Table of Contents
Departments
Books, Etc.
Evidence Trumps Belief: Nurse Anesthetists and Evidence-Based Decision Making
Reviewer: Mark Welliver, CRNA, DNP, ARNP
Print version: 2010;78(4):261.
Legal Briefs Patient Privacy and Social Media Amy L. Hader, JD Evan D. Brown, JDPrint version: 2010;78(4):270-274.
Keywords: Confidentiality, Facebook, Health Insurance Portability and Accountability Act of 1996 (HIPAA), Internet, privacy.
Guest Editorial Advancing Evidence-Based Nurse Anesthesia Practice
Lisa J. Thiemann, CRNA, MNA John J. McFadden, CRNA, PhDPrint version: 2010;78(4):279-282.
Keywords: Evidence-based practice, evidence-based process, nurse anesthesia practice, quality care.
Use of Clevidipine for Intraoperative Hypertension Caused by an Undiagnosed Pheochromocytoma: A Case Report
Jonathan P. Kline, CRNA, MSNAThe severe intraoperative hypertension caused by an undiagnosed pheochromocytoma is a rare and challenging event for the anesthesia provider. If treatment is not prompt and successful, permanent and possibly lethal complications can ensue. This article reports what the author believes to be the first case study in which clevidipine (Cleviprex) was successfully used to treat a suspected, and later diagnosed, pheochromocytoma.
Print version: 2010;78(4):288-290.
Keywords: Catecholamine response, clevidipine (Cleviprex), intraoperative hypertension, pheochromocytoma.
Inhalational Anesthesia for Organ Procurement: Potential Indications for Administering Inhalational Anesthesia in the Brain-Dead Organ Donor Laurie J. Elkins, CRNA, MS, CCRNIn this review article, the author reports that there is minimal research regarding perioperative care of the brain-dead organ donor during the procurement procedure. She concludes that further studies are required to determine if administration of inhalational anesthetics reduces catecholamine release occurring with surgical stimulation during the organ procurement procedure and whether this technique increases viability of transplanted organs.
Print version: 2010;78(4):293-299.
Keywords: Brain-dead organ donor, inhalational anesthesia, organ procurement.
Determining the Relationship of Acute Stress, Anxiety, and Salivary α-Amylase Level With Performance of Student Nurse Anesthetists During Human-Based Anesthesia Simulator Training CPT Kelly A. Chiffer McKay, CRNA, MSN, ANC, USACPT John E. Buen, CRNA, MSN, ANC, USALt Col Kevin J. Bohan, CRNA, PhD, USAF, NCCDR John P. Maye, CRNA, PhD, NC, USNThe purpose of this study was to determine the relationship between physiologic measures of stress and performance of student nurse anesthetists during anesthesia simulator training. Analysis of the descriptive statistics and means of each group suggests that low performers have increased stress and perform poorly, high performers have increased stress and perform superbly, and moderate performers have modest stress and perform moderately.
Print version: 2010;78(4):301-309.
Keywords: Anesthesia simulator training, salivary α-amylase, State-Trait Anxiety Inventory, stress, student nurse anesthetist.
Pseudocholinesterase Deficiency: A Comprehensive Review of Genetic, Acquired, and Drug Influences Flanna K. Soliday, CRNA, MSNYvette P. Conley, PhDRichard Henker, CRNA, PhDPseudocholinesterase deficiency is an inherited or acquired condition in which the metabolism of succinylcholine, mivacurium, or ester local anesthetics is potentially impaired. The aim of this review article is to examine both the genetic aspects of pseudocholinesterase deficiency and the acquired aspects to help the reader stay abreast of established and current literature and theories. Nearly 250 articles were examined for importance, and 50 case reports, research studies, and review articles were cited.
Print version: 2010;78(4):313-320.
Keywords: Atypical pseudocholinesterase, BChE, butyrylcholinesterase, genetic variants, pseudocholinesterase.
Anesthetic Management for Lobectomy in a Patient With Coccidioidomycosis: A Case Report Abbie J. Choleva, RN, BSNCoccidioidomycosis is a fungal disease with a wide variety of manifestations. The rare coccidioidomycosis cases requiring surgical intervention present unique challenges to anesthesia providers. The author states that careful attention to perioperative fungal therapies, invasive monitoring, and electrolyte stabilization remain pivotal concerns offering the best outcomes for patients with coccidioidomycosis.
Print version: 2010;78(4):321-325.
Keywords: Acute tubular necrosis, amphotericin B, coccidioidomycosis, difficult airway, fungal sepsis.
Acute Normovolemic Hemodilution in a Jehovah’s Witness Patient: A Case Report Eric Lindstrom, CRNA, MHSRobert Johnstone, MDPatients who are Jehovah’s Witnesses refuse blood transfusions and blood products as a matter of faith. For surgical procedures during which substantial blood loss is possible, their refusal presents a challenge. Anesthetists must generally respect the requests of adults not to receive blood and thus should have a clear understanding of how they will respond in the event of bleeding. In this case report, acute normovolemic hemodilution contributed to the successful outcome of an anemic Jehovah’s Witness who was undergoing major surgery.
Print version: 2010;78(4):326-330.
Keywords: Acute normovolemic hemodilution, blood conservation, blood loss, blood transfusion, Jehovah’s Witness.
AANA Journal Course: Update for Nurse Anesthetists – Part 3 – Ultrasound in Anesthesia: Applying Scientific Principles to Clinical Practice Christian R. Falyar, CRNA, DNAPThe use of ultrasound as an adjunct to invasive anesthesia procedures is becoming commonplace; however, a major disadvantage often cited is that success is user-dependent, and using ultrasound is a unique skill that requires training and experience to become proficient. In this course, the author discusses the principles of sound, the Doppler effect, tissue properties, transducers, and clinical considerations.
Print version: 2010;78(4):332-340.
Keywords: Attenuation, Doppler, frequency, propagation velocity, ultrasound.