February 1999 AANA Journal

Table of Contents


Femoral Nerve Block and 3-in-1 Block in Anesthesia
Michael K. Perry, CRNA, BSN
Don Elswick, CRNA
Print version: 1999;67(1):11.

Legal Briefs
Significance of Signing Medical Chart on Legal Liability
Gene A. Blumenreich, JD
Print version: 1999;67(1):13-16.
Keywords: Employment, medical records, negligence.

Education News
Nurse Anesthesia Education: A Different Challenge
Sandra M. Ouellette, CRNA, MEd, FAAN
Nancy Courts, MSN, PhD
Pamela J. Lincoln, RN, MSN
Print version: 1999;67(1):21-31.
Keywords: Nurse anesthesia education, program design, program admission criteria, program attrition.

Imagining in Time
Alice Magaw and the Great Secret of Open Drop Anesthesia
Evan Koch, CRNA, MSN
Print version: 1999;67(1):33-38.
Keywords: Alice Magaw, chloroform, ether.

Reimbursement News
HCFA Announces 1999 Anesthesia Medicare Conversion Factor Increases and Other Changes
Billie C. Bradford, BA
Print version: 1999;67(1):39-43.
Keywords: Conversion factors, Health Care Financing Administration, medical direction, practice expenses, provider user fee.

Teaching, Learning, and Leading
Kathleen Fagerlund, CRNA, PhD
Mitchell Kusy, EdD
Instructional systems design is a process for assessing learning needs, creating instructional programs, and evaluating effectiveness of learning. In this article, the authors discuss the benefits of including instructional systems design theory and practice in the curriculum, with an emphasis on making the process relevant for student nurse anesthetists.
Print version: 1999;67(1):45-47.
Keywords: Instructional systems, learning styles, nurse anesthesia students, teaching styles.


Postoperative Sore Throat: Incidence and Severity After the Use of Lidocaine, Saline, or Air to Inflate the Endotracheal Tube Cuff
Nancy E. Porter, CRNA
Vicki Sidou, MD
Jim Husson, CRNA, MS
Postoperative sore throat occurs in up to 90% of intubated patients and is the most common complaint of patients after endotracheal intubation. The findings in this study suggest that the use of lidocaine, saline, and air had similar effects on postoperative sore throat.
Print version: 1999;67(1):49-52.
Keywords: Anesthesia complication, endotracheal tube, lidocaine, sore throat.

Radiation Exposure of Certified Registered Nurse Anesthetists During Ureteroscopic Procedures Using Fluoroscopy 
Lenn Kevin Otto, CRNA, MSN
Susan Davidson, RN, EdD
Due to the use of fluoroscopy in the operating room, CRNAs frequently are exposed to the dangers of radiation emitted during surgical procedures during fluoroscopy. The purposes of this research were to determine the level of radiation exposure of the CRNA during fluoroscopic procedures in the operating room and to determine whether these levels are within the limits of maximum permissible dose equivalents.
Print version: 1999;67(1):53-58.
Keywords: Fluoroscopy, radiation exposure, workplace hazards.

Anesthesia Considerations for Patients with Narcolepsy
Joseph A. Joyce, CRNA, BS
Detailed information on narcolepsy, a derangement of the normal sleep-wakefulness rhythms, is provided in this review article. The author states that the anesthetist should be aware of narcolepsy, its symptoms, and the medications used in the alleviation of those symptoms.
Print version: 1999;67(1):59-66.
Keywords: Cataplexy, excessive daytime sleepiness, hypnogogic and hypnopompic hallucinations, narcolepsy, sleep paralysis.

Laparoscopic Cholecystectomy for the Adult with Unrepaired Tetralogy of Fallot:
A Case Report

Jayne D. Andrews, CRNA, MN
This is a case study of a 24-year-old woman with a history of tetralogy of Fallot who underwent general endotracheal anesthesia for laparoscopic cholecystectomy for cholelithiasis and pancreatitis. Principles for the anesthetic management of the patient with cyanotic congenital heart disease undergoing noncardiac surgery are reviewed.
Print version: 1999;67(1):67-71.
Keywords: Congenital heart disease, laparoscopic cholecystectomy, tetralogy of Fallot.

Legal Implications of Evaluation Procedures for Students in Healthcare Professions
Kathleen R. Wren, CRNA, PhD
Timothy L. Wren, RN, MS
Because today's students are more willing to appeal to the legal system for satisfaction of grievances, healthcare educators must be aware of the legal parameters and ramifications of student evaluation processes. Reviewing past litigation involving healthcare education, the authors find that while dismissing a student is always difficult, fear of legal intervention should not deter educators from fulfilling their responsibility to education, the profession, society, and patient safety.
Print version: 1999;67(1):73-78.
Keywords: Academic dismissals, clinical training, due process, grievance, student evaluatiion.

A National Study: Stress Perception by Nurse Anesthesia Students 
Ernesto C. Perez, CRNA, MS
Idena Carroll-Perez, CRNA, MS
Nurse anesthesia education is highly stressful. While stress cannot be eradicated from the practice of anesthesia, it can be managed, especially when recognized early. In this study, the authors examine the perception of students' stress in nurse anesthesia programs, the presence and use of stress management programs available to students, and open-door policies existing in nurse anesthesia schools.
Print version: 1999;67(1):79-86.
Keywords: Anxiety, nurse anesthesia student, stress, stress management, student anxiety.

AANA Journal
Course: Update for Nurse Anesthetists—Part 6—Anesthetic Management During Electroconvulsive Therapy: Effects on Seizure Duration and Antidepressant Efficacy 

Elizabeth M. Hick CRNA, MNA
John L. Black, MD
Electroconvulsive therapy (ECT) is an effective treatment for some types of depression and psychotic disorders. Although ECT is considered relatively safe, the treatment team must know how to deal with adverse effects and understand the effect of anesthetic agents on seizure activity. In this Journal course, the authors review ECT, anesthesia for ECT, and the effect of propofol and methohexital on seizure duration and seizure efficacy.
Print version: 1999;67(1):87-92.
Keywords: Anesthesia, electroconvulsive therapy, seizure duration, seizure efficacy, seizure threshold.

February 1999 AANA Journal
Volume 67 , Number 1
ISSN 0094-6354
On the Cover: