October 1997 AANA Journal

Table of Contents

Contents

Legal Briefs
By Gene A. Blumenreich, JD
LeCroix case
Print version: 1997;65(5):419-422.
Keywords: Expert testimony, hospital policies, supervision.

Washington Scene
By Greta Todd, MA
Antidiscrimination: The path of a legislative issue
Print version: 1997;65(5):424-427.
Keywords: Antidiscrimination, healthcare reform, managed care, Patient Access to Responsible Care Act (PARCA).

Letters
Sevoflurane use in Veterans Affairs medical centers: Utility, safety, and cost effectiveness; The laryngeal mask airway: Implications for cricoid pressure; Leadership: The courage to care
Print version: 1997;65(5):430-436.

Correction
Print version: 1997;65(5):436.

On Leadership
By Karlene Kerfoot, RN, CNAA, PhD, FAAN
Glue: The essence of leadership
Print version: 1997;65(5):437-438.
Keywords: Connective leaders, healthcare, leadership, nursing.

Education News
By Marjorie Peace Lenn, EdD
Nurse anesthesia and the globalization of the professions
Print version: 1997;65(5):444-449.
Keywords: International Federation of Nurse Anesthetists (IFNA), international higher education, international professional education, professional trade agreement.

A few remarks from Ronald F. Caulk, CRNA, IFNA executive director
Print version: 1997;65(5):449-450.

AANA Journal Course: Update for nurse anesthetists-Improving the efficacy of subarachnoid and epidural blocks-Part B
By Michael A. Fiedler, CRNA, MS
The most common cause of a failed block appears to be an inadequate level. Other causes of failed block account for a small number of failures and are often corrected with experience. In this second part of a two-part AANA Journal Course, the author addresses the effectiveness of spinal and epidural blocks and includes information on failed blocks, optimizing blocks, alpha agonists, and other considerations.
Print version: 1997;65(5):451-459.
Keywords: Anesthesia, conduction (methods), epidural anesthesia, spinal anesthesia.

Clinical pathways and case management in anesthesia practice: New tools and systems for the evolving healthcare environment
By Carole Rietz, CRNA, MSN
Susan Erickson, RN, MPH
Jayant K. Deshpande, MD
Clinical care pathways and case management are strategies utilized by increasing numbers of hospitals to meet the challenges of capitated reimbursement and managed care. In this article, the authors explain that these tools and systems have great potential for use by nurse anesthetists in ensuring that high-quality anesthesia care is delivered in a cost-effective manner.
Print version: 1997;65(5):460-467.
Keywords: Advanced nursing practice role development, anesthesia case management, clinical pathways, collaborative pathways, critical pathways.

Anesthetic implications for implantation of a left ventricular assist device: A case study
By Timothy J. Phillips, CRNA
Tremendous advances have been made in cardiac transplantation; however, there is an acute donor shortage in the face of an increased need for donor hearts. This case report discusses the anesthetic management of a patient undergoing implantation of a left ventricular assist device.
Print version: 1997;65(5):468-474.
Keywords: Bridge to transplantation, cardiomyopathy, end-stage cardiac disease, left ventricular assist device (LVAD).

Comparative recovery from three nondepolarizing neuromuscular blockers in a patient before and after chronic anticonvulsant therapy
By Richard E. Haas, CRNA, EdM, MS
James E. Masters, MD
In this case report, the authors describe a patient with previously normal recovery from neuromuscular blockers in whom an accelerated recovery profile from the nondepolarizing muscle relaxants pancuronium, vecuronium, and doxacurium developed after long-term anticonvulsant therapy. A brief review of the possible mechanisms of action of the acceleration of the patient's recovery profile is also presented.
Print version: 1997;65(5):475-478.
Keywords: Anticonvulsants, drug interactions, neuromuscular blockers, phenytoin.

Poster Session abstracts presented at the 1997 AANA Annual Meeting in San Francisco
Print version: 1997;65(5):479-508.


General and Subscription Information
Print version: 1997;65(5):412.

Index to Advertisers
Print version: 1997;65(5):512.

October 1997 AANA Journal
Volume 65 , Number 5
ISSN 0094-6354
On the Cover: