Students Lynne Edwards (closest to front) and Lisa Cummings practice the technique of spinal anesthesia in the clinical skills laboratory of the Wake Forest University Baptist Medical Center Nurse Anesthesia Program, Winston-Salem, North Carolina. The skills lab is one portion of the program of applied learning, which includes a human cadaver lab, a simulation lab, and a mock operating room, where students participate in multidisciplinary crew resource management training. (Photo by Michael Rieker, CRNA, DNP, director, Nurse Anesthesia Program.)
Airway Management in a Bleeding Adult Following Tonsillectomy: A Case ReportIn this case report, the author describes a morbidly obese man with a history of obstructive sleep apnea who underwent elective tonsillectomy. The author concludes that difficult situations such as a bleeding airway, which occurred in this case, require a thorough assessment of the airway, careful planning to ensure that alternative devices and plans are available, asking for additional expert support, and the availability of a backup surgeon for establishing an emergency surgical airway.
Keywords: Bleeding oropharynx, GlideScope, Macintosh blade.
Version: 2009;77(6):428-430.Authors: Manjit Singh Brar, CRNA, MS
CRNA-Physician Collaboration in AnesthesiaIn this study, a sample of nurse anesthetists and anesthesiologists affiliated with postgraduate training programs in the state of Texas responded to a survey designed to gather attitudes toward physician-nurse collaboration using an adaptation of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. The findings suggest that Certified Registered Nurse Anesthetists who deal with role conflict or unclear expectations as well as limited scope of practice may have increased job stress and dissatisfaction.
Keywords: Anesthesia care team, attitudes, physician-nurse collaboration.
Version: 2009;77(6):431-436.Authors: Terri S. Jones, CRNA, DNP
Joyce J. Fitzpatrick, RN, PhD, FAAN
Health Insurance in the United StatesLack of insurance and inadequate insurance have serious consequences for individuals, families, and the country. This article provides facts about the current system of health insurance in the United States and current government reform efforts. The author concludes that as providers and consumers of healthcare, we should keep our eye on the ultimate goal—providing affordable insurance coverage for all.
Keywords: Health insurance, medical bankruptcy, underinsured, uninsured, universal healthcare.
Version: 2009;77(6):439-444.Authors: Lisa M. Riedel, CRNA, DNP
Anxiolytic Effects of L-theanine – a Com-ponent of Green Tea – When Combined With Midazolam, in the Male Sprague-Dawley Rat The purpose of this study was to determine if the green tea component L-theanine has anxiolytic effects in the rat model and to investigate possible modulation of the GABAA receptor by L-theanine in the rat central nervous system (CNS). Although the data did not support the hypothesis that L-theanine has anxiolytic effects in the rat model, the findings suggest that L-theanine in combination with midazolam modulates the CNS by increasing anxiolysis and decreasing fine and basic motor movements.
Keywords: Anxiolysis, elevated plus-maze, green tea, L-theanine, rats.
Version: 2009;77(6):445-449.Authors: LTC Traci Heese, CRNA, MSN, ANC, USA MAJ Jack Jenkinson, RN, BSN, ANC, USA MAJ Cheryl Love, CRNA, MSN, ANC, USA MAJ Ronald Milam, CRNA, MSN, ANC, USA MAJ Lillian Perkins, CRNA, MSN, ANC, USA CPT Cynthia Adams, CRNA, MSN, ANC, USA
Thomas E. Ceremuga, CRNA, PhD, LTC (ret), ANC, USA
AANA Journal Course: Update for Nurse Anesthetists—Part 5—Evaluation of Older AdultsOlder adults have specific management needs, and these demands continue to pose challenges to anesthesia providers. These challenges relate to the accrual of numerous and diverse anatomic and physiologic changes that occur in older adults throughout the course of aging. In this course, the authors discuss risks of anesthesia and surgery, the preanesthesia evaluation, age-related physiologic changes in older adults, and age-related physiologic changes in organ subsystems.