On The Cover

Daily check of an emergency cart is completed by Janice Izlar, CRNA, BS, at Georgia Institute for Plastic Surgery, Savannah, Ga. Among the many items on the cart are a defibrillator, portable suction machine, intravenous catheters and fluids, laryngoscope blades and handles, emergency drugs such as dantrolene, and a malignant hyperthermia algorithm and flowsheet for charting. In 1999, the AANA developed Standards for Office Based Anesthesia Practice that describes a properly equipped crash cart. In November 2004, the AANA released the patient education brochure, "Office Based Anesthesia: What Every Patient Should Know ." Both are available through the AANA Bookstore at shorton@aana.com or 847-655-1129.

Articles

  • Local block for postoperative knee arthroscopy pain management: A retrospective study Knee arthroscopy is one of the most common orthopedic procedures done in the United States. It is usually performed as an outpatient procedure. This retrospective study was designed to assess the level of postoperative analgesia provided by the local knee block. Results suggest that the local knee block provides superior postoperative analgesia for the knee arthroscopy patient.
    Keywords: Knee arthroscopy, local anesthesia, local knee block, postoperative pain management.
    Version: 2004;72:419-421. Authors: Richard Lee, CRNA, MMS, BS, BSN
  • Ruptured arteriovenous malformation and subarachnoid hemorrhage during emergent cesarean delivery: A case report Cerebral arteriovenous malformations (AVMs) are formed from a vascular plexus of direct arterial-venous connections that progressively dilate, making them prone to rupture. This case report describes the anesthetic management of a 31-year-old laboring patient who first complained of a headache, then suffered an acute subarachnoid hemorrhage secondary to rupture of a previously undiagnosed AVM during emergent cesarean delivery.
    Keywords: Anesthesia, arteriovenous malaformation, headache, pregnancy.
    Version: 2004;72:423-426. Authors: LCDR Lorraine A. English, CRNA, MS, NC, USN Deborah C. Mulvey, CRNA, MBA
  • Use of the LMA Classic to secure the airway of a premature neonate with Smith-Lemli-Opitz syndrome: A case report In this case report, the author describes a premature infant born with multiple and life threatening congenital anomalies in a rural facility. The current recommendations of the American Heart Association for neonatal resuscitation were followed: however, the resuscitating team was unable to secure the airway with standard intubating techniques. Consultation with the anesthetist on duty resulted in the successful placement of the laryngeal mask airway.
    Keywords: Laryngeal mask airway, neonate, Smith-Lemli-Opitz syndrome.
    Version: 2004;72:427-430. Authors: Yolanda R. Leal-Pavey, CRNA, BS
  • AANA Journal Course, Part 5 Update for nurse anesthetists -- The SLAM Emergency Airway Flowchart: A new guide for advanced airway practitioners The SLAM Emergency Airway Flowchart is intended to prevent the 3 reported primary causes of adverse respiratory events (inadequate ventilation, undetected esophageal intubation, and difficult intubation). The flowchart's 5 pathways are primary ventilation, rapid-sequence intubation, difficult intubation, rescue ventilation, and cricothyrotomy. It is intended for use with adult patients by advanced airway practitioners competent in direct laryngoscopy, tracheal intubation, administration of airway drugs, rescue ventilation, and cricothyrotomy.
    Keywords: Combitube, emergency airway algorithm, failed intubation, laryngeal mask airway, rescue ventilation.
    Version: 2004;72:431-439. Authors: James M. Rich, CRNA, MA Andrew M. Mason, MB, BS, MRCS, LRCP Michael A. E. Ramsay, MD, FRCA