June 1997 AANA Journal

Table of Contents


Reintubation – What is the gold standard?; Contaminated sevoflurane
Print version: 1997;65(3):200-202.

Legal Briefs
By Gene A. Blumenreich, JD
The nature of supervision
Print version: 1997;65(3):208-211.
Keywords: Captain of the ship, standard of care, supervision.

Imagining in Time
By Lee C. Fosburgh, MLIS, MA
Nurse anesthesia and religious sisters: Sister Secundina Mindrup
Print version: 1997;65(3):219-220.
Keywords: History of nurse anesthesia, religious sisters.

Washington Scene
By Wendy Parker, BA
Managed care reform in the 105th Congress
Print version: 1997;65(3):225-226.
Keywords: Employee Retirement Income Security Act (ERISA), federal standards, gag clause, H.R. 2400, H.R. 1415, S. 644.

Management Briefs
By Jeanne Learman, CRNA, MS
Nada Loppnow, RN, MA, AHRMQR
Credentialing of CRNAs – Time for a new look
Print version: 1997;65(3):228-234.
Keywords: Allied health provider, clinical privileges, Joint Commission on Accreditation of Healthcare Organizations (JCAHO), medical staff, primary source verification.

Incidence of visible and occult blood on laryngoscope blades and handles
By Capt Rita A. Phillips, CRNA, MSN, USAF, NC
W. Patrick Monaghan, CLS, SBB, PhD
The presence of blood is an indicator of potential cross-infection, since biological fluids, such as blood and saliva, are known to transmit infectious diseases. Results from this original research suggest the procedures for cleaning, disinfection, sterilization, and handling of laryngoscope blades and handles are not effective, as evidenced by occult blood detected on laryngoscope blades and handles identified as ready for patient use.
Print version: 1997;65(3):241-246.
Keywords: Anesthesia equipment, equipment sterilization, laryngoscope, occult blood, universal precautions.

Suspected malignant hyperthermia in a 13-month-old: Today's typical episode–A case report
By CPT Christopher A. Smith, CRNA, MSN, USA, ANC
LTC Kathleen A. Carvill, CRNA, MSN, USA (ret.)
MAJ Theodore Eckert III, CRNA, MHS, USA, ANC
In this case report, a 13-month-old female presented for a repair of the right radial nerve under general anesthesia. At the conclusion of the surgical procedure, an abrupt increase in ETCO2, an elevation in body temperature, and a mixed acidosis was observed. Resolution of symptoms followed the administration of dantrolene sodium.
Print version: 1997;65(3):247-249.
Keywords: Malignant hyperpyrexia, malignant hyperthermia.

Frustrated wants and entitlements: Fundamental components of CRNA job satisfaction
By Michael D. Fallacaro, CRNA, DNS
Yow-Wu B. Wu, PhD
A comparative study was conducted examining CRNA feelings of deprivation or resentment as they relate to their job satisfaction. The descriptive objective of the study was to examine how different groups of CRNAs compared with one another in terms of both demographic and psychological variables, and the theoretical aim of the study was to validate relative deprivation theory in the sample as a predictor of job related grievance and to examine what preconditions most influenced feelings of deprivation among CRNAs.
Print version: 1997;65(3):250-256.
Keywords: Deprivation, grievance, job satisfaction.

Comparison of axillary block techniques: Is there a difference in success rates?
By Terri S. Jones, CRNA, MSN
This study compared the success rates between two accepted methods of performing axillary blocks, the peripheral nerve stimulator (PNS) and the transarterial (TA) techniques. The axillary nerve was the only nerve with an increased success rate using the TA technique, indicating that both the PNS and TA techniques are equally acceptable.
Print version: 1997;65(3):257-259.
Keywords: Axillary block, mepivacaine, peripheral nerve stimulator technique, transarterial technique.

Recovery times from subarachnoid blocks using bupivacaine hydrochloride and tetracaine hydrochloride with and without epinephrine
By Mildred Leonard, CRNA, MSN
Linda Moore, RN, EdD
Robert Algozzine, PhD
Jane Gregorino, CRNA, MSN
Bill Giles, CRNA, MS
This retrospective study examined the length of time patients spent in the postanesthesia care unit recovering from a subarachnoid block with either bupivacaine hydrochloride or tetracaine hydrochloride with and without epinephrine after total knee replacement surgery or total hip replacement surgery.
Print version: 1997;65(3):260-264.
Keywords: Bupivacaine hydrochloride, local anesthetics, regional anesthesia, subarachnoid blocks, tetracaine hydrochloride.

Update on carcinoid syndrome
By Dean L. Melnyk, MD, PhD
Carcinoid syndrome is a rarely occurring complex associated with carcinoid tumors. In this review article, the author provides background on carcinoid tumors and discusses the pathophysiology of carcinoid syndrome, diagnosis and treatment of carcinoid syndrome, as well as preoperative assessment and workup, anesthetic implications, intraoperative crises, postoperative concerns, and unanticipated cases.
Print version: 1997;65(3):265-270.
Keywords: Carcinoid syndrome, carcinoid tumor, octreotide, serotonin.

AANA Journal Course: Update for nurse anesthetists–Serotonin agonists and antagonists: Anesthetic implications
By John Nagelhout, CRNA, PhD
Colleen Beauchamp, CRNA, MS, RPh
A number of important new pharmacologic agents in widespread clinical use share the ability to manipulate serotonin as their mechanism of action. In this AANA Journal course, the authors review the pharmacology of serotonin receptors, discuss the new drugs available, and outline the anesthetic implications when caring for patients on these drugs.
Print version: 1997;65(3):271-281.
Keywords: Agonists, anesthesia, antagonists, nausea and vomiting, serotonin.

Book Reviews
Anesthetic and Obstetric Management of High-Risk Pregnancy
Reviewed by: Shan L. Bowers, CRNA, BSN
Print version: 1997;65(3):285.

On Leadership
By Karlene Kerfoot, RN, CNAA, PhD, FAAN
Leadership–The courage to care
Print version: 1997;65(3):287-289.
Keywords: Excellence, healthcare, leadership, nursing.

General and Subscription Information
Print version: 1997;65(3):199.

AANA 64th Annual Meeting in San Francisco, August 9-14
Print version: 1997;65(3):204.

Index to Advertisers
Print version: 1997;65(3):296.

June 1997 AANA Journal
Volume 65 , Number 3
ISSN 0094-6354
On the Cover: