June 2004 AANA Journal

Table of Contents


Books and Multimedia of Interest
Fundamentals of Disaster Management
Reviewer: Lynne M. Van Wormer, CRNA, MSN

Peripheral Nerve Blocks, A Color Atlas
Reviewers: Nick Keene, CRNA, MS
Josh Weiss, MD

Print version: 2003;72:170-171.
Legal Briefs
Expert Testimony
Gene A. Blumenreich, JD
Print version: 2004;72:173-177.
Key words: Expert testimony, standard of care.
Rural nurse anesthesia practice: A pilot study
Elizabeth Monti Seibert, CRNA, MSN
Judith Alexander, RN, PhD
Alfred E. Lupien, CRNA, PhD

The purposes of this study were to pilot test the Nurse Anesthesia Rural Practice Inventory, determine whether CRNAs can provide the requested data, and provide data about characteristics of rural nurse anesthesia practice.
Print version: 2004;72:181-190.
Key words: Anesthesia manpower, nurse anesthetist, rural.
Use of deep hypodermic circulatory arrest following ventricular laceration: A case report
Ken Spain, CRNA, MSEd
Deep hypothermic circulatory arrest (DHCA) is usually a planned approach to certain types of cardiovascular surgery. This case report is an example of DHCA used to provide cerebral protection for a patient whose right ventricle was lacerated by an oscillating saw during sternotomy. Anesthetic intervention with specific drug administration and steps taken for neuroprotection are discussed.
Print version: 2004;72:193-195.
Keywords: Cerebral protection, deep hypothermic circulatory arrest, ventricular laceration.
Stunning the neural nexus: Mechanisms of general anesthesia
Penelope S. Villars, CRNA, MSN, RRT
Joseph T. Kanusky, CRNA, MS
Thomas B. Dougherty, MD, PhD

In this review article, the authors define clinical anesthesia and discuss general anesthesia mechanisms, neural communication, key receptors in the central nervous system, major inhibitory and excitatory pathways, and mechanisms of anesthetic agents.
Print version: 2004;72:197-205.
Key words: General anesthesia, ion channels, theories of anesthetic action.
Acute hypoxemia after repositioning of patient: A case report
John A. Shields, CRNA, BSN
Cheril M. Nelson, CRNA, MSN

Anesthesia is associated with lower oxygen tensions, and occasionally oxygen desaturation and hypoxemia occur. In this case report, the authors detail the occurrence of hypoxemia after induction of anesthesia and repositioning in a patient undergoing hip pinning, and they report how this case was successfully handled.
Print version: 2004;72:207-210.
Key words: Atelectasis, hypoxemia, ventilation-perfusion mismatch.
An evaluation of anesthesia patient satisfaction instruments
Donald M. Bell, CRNA, DNSc
James R. Halliburton, CRNA, DNSc
John C. Preston, CRNA, DNSc

In this study, the authors sought to systematically review the instruments used to obtain anesthesia-specific patient satisfaction data and to determine the degree to which each instrument controlled for measurement error bias, such as poor survey design.
Print version: 2004;72:211-217.
Key words: Anesthesia outcome, measurement techniques, patient satisfaction.
Using liquid ventilation to improve lung function in patients with respiratory distress syndrome: A comprehensive review of the literature
Jennifer B. Hancock, CRNA, MSN
Susan Davidson, RN, EdD
Cherry Guinn, RN, EdD
Richard Zachary, CRNA, MSN

This article is a review of the research findings on the subject of liquid ventilation and how it has shown to improve lung function in patients with respiratory distress syndrome. An overview of the physiology behind the success of liquid ventilation, including current research outcomes, is presented.
Printed version: 2004;72:218-224.
Key words: Liquid ventilation, partial liquid ventilation, perfluorocarbon-assisted ventilation, total liquid ventilation, respiratory distress syndrome.

AANA Journal Course, Part 2
Update for nurse anesthetists -- 
Anticoagulation and spinal and epidural anesthesia
Andrea J. Claerhout, CRNA, MSN
Michael Johnson, CRNA, MSN
Jennifer D. Radtke, CRNA, MSN
Karen L. Zaglaniczny, CRNA, PhD, FAAN

The purpose of this AANA Journal course is to update anesthesia providers regarding the common anticoagulants used for surgical patients, the risks associated with epidural and spinal anesthesia in conjunction with anticoagulation, and recommendations for the use of epidural and spinal anesthesia in anticoagulated patients. Antiplatelet drugs, oral anticoagulants, heparin, low-molecular-weight heparin, other new anticoagulants, and herbal medications are reviewed.
Printed version: 2004;72:225-231.
Key words: Anticoagulation, epidural anesthesia, epidural hematoma, spinal anesthesia.
June 2004 AANA Journal
Volume 72 , Number 3
ISSN 0094-6354
On the Cover:
Sherita Edwards, RN, BSN, and Lance Grizzard, RN, BSN, at Virginia Commonwealth University, Department of Nurse Anesthesia, Richmond, Va (both seated) receive instruction on surgical cricothryotomy, an emergency airway procedure from Mimi Hotchkiss, CRNA, MSNA, assistant professor. The procedure is part of an extensive course in advanced alternative airway management that includes both actual and simulated hands-on instruction using pig larynxes.