AANA Journal Issue Details

On The Cover

AANA President Garry Brydges, PhD, DNP, MBA, ACNP-BC, CRNA, FAAN, is pictured speaking with Region 6 Director Sonya Moore, DNP, CRNA, during the 2019 AANA Mid-Year Assembly.


  • Ultrasound-guided Intravenous Line Placement Course for Certified Registered Nurse Anesthetists: A Necessary Next Step Ultrasonography (US) proficiency has become a desirable skill for anesthesia providers. However, there is no structured US training program for CRNAs for vascular access at our institution. We designed and implemented a multimodality US training program specifically for the use of surface US for central and peripheral vascular access for CRNAs.
    Keywords: Certified Registered Nurse Anesthetist, training program, ultrasonography, venous access.
    Version: 2019;87(4):269-275. Authors: Jeffrey Bortman, BS; Faraz Mahmood, MD; John Mitchell, MD; Ruby Feng, BA; Yanick Baribeau, BS; Vanessa Wong, BS; Beth Coolidge, CRNA; Ruma Bose, MD; Zhifeng Gao, MD; Stephanie Jones, MD; Robina Matyal, MD
  • Accuracy of Visually Estimated Blood Loss in Surgical Sponges by Members of the Surgical Team It is important that operating room personnel monitor the correct amount of blood loss during surgery in order to properly replace lost volume. The aim of this study was to investigate the accuracy of operating room personnel in visually estimating blood loss in surgical sponges. We performed an observational study with comparative descriptive design at a university hospital including all members of the surgical team.
    Keywords: Blood loss, surgery, surgical sponges, visual estimation.
    Version: 2019;87(4):277-284. Authors: Sandra E. Kollberg, MMSc, RN, ORN; Ann-Cristin E. Häggström, MMSc, RN, CRNA; Helena Claesson Lingehall, PhD, RN, CRNA; Birgitta Olofsson, PhD, RN
  • Implications of Inspired Carbon Dioxide During Ophthalmic Surgery Performed Using Monitored Anesthesia Care Inspired concentration of carbon dioxide (FICO2) in ophthalmic surgery performed under monitored anesthesia care (MAC) has been largely ignored in the recommended monitoring standards of professional anesthesia societies. Most ophthalmic procedures are performed using MAC with facial draping that has been shown to retain carbon dioxide in the ambient air surrounding the patient. The goal of this review is to encourage investigation of this underreported parameter.
    Keywords: Inspired carbon dioxide, monitored anesthesia care, ophthalmic surgery.
    Version: 2019;87(4):285-290. Authors: Thomas A. McHugh, MN, CRNA
  • Preparing for Total Power Failure in the Operating Room Total electrical power failure in the operating room is an uncommon event, but when it occurs, it poses a major threat to patient safety. The purpose of this project was to determine the internal battery-related capabilities and duration of function of site-specific anesthesia equipment during a total power failure and to develop a power failure protocol.
    Keywords: Anesthesia, anesthetic equipment, operating room, power failure.
    Version: 2019;87(4):291-297. Authors: Alex G. Vetter, DNP, CRNA; Robert J. Harman, DNAP, CRNA; Matt J. Stamper, DNP, CRNA; J. F. Titch, DNP, CRNA; Charles A. Vacchiano, PhD, CRNA
  • Refusal of Epidural Anesthesia for Labor Pain Management by African American Parturients: An Examination of Factors Most parturients use epidural anesthesia for labor pain management, with excellent pain relief possible within minutes of administration. An examination of the literature revealed a disparity of use that existed along ethnic and racial lines, with African Americans less likely to accept epidural anesthesia. The purpose of this qualitative study was to identify those factors that influence African American parturients to decline epidural anesthesia for labor pain management.
    Keywords: African American, anesthesia, disparity, labor epidural, refusal.
    Version: 2019;87(4):299-304. Authors: Michael C. Roberson, PhD, DNAP, CRNA
  • Use of a Double Gloving Technique to Decrease Cross-Contamination by Anesthesia Providers The purpose of this project was to determine the impact of double gloving during the induction of general anesthesia on the incidence of cross-contamination by the anesthesia provider. Use of a double gloving technique decreased cross-contamination by greater than 50%.
    Keywords: Anesthesia induction, contamination, double gloving, general anesthesia, intraoperative infection control.
    Version: 2019;87(4):307-312. Authors: Garrett Jaffe, DNP, CRNA; Nancy Moriber, PhD, CRNA
  • Delayed Onset and Prolonged Horner Syndrome in Two Children After Single-Shot Ultrasound-Guided Infraclavicular and Subclavian Perivascular Brachial Plexus Blocks for Upper Extremity Surgery: Case Reports Horner syndrome is a known complication of cervical approaches to brachial plexus blocks due to local anesthetic-induced oculosympathetic paresis. The authors report delayed manifestations of Horner syndrome in 2 children following ultrasound-guided infraclavicular and subclavian perivascular blocks.
    Keywords: Brachial plexus block, delayed presentation, Horner syndrome, ultrasound.
    Version: 2019;87(4):313-316. Authors: Anju Gupta, MD, DNB; Vandana Talwar, MD; Geeta Kamal, MD; Neeraj Gupta, MS
  • Anesthetic Management of a Patient with Severe Diastolic Dysfunction for Umbilical Hernia Repair: A Case Report Research has shown that 1 out of 3 people aged 55 or older will develop heart failure, which is often a fatal prognosis. This case report examines the anesthetic management of a patient with a known diagnosis of severe left ventricular diastolic dysfunction, with acute exacerbation of congestive heart failure, who presented to the emergency room with an incarcerated umbilical hernia.
    Keywords: Diastolic dysfunction, heart failure, regional anesthesia, transversus abdominis plane, truncal blocks.
    Version: 2019;87(4):319-323. Authors: Kellon S. Smith, MHS, CRNA
  • AANA Journal Course: Update for Nurse Anesthetists—Perioperative Management of the Direct-Acting Oral Anticoagulants Since the 1950s, warfarin has been the most commonly prescribed anticoagulant in the prevention of stroke-related thromboembolism. Beginning in 2008, direct-acting oral anticoagulants (DOACs) began to replace warfarin. Although the DOACs had a greater safety profile, approved reversal agents for use in emergent/excessive hemorrhage did not exist. This course reviews the perioperative management of the DOACs.
    Keywords: Direct-acting oral anticoagulants, reversal agents, warfarin.
    Version: 2019;87(4):325-331. Authors: Terri D. Kane, DNAP, CRNA; Tito D. Tubog, DNAP, CRNA