August 2003 AANA Journal

Table of Contents

Columns

Letters
Surgical mortality and type of anesthesia provider

Ronald A. Gabel, MD
Print version: 2003;71:257.

Response
Michael Pine, MD, PhD
Kathleen D. Holt, PhD
You-Bei Lou, PhD

Legal Briefs
United States Supreme Court upholds "any willing provider" statutes
Gene A. Blumenreich, JD
Print version: 2003;71:259-262.
Key words: Doctrine of preemption, federalism.

Answers to the AANA Journal Course No. 22 Examination
Print version
: 2003;71:305-309.

Features

Variability in the American Society of Anesthesiologists Physical Status Classification Scale
Capt Wendy L. Aronson, CRNA, MSN, NC, USAF
Maura S. McAuliffe, CRNA, PhD, FAAN
Ken Miller, RN, PhD, FAAN

The American Society of Anesthesiologists (ASA) Physical Status (PS) Classification is used worldwide anesthesia providers as an assessment of the preoperative physical health of patients. The purpose of this study was to assess interrater reliability and describe sources of variability among anesthesia providers in assigning ASA PS scores.
Print version: 2003;71:265-274.
Key words: ASA physical status, assessment, classification, physical status, preoperative physical status.

The use of simulation to demonstrate hemodynamic response to varying degrees of intrapulmonary shunt
Melanie Register, CRNA, MN
Judy Graham-Garcia, CRNA, MN, BC, APRN
Richard Haas, CRNA, EdM, MS

The concept of intrapulmonary shunt can be difficult to master, but mastery is necessary for advanced practice nurses in anesthesia and critical care. A recent study explored the effects of increased cardiac output on arterial hemoglobin oxygen saturation and shunt during 1-lung ventilation of pigs. To learn more about shunt-related pathophysiology, the authors replicated the study on a human patient simulator in the classroom/laboratory setting.
Print version: 2003;71:277-284.
Key words: Intrapulmonary shunt, nurse anesthesia, simulation education, simulation technology.

Laryngeal mask anesthesia in children: A case report
Brian Ross, MD, PhD
Youri Vater, MD, PhD
Greg Dembo, MD
Clare Hunter, RN, BA, BSc
Kenneth Martay, MD

The laryngeal mask airway has become one of the major tools of modern anesthesia airway management. The authors report the case of an uneventful 5-hour long laryngeal mask anesthesia in a spontaneously breathing 11-year-old boy undergoing lower limb surgery.
Print version: 2003;71:285-286.
Key words: Laryngeal mask airway; operation, duration; pediatric anesthesia; spontaneous ventilation.

Accessing the living laboratory: Trigger films as an aid to developing, enabling, and assessing anesthesia clinical instructors
William Hartland, CRNA, PhD
Chuck Biddle, CRNA, PhD
Michael Fallacaro, CRNA, DNSc

Trigger films are 2- to 4-minute vignettes simulating real-life situations that finish abruptly, stimulating participants to analyze situations in a safe environment. The purpose of this study was to develop and assess the validity of high fidelity trigger films in facilitating nurse anesthesia clinical instructor development.
Print version: 2003;71:287-291.
Key words: Anesthesia faculty development, clinical instruction, simulation, teaching methodologies, trigger films.

Parental presence during pediatric anesthetic inductions
Mary Kay Himes, CRNA, MS
Kristina Munyer, CRNA, MS
Susan J. Henly, RN, PhD

Children's responses to parental presence during anesthetic induction have been researched thoroughly; however, not much is known about the response of parents to being present at their child's induction. In this research article, the authors examine parent's preparation for, attitudes and emotions about, and experiences with being present for their child's anesthetic induction.
Print version: 2003;71:293-298.
Key words: Parental presence, pediatric anesthesia induction, preoperative education.


AANA Journal Course, Part 3
Update for nurse anesthetists
Aspiration prophylaxis: Is it time for changes in our practice?

John J. Nagelhout, CRNA, PhD
Pulmonary aspiration of gastric contents during anesthesia is a complication that is fortunately rare, yet potentially catastrophic. Despite its infrequency, techniques geared toward preventing this serious outcome influence many of our routine practices and beliefs. This AANA Journal course outlines current knowledge as to the incidence, risk factors, and efficacy of practices geared toward preventing aspiration.
Print version: 2003;71:299-303.
Key words: Aspiration, cricoid pressure, preoperative fasting, preoperative medications, rapid-sequence induction.

August 2003 AANA Journal
Volume 71 , Number 4
ISSN 0094-6354
On the Cover:
A statue of Paul Revere, messenger of the American Revolution, is one of the many historical sites along Boston's Freedom Trail. The Hynes Convention Center in Boston's Back Bay is the site for the 70th Annual Meeting of the American Association of Nurse Anesthetists (AANA), August 2-6, 2003. The Annual Meeting program has been compressed to allow more free time to visit the city's attractions, while still offering a quality educational program and networking opportunities. (Photo courtesy of Greater Boston Convention & Visitors Bureau)