This photo depicts a central line workshop created and attended by Duke University nurse anesthesia students. Duke University's nurse anesthesia program incorporates several faculty and CRNA led workshops during the course of the program that includes pig heart dissection, difficult airway workshop, crisis scenarios, and pediatric scenarios. Photo by Arnon Chamkasem, BSN.
A Patient Safety Dilemma: Obesity in the Surgical PatientSpecial populations (eg, obese patients) need study in order to support patient safety, quantify risks, advance education for healthcare-workers, and establish healthcare policy. This study examines the incidence of adverse outcomes in the obese surgical population through AHRQ Patient Safety Indicators. In this study, the surgical population was overwhelmingly positive for obesity. Body mass index (BMI) was also a significant positive predictor for 2 of 3 postoperative outcomes. This finding suggests that as BMI reaches the classification of obesity, the risk of these adverse outcomes increases.
Laryngospasm as a Cause of Unsuccessful Placement of Laryngeal Mask Airway ProSeal: A Case ReportLaryngospasm is a potential complication encountered during anesthesia using a laryngeal mask airway (LMA). We report a case in which laryngospasm resulted in unsuccessful placement of an LMA ProSeal Airway (Teleflex Inc), and we discuss the various causes of unsuccessful placement of this type of airway device. The possibility of laryngospasm as a cause of failed placement of an LMA ProSeal must be considered in clinical practice.
Laryngeal Mask Airway and Valsalva Maneuver During Ophthalmic Surgery: A Case ReportUse of infraglottic airways (tracheal tubes) allows for positive pressure ventilation and maneuvers, such as holding continuous positive pressure in the airway to check for pleural and dural leaks. We describe the successful use of the laryngeal mask airway (LMA; Teleflex Inc) for general anesthesia, in which continuous positive airway pressure of 15 cm H2O held for 20 seconds allowed the neurosurgeon to identify the site of a cerebrospinal fluid leak and successfully repair the leak. A well-seated LMA can be successfully used to produce continuous positive pressure in the airway not exceeding 20 cm H2O for 20 seconds to facilitate surgical identification of CSF leaks.
AANA Journal Course: Update for Nurse Anesthetists—Part 5—Use of Tranexamic Acid in Preventing Postpartum HemorrhagePostpartum hemorrhage (PPH) continues to be a serious complication in both developed and underdeveloped countries. It remains the leading cause of maternal mortality in underdeveloped countries. Implementation of the World Health Organization guidelines of PPH treatment has reduced mortality. In addition, the prophylactic administration of tranexamic acid with uterotonic agents may contribute to the reduction of PPH. This evidence-based literature review of tranexamic acid will examine its mechanism of action as well as its effectiveness in prevention of PPH and blood loss reduction in elective surgery, obstetrics, and trauma.