Table of Contents
The AANA Journal is now available in a digital edition.
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Print version: 2012;80(4):258.
Answers to AANA Journal Course No. 31 Examination
Print version: 2012;80(4):307-311.
Print version: 2012;80(4):312-317.
Pauline Marie Maietta, CRNA, MS
More than 2.1 million central venous catheters are placed annually. This article describes a case of accidental carotid artery catheterization during attempted right internal jugular vein catheterization and the steps taken to treat the patient following its recognition. A discussion of technique for central venous catheterization, indications for suspicion of arterial puncture, methods for confirming venous or arterial placement, appropriate methods for management of carotid artery cannulation, and the benefit of ultrasound in central venous cannulation are included.
Print version: 2012;80(4):251-255.
Keywords: Carotid artery catheterization, central venous catheter, complication, ultrasound.
MAJ John Tyler Wilson, CRNA, PhD, ANC, USA
Marie E. Pokorny, RN, PhD
For the last decade, the United States has been involved in war in Iraq and Afghanistan; however, the US healthcare system is only recently recognizing the traumatic psychological effects of battlefield stress on soldiers. The authors conducted this qualitative study to understand the experiences of military nurse anesthetists working with service personnel who have traumatic brain injury and/or posttraumatic stress disorder and are emerging from general anesthesia. The authors point out the absence of studies in the literature that describe the experiences of anesthetists working with patients having these specific problems.
Print version: 2012;80(4):260-265.
Keywords: Emergence delirium, posttraumatic stress disorder, traumatic brain injury.
Jeffrey S. Greathouse, CRNA, BS
Jamie L. Stuart, CRNA, MS
William A. White Jr, CRNA, DMP
Airway management in the thermally injured patient presents a host of complex problems. This article reports the experience of caring for a female who was involved in an altercation, doused with gasoline, and set on fire. The authors conclude that airway management of the patient with severe, extensive burns of the face, neck and chest requires a coordinated effort by the entire care team. Rapid initial assessment should guide the anesthesia provider to move quickly through established difficult airway maneuvers.
Print version: 2012;80(4):268-272.
Keywords: Airway management, burn injury, emergency tracheostomy, inhalation injury.
Melissa D. Machan, CRNA, DNP, ARNP
Current procedures for cleaning anesthesia airway equipment as assessed by the presence of visible and occult blood on laryngoscope blades and handles as labeled “ready for patient use” has been reported to be ineffective. The purpose of this literature review is to determine the use and infection control practices of disposable laryngoscope blades. Their frequency of use, evaluation of ease of use, and any complications encountered when using the disposable blade are reviewed, as well as the perceptions of anesthesia providers regarding disposable laryngoscope blades.
Print version: 2012;80(4):274-278.
Keywords: Disposable laryngoscope blade, laryngoscope, laryngoscope blade, reusable laryngoscope blade.
LCDR Philip Grady, CRNA, MSN, NC, USN
LCDR Nathaniel Clark, CRNA, MSN, NC, USN
LCDR John Lenahan, CRNA, MSN, NC, USN
CDR Christopher Oudekerk, CRNA, DNP, NC, USN
CDR Robert Hawkins, CRNA, DNP, NC, USN
CDR Greg Nezat, CRNA, PhD, NC, USN
Joseph E. Pellegrini, CRNA, PhD, CAPT(ret), NC, USN
Abdominal surgery has a high incidence of postoperative pain and dysfunctional gastrointestinal motility. This double-blind, placebo-controlled study investigated the effects of perioperative lidocaine infusion on pain, as measured by verbal analog scale scores, and on bowel function, as subjectively reported by patients undergoing laparoscopic gynecologic outpatient surgery. The authors state the study results are consistent with previous research suggesting that intraoperative lidocaine infusion may improve postoperative pain levels and may shorten the time to return of bowel function.
Print version: 2012;80(4):282-288.
Keywords: Intravenous infusion, laparoscopic abdominal gynecologic surgery, lidocaine, morphine consumption, opiate consumption.
Grace Kline Loftis, CRNA, MSN
Shawn Collins, CRNA, PhD, DNP
Mason McDowell, CRNA, MSNA
Anesthesia is generally accepted as safe in most adult populations; however, in pediatric patients questions exist regarding the potential for long-term detrimental effects. Various anesthetic agents are associated with neuronal degeneration when administered to neonatal animals. The mechanism of damage is thought to be via accelerated apoptosis, a normally beneficial process in the maintenance of homeostasis. This review of the literature examines the current evidence in neonatal rodents, nonhuman primates, and humans experiencing anesthesia-induced neuronal apoptosis.
Print version: 2012;80(4):291-298.
Keywords: Anesthesia, apoptosis, neonate, neuroapoptosis, neurodegeneration.
Vincent Bogan, CRNA, DNAP, CPT(ret), ANC, USA
The rapid growth of office-based cosmetic surgery and anesthesia increases the likelihood of an individual nurse anesthetist’s involvement in this practice area. Because the special knowledge and skills inherent to this setting may not be presently taught in most anesthesia programs, it is up to the practitioner to become aware of the special considerations and requirements involved to ensure patient safety. This course will help anesthetists understand the special characteristics of this setting, the monitored anesthesia care-based approach that is often used, the anesthesia and safety considerations for the cosmetic surgical procedures performed, and the importance of prophylaxis for venous thromboembolism.
Print version: 2012;80(4):299-305.
Keywords: Cosmetic surgery, monitored anesthesia care, office-based anesthesia, off-site anesthesia, venous thromboembolism prophylaxis.