February 2000 AANA Journal

Table of Contents


Legal Briefs
The Importance of Being Certified
Gene A. Blumenreich, JD
Print version: 2000;68(1):9-12.
Keywords: Insurance, misrepresentation, notice.

Practice Issues
Transmission-based Precautions and Anesthesia Care
Darlene G. Homa, CRNA, MEd
Marsha A. Palfreyman, RN, BSN, MS, CIC

Print version: 2000;68(1):37-41.
Keywords: Infections, infection control guide, isolation, transmission-based precautions.

Reimbursement News
HCFA Announces 2000 Medicare Anesthesia Conversion Factor Increases and Other Changes
Billie C. Bradford, BA
Print version: 2000;68(1):59-65.
Keywords: Conversion factors, CPT 2000 anesthesia code changes, CPT 2000 spinal code changes, resource-based practice expense.


Use of Complementary and Alternative Medicines by Surgical Patients
Carol L. Norred, CRNA, MHS
Stacy Zamudio, PhD
Susan K. Palmer, MD

In this study, the authors examine the frequency of use of alternative medicines by surgical patients and evaluate potential adverse interactions with anesthesia based upon a literature review of known effects of unconventional medicines.
Print version: 2000;68(1):13-18.
Keywords: Anesthesia, complementary and alternative medicine, drug interaction, herbs, surgical patient.

Statistical Method Using Operating Room Information System Data to Determine Anesthetist Weekend Call Requirements
Franklin Dexter, MD, PhD
Alex Macario, MD, MBA
Rodney D. Traub, PhD

This article presents a statistical method that uses data from surgical services information systems to determine the minimum number of anesthetists to be scheduled for weekend call in an operating room suite. Using this method, an anesthesia group can assure as few anestetists are on call as possible, and for as few hours as possible, while maintaining the level of risk of understaffing that the group is willing to accept.
Print version: 2000;68(1):21-26.
Keywords: Anesthetist staffing, operating room economics, operating room information system, operating room management, staff scheduling.

Determining Staffing Requirements for a Second Shift of Anesthetists by Graphical Analysis of Data From Operating Room Information Systems
Franklin Dexter, MD, PhD
Rodney D. Traub, PhD

In this article, the authors present a graphical statistical method that can be used to determine how many anesthesia providers are required on the second shift to minimize labor costs. The method uses data from surgical services information systems or hospital information systems to compensate for seasonality or seasonal variation in the number of operating rooms running at different times of the day.
Print version: 2000;68(1):31-36.
Keywords: Health economics, operating room information systems, operating room management, staff scheduling.

Comparison of 4 Analgesic Agents for Venipuncture
MAJ Priscilla Patterson, CRNA, MSN, AN, USA
MAJ Ann A. Hussa, CRNA, MSN, AN, USA
MAJ Kimberly A. Fedele, CRNA, MSN, AN, USA
CPT Gary L. Vegh, CRNA, MSN, AN, USA
MAJ Christina M. Hackman, CRNA, MSN, AN, USA

Venipuncture is perceived as a painful and stressful event to an already anxious surgical patient. If an inexpensive and effective analgesic agent for venipuncture can be identified, healthcare agencies can preserve patient comfort while attempting to minimize the cost of venipuncture. This study compares pain on application, pain on venipuncture, cost, and convenience of 4 analgesic agents used for venipuncture.
Print version: 2000;68(1):43-51.
Keywords: Analgesia, application pain, convenience, cost, venipuncture pain.

Peripheral Nerve Injury From Intravenous Cannulation: A Case Report
Mary Beth Boeson, CRNA, MSN
Anne Hranchook, CRNA, MSN
Jeff Stoller, CRNA

When an intravenous (IV) catheter penetrates a nerve, it can cause temporary or permanent nerve damage. This case report of a patient who had an IV catheter inserted into her cephalic vein and sustained an injury to the superficial branch of the radial nerve also discusses IV therapy, the location of the peripheral nerves, injury to neurons, and recommendations to avoid nerve damage.
Print version: 2000;68(1):53-57.
Keywords: Intravenous therapy, nerve damage, neuroma, peripheral intravenous cannulation.

Influence of Whitacre Spinal Needle Orifice Direction on the Level of Sensory Blockade
Franklin J. McShane, CRNA, MSN
CPT Nelson Burgos, CRNA, MSN, AN, USA
CPT Michael Kapp, CRNA, MSN, AN, USA
Christine Wieczorek, CRNA, MSN

This research examines whether the direction of the needle orifice during injection of anesthetic into the subarachnoid space affects the level of sensory blockade achieved, and if the time from injection to surgical anesthesia differs when the anesthetic is injected with the needle in a cephalad vs a caudad orientation.
Print version: 2000;68(1):67-72.
Keywords: Regional anesthesia, spinal anesthesia, spinal needle, Whitacre spinal needle.

AANA Journal Course: Update for Nurse Anesthetists—Part 6
Anesthesia for the Ruptured Globe
Elizabeth Laura Wright, CRNA, MNA
Mark A. Kossick, CRNA, MS

When giving anesthesia to a patient with a ruptured globe, a smooth, atraumatic induction is desired to avoid increasing intraocular pressure. However, methods to achieve this end may place the patient at risk for aspiration. This AANA Journal Course describes various anesthetic techniques for this type of injury, including the use of narcotics, lidocaine, nitroglycerin, alpha (α 2), agonism, beta (β) adrenergic and calcium channel blockades, plus the layrngeal mask airway.
Print version: 2000;68(1):78-83.
Keywords: Intraocular pressure, ocular anesthesia, perforated globe.

February 2000 AANA Journal
Volume 68 , Number 1
ISSN 0094-6354
On the Cover: