February 2004 AANA Journal

Table of Contents​

Bandolier's Little Book of Pain
Reviewed by Thomas C. Bloomquist, CRNA, MA, FAAPM
Print version: 2004;72:29.


Distribution of US anesthesia providers and services
Michael D. Fallacaro, CRNA, DNS
Theresa Ruiz-Law, BA

In this study, the authors describe the correlation between anesthesia providers by type (CRNA or anesthesiologist) and their respective rural or urban distributions across America. Analyses are based on county level data contained in several distinct databases with a given assumption that most providers practice and reside in the same rural or urban designation category.
Print version: 2004;72:9-14.
Key words: Manpower, medically underserved, nurse anesthetist, rural, workforce.
The critical airway, rescue ventilation, and the Combitube: Part 1
James M. Rich, CRNA, MA
Andrew M. Mason, MB, BS, MRCS, LRCP
Tareg A. Bey, MD
Peter Krafft, MD, PhD
Michael Frass, MD

In Part 1 of this review article, the authors discuss the proper use of the esophageal-tracheal Combitube (ETC) in combination with the self-inflating bulb and/or portable carbon dioxide detector to resolve critical airway situations. In addition, critical airway events and rescue ventilation options; ETC design, technical aspects, training, insertion, and ventilation; determining ETC location; and monitoring ETC lung ventilation are reviewed.
Print version: 2004;72:17-27.
Key words: Capnography, Combitube, critical airway event, esophageal detector device, rescue ventilation.
A report on the Council on Certification of Nurse Anesthetists 2001 Professional Practice Analysis  
Franklin McShane, CRNA, MSN
Kathleen A. Fagerlund, CRNA, PhD

The purpose of this article was to report the results of the 2001 Professional Practice Analysis performed by the Council on Certification of Nurse Anesthetists. This analysis was used to validate the content and test specifications for the National Certification Examination.
Print version: 2004;72:31-52.
Key words: Certification examination, Professional Practice Analysis.
Intraoperative thyroid storm: A case report
Catherine M. Grimes, CRNA, MS
CPT Hector Muniz, CRNA, MS, AN, USA
William H. Montgomery, MD
Yong S. Goh, MD

Thyroid storm, although uncommon, still can occur, as in this case report. The authors state that in these days of outpatient surgery, the practitioner needs to stay alert when seeing for the first time a patient with hyperthyroidism admitted for surgery, whether the surgery involves the thyroid or not.
Print version: 2004;72:53-55.
Key words: Intraoperative thyroid storm.
Effect of needle size on success of transarterial axillary block
LCDR Lorraine A. English, CRNA, MS, NC, USN
LT Johnnie M. Holmes, CRNA, MS, NC, USN
LCDR Joseph F. Burkard, CRNA, MS, NC, USN
CAPT Charles A. Vacchiano, CRNA, PhD, NC, USN
Alexander Shin, MD
CDR Joseph Pellegrini, CRNA, DNSc, NC, USN
LCDR John Maye, CRNA, PhD, NC, USN

The transarterial approach to brachial plexus block is a well-established method of producing anesthesia of the upper extremity; however, it is associated with a failure rate of 20% to 30%. The purpose of this investigation was to compare success rates following transarterial brachial plexus block with a standard 22-gauge, 1½-in needle or a 26 gauge, ½-in needle.
Print version: 2004;72:57-60.
Key words: Needle size, regional anesthesia, transarterial brachial plexus block, success rate.

AANA Journal
Course, Part 6

Update for nurse anesthetists --
Rave drugs: Pharmacological considerations
Mary Klein, RN, BSN
Frances Kramer, CRNA, ND, MSN

An increasingly prevalent component of today's adolescent and young adult culture are the rave or club drugs, such as Ecstasy, Rohypnol, g-hydroxybutyric acid, ketamine, Fry, lysergic acid diethylamide (LSD), and methamphetamine. Considering the incidence of accidental injury in this age group, young patients admitted to the operating room in emergency situations may be under the influence of one of these drugs. In this AANA Journal course, the clinically significant physiologic effects on the neurological, cardiovascular, hepatic, renal, and respiratory systems are summarized for these 7 illicit drugs.
Print version: 2004;72:61-66.
Key words: Anesthesia interactions, club drugs, illicit drugs, rave drugs
February 2004 AANA Journal
Volume 72 , Number 1
ISSN 0094-6354
On the Cover:
Kimberly Raspa, CRNA, MS (left) and Kelly Crowley, CRNA, MSN (right), view tablet PCs to obtain patient histories at St Christopher's Hospital for Children, Philadelphia, Pa. Patient information is recorded on table PCs and is available to all anesthesia providers instantaneously. "Our technological advances have allowed us to streamline and improve patient care and medical record keeping," said Crowley, who credits Mohamed Rehman, MD, with initiating the computerized record system at St Christopher's Hospital.