February 1997 AANA Journal

Table of Contents

Contents

Books of Interest
The Ambulatory Anesthesia Handbook
Reviewed by: Margaret S. Tierney, CRNA, MS

Anatomy of an Illness as Perceived by the Patient
Reviewed by: Chuck Biddle, CRNA, PhD

Postoperative Care of the Critically Ill Patient
Reviewed by: Bernard P. Gallacher, MD, CM, CCFP, FRCPC

Regional Anesthesia in Infants, Children, and Adolescents
Reviewed by: Burdett S. Dunbar, MD

Clinical Orthopedic Anesthesia
Reviewed by Elizabeth J. Monti, CRNA, MSN
Print version: 1997;65(1):6,91-92.

Washington Scene
By Greta Todd, BS
Education shifts in the 105th Congress
Print version: 1997;65(1):10-12.
Keywords: Appropriations, education, Medicare, nurse anesthesia programs, reauthorization.

Management Briefs
By Billie C. Bradford, BA
HCFA issues 1997 anesthesia Medicare conversion factors: Significant increase in anesthesia services approved
Print version: 1997;65(1):20-22.
Keywords: Conversion factors, Health Care Financing Administration, Medicare, Medicare Physician Fee Schedule, Physician Payment Review Commission.

Education News
By Betty J. Horton, CRNA, MA, MSN
The future of education and accreditation
Print version: 1997;65(1):23-28.
Keywords: Accreditation, education, future changes.

Letters
Nondisposable sphygmomanometer cuffs harbor frequent bacterial colonization and significant contamination by organic and inorganic matter
Print version: 1997;65(1):28.

Legal Briefs
By Gene A. Blumenreich, JD
Res ipsa loquitur: Dental damage during anesthesia
Print version: 1997;65(1):33-36.
Keywords: Dental damage, negligence, res ipsa loquitur.

HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) pathophysiology and anesthetic considerations
By Ritho Portis, CRNA, MS
Maureen A. Jacobs, CRNA, BS
Jonathan H. Skerman, BDSC, MScD, DSc
Elizabeth B. Skerman, RNC
HELLP syndrome in the parturient is associated with poor maternal and fetal outcomes. In this review article, the authors include information on HELLP syndrome, pathophysiology, review of literature, obstetric management, anesthetic considerations, fluid management and monitoring, anesthetic management
of labor and delivery, and anesthetic management of
cesarean section.
Print version: 1997;65(1):37-47.
Keywords: HELLP syndrome, obstetric anesthesia, pathophysiology.

The expanding role of the clinical coordinator
By Leon F. Deisering, CRNA, MSN
Steve L. Alves, CRNA, MSNA
In this article, the authors describe the role of the clinical coordinator in nurse anesthesia educational programs, a role which has greatly expanded as programs shift to university-based frameworks with multiple clinical sites.
Print version: 1997;65(1):48-51.
Keywords: Clinical coordinator, nurse anesthesia education, regional coordinator.

Perioperative pulmonary tumor embolus: A case report
By Ann Marie Kakavand, CRNA, MSN
In this case report, a patient with renal cell carcinoma sustained severe right ventricular decompensation following an acute obstruction of the pulmonary artery by tumor emboli. The author concludes that cardiovascular and respiratory parameters can change dramatically and immediately following a classic pulmonary thrombus.
Print version: 1997;65(1):52-58.
Keywords: Immediate treatment, pulmonary thrombus, renal cell carcinoma.

Inhaled nitric oxide as a selective pulmonary vasodilator in clinical anesthesia
By Geoffrey N. Morris, MB, BS, FRCA
George F. Rich, MD, PhD
In this review article, the authors explore the topic of inhaled nitric oxide as a selective pulmonary vasodilator in adult and pediatric patients. The authors state that there is growing evidence that nitric oxide may be a useful therapeutic agent in the treatment of pulmonary hypertension and hypoxemia from a variety of causes.
Print version: 1997;65(1):59-67.
Keywords: Endothelium-derived relaxant factor, nitric oxide, nitric oxide synthase, pulmonary hypertension, pulmonary vasodilation.

Hyperthermia during repair of pectus excavatum
By Joseph D. Tobias, MD
Walter M. Morgan III, MD
George W. Holcomb III, MD
Wallace W. Neblett III, MD
Michael Hutchins, MD
In this retrospective-prospective study, the authors documented their observation that children undergoing repair of pectus excavatum frequently develop significant increases in their core body temperature. The retrospective part of the study involved a chart review; the prospective arm of the study included an evaluation of certain measures to limit intraoperative hyperthermia.
Print version: 1997;65(1):68-71.
Keywords: Hyperthermia, pectus excavatum, pediatric anesthesia.

AANA Journal Course: Update for nurse anesthetists–Thoracic trauma
By Mary C. Karlet, CRNA, PhD
Anesthesia care for the thoracic trauma patient often involves continued resuscitation to combat shock, as well as the careful administration of anesthetic agents. In this AANA Journal course, the author details mechanisms of thoracic trauma, general considerations, anesthetic considerations, and specific thoracic injuries.
Print version: 1997;65(1):73-80.
Keywords: Thoracic trauma, trauma.

Practice Issues
By Donald Heon, CRNA, MSN
Labor intrathecal analgesia
Print version: 1997;65(1):86-87.
Keywords: Fentanyl, intrathecal narcotics, labor, morphine, sufentanil.

General and Subscription Information
Print version: 1997;65(1):5.

Index to Advertisers
Print version: 1997;65(1):96.

February 1997 AANA Journal
Volume 65 , Number 1
ISSN 0094-6354
On the Cover: