On The Cover

Mary Ford, PhD, CRNA, and Amber Coleman, BSN, during a post-anesthetic visit with Akesha Clark and her one-day-old newborn, Ahjoi, in the obstetrical unit at Virginia commonwealth University Medical Center, Richmond, Virginia. Post-anesthetic assessment is an essential component of the perioperative care provided by nurse anesthetists. Photo by Allen T. Jones

Articles

  • Social Media in Nurse Anesthesia: A Model of a Reproducible Educational Podcast Social media and specifically podcasting are available to the field of nurse anesthesia as potential educational tools. This article outlines key concepts in social media, including free open access medical education and literature supporting the use of podcasting in higher, medical, and nursing education.
    Keywords: Free open access medical information, Keller ARCS model, nurse anesthesia education, podcast, social media
    Version: 2017;85(1):10-16 Authors: Kristin Andrejco, MSN, CRNA, Jon Lowrance, MSN, CRNA, Brad Morgan, MSN, CRNA, Cassidy Padgett, MSN, CRNA, Shawn Collins, PhD, DNP, CRNA
  • Postoperative Cognitive Dysfunction after Noncardiac and Nonneurologic Surgery: An Integrative Review Postoperative cognitive dysfunction (POCD) is a major concern for the growing, elderly population. This review examines the state of the science of POCD after noncardiac surgery. Further research is needed for the use of other anesthetic techniques and biomarkers in the study of POCD.
    Keywords: Anesthesia, bioimaging, biomarkers, postoperative cognitive dysfunction, surgery
    Version: 2017;85(1):17-27. Authors: Joanna Woersching, MSN, CRNA
  • Simple Cost-Effective Alternative to Fluid and Blood Warming System to Prevent Intraoperative Hypothermia Fluid and blood warming devices are useful in situations of massive transfusions and in pediatric patients. However, the initial cost and disposable nature of many of these devices are a major hindrance in their efficient utilization. The authors report a simple cost-effective means of warming blood and other fluids.
    Keywords: Blood warming method, cost-effective, innovation.
    Version: 2017;85(1):28-30. Authors: Dhritiman Chakrabarti, MD, Sriganesh Kamath, MD, DNB, DM, Deepti, BS, MD, Dheeraj Masapu, MD
  • Instruments to Measure Preoperative Acute Situational Anxiety: An Integrative Review Acute situational anxiety is a subjective fearful feeling of emotion that is influenced by an immediate situation. Untreated anxiety in the perioperative period can lead to multiple deleterious effects for patients. Reliability and validity are not consistently reported among instruments that measure preoperational anxiety, making it difficult for providers to measure preoperational anxiety and provide treatment based on the results.
    Keywords: Anxiety, anxiety index, complementary therapy, instrument, preoperative period.
    Version: 2017;85(1):31-35. Authors: Candace B. Jaruzel, PhD, MSN, CRNA, Mathew J. Gregoski, PhD, MS
  • Anesthetic Management and Intraoperative Implications for Surgical Resection of a Recurring Primary Cardiac Rhabdomyosarcoma: A Case Report Primary malignant cardiac tumors are rare. The incidence is only 0.02%. These cancers have a poor prognosis because of early metastases and a high recurrence rate. The case of a 38-year-old woman with a recurring primary rhabdomyosarcoma is discussed.
    Keywords: Malignant, primary cardiac tumor, rhabdomyosarcoma.
    Version: 2017;85(1):36-41. Authors: Mary R. Cushing, MS, CRNA, Britney Leonardi, MN, CNE
  • Implementation of an Obstructive Sleep Apnea Screening Program at an Overseas Military Hospital Anesthesia providers and surgeons do poorly at consistently identifying patients with obstructive sleep apnea (OSA) without use of screening tools. Aims of this project were to determine whether educating nurses about OSA and incorporating the STOP-BANG Questionnaire into preoperative forms was associated with an increased identification of patients with suspected OSA and an increased frequency of nurse-generated anesthesia consultation for OSA.
    Keywords: Anesthesia, obstructive sleep apnea, screening, STOP-BANG Questionnaire.
    Version: 2017;85(1):42-48. Authors: Riley Williams, DNP, CRNA, LCDR(ret), NC, USN, Maria Williams, DNP, CRNA, LCDR(ret), NC, USN, Marietta P. Stanton, PhD, RN, CNAA, BC, CMAC, CCM, CNL, CAPT Dennis Spence, PhD, CRNA, NC, USN
  • Usefulness of Cerebral Oximetry in Preventing Postoperative Cognitive Dysfunction in Patients Undergoing Coronary Artery Bypass Grafting Postoperative cognitive dysfunction (POCD) following coronary artery bypass grafting has a negative impact on patients physically and psychologically. Of increasing interest is the role that cerebral autoregulation plays in postoperative neurologic outcomes. The authors sought evidence examining the usefulness of cerebral oximetry data in preventing POCD.
    Keywords: Cerebral oximetry, interventional protocols, postoperative cognitive dysfunction.
    Version: 2017;85(1):49-54. Authors: Terri Kane, DNAP, CRNA Marilyn A. Pugh, PhD
  • Point-of-Contact Assessment of Nurse Anesthetists’ Knowledge and Perceptions of Management of Anesthesia-Related Critical Incidents Most anesthesia providers will experience at least one perioperative critical incident during their career, potentially causing critical incident stress symptoms that may affect their ability to provide patient care. The purpose of this descriptive pilot investigation of CRNAs was to determine their knowledge of the psychological and physical ramifications of critical incidents, coping strategies to deal with critical incident stress, and satisfaction with departmental handling of critical incidents.
    Keywords: Anesthesia, critical event, critical incident, critical incident stress, debriefing, critical incident stress management.
    Version: 2017;85(1):55-60. Authors: Linda Stone, DNP, CRNA, Scott Tyrey, MD, Virginia C. Muckler, DNP, CRNA, CHSE, Charles A. Vacchiano, PhD, CRNA, FAAN
  • AANA Journal Course: Update for Nurse Anesthetists—Part 6—The Other Side of the Difficult Airway: A Disciplined, Evidence-Based Approach to Emergence and Extubation Successful intubation of the patient with a difficult airway marks the beginning of the challenges facing the nurse anesthetist. Too often, on successful intubation of this patient, the anesthetist and other members of the perioperative team may relax too much. Substantial planning and consultations have been employed to achieve the successful intubation of the patient with the difficult airway. Yet frequently, the final aspect of any general anesthetic—extubation—does not receive sufficient planning. This article provides an evidence-based approach to emergence and extubation.
    Keywords: Bailey maneuver, difficult airway, extubation failure, extubation-related complications, intubation.
    Version: 2017;85(1):61-71. Authors: Joseph A. Joyce, CRNA