January 31, 2014
AANA to CMS: Do Not Slash Coverage for Pain Injections
The relative values of certain chronic pain management injection services should not be reduced by up to a third as Medicare has recommended, but kept relatively consistent with current levels, said the AANA to the Centers for Medicare & Medicaid Services. “Substantially and suddenly reducing the relative value related to chronic pain injection treatment may limit or eliminate patient access to this care,” states the letter signed by AANA President Dennis Bless, CRNA, MS.
Read the letter here
. (AANA member login and password required.)
- January Marks 10-Year Anniversary of Landmark Decision Ensuring Montanans Access to Safe, Cost-Effective Anesthesia Care
- Time is running out to register for the AANA Assembly of School Faculty in Sunny San Diego
- National Nurse Anesthetists Week 2014: CRNAs and Students Spread the Good News About Their Profession
- Support Your Profession at the Mid-Year Assembly
- Make Professional Development a Priority: AANA 2014 Meetings and Workshops Calendar Now Available
- The AANA Essentials of Obstetric Analgesia/Anesthesia Workshop
- AANA Foundation Applications Now Available Online
- AANA Foundation Assembly of School Faculty Hawaiian Luau
- AANA Foundation 2014 Award Nominations: Deadline is Feb. 1
- AAMI Survey on Alarmy Safety
- OSHA Launches Website With Resources on Workplace Safety
- Laura Ardizzone, CRNA, DNP, DCC, Appointed to NQF Patient Safety Steering Committee
- Attention Facebook Fans: Click that Like Button!
- AANA, VA CRNAs Meet with Veterans Health Administration to Support Recognition of CRNAs as Full Practice Authority Providers
- Congress OKs 2014 Budget Including Modest Boosts for Nurse Workforce Development, Nursing Research
- Medicare Administrative Contractor Reverses CRNA Ultrasound Denials in Kentucky and Ohio
- Register Now for 2014 AANA Mid-Year Assembly
- Pardon the Interruption
- At PCORI Nursing Roundtable, AANA Gathers Information About Patient-Centered Outcomes Research Opportunities
- FEC REQUIRED LEGAL DISCLAIMER FOR CRNA-PAC
Healthcare HeadlinesHealthcare Headlines is for informational purposes, and its content should not be interpreted as endorsements, standards of care, or position statements of the American Association of Nurse Anesthetists.
Inside the Association
January Marks 10-Year Anniversary of Landmark Decision Ensuring Montanans Access to Safe, Cost-Effective Anesthesia Care
Ten years ago this month Montana became the 12th state to opt out of the federal physician supervision requirement for Certified Registered Nurse Anesthetists (CRNAs). The landmark decision by then Governor Judy Martz, which was supported by the Montana Association of Nurse Anesthetists (MANA), ensured Montana access to safe, cost-effective anesthesia care, particularly in rural and other medically underserved areas of the state. Read more
Time is running out to register for the AANA Assembly of School Faculty in Sunny San Diego
Join your colleagues in anesthesia education in sunny San Diego for the AANA Assembly of School Faculty, February 18-20. Register to attend today
National Nurse Anesthetists Week 2014: CRNAs and Students Spread the Good News About Their Profession
Find out how your colleagues from around the country promoted their profession during National Nurse Anesthetists Week (NNAW) (Jan. 19-25) by visiting www.aana.com/nnaw
. We have received numerous reports from members and will continue to post them on the webpage and in the May issue of the AANA NewsBulletin
. Do you have NNAW news of your own to share? We would love to hear it—send it to email@example.com
Save $50: Register Now for the Mid-Year Assembly
Mid-Year Assembly harnesses the voices of CRNAs to protect and advance your practice and the nurse anesthesia profession. Register today
Make Professional Development a Priority: AANA 2014 Meetings and Workshops Calendar Now Available
AANA Meetings and Workshops are offered throughout the year and provide CRNA's a great opportunity for professional development, to earn continuing education credits, and for peer-to-peer interaction with colleagues about critical topics in the field of nurse anesthesia. Click here
to access the calendar.
The AANA Essentials of Obstetric Analgesia/Anesthesia Workshop
Building and maintaining knowledge of the parturient is critical to the success of CRNAs who work, or who are preparing to begin working, in the labor and delivery suite. AANA’s Essentials of Obstetric Analgesia/Anesthesia Workshop will be held on April 30, 2014, at the AANA’s offices in Park Ridge, Ill. Register here.
AANA Foundation Applications Now Available Online
The AANA Foundation is pleased to continue its long history of funding research and education to advance the science of anesthesia. The following applications are currently available on the AANA Foundation website:
- Nurse Anesthesia Student Scholarships – Deadline: March 1, 2014
- Dean Hayden Student Research Scholarship Application – Deadline: March 1, 2014
- “State of the Science” Oral Poster Presentation Application – Deadline: April 1, 2014
- “State of the Science” General Poster Presentation Application – Deadline: May 1, 2014
Contact the AANA Foundation at (847) 655-1170 or firstname.lastname@example.org
if you have any questions.
AANA Foundation Assembly of School Faculty Hawaiian Luau
It’s not too late to register for the AANA Foundation’s Hawaiian Luau at Buster’s Beach House—located right on the water just a short walk from the San Diego Marriott Marquis & Marina. Click here
to learn more and register for this event. We hope to see you there!
AANA Foundation 2014 Award Nominations: Deadline is Feb. 1
The AANA Foundation presents prestigious awards at the AANA Nurse Anesthesia Annual Congress to individuals who have made a difference in the nurse anesthetist community. Please take the time today to nominate and recognize a fellow CRNA. Click here
to access the nomination/application forms for:
- Advocate of the Year—Presented to an advocate committed to supporting the AANA Foundation and encouraging others to do the same.
- John F. Garde Researcher of the Year—Presented to an individual who has made a significant contribution to the practice of anesthesia through clinical research.
- Rita L. LeBlanc Philanthropist of the Year—Presented to an individual who has donated time, talent, and direct financial support to the AANA Foundation and other deserving organizations.
- Janice Drake CRNA Humanitarian Award—Presented to a CRNA who wishes to volunteer and provide anesthesia, education, and training in underserved areas.
Forward the completed form to the AANA Foundation—email to email@example.com
or mail to 222 S. Prospect Avenue, Park Ridge, IL 60068. Thank you in advance for recognizing a member of the nurse anesthesia community. If you have any questions, please contact the AANA Foundation at (847) 655-1170 or firstname.lastname@example.org
AAMI Survey on Alarm Safety
A research study on biomedical alarm parameters is being conducted by the Association for the Advancement of Medical Instrumentation (AAMI) Foundation’s National Alarm Steering Committee. This survey can help hospitals focus efforts to improve clinical alarm safety and compliance with the Joint Commission’s 2014 National Patient Safety Goal on clinical alarm safety
. To obtain more information on survey parameters and to take the survey, click here
OSHA Launches Website With Resources on Workplace Safety
The Occupational Safety and Health Administration (OSHA) has created a website dedicated to promoting the safety of healthcare workers in hospitals. The resources can help hospitals assess workplace safety needs, implement safety and health management systems, and enhance their safe patient handling programs. The website compiles various resources which include self-assessments, fact sheets, patient safety flyers, best practice guides, and examples of high-performing facilities. Access this information at OSHA’s Worker Safety in Hospitals webpage
Laura Ardizzone, CRNA, DNP, DCC, Appointed to NQF Patient Safety Steering Committee
Laura Ardizzone, CRNA, DNP, DCC, has been appointed to the National Quality Forum’s (NQF) Patient Safety Steering Committee. This multidisciplinary steering committee will evaluate measures related to patient safety, such as healthcare-associated infections, medication safety, imaging safety, all-cause and condition specific admission measures, condition-specific readmissions, and measures examining length of stay. Ardizzone is the chief CRNA at Memorial Sloan Kettering Cancer and an Assistant Clinical Professor of Nursing at Columbia University. She serves as an elected board member of the New York State Association of Nurse Anesthetists, is appointed to the AANA National Peer Assistance Committee and the advisory board of the Hillman Alumni Association, and is an officer in Sigma Theta Tau International, Alpha Zeta.
Attention Facebook Fans: Give our Page the Thumbs Up!
The AANA Facebook page
is the perfect virtual gathering place for the nurse anesthesia community: It’s filled with news about the AANA and the profession and offers the opportunity to connect with members worldwide. Make sure that you don’t miss a post: Clicking that “Like” link.
FTC Submits Letter Concerning Massachusetts CRNA Legislation
On Jan. 17, 2014, the Federal Trade Commission (FTC) submitted a letter to the Massachusetts House of Representatives concerning House Bill 2009, which would permit CRNAs and nurse practitioners (NPs) to order tests and therapeutics and issue written prescriptions without a supervisory agreement with a physician. The FTC letter states in part that “we urge legislators to consider the potential benefits of enhanced competition that H.2009 may facilitate. If APRNs are better able to practice to the extent of their education, training, and abilities, and if institutional health care providers are better able to deploy APRNs as needed, Massachusetts health care consumers are likely to benefit from lower costs, additional innovation, and improved access to health care.”
The FTC press release and the full text of the letter are available here
AANA, VA CRNAs Meet with Veterans Health Administration to Support Recognition of CRNAs as Full Practice Authority Providers
In the interest of veterans’ access to quality care, the Veterans Health Administration (VHA) should continue work to recognize CRNAs and other advanced practice registered nurses (APRNs) as full practice authority providers as part of the modernization of its nursing handbook, said a delegation of AANA leaders in a meeting with the VHA in January.
Pictured below from left to right, AANA Executive Director/CEO Wanda Wilson, CRNA, PhD; Association of Veterans Affairs Nurse Anesthetists President Sherry Swearngin, CRNA, MHA; and AANA President Dennis Bless, CRNA, MS; joined members of the AANA’s Washington staff in meeting with VHA Principal Under Secretary for Health Dr. Robert Jesse, MD, PhD.
Congress OKs 2014 Budget Including Modest Boosts for Nurse Workforce Development, Nursing Research
Congress has approved and the president has signed into law a 2014 omnibus appropriations package providing modest boosts for Title 8 nurse workforce development and nursing research programs. Developed by veteran Rep. Hal Rogers (R-KY) and Sen. Barbara Mikulski (D-MD), the bill, H.R. 3547, was approved Jan. 17, averting a threatened government shutdown. Title 8 funding, which includes resources for expanding nurse anesthesia educational programs and promoting nurse anesthesia traineeships, totaled $224 million, and National Institute of Nursing Research was provided $140.5 million. Both are up slightly from 2013 levels but below the president’s 2014 budget request. See how your Senators voted on HR 3547 here
and how the House voted here
Medicare Administrative Contractor Reverses CRNA Ultrasound Denials in Kentucky and Ohio
Following months of erroneously denied claims, CGS Medicare serving Kentucky and Ohio has resumed reimbursing CRNAs for CPT 76942, ultrasonic guidance for needle placement, following work by AANA and AANA members. In its notice, CGS Medicare encourages CRNAs whose claims for Medicare CPT 76942 modifier 26 services in Kentucky and Ohio were denied between Jan. 1 to Dec. 28, 2013, to resubmit the claims or request their reopening. http://www.cgsmedicare.com/ohb/pubs/news/2014/0114/cope24425.html
AANA to CMS: Do Not Slash Coverage for Pain Injections
The relative values of certain chronic pain management injection services should not be reduced by up to a third as Medicare has recommended, but kept relatively consistent with current levels, said the AANA to the Centers for Medicare & Medicaid Services. “Substantially and suddenly reducing the relative value related to chronic pain injection treatment may limit or eliminate patient access to this care,” states the AANA’s Jan. 23 letter
signed by AANA President Dennis Bless, CRNA, MS.
Register Now for 2014 AANA Mid-Year Assembly
To make your voice, and the voice of all CRNAs, strong in Washington, register for the AANA Mid-Year Assembly, April 5-9, 2014, in Arlington, Va. Learn more at: http://www.aana.com/meetings/aanaassemblies/Pages/Mid-Year-Assembly-Registration.aspx
. Register for the CRNA-PAC’s Monumental Occasion Sunday night, April 6, at: http://www.aana.com/meetings/aanaassemblies/Pages/%E2%80%9CA-MONUMENTAL-OCCASION%E2%80%9D-CRNA-PAC-Eventq.aspx
Pardon the Interruption
Effective Jan. 1, 2014, AANA members may no longer be able to access the CRNA-PAC Care to be Counted site (www.caretobecounted.org
) for federal advocacy information. While we are building a new and improved website (expected February 2014), you can find information about our federal advocacy activities and how to donate to the CRNA-PAC on the AANA website at http://www.aana.com/myaana/Advocacy/fedgovtaffairs/Pages/CRNA-Advocacy-and-CRNA-PAC.aspx
. Of course you can also email us anytime at email@example.com.
At PCORI Nursing Roundtable, AANA Gathers Information About Patient-Centered Outcomes Research Opportunities
Out of hundreds of research grants issued by the federal Patient-Centered Outcomes Research Institute (PCORI), only a small percentage has an APRN as a principal investigator. To draw more research interest from nurses and APRNs in the topics the PCORI is examining, the agency hosted a roundtable, at which AANA participated, in January.
Since its inception in 2011, the PCORI has issued some $500 million in research grants, most related to comparative effectiveness research, methodological research, and communication and dissemination research, and to its national clinical research network, PCORnet. The AANA’s participation in the PCORI Nursing Roundtable included Ladan Eshkevari, CRNA, PhD, from Georgetown University, and a member of AANA’s Washington staff.
To learn more about PCORI and research funding it has available, see: http://www.pcori.org/funding-opportunities/landing/
The following is an FEC required legal notification for CRNA-PAC: Gifts to political action committees are not tax deductible. Contributions to CRNA-PAC are for political purposes. All contributions to CRNA-PAC are voluntary. You may refuse to contribute without reprisal. The guidelines are merely suggestions. You are free to contribute more or less than the guidelines suggest and the association will not favor or disadvantage you by reason of the amount contributed or the decision not to contribute. Federal law requires CRNA-PAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. Each contributor must be a US Citizen.
Patient Participation in Surgical Safety Checklist Effective
Findings from a pilot study indicate that when patients get actively involved in using the World Health Organization (WHO) Surgical Safety Checklist (SSC), the rate of complications goes down. Researchers at Tulane University Hospital and Clinic discovered that surgical teams were more likely to use the the quality improvement tool when patients were informed about it and requested caregivers to adhere to it. SSC compliance was measured for 61 patients who were unaware of the resource, along with 43 who were provided a copy of the list and an explanation of its purpose. Compliance rose for all 26 checklist items among the informed group, including confirmation of patient allergies prior to anesthesia and verification of surgical site before incision. For one metric—assurance that sponges and other instruments are accounted for before the patient leaves the operating room—the difference in compliance levels between informed and uninformed patients was staggering: 87 percent compared to just 19 percent. "The checklist is only beneficial when it is used," said Seth Christian, MD, of the hospital's anesthesiology department, "and we found that involving patients helps ensure that surgical teams complied with it. Empowering patients to participate in their own care creates a culture of safety and makes them feel safer — and rightly so."
From "Patient Participation in Surgical Safety Checklist Effective"
Medical Xpress (01/27/14)
'Alarm Fatigue' a Top-of-Mind Concern for U.S. Hospitals, Finds National Survey Presented at Society for Technology in Anesthesia Annual Meeting
Nineteen out of 20 hospitals say that "alarm fatigue" is a leading concern for them, according to a new survey presented at the Society for Technology in Anesthesia Annual Meeting in Orlando. "Hospitals are greatly concerned about alarm fatigue because it interferes with patient safety, and it exposes patients—and the hospitals themselves—to grave harm," said Michael Wong, executive director of the Physician-Patient Alliance for Health & Safety, who presented alarm fatigue results from the First National Survey of Patient-Controlled Analgesia Practices. To improve alarm management, hospitals should develop a systemic approach that takes into account staffing patterns, care models, architectural layouts, patient populations, and how responsibilities are assigned, said Wong. He noted that 87.8 percent of hospitals surveyed believe that reducing false alarms would increase their use of patient monitoring devices that use capnography and/or pulse oximetry. The survey also found that hospitals that use smart pumps with integrated end tidal monitoring were nearly threefold more likely to see reductions in adverse events or a return on investment in terms of reduced costs and expenses.
From "'Alarm Fatigue' a Top-of-Mind Concern for U.S. Hospitals, Finds National Survey Presented at Society for Technology in Anesthesia Annual Meeting"
Physician-Patient Alliance for Health & Safety (01/22/2014) Wong, Michael
Report Sees Low Risk for Hematoma From Regional Anesthesia During Joint Surgery
The potential for hematoma to develop during spinal or epidural anesthesia has long been a concern in the operating room, but new findings point to a very low risk of the needle damaging blood vessels and causing blood to pool at the injection site during joint replacement surgery. That condition can cause paralysis that, if left untreated, becomes permanent. But a study from New York City's Hospital for Special Surgery (HSS) identified only eight out of 100,000 knee- or hip-replacement patients who developed back pain, mobility issues, or other signs of hematoma. Spinal and epidural anesthesia have had a high success rate over many decades, notes lead researcher Otto Stundner, MD; yet, he says only about one in four anesthesia providers choose this approach during joint replacements, perhaps our of fear of the potential but rare complications. "One really should consider the major associated benefits when contemplating the only rare complications," Stundner remarks. Those advantages include avoiding general anesthesia, which carries its own set of risks. The HSS research was released at the 2013 annual Euroanesthesia meeting.
From "Report Sees Low Risk for Hematoma From Regional Anesthesia During Joint Surgery"
Anesthesiology News (01/01/14) Vol. 40, No. 1 McCook, Alison
Oral Opioid Use Sufficient Following Cardiac Surgery
Swiss researchers report that opioids taken orally alleviate pain in cardiac surgery patients just as effectively those administered intravenously. Their randomized study involved 50 subjects, 24 of whom received oral painkillers after rapid postoperative respiratory weaning and 26 of whom received patient-controlled IV painkillers. The investigators found that oral opioids achieved a similar level of pain score as did IV opioids, but with significantly less medication. There was no difference between the two groups of patients in terms of spontaneous respiratory rate and their odds of being deeply sedated or experiencing side effects; however, patients in the oral opioid group were less likely to suffer from vomiting. Based on their results, the researchers believe that oral painkillers are adequate even following very painful procedures and at an early postoperative stage. Reporting in the Journal of Anesthesia, they speculate that administering them early following cardiac surgery also could help lower healthcare costs.
From "Oral Opioid Use Sufficient Following Cardiac Surgery"
MedWire News (01/20/14) Piper, Lucy
Intravenous Sedation Drugs Show Promise From Results of Clinical Dental Trial
Fospropofol may be a viable agent for safe and effective dental sedation, according to new research presented in the January issue of Anesthesia Progress
. Investigators randomly assigned 60 oral surgery patients to receive either intravenous fospropofol or intravenous midazolam along with fentanyl and local anesthesia. The findings produced no substantial differences between the two groups in terms of sedation maintenance, safety, cognitive recovery, or patient and surgeon satisfaction. However, midazolam was slower to take effect; and the patients who received it took longer to recover physically and were more likely to experience an elevated heart rate. Although fospropofol appears to be a safe alternative to midazolam, it may not completely replace it because of its own side effects: higher rates of perineal discomfort and anesthesia injection recall.
From "Intravenous Sedation Drugs Show Promise From Results of Clinical Dental Trial"
Dentistry IQ (01/16/2014)
Less Pain Found With Subvastus vs. Parapatellar TKA Approach
A retrospective study published in the January issue of the Journal of Arthroplasty
shows that patients had better postoperative pain outcomes when their total knee arthroplasty (TKA) was performed using the subvastus approach versus the standard parapatellar approach. The research included two patient cohorts: Group A, or 546 patient undergoing TKA with a parapatellar approach; and Group B, or 255 patient undergoing TKA with a subvastus approach. The findings revealed that while preoperative pain values for the two groups were comparable, there were statistically significant differences that showed that the subvastus approach provided better pain scores at follow-ups conducted at six months and one year postoperatively. The two approaches had comparable blood loss, operating room time, tourniquet time, number of manipulations, and length of hospital stay.
From "Less Pain Found With Subvastus vs. Parapatellar TKA Approach"
Healio (01/14/2014) Ingram, Christian
Combining Morphine With Acetaminophen for Postsurgical Pain
It is thought that multimodal analgesia increases the efficacy of the analgesics while minimizing the overall adverse effects and allowing for the use of lower doses of the drugs. A clinical trial published in the British Journal of Anaethesia
compared the use of acetaminophen and morphine administered individually for analgesia with the use of an acetaminophen/morphine multimodal analgesic in 90 patients undergoing appendectomy, anal fistulotomy, breast lump resection, hernia repair, varicocelectomy, or a minor orthopedic surgical procedure. Recovery room pain levels were then evaluated. Patients who reported a pain score of three of higher on the standard 0-to-10 pain scale were randomly assigned to receive one of the three analgesic approaches. The effective dose in 50 percent of patients (ED50) for analgesic efficacy was calculated for each approach using the Dixon and Mood up-and-down technique. The median ED50 for the combination of acetaminophen and morphine was found to be lower than that of each drug given alone, indicating that the combination produced an additive analgesic effect. While other studies have shown that acetaminophen has a 20 to 40 percent opioid-sparing effect when used in combination with morphine, this does not automatically result in a reduction in opioid-related adverse effects.
From "Combining Morphine With Acetaminophen for Postsurgical Pain"
Medscape (01/14/14) Macario, Alex
Preliminary Results Show Guideline Helps Taper Patients Off High-Dose Opioids
The preliminary results of a retrospective review indicate that patients taking extremely high levels of opioids can have their dosage safety tapered to lower amounts when done gradually, a strategy that also reduces their pain and depression scores. The study, presented at PainWeek 2013 in Las Vegas, involved chart reviews for 16 patients with chronic pain who were managed at the Union City (Calif.) Kaiser Permanente Chronic Pain Clinic from December 2009 through April 2011. All of the patients reviewed were taking a morphine equivalent dose of at least 300 mg a day and had reported average pain scores of at least six on the 10-point pain scale. Under a guideline developed by lead researcher Raj Kalra, MD—the clinic's medical director—the patients' lowest-dose opioid was reduced by between four and 16 percent every five to 10 days until the reduction from the original dose reached 40 to 60 percent. The dose was then reduced by eight to 16 percent every five to 10 days, with the full process repeated for the second opioid, if applicable. All dose reduction continued until the dose for every opioid given to the patient was no greater than 30 percent of the original amount. Some patients were converted to a different opioid, while others continued reduction until they were able to cease taking the drug. Withdrawal symptoms were experienced by 80 percent of the patients, though no significant complications were recorded. Meanwhile, patients' average pain score declined to 4.9 from 7.2 and their average depression score dropped to 9.5 from 13.5.
From "Preliminary Results Show Guideline Helps Taper Patients Off High-Dose Opioids"
Pain Medicine News (01/01/2014) Vol. 12 Frei, Rosemary
Liposomal Bupivacaine Boosts TAP Block
A new study suggests that liposomal bupivacaine, when injected by infiltration of the transversus abdominis plane (TAP), offers up to 72 hours of pain relief following surgeries involving incisions of the mid- and lower abdominal wall. Previous research has documented the drug's efficacy for only 12 to 18 hours following this type of operation. The new investigation examined 13 patients who had open umbilical hernia repair under general anesthesia, with a bilateral TAP infiltration performed at the end of the procedure. Pain was reported on a scale of one to 10 before and after injection as well as at regular intervals for up to 120 hours after the TAP block. One TAP infiltration failed immediately due to significant pain; but the others were successful, with mean satisfaction scores of 4.4 at patient discharge and 4.6 at two-week followup. No serious adverse events or complications were reported as a result of the drug, an extended-release version that has only recently been approved. The findings suggest that clinicians may be able to use nerve blocks instead of local anesthetics for postoperative pain in some cases. Pediatric anesthesiologist and lead researcher Eduard Logvinskiy, DO, says the costs associated with nerve blocks "can potentially be eliminated if you're using a drug like liposome bupivacaine, with a single injection." The research—presented at the New York School of Regional Anesthesia 2013 annual meeting on regional anesthesia, pain management, and perioperative medicine—was funded by the drug's manufacturer, Pacira.
From "Liposomal Bupivacaine Boosts TAP Block"
General Surgery News (01/01/14) Vol. 41, No. 1 Raj, Ajai
Endotracheal Extubation Technique Training Video By BMC Anesthesiologist Published in NEJM
The seventh in a series of Boston Medical Center (BMC) training videos, with a focus on endotracheal extubation, recently ran in the New England Journal of Medicine
. Appearing in the publication's Videos in Clinical Medicine section, it offers best practices for anesthesia providers and other clinicians to remove breathing tubes as soon as possible following a patient's safe emergence from anesthesia. The video provides a detailed analysis of routine extubation but also touches on complications and emergency contingencies of a more difficult procedure. "The take-home point of the review," according to Rafael Ortega, MD, of BMC's anesthesiology department and lead author of the article accompanying the video, is that most complications of short-term extubation are preventable, and can be avoided by careful training and preparation."
From "Endotracheal Extubation Technique Training Video By BMC Anesthesiologist Published in NEJM"