October 1999 AANA Journal

Table of Contents

Columns

Legal Briefs
Partial-day Absences for Exempt Employees: Who's Counting?
Robert D. Webb, JD
Print version: 1999;67(5)405-408.
Keywords: Exempt employees, overtime pay, partial-day absences.

Education News
Promoting Teaching Competency and Effectiveness for the 21st Century
Sherril B. Gelmon, DrPH, FACHE
Print version: 1999;67(5)409-416.
Keywords: Competency, faculty assessment, teaching.

Features

Epinephrine-induced Potentially Lethal Arrhythmia During Arthroscopic Shoulder Surgery: A Case Report
Capt Jeffry L. Karns, CRNA, MSN, NC, ANG
This case report describes how arthroscopic shoulder surgery could have resulted in a fatal outcome when the epinephrine present in the arthroscopic irrigating solution contributed to the onset of ventricular tachycardia during surgery.
Print version: 1999;67(5)419-421.
Keywords: Arthroscopic shoulder surgery, defibrillation, intraosseous infusion, trocar instrumentation.

Negative Pressure Pulmonary Edema after a Tonsillectomy and Adenoidectomy in a Pediatric Patient
Caroline L. Thomas, CRNA, MSN
Timothy J. Palmer, CRNA, MS
Peter Shipley, CRNA, MS

Negative pressure pulmonary edema (NPPE) is a complication of upper airway obstructions seen by anesthesia providers during induction or emergence. The onset of NPPE is usually rapid, and without prompt recognition and intervention, the outcome can be fatal. This case report describes NPPE in a pediatric patient after an otherwise uncomplicated surgical procedure.
Print version: 1999;67(5)425-430.
Keywords: Anesthesia, negative pressure pulmonary edema, upper airway obstruction.

To Reuse your Circuit: The HME Debate
MAJ Michael W. Neft, CRNA, CCRN, MSN, MHA, AN, USA
CPT Jerri R. Goodman, CRNA, MSN, AN, USA
MAJ John P. Hlavnicka, CRNA, MSN, AN, USA
Bruce C. Veit, PhD

Heat and moisture exchangers (HMEs) have been used for more than 30 years for heat and moisture retention during general anesthesia. This study adds to existing knowledge about the HME's ability to prevent transmission of bacteria, with implications for cost reduction resulting from reuse of anesthesia breathing circuits among patients.
Print version: 1999;67(5)433-439.
Keywords: Anesthesia breathing circuit, bacteriostatic heat and moisture exchanger, endotracheal tube, nonbacteriostatic heat and moisture exchanger.

Poster Session Abstracts Presented at the 1999 AANA Annual Meeting in Boston, Massachusetts
Print version: 1999;67(5)441-454.

The Knowledge and Attitudes of Nonanesthesia Nurses Regarding Postoperative Epidural Analgesia
LT Colleen L. Sandie, CRNA, MS, NC, USN
CDR Louis J. Heindel, CRNA, ND, NC, USN

Registered nurses are responsible for the day-to-day management of patients receiving epidural analgesia. In this original research, the authors found that while the nurses' attitudes and practices were good, their knowledge level regarding epidural analgesia was low. Recommendations include implementing a multidisciplinary epidural education program and conducting similar studies in the future.
Print version: 1999;67(5)455-460.
Keywords: Epidural analgesia, nurses' knowledge, pain assessment, pain education, pain management.

A Comparative Analysis of Latex Allergy in the Healthy Versus High-risk Pediatric Population
Kristine Faust, CRNA, MS
Christine Shrewsbury, CRNA, MS
Karen Zaglaniczny, CRNA, PhD
Maryann Jarrett, CRNA, MS

The purpose of this research is to compare the incidence of latex sensitivity in the healthy pediatric population with that of an identified high-risk population and determine whether a survey of known risk factors for latex sensitivity was predictive of positive serum latex antibody.
Print version: 1999;67(5)461-466.
Keywords: Latex allergy, myelodysplasia, pediatrics, spina bifida.

Anesthetic Considerations in Patients Undergoing Percutaneous Radiofrequency Interstitial Tissue Ablation
Betsy Sabo, CRNA, BS
Gerald D. Dodd, III, MD
Glenn A. Halff, MD
Joseph J. Naples, MD

Radiofrequency interstitial tissue ablation is a new, minimally invasive procedure for patients with liver cancer that can be done under monitored anesthesia care on an outpatient basis. This article describes this procedure and its anesthetic considerations, which require that intravenous sedation be meticulously titrated to maintain a delicate balance of patient cooperation and optimal comfort.
Print version: 1999;67(5)467-468.
Keywords: Intravenous sedation, liver tumors, patient comfort and cooperation, radiofrequency tissue ablation.

AANA Journal Course: Update for Nurse Anesthetists —Part 4—Anesthesia-related Noncardiogenic Pulmonary Edema: A Literature Review
Joseph Joyce, CRNA, BS
Noncardiogenic pulmonary edema usually occurs as the result of acute upper airway obstruction, of which laryngospasm is one form, but it also has been reported in association with the administration of naloxone and nalmefene. This form of pulmonary edema often can be attributed to the administration of anesthesia and is the focus of this Journal Course.
Print version: 1999;67(5)469-473.
Keywords: Laryngospasm, Müeller maneuver, nalmefene, naloxone, negative inspiratory pressure.

October 1999 AANA Journal
Volume 67 , Number 5
ISSN 0094-6354
On the Cover: