On The Cover

April King, CRNA, MSN, demonstrates the proper positioning of the Jaw Elevation Device (JED) to her colleague, Ken Wingler, MD, at the Naval Medical Center San Diego, California. King, founder and CEO of Hypnoz Therapeutic Devices, is the main inventor of the JED. Once positioned, the JED is designed to maintain jaw thrust and allow the provider a hands-free solution to keep the airway open. (Photo taken by Sharon Hackley, CRNA, MSHS.)

Articles

  • Predicting Success in Nurse Anesthesia Programs: An Evidence-Based Review of Admission Criteria The authors examined the evidence for evaluating applicants to nurse anesthesia programs that may help predict success in the program and on the National Certification Examination for Nurse Anesthetists.
    Keywords: Admission selection criteria, education, academic success, nurse anesthetist, review article.
    Version: 2013;81(3):183-189. Authors: Keri H. Ortega, CRNA, DNAP, Sharon M. Burns, CRNA, EdD, Leslie C. Hussey, RN, PhD, James Schmidt, PhD, Paul N. Austin, CRNA, PhD
  • Investigation of the Anxiolytic Effects of Xanthohumol, a Component of Humulus lupulus (Hops), in the Male Sprague-Dawley Rat This study investigated the anxiolytic effects of xanthohumol, a component of Humulus lupulus (hops), and its potential interaction with the benzodiazepine binding site on the γ-aminobutyric acid (GABAA) receptor in the male Sprague-Dawley rat.
    Keywords: Anxiolysis, hops, Humulus Iupulus, Sprague-Dawley rat, xanthohumol.
    Version: 2013;81(3):193-198. Authors: Thomas E. Ceremuga, CRNA, PhD, LTC(ret), ANC, USA, MAJ Lori A. Johnson, BSN, CCRN, ANC, USA, CPT Jamilia M. Adams-Henderson, BSN, CCRN, ANC, USA, Suzanne McCall, Don Johnson, RN, PhD, Col(ret), USAFR, NC,
  • Posttraumatic Stress Disorder and Anesthesia Emergence In a US Army hospital’s postanesthesia care unit, combat-related posttraumatic stress disorder can complicate interventions. The authors conclude that best practice includes a proper identification of patients at risk of emergence agitation, a minimally stimulating environment and intraoperative sympatholytic therapy.
    Keywords: Emergence agitation, emergence delirium, flashbacks, general anesthesia, posttraumatic stress disorder.
    Version: 2013;81(3):199-203. Authors: Donnamarie Lovestrand, RN, MAJ P. Steven Phipps, CRNA, USAR, Steven Lovestrand, PhD
  • Absorption Atelectasis: Incidence and Clinical Implications One mechanism for the formation of atelectasis intraoperatively is ventilation with 100% oxygen. The goal of this review is to determine if research suggests that intraoperative ventilation with 100% oxygen leads to clinically significant pulmonary side effects.
    Keywords: Atelectasis, oxygen, ventilation.
    Version: 2013;81(3):205-208. Authors: Jennifer O’Brien, CRNA, MSN
  • Preoperative Chlorhexidine Anaphylaxis in a Patient Scheduled for Coronary Artery Bypass Graft: A Case Report This case report describes a 65-year-old patient scheduled for coronary artery bypass graft surgery who preoperatively experienced anaphylaxis to chlorhexidine delivered through multiple routes of administration.
    Keywords: Anaphylaxis, central venous catheter, chlorhexidine, hospital-acquired infection.
    Version: 2013;81(3):209-214. Authors: Matthew Toomey, CRNA, DNAP
  • Methylene Blue Encephalopathy: A Case Report and Review of Published Cases There have been a number of reports of altered neurologic status postoperatively in patients who are taking antidepressant medications when they received methylene blue for their surgery. We present a case report and review 30 additional cases reported in the literature.
    Keywords: Methylene blue, parathyroidectomy, postoperative encephalopathy, serotonin syndrome.
    Version: 2013;81(3):215-221. Authors: Ellen Shopes, CRNA, MHS, MSN, CCRN, Wayne Gerard, MD, Jessica Baughman, CRNA
  • Elective Laparoscopic Fetal Laser Photocoagulation in Twin-Twin Transfusion Syndrome: A Case Report Twin-twin transfusion syndrome (TTTS) is a complication of multiple gestation in which arteriovenous vascular communications occur in a shared placenta. This case report involves a 32-year-old, gravida 5, para 2 patient at 19 weeks’ estimated gestational age with a monochorionic diamniotic twin gestation with TTTS diagnosed using ultrasonography presenting for an elective laparoscopic fetal laser photocoagulation.
    Keywords: Epidural anesthesia, fetal laser photocoagulation, monochorionic placenta, twin-twin transfusion syndrome (TTTS).
    Version: 2013;81(3):222-224. Authors: Morgan A. Ward, CRNA
  • Examining Transfer of Care Processes in Nurse Anesthesia Practice: Introducing the PATIENT Protocol This article describes a 2-phase, nonexperimental exploratory study with a purpose to (1) examine current transfer of care practices of Certified Registered Nurse Anesthetists during the intraoperative period and (2) develop, implement, and evaluate a communication checklist tool designed to improve situation awareness.
    Keywords: Awareness, checklist, handoff, situation awareness, transfer of care.
    Version: 2013;81(3):225-232. Authors: Suzanne M. Wright, CRNA, PhD
  • Unilateral Hypoglossal Neurapraxia Following Endotracheal Intubation for Total Shoulder Arthroplasty In this case report, postulated causes of hypoglossal neurapraxia are presented. A review of the literature pertaining to anesthesia-related causes of hypoglossal nerve injury is included. In suspected cases of hypoglossal neurapraxia, conservative therapeutic interventions may be warranted.
    Keywords: Beach chair position, cranial nerve XII, endotracheal tube, hypoglossal nerve, laryngeal mask airway.
    Version: 2013;81(3):233-236. Authors: Bryan Haslam, CRNA, MSN, CCRN, Shawn Collins, CRNA, PhD, DNP
  • AANA Journal Course: Update for Nurse Anesthetists – Part 2 – Mitochondrial Diseases and Anesthesia: A Literature Review of Current Opinions This course explores the considerations that the anesthesia provider has to be aware of, when caring for a patient with a mitochondrial myopathy. Even though these disorders are rare, these patients may also need surgical care, requiring that the anesthesia provider be informed of the best anesthesia options to consider.
    Keywords: Anesthesia, mitochondria, myopathies, ragged-red fibers, respiratory chain.
    Version: 2013;81(3):237-243. Authors: MAJ Berenice Rivera-Cruz, CRNA, DNAP, USAR