified Registered Nurse Anesthetists (CRNAs). No published research is currently available on the impact of second victim specifically in CRNAs, but it is known that second victim poses major challenges for healthcare professionals. Therefore, it is important to acknowledge its occurrence and to develop an educational curriculum based on the available evidence in order to promote peer and organizational support infrastructures. Read More

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April 2016
57 Reads

Local Anesthetic Adjuvants Providing the Longest Duration of Analgesia for Single- Injection Peripheral Nerve Blocks in Orthopedic Surgery: A Literature Review.

AANA J 2016 Apr;84(2):95-103

Inadequate pain relief after surgery may delay surgical recovery, decrease patient satisfaction, increase length of stay, raise the risk of hospital readmissions, and increase overall healthcare costs. One way to decrease postoperative pain for patients undergoing orthopedic surgery is through the use of peripheral nerve blocks. Anesthesia providers can add many adjuvants to local anesthetics to improve quality and prolong duration of analgesia. Read More

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April 2016
112 Reads

Effect of Ultrasound-Guided Placement of Difficult-to-Place Peripheral Venous Catheters: A Prospective Study of a Training Program for Nurse Anesthetists.

AANA J 2016 Apr;84(2):86-92

Patients with difficult intravenous access (DIVA) often experience discomfort because of failed attempts to place peripheral venous catheters (PVCs); however, ultrasound guidance may improve this problem with catheter placement. The aim of this study was to evaluate the use of ultrasound when operated by nurse anesthetists for these patients. This prospective observational study with a pre/post design focused on inpatients with DIVA referred for PVC placement, a service provided by nurse anesthetists in most Scandinavian hospitals. Read More

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http://www.aana.com/newsandjournal/20102019/effect-of-ultras
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April 2016
22 Reads

Intrathecal Spread of Injectate Following an Ultrasound-Guided Selective C5 Nerve Root Injection in a Human Cadaver Model.

AANA J 2016 Apr;84(2):80-4

Ultrasound-guided selective C5 nerve root blocks have been described in several case reports as a safe and effective means to anesthetize the distal clavicle while maintaining innervation of the upper extremity and preserving diaphragmatic function. In this study, cadavers were injected with 5 mL of 0.5% methylene blue dye under ultrasound guidance to investigate possible proximal and distal spread of injectate along the brachial plexus, if any. Read More

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http://www.aana.com/newsandjournal/20102019/intrathecal-spre
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April 2016
13 Reads

Caution: Predatory Journals Want Your Business!

Authors:
John Aker

AANA J 2016 Apr;84(2):79

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April 2016
12 Reads