On The Cover

Michigan State University Nurse Anesthesia Program Assistant Director Gayle Lourens, CRNA, MS, DNP, in the simulation lab with MSU instructor Samuel McCarthy, CRNA, MSN, preparing for students during the annual Advanced Airway Workshop. (Photo taken by Henry Talley, CRNA, MSN, PhD.)

Articles

  • Army Anesthesia Providers’ Perceptions of Emergence Delirium After General Anesthesia in Service Members The primary aim of this study was to investigate emergence delirium (ED) in service members, through the perceptions of active duty US Army anesthesia providers. There was a statistically significant association between perceived severity of ED and the ED case experience. The behaviors and consequences that were often or always seen included hyperactive motor behavior, removing monitoring equipment, and making disruptive movements.
    Keywords: Emergence delirium, general anesthesia, Global War on Terrorism, military service members.
    Version: 2013;81(6):433-440. Authors: MAJ John Tyler Wilson, CRNA, PhD, ANC, USA
  • Delayed Onset of Suspected Malignant Hyperthermia During Sevoflurane Anesthesia in an Afghan Trauma Patient: A Case Report Malignant hyperthermia (MH) is a rare pathologic hypermetabolic pharmacogenetic disorder of skeletal muscle calcium regulation following exposure to depolarizing muscle relaxants and/or volatile anesthetics. This article describes the presentation and management of a suspected case of MH in an Afghan national who underwent surgery following lower extremity trauma resulting from an improvised explosive device.
    Keywords: Emergency surgery, malignant hyperthermia, sevoflurane, succinylcholine, trauma.
    Version: 2013;81(6):441-445. Authors: LCDR Rafal Banek, CRNA, MSN, NC, USN, LCDR John Weatherwax, MD, MC, USN, CDR Dennis Spence, CRNA, PhD, NC, USN, LTC Susan Perry, CRNA, PhD, USAF, NC, Sheila Muldoon, MD, John Capacchione, MD
  • Preoperative Forced-Air Warming Combined With Intraoperative Warming Versus Intraoperative Warming Alone in the Prevention of Hypothermia During Gynecologic Surgery Hypothermia in the perioperative setting can have serious consequences, including increased risk of infection or adverse cardiac events. Forced-air warming units commonly are used to prevent hypothermia. This study examined the impact of adding preoperative warming (Bair Paws, 3M) to conventional intraoperative forced-air warming modalities.
    Keywords: Forced-air warmer, hypothermia, perioperative warming, temperature.
    Version: 2013;81(6):446-451. Authors: Melissa Bucci Adriani, CRNA, MSN, Nancy Moriber, CRNA, PhD
  • An Evidence-Based Review of the Use of a Combat Gauze (QuikClot) for Hemorrhage Control Hypothermia in the perioperative setting can have serious consequences, including increased risk of infection or adverse cardiac events. Forced-air warming units commonly are used to prevent hypothermia. This study examined the impact of adding preoperative warming (Bair Paws, 3M) to conventional intraoperative forced-air warming modalities.
    Keywords: Forced-air warmer, hypothermia, perioperative warming, temperature.
    Version: 2013;81(6):453-458. Authors: Melissa Bucci Adriani, CRNA, MSN, Nancy Moriber, CRNA, PhD
  • Pulseless Electrical Activity in a Pediatric Patient: A Case Report and Review of Causative Factors and Treatment Pulseless electrical activity (PEA), an arrhythmia that leads to cardiac arrest, is defined as the presence of organized electrical activity without a palpable pulse or arterial blood pressure. This arrhythmia is usually associated with a poor prognosis unless a reversible cause is investigated and treated immediately. This article summarizes the causative factors of PEA and its treatment modalities.
    Keywords: Cardiac arrest, pediatric, pulseless electrical activity
    Version: 2013;81(6):459-464. Authors: Johanna Newman, CRNA, DNAP
  • Emotional Intelligence as a Noncognitive Factor in Student Registered Nurse Anesthetists Nurse anesthesia program admissions requirements usually focus on high GPAs, GRE scores, years of acute care experience, and a personal interview to assist in predicting who will succeed in these intensive academic and clinical programs. Some believe these criteria may not be sufficient in predicting success and have suggested that the use of noncognitive criteria such as emotional intelligence measurements may be helpful. This cross-sectional correlational study explores the relationship between emotional intelligence and academic factors.
    Keywords: Emotional intelligence, profiles, Q-factor, student registered nurse anesthetist.
    Version: 2013;81(6):465-472. Authors: Shawn Collins, CRNA, DNP, PhD
  • AANA Journal Course: Update for Nurse Anesthetists – Part 5 – Like a Slippery Fish, a Little Slime Is a Good Thing: The Glycocalyx Revealed The glycocalyx is a dynamic network of multiple membrane-bound complexes lining the vascular endothelium. Its role in maintaining vascular homeostasis includes regulating vascular permeability as well as a range of vital functions, such as mechanotransduction, hemostasis, modulation of inflammatory processes, and serving as an antiatherogenic. Revisionist thinking about the Starling principle is discussed in terms of the major influence of the glycocalyx on capillary and tissue fluid homeostasis. The clinical and pathophysiologic threats to the glycocalyx are reviewed as well as strategies to maintain its integrity.
    Keywords: Diabetes, hypervolemia, intravenous fluids, vascular disease, vascular endothelial glycocalyx.
    Version: 2013;81(6):473-480. Authors: Chuck Biddle, CRNA, PhD