Army Anesthesia Providers’ Perceptions of Emergence Delirium After General Anesthesia in Service MembersMAJ John Tyler Wilson, CRNA, PhD, ANC, USA
The primary aim of this study was to investigate emergence delirium (ED) in service members, through the perceptions of active duty US Army anesthesia providers. There was a statistically significant association between perceived severity of ED and the ED case experience. The behaviors and consequences that were often or always seen included hyperactive motor behavior, removing monitoring equipment, and making disruptive movements.
Keywords: Emergence delirium, general anesthesia, Global War on Terrorism, military service members.
Print version: 2013;81(6):433-440.
Delayed Onset of Suspected Malignant Hyperthermia During Sevoflurane Anesthesia in an Afghan Trauma Patient: A Case ReportLCDR Rafal Banek, CRNA, MSN, NC, USNLCDR John Weatherwax, MD, MC, USNCDR Dennis Spence, CRNA, PhD, NC, USNLTC Susan Perry, CRNA, PhD, USAF, NCSheila Muldoon, MDJohn Capacchione, MD
Malignant hyperthermia (MH) is a rare pathologic hypermetabolic pharmacogenetic disorder of skeletal muscle calcium regulation following exposure to depolarizing muscle relaxants and/or volatile anesthetics. This article describes the presentation and management of a suspected case of MH in an Afghan national who underwent surgery following lower extremity trauma resulting from an improvised explosive device.
Keywords: Emergency surgery, malignant hyperthermia, sevoflurane, succinylcholine, trauma.
Print version: 2013;81(6):441-445.
Keywords: Forced-air warmer, hypothermia, perioperative warming, temperature.
Print version: 2013;81(6):446-451.
Trauma is a leading cause of morbidity and mortality. Uncontrolled hemorrhage related to the traumatic event is often the major cause of complications and death. The use of hemostatic agents may be one of the easiest and most effective methods of treating hemorrhage. The US military recommends a hemostatic combat gauze (QuikClot Combat Gauze) as the first-line hemostatic agent for use in treatment of severe hemorrhage. This review provides essential information for evidence-based use of this agent.
Keywords: Combat gauze, hemorrhage control, hemostatic agent, trauma, QuikClot Combat Gauze.
Print version: 2013;81(6):453-458.
Keywords: Cardiac arrest, pediatric, pulseless electrical activity.
Print version: 2013;81(6):459-464.
Emotional Intelligence as a Noncognitive Factor in Student Registered Nurse AnesthetistsShawn Collins, CRNA, DNP, PhD
Nurse anesthesia program admissions requirements usually focus on high GPAs, GRE scores, years of acute care experience, and a personal interview to assist in predicting who will succeed in these intensive academic and clinical programs. Some believe these criteria may not be sufficient in predicting success and have suggested that the use of noncognitive criteria such as emotional intelligence measurements may be helpful. This cross-sectional correlational study explores the relationship between emotional intelligence and academic factors.
Keywords: Emotional intelligence, profiles, Q-factor, student registered nurse anesthetist.
Print version: 2013;81(6):465-472.
AANA Journal Course: Update for Nurse Anesthetists – Part 5 – Like a Slippery Fish, a Little Slime Is a Good Thing: The Glycocalyx RevealedChuck Biddle, CRNA, PhD
The glycocalyx is a dynamic network of multiple membrane-bound complexes lining the vascular endothelium. Its role in maintaining vascular homeostasis includes regulating vascular permeability as well as a range of vital functions, such as mechanotransduction, hemostasis, modulation of inflammatory processes, and serving as an antiatherogenic. Revisionist thinking about the Starling principle is discussed in terms of the major influence of the glycocalyx on capillary and tissue fluid homeostasis. The clinical and pathophysiologic threats to the glycocalyx are reviewed as well as strategies to maintain its integrity.
Keywords: Diabetes, hypervolemia, intravenous fluids, vascular disease, vascular endothelial glycocalyx.
Print version: 2013;81(6):473-480.