On The Cover

Elizandra Pierre, CRNA, MS, performs a lumbar puncture in the maternity ward while on assignment in Aweil, South Sudan, with Doctors Without Borders. Photo taken by Nicole Campbell, RN.

Articles

  • Combat Anesthesia: A Case Report of a Gunshot Wound and New Trauma Protocols The US Army Forward Surgical Team (FST) is a small, mobile surgical unit fielded since the 1990s, but not ubiquitously used until the current contingency operations in southwest Asia. The FST has been used in a variety of ways during the current conflict with or without augmentation by a forward support medical company, Area Support Medical Company, and Brigade Medical Company also known as C-Med. Far forward stand-alone FSTs have often been emplaced to provide a surgical capability for patients in austere operational environments.
    Keywords: Forward surgical care, nurse anesthesia, trauma
    Version: 2015;83(4):247-253 Authors: MAJ Peter D. Strube, CRNA, MSNA, APNP, ARNP, ANC, USA MAJ Andrew D. Perkins, CRNA, MSNA, ANC, USA
  • Snoring, Trouble Breathing, Un-Refreshed (STBUR) Screening Questionnaire to Reduce Perioperative Respiratory Adverse Events in Pediatric Surgical Patients: A Quality Improvement Project Children who present for surgery with undiagnosed sleep-disordered breathing are particularly vulnerable to perioperative respiratory adverse events. Preoperative screening can identify children at increased risk who would benefit from evidence-based perioperative management, reducing serious preventable harm or death. The purpose of this quality improvement study was 2-fold: (1) increase identification of pediatric surgical patients who may be at increased risk of perioperative respiratory adverse events through the introduction of a validated pediatric screening questionnaire (STBUR), and (2) reduce preventable harm by introducing evidence-based perioperative management guidelines.
    Keywords: Obstructive sleep apnea, pediatric, perioperative respiratory adverse events, sleep-disordered breathing, STBUR (Snoring, Trouble Breathing, Un-Refreshed) questionnaire
    Version: 2015;83(4):256-262 Authors: Karrey L. Terry, CRNA, DNP Jennifer Disabato, DNP, RN, CPNP-PC, AC Marilyn Krajicek, EdD, RN, FAAN
  • Handoffs in the Postoperative Anesthesia Care Unit: Use of a Checklist for Transfer of Care Information loss can occur during all phases of care. The transfer of care (handoff) from the operating room to the postoperative anesthesia care unit (PACU) is an especially susceptible time. The purpose of this research was to determine if the utilization of a formulated checklist with objective measures during the handoff from the operating room to the PACU decreased information loss, the need for information clarification, and anesthesia providers’ time spent in transfer of care, with improved adequacy.
    Keywords: Checklist, handoff, information loss
    Version: 2015;83(4):264-268 Authors: Holly-May Robins, CRNA, DNAP, MBA Feng Dai, MS, PhD
  • Prevention of Surgical Fires: A Certification Course for Healthcare Providers This article introduces a potential certification program for the prevention of surgical fires. A pilot study was conducted with a convenience sample of 10 anesthesia providers who participated in the education module. The overall objective was to educate surgical team members and to prepare them to become certified in surgical fire prevention.
    Keywords: Fire triangle, prevention, situational awareness, surgical fires
    Version: 2015;83(4):271-274 Authors: Marquessa Fisher, CRNA, DNP
  • Comparison of Second-Generation Supraglottic Airway Devices (i-gel versus LMA ProSeal) During Elective Surgery in Children Second-generation supraglottic airway devices i-gel (Intersurgical Ltd) and LMA ProSeal (Teleflex Inc) are designed for a superior airway seal with a high success rate in adults. This study compared the efficacy of i-gel and LMA ProSeal (sizes 1, 1.5, and 2) as an airway device in a pediatric population, especially infants.
    Keywords: i-gel, LMA ProSeal, pediatric, supraglottic airway devices
    Version: 2015;83(4):275-280 Authors: Bhargavi Sanket, DNB Chandrika Yabagodu Ramavakoda, MD Madhavi Ravindra Nishtala, MD Chandrakala Kunigal Ravishankar, MD Anuradha Ganigara, MD
  • Infection Associated With Single-Dose Dexamethasone for Prevention of Postoperative Nausea and Vomiting: A Literature Review Postoperative nausea and vomiting is one of the most common complications affecting surgical patients. The glucocorticoid dexamethasone is often used for the prevention of postoperative nausea and vomiting. This literature review seeks to summarize research related to the use of a single perioperative dose of dexamethasone for prophylactic treatment of postoperative nausea and vomiting and its impact on surgical healing.
    Keywords: Corticosteroids, dexamethasone, infection, postoperative nausea and vomiting, surgical site complications
    Version: 2015;83(4):281-288 Authors: Jenna Assante, CRNA, MS Shawn Collins, CRNA, DNP, PhD Ian Hewer, CRNA, MSN, MA
  • AANA Journal Course: Update for Nurse Anesthetists—Part 3—Acupuncture: History from the Yellow Emperor to Modern Anesthesia Practice Acupuncture and acupressure are components of Oriental medicine that have been in existence for thousands of years. With a rich history rooted in Oriental medicine these practices have transcended from Asia into Western culture. In the context of anesthesia practice, acupuncture and acupressure have demonstrated clinical usefulness in the perioperative setting. Studies reveal both can successfully decrease preoperative anxiety, decrease intraoperative anesthetic requirements, assuage postoperative pain, decrease the incidence of PONV, and support chronic pain management.
    Keywords: Acupressure, acupuncture, complementary and alternative medicine, Oriental medicine
    Version: 2015;83(4):289-295 Authors: Amanda C. Faircloth, CRNA, PhD, DNAP