August 2004 AANA Journal

Table of Contents



A comparison of endotracheal tube cuff pressures using estimation techniques and direct intracuff measurement
John M. O'Donnell, CRNA, MSN 

Scott Stewart, CRNA, MSN
Janet A. Secrest, RN, PhD
Barbara R. Norwood, RN, EdD
Richard Zachary, CRNA, MSN
Print version: 2004;72:250-251.
Legal Briefs
The power of words
Gene A. Blumenreich, JD
Print version: 2004;72:253-257.
Key words: Exculpatory release, informed consent.
Books and Multimedia of Interest
And If I Perish: Frontline U.S. Army Nurses in World War II

Reviewers: Evan Koch, CRNA, MSN
MAJ Cheryl Blankemeier, CRNA, BSN, AN, USA-ret.
Print version: 2004;72:264.
AANA Journal Course No. 23 Examination Answers
Print version
: 2004;72:300-303.
Anesthetic management of a difficult airway in a patient with epidermolysis bullosa: A case report
Kelly L. Crowley, CRNA, MSN 
Yuri O. Shevchenko, MD

Epidermolysis bullosa is an inherited skin disease that leads to an array of medical problems. This case report describes a 15-year-old patient with epidermolysis bullosa presenting for contracture release, with a difficult airway.
Print version: 2004;72:361-263.
Key words: Difficult airway, epidermolysis bullosa, fiberoptic intubation.
Arterial cannulation: A critical review
Teresa R. Cousins, RN, BSN
John M. O'Donnell, CRNA, MSN 

Arterial catheterization for hemodynamic monitoring is used widely in clinical management. Complications of cannulation have been recognized since introduction of the technique. This review article examines radial, brachial, axillary, and femoral cannulation sites. Waveform distortion, adjacent structure injury, and the incidence of thrombus also are described.
Print version: 2004;72:267-271.
Key words: Arterial cannulation, site review
The addition of clonidine to bupivacaine in combined femoral-sciatic nerve block for anterior cruciate ligament reconstruction
LT Darren J. Couture, CRNA, MSN, NC, USNR
LT Heather M. Cuniff, CRNA, MSN, NC, USNR
LCDR Joseph F. Burkard, CRNA, MSN, NC, USN
LCDR John P. Maye, CRNA, PhD, NC, USN
CDR Joseph Pellegrini, CRNA, DNSc, NC, USN 

Clonidine has been shown to prolong sensory analgesia when given as an adjunct to peripheral nerve blocks but has not been evaluated when given in conjunction with a femoral-sciatic nerve block. The purpose of this investigation was to determine whether the addition of clonidine to a femoral-sciatic nerve block would prolong the duration of sensory analgesia in groups of patients undergoing anterior cruciate ligament reconstruction.
Print version: 2004;72:273-278.
Key words: Anterior cruciate ligament reconstruction, femoral-sciatic nerve block, postoperative pain management, regional anesthesia.
Childhood airway manifestations of lymphangioma: A case report
Bettina M. Thompson, CRNA, MNA
Jeffrey O. Welna, DO
Jan L. Kasperbauer, MD
James M. Van Ess, DDS, MD
Mary E. Shirk Marienau, CRNA, MS 

This is a case report of a 9-year-old patient with lymphangioma who had impacted teeth and a suspected odontogenic cyst. There seems to be little information on the optimal anesthetic management for this age group. The challenges with airway management, including bleeding, laryngospasm, and a difficult intubation, are outlined.
Print version: 2004;72:280-283.
Key words: Airway management, anesthesia, intubation, lymphangioma.
Visual loss as a complication of non-ophthalmologic surgery: A review of the literature
Kimberly Rupp-Montpetit, CRNA, MS
Merri L. Moody, CRNA, MS

Decreased visual acuity and loss of visual ability are devastating anesthetic and surgical complications. In this review article, the authors provide information on anatomy and physiology, cause of visual impairment, ischemic optic neuropathy, incidence of eye injury and visual loss, onset of symptoms, preexisting and predisposing factors, and review of the literature.
Print version: 2004;72:285-292.
Key words: Anterior ischemic optic neuropathy, intraocular pressure, ischemic optic neuropathy, posterior ischemic optic neuropathy.

AANA Journal Course, Part 3
Update for nurse anesthetists -- 
Eliminating surgical fires: A team approach
In this AANA Journal course, the author reports that surgical fires are on the rise, and one agency estimates the frequency of surgical fires is comparable to that of wrong-site surgery, with an incidence of 50 to 100 fires annually. The need for a clearly formulated plan, rehearsing a response to fires in or on the patient, and clearly designated prevention parameters are included.
Print version: 2004;72:293-298.
Key words: ECRI recommendations, fire triangle, surgical fires. 
August 2004 AANA Journal
Volume 72 , Number 4
ISSN 0094-6354
On the Cover:
Just one of the countless memorable scenes to be enjoyed by nurse anesthetists, nurse anesthesia students, exhibitors, and guests attending the 71st AANA Annual Meeting in Seattle, August 7-11. Throughout the meeting, participants will have opportunities to benefit from quality educational programs, the exhibit hall, and social activities. Visitors to the "Emerald City" of Seattle, known for its lush surroundings, also will enjoy a variety of outdoor activities, shopping and nightlife. (Photo courtesy of Seattle's Convention and Visitors Bureau.)