Table of Contents
Print version: 2011;79(3):235.
Early Postoperative Takotsubo Cardiomyopathy: A Case Report
Barbara Bradbury, CRNA, MSNFerne Cohen, CRNA, MSN
Takotsubo cardiomyopathy (TC), also called stress-induced cardiomyopathy, is a rare type of nonischemic cardiomyopathy accompanied by a transient ballooning and akinesis of the left ventricle. This case report describes a premenopausal woman in whom TC developed in the immediate postoperative period following general anesthesia.Print version:
“Broken heart syndrome,” left ventricular apical ballooning, reversible ventricular dysfunction, stress-induced cardiomyopathy, Takotsubo cardiomyopathy.
Predicting Academic Progression for Student Registered Nurse Anesthetists Sharon M. Burns, CRNA, EdD
The purpose of this quantitative correlational study was to determine if a relationship existed between admission criteria (grade point average, science grade point average, Graduate Record Examination scores, and critical care experience) and academic progression (current academic status and grade point average). Key findings revealed that statistically significant relationships exist between the admission selection criteria and academic progression.Print version:
Academic progression, admission selection criteria, attrition, nurse anesthesia education.
Ultrasound Guidance in Anesthesia Jonathan P. Kline, CRNA, MSNA
Sonography addresses a variety of concerns, such as patient safety and comfort, cost-effectiveness, time to complete a procedure, and success rates associated with invasive anesthesia procedures. The general terms and application of ultrasound to the practice of anesthesia are discussed in this article, as well as the general principles and the interpretation of basic images. Common procedures that include its use are also reviewed. Print version:
Imaging, sonography, regional anesthesia, ultrasound, vascular access.
Dexmedetomidine as a Pediatric Anesthetic Premedication to Reduce Anxiety and to Deter Emergence Delirium Brian W. Mountain, CRNA, MSN, APNLinda Smithson, RN, MSNMark Cramolini, MD, FACA, FAAPTami H. Wyatt, RN, PhD, CNEMike Newman, MS
Presurgery anxiety in children may result in preoperative and postoperative complications. Emergence delirium is a mental disturbance common in children during recovery from general anesthesia. This study investigated the role of preoperative dexmedetomidine on parental separation anxiety and acceptance of wearing an anesthesia mask and its effectiveness in reducing the incidence and severity of emergence delirium.Print version:
Dexmedetomidine, emergence delirium, oral premedication.
Faculty Discernment of Student Registered Nurse Anesthetist’s Personality Characteristics That Contribute to Safe and Unsafe Nurse Anesthesia Practice: Metrics of Excellence Elizabeth Wong, CRNA, MSNQiaowu Li, MS
A review of the literature revealed that nurse anesthesia educational program (NAEP) faculty members perceive certain personality characteristics and clinical awareness as the most important traits needed for clinical success in an NAEP. Clinical success in an NAEP is equated with safe nurse anesthesia practice. The purpose of this study is for NAEP academic faculty and expert Certified Registered Nurse Anesthetist clinical faculty to discern which of the 63 intrapersonal and 15 interpersonal characteristics that student registered nurse anesthetists exhibit contribute to safe or unsafe nurse anesthesia practice.Print version:
Intrapersonal characteristics, interpersonal characteristics, patient safety, personality characteristics.
Prevention of Emergence Agitation in Seven Children Receiving Low-dose Ketamine and Propofol Total Intravenous Anesthesia Doralina L. Anghelescu, MDLauren C. Rakes, MDJack R. Shearer, CRNAGeorge B. Bikhazi, MD
The authors of this research article state that low-dose ketamine infused in combination with propofol total intravenous anesthesia appears to be associated with prevention of emergence agitation recurrence in young children who undergo repetitive anesthesia for radiation therapy. They conclude that clear determination of cause and effect cannot be made on the basis of our retrospective analysis; prospective randomized controlled trials are needed to confirm the efficacy of ketamine in preventing emergence agitation and compare it to other adjuvant agents.Print version:
Emergence agitation, ketamine, propofol, radiation therapy, sedation.
Anesthesia Considerations in a Patient With McArdle Disease: A Case Report Abbie J. Choleva, CRNA, MSNA
McArdle disease is a rare skeletal muscle disorder affecting approximately 1 in 100,000 people. In this case report, a patient with McArdle disease underwent bowel surgery with general anesthesia and was successfully managed. The author cautions that when a patient with McArdle disease presents for any surgical procedure, a variety of anesthesia implications should be discussed and incorporated into the overall management of his or her care.Print version:
McArdle disease, myophosphorylase C, rhabdomyolysis, thermoregulation, type V glycogen storage disease.
Severe Preeclampsia, Pulmonary Edema, and Peripartum Cardiomyopathy in a Primigravida Patient
LT Curt Cunningham, CRNA, MSN, NC, USNLCDR Jesse Rivera, CRNA, MS, NC, USNCDR Dennis Spence, CRNA, PhD, NC, USN
Peripartum cardiomyopathy (PPCM) is a rare life-threatening cardiomyopathy of unknown cause that occurs in the peripartum period in previously healthy women. This case report demonstrates the need for vigilance and a high index of suspicion for PPCM in parturients with subtle symptoms of heart failure, such as shortness of breath and edema. The authors conclude that early diagnosis, intervention, and treatment may prevent or, at least, lessen symptoms of PPCM and improve maternal and fetal outcomes.Print version:
Emergent cesarean delivery, peripartum cardiomyopathy, peripartum pulmonary edema, severe preeclampsia.
Gillian Phillips, CRNA, MS, MSN
W. Patrick Monaghan, PhD, CLS, SBB
Many modern diagnostic and surgical procedures rely heavily on the use of ionizing radiation. These procedures include computed tomography, nuclear medicine procedures, interventional radiology, and cardiac catheterization and electrophysiology procedures. An overview of some of the basic principles of radiation biology, radiation physics, and radiation protection and specific guidelines related to radiation exposure and pregnancy are described. The authors of this course state that the effects of radiation exposure are cumulative and permanent, and an understanding of these principles and practices will help anesthesia providers keep their occupational exposure to a minimum.
Print version: 2011;79(3):257-267.
Keywords: ALARA (as low as reasonably achievable), anesthesia provider, electromagnetic radiation, inverse square law, ionizing radiation, radiation safety, x-rays.