MAJ Peter Strube, CRNA, MSNA, APNP, ARNP, ANC, USA, (right) is assisted by Spanish anesthesia provider Jorge Gomez in the delivery of care to a trauma patient in Herat, Afghanistan.
Role of Esmolol in Perioperative Analgesia and Anesthesia: A Literature ReviewIn an effort to reduce perioperative opioid administration yet provide appropriate pain relief, researchers began to study the use of esmolol beyond its well-known cardiovascular effects. Perioperative esmolol has been shown to reduce anesthetic requirements, decrease perioperative opioid use, decrease the incidence of postoperative nausea and vomiting, lead to an earlier discharge, and increase patient satisfaction. This article provides a review of the literature on the use of esmolol as an adjunct for perioperative analgesia and anesthesia.
Keywords: Esmolol, opioid sparing, perioperative analgesia and anesthesia.
Version: 2015;83(3):167-177.Authors: Megan Harless, CRNA, MSN
Caleb Depp, CRNA, MSN
Shawn Collins, CRNA, DNP, PhD
Ian Hewer, CRNA, MSN, MA
Healthcare Utilizing Deliberate Discussion Linking Events (HUDDLE): A Systematic Review"Huddle moments" can be described as a preparatory briefing among healthcare providers for the purpose of exchanging information and bringing awareness to patient safety concerns. A historical background of huddle communication is described, and a systematic literature review was conducted on preoperative briefing and huddle communication. This article provides a systematic review of HUDDLE communication and gives future evidence based recommendations on how the huddle can be used in healthcare.
Keywords: Communication, huddle, interprofessional communication, preoperative brief, team brief.
Implementation of Mass Transfusion Protocol in the Outpatient Operating Room Setting: A Case StudyThe current definition of massive transfusion is replacement of 5 U of packed red blood cells in 3 hours because of uncontrolled hemorrhage or replacement of the entire blood volume within a 24-hour period. The prompt activation of a transfusion protocol can quickly restore hemodynamic stability. This case study demonstrates the effectiveness of using a massive transfusion protocol in an outpatient setting.
Low-Flow Anesthesia, Low Fresh Gas Flow, and Oxygen Flush: An Interesting InterplayIdentification and analysis of critical respiratory alarms during use of an advanced anesthesia workstation is essential in the intraoperative period. We present and discuss a scenario in which there was activation of a fresh gas flow alarm during low-flow anesthesia intraoperatively and use of oxygen flush to counteract it led to a diluted concentration of the inspired anesthetic agent.
Keywords: Dräger Primus ventilator, fresh gas decoupling, low-flow anesthesia, oxygen flush.
AANA Journal Course: Update for Nurse Anesthetists—Part 2—Venous Thromboembolism: New Concepts in Perioperative ManagementVenous thromboembolism (VTE) is a serious pathophysiologic condition that is a major cause of morbidity and mortality, especially during the perioperative period. A
collective term, VTE is used to describe a blood clot that develops inside the vasculature and results in a deep vein thrombosis and/or a pulmonary embolism (PE). This article reviews the current approaches to pharmacologic and nonpharmacologic prevention and management of VTE during the perioperative period. Identification and treatment of deep vein thrombosis and acute PE are also described.
Keywords: Antithrombotic therapy, deep vein thrombosis, pulmonary embolism, venous thromboembolism.
Version: 2015;83(3):211-.Authors: Sass Elisha, CRNA, EdD
Jeremy Heiner, CRNA, EdD
John Nagelhout, CRNA, PhD, FAAN
Mark Gabot, CRNA, MSN