Anesthetic Management of a Complex Pediatric Trauma PatientBrian G. Cornelius, CRNA, MSNMike Strong, CRNA, MSNARodney Posey, MD
Trauma is a leading cause of mortality for pediatric patients worldwide. This case report presents the anesthetic care and management of a 15-year-old female who was involved in a high-speed rollover motor vehicle accident. In this case, multiple emerging therapies were combined with long-standing treatments.
Keywords: Cardiac arrest, hepatic injury, massive transfusion, pediatric trauma, tranexamic acid.
Print version: 2014;82(4):270-274.
The Prevalence and Patterns of Substance Abuse Among Nurse Anesthesia StudentsGregory Bozimowski, CRNA, DNPCarla Groh, RN, PhDPatricia Rouen, RN, PhDMichael Dosch, CRNA, PhD
The purpose of this study was to assess the prevalence, demographic factors, outcomes, and preventative measures for substance abuse among nurse anesthesia students over a 5-year period from 2008 to 2012. An electronic survey was sent to 111 program directors of accredited nurse anesthesia programs in the United States. Future studies evaluating the effectiveness of wellness promotion efforts might lead toward a standardized, best practice approach to risk reduction strategies.
Keywords: CRNA, nurse anesthesia students, substance abuse.
Print version: 2014;82(4):277-283.
Effect of Elective Surgery on Subjective Health in Veterans With Chronic Posttraumatic Stress DisorderLCDR Ken Wofford, CRNA, PhDMichael Hertzberg, MDSusan Silva, PhDCharles Vacchiano, CRNA, PhD
Posttraumatic stress disorder (PTSD) is common, is often chronic, and has been associated with greater risk of postoperative mortality in veterans. The purpose of this study was to determine if elective outpatient surgery had a persistent
effect on the physical or mental health of veterans with chronic PTSD. A longitudinal, quasi-experimental study was conducted that followed up 60 veterans with chronic PTSD over 12 weeks.
Keywords: Elective surgery, mental health, posttraumatic stress disorder, PTSD, veterans.
Print version: 2014;82(4):285-292.
Anesthetic Considerations for an Adult Heart Transplant Recipient Undergoing Noncardiac Surgery: A Case ReportRegalado Valerio Jr, CRNA, MSOmar Durra, MDMichele E. Gold, CRNA, PhD
Approximately 3,500 Americans undergo heart transplantation each year. Anesthesia professionals can be tasked to assess and provide the anesthesia management for heart transplant recipients undergoing a noncardiac surgical procedure. The purposes of this case report were to discuss the indications for the perioperative care of heart transplant recipients undergoing noncardiac procedures, and to discuss the evidence-based literature to provide delivery of safe and effective patient care.
Keywords: Anesthesia, denervated heart, noncardiac surgery, postheart transplant.
Print version: 2014;82(4):293-299.
Accuracy of Blood Loss Estimations Among Anesthesia ProvidersAshleigh R. Adkins, CRNA, DMPNADoohee Lee, PhD, MPHDelilah J. Woody, CRNA, MSWilliam Asa White Jr, CRNA, DMP, MS
Research regarding the accuracy of estimating blood loss by anesthesia providers has been limited, generally consisting of small sample sizes with conflicting findings. A prospective study using a convenience sample of 91 anesthesia providers was conducted. Findings suggest that some anesthesia providers may not estimate blood loss accurately.
Keywords: Accuracy, anesthesia, estimated blood loss, moulage blood.
Print version: 2014;82(4):300-306.
AANA Journal Course: Update for Nurse Anesthetists—Part 3—Alveolar Recruitment Maneuvers: Are Your Patients Missing Out?Benjamin L. Hartland, BSN, RNTimothy J. Newell, BSN, RNNicole Damico, CRNA, MSNA
Awake, spontaneously breathing humans sigh on average 9 to 10 times per hour. The sigh is a normal homeostatic reflex proposed to maintain pulmonary compliance and decrease the formation of atelectasis by recruiting collapsed alveoli. Alveolar recruitment maneuvers, which make up one component of open lung ventilation, have been described as vital capacity breaths, double tidal volume breaths, and sigh breaths. These simple maneuvers result in a sustained increase in airway pressure that serves to recruit collapsed alveoli and improve arterial oxygenation. This article examines the literature regarding the application of alveolar recruitment maneuvers in the perioperative setting.
Keywords: Alveolar recruitment maneuvers, open lung ventilation, sigh breaths.
Print version: 2014;82(4):307-314.