On The Cover

Using ultrasound guidance, Amavi Pitts, MSN, CRNA, APRN, performs an axillary block with the assistance of a fellow Certified Registered Nurse Anesthetist at an outpatient surgery center in Delaware. The sterile field is prepped and draped and the ultrasound probe is place in a sterile Tegaderm wrap prior to application of the probe for identification of nerves and insertion of a needle. Photo by Christopher Bettin, MA.

Articles

  • Examination of Hospital Policies Regarding Certified Registered Nurse Anesthetist Attire in the Operating Room The purpose of this study was to examine operating room policies related to infection control and attire worn by Certified Registered Nurse Anesthetists (CRNAs) and the attitudes of CRNAs toward these policies. Implications for practice include evidence-based standardization of attire policies and encouragement of CRNAs' participation in development of and compliance with policies to reduce surgical site infection rates.
    Keywords: Infection control, laundering, operating room attire, surgical site infection.
    Version: 2017;85(6):410-416. Authors: Kristin Annis, MSN, CRNA; Casey Coates, MSN, CRNA; Kelly Renehan, MSN, CRNA; Blake Ridgway, MSN, CRNA; Donna Jasinski, PhD, CRNA
  • Propofol Disposal in the Anesthesia Setting: Overcoming Barriers Propofol accounts for 41% of reported substance abuse cases among anesthesia providers. No guidelines outline appropriate propofol disposal in the healthcare setting. The lack of controlled disposal presents concerns for environmental harm, economic waste, and diversion.
    Keywords: Barrier assessment, Deterra drug deactivation system, propofol disposal, propofol diversion, tailored interventions.
    Version: 2017;85(6):417-423. Authors: Danielle Schneider, DNP, CRNA, APRN; Julie Ponto, PhD, APRN, CNS, AGCNS-BC, AOCNS; Erin Martin, DNP, CRNA, APRN
  • An Unusual Complication After Ganglion Impar Block for Chronic Cancer Pain Management Patients with advanced pelvic malignancies present with pain of varying severity. Their pain can be effectively managed using a systemic pharmacologic approach, including oral administration of morphine. The authors report a rare neurologic complication after a fluoroscopic-guided ganglion impar block.
    Keywords: Ganglion impar block, malignancy, pain.
    Version: 2017;85(6):424-426. Authors: Nishkarsh Gupta, MD; Rakesh Garg, MD; Shalini Saini, MD; Sachidanand Jee Bharti, MD; Vinod Kumar, MD
  • Lyme Disease and Anesthesia Considerations This review seeks to examine the epidemiology, clinical presentation, diagnosis, and treatment of Lyme disease and focuses on the anesthetic implications of the infection. Lyme disease has become the fifth most common nationally notifiable disease and is the most commonly reported vector-transmitted infection in the United States.
    Keywords: Carditis, Lyme disease, tick.
    Version: 2017;85(6):427-430. Authors: Tammy Smit, MSNA, CRNA
  • A Needs Assessment for Development of the TIME Anesthesia Handoff Tool Standardized handoff is critical to providing safe and effective patient care. Limited studies assess the need for developing a handoff tool for anesthesia providers. The purpose of this descriptive study was to assess the need for a standardized anesthesia handoff tool and to identify the most essential components.
    Keywords: Anesthesia, checklist, communication, handoff, handover.
    Version: 2017;85(6):431-437. Authors: Courtney Gibney, DNP, CRNA; Young-Me Lee, PhD, RN; Julia Feczko, DNP, CRNA; Elizabeth Aquino, PhD, RN
  • Perceptions of Certified Registered Nurse Anesthetists on Factors Affecting Their Transition From Student This study has implications for employers of newly graduated CRNAs in implementing interventions that promote successful role transition and may guide future research.
    Keywords: Certified Registered Nurse Anesthetist, online interviewing, phenomenography, role transition, student registered nurse anesthetist.
    Version: 2017;85(6):438-444. Authors: Andy Tracy, PhD, CRNA
  • A Randomized, Blinded, Clinical Study of Injury Incidence During Endotracheal Intubation: Comparison of GlideScope Video Laryngoscopy and Direct Laryngoscopy Injuries can occur during endotracheal intubation. This prospective, randomized, blinded study aimed to determine if a difference exists in incidence of injury following endotracheal intubation using either direct laryngoscopy or the GlideScope video laryngoscope (Verathon Inc).
    Keywords: Endotracheal intubation, GlideScope, injury, video laryngoscope.
    Version: 2017;85(6):445-451. Authors: Michael P. Scholtis, DNP, MS, CRNA; Rebecca S. Stoudt, DNP, CRNA; Theodore R. Gavel, MSN, CRNA.
  • Anesthetic Implications of Superior Vena Cava Syndrome in Interventional Radiology: A Case Report This case report describes a case performed in the interventional radiology suite and the subsequent difficulties related to the anesthetic management of superior vena cava syndrome outside the safety and controlled environment of the OR.
    Keywords: Interventional radiology anesthesia, interventional radiology sedation, superior vena cava syndrome, SVC syndrome anesthesia.
    Version: 2017;85(6):453-459. Authors: Deniz Dishman, DNAP, CRNA
  • Conductive Skin Warming and Hypothermia: An Observational Study The purpose of this study is to describe outcomes of hypothermia after a combination of preoperative and intraoperative conductive skin warming (CSW). This retrospective observational study included 972 adult surgical patients receiving general or neuraxial anesthesia.
    Keywords: Anesthesia, body temperature, hypothermia, intraoperative complication, perioperative care.
    Version: 2017;85(6):461-468. Authors: Victoria M. Steelman, PhD, RN, CNOR, FAAN; Ann G. Schaapveld, BSN, RN; Yelena Perkhounkova, PhD; Jennifer L. Reeve, MSN, RN; John P. Herring, MD
  • AANA Journal Course: Update for Nurse Anesthetists - Part 5 - Maxillomandibular Fixation and Anesthesia Management This article aims to give an overview of maxillomandibular fixation (MMF) from a surgical perspective, complications that can arise from MMF, anesthesia management strategies in MMF cases, and perhaps most importantly, an overview of how to release a patient from MMF in an emergency.
    Keywords: Airway emergency, anesthesia complications, difficult airway, intermaxillary fixation, maxillomandibular fixation.
    Version: 2017;85(6):469-477. Authors: Kyle M. Stein, DDS, FACS; Sarah Titler, MD