Kathy Mann, CRNA, is shown with a 2 ½-year-old patient in the dental office of Gregg Codelli, DDS, Blue Ridge, Georgia. “I almost never use any preoperative sedation for children, just some distraction and sharing,” explains Mann, who is the anesthesia department head at Fannin Regional Hospital, Blue Ridge, Georgia. Like many CRNAs, Mann says she administers office-based anesthesia on her day off. (Photo taken by Lauren Wyatt Mann, the child’s mother.)
Accidental Carotid Artery Catheterization During Attempted Central Venous Catheter Placement: A Case ReportMore than 2.1 million central venous catheters are placed annually. This article describes a case of accidental carotid artery catheterization during attempted right internal jugular vein catheterization and the steps taken to treat the patient following its recognition. A discussion of technique for central venous catheterization, indications for suspicion of arterial puncture, methods for confirming venous or arterial placement, appropriate methods for management of carotid artery cannulation, and the benefit of ultrasound in central venous cannulation are included.
Keywords: Carotid artery catheterization, central venous catheter, complication, ultrasound.
Version: 2012;80(4):251-255.Authors: Pauline Marie Maietta, CRNA, MS
Experiences of Military CRNAs with Service Personnel Who Are Emerging from General AnesthesiaFor the last decade, the United States has been involved in war in Iraq and Afghanistan; however, the US healthcare system is only recently recognizing the traumatic psychological effects of battlefield stress on soldiers. The authors conducted this qualitative study to understand the experiences of military nurse anesthetists working with service personnel who have traumatic brain injury and/or posttraumatic stress disorder and are emerging from general anesthesia. The authors point out the absence of studies in the literature that describe the experiences of anesthetists working with patients having these specific problems.
Infection Control Practices of Laryngoscope Blades: A Review of the LiteratureCurrent procedures for cleaning anesthesia airway equipment as assessed by the presence of visible and occult blood on laryngoscope blades and handles as labeled “ready for patient use” has been reported to be ineffective. The purpose of this literature review is to determine the use and infection control practices of disposable laryngoscope blades. Their frequency of use, evaluation of ease of use, and any complications encountered when using the disposable blade are reviewed, as well as the perceptions of anesthesia providers regarding disposable laryngoscope blades.
Anesthesia-Induced Neuronal Apoptosis During Synaptogenesis: A Review of the LiteratureAnesthesia is generally accepted as safe in most adult populations; however, in pediatric patients questions exist regarding the potential for long-term detrimental effects. Various anesthetic agents are associated with neuronal degeneration when administered to neonatal animals. The mechanism of damage is thought to be via accelerated apoptosis, a normally beneficial process in the maintenance of homeostasis. This review of the literature examines the current evidence in neonatal rodents, nonhuman primates, and humans experiencing anesthesia-induced neuronal apoptosis.
AANA Journal Course: Update for Nurse Anesthetists – Part 3 – Anesthesia and Safety Considerations for Office-based Cosmetic Surgery PracticeThe rapid growth of office-based cosmetic surgery and anesthesia increases the likelihood of an individual nurse anesthetist’s involvement in this practice area. Because the special knowledge and skills inherent to this setting may not be presently taught in most anesthesia programs, it is up to the practitioner to become aware of the special considerations and requirements involved to ensure patient safety. This course will help anesthetists understand the special characteristics of this setting, the monitored anesthesia care-based approach that is often used, the anesthesia and safety considerations for the cosmetic surgical procedures performed, and the importance of prophylaxis for venous thromboembolism.