On The Cover

CPT Joe Romero, CRNA, ANC, USA, a Certified Registered Nurse Anesthetist assigned to the 948th Forward Surgical Team (Southfield, Michigan), anesthetizes a patient in preparation for surgery at Camp Havoc, Al Asad Airbase, Iraq, May 31, 2016. Photo by SGT Kalie Jones.

Articles

  • Pulmonary Hemorrhage During Computed Tomography–Guided Percutaneous Lung Biopsy: A Case Report and Review of the Literature The authors describe a 22-year-old man with chronic granulomatous disease who experienced a pulmonary hemorrhage after percutaneous lung biopsy using computed tomography guidance while he was under general endotracheal anesthesia. Potential treatment algorithms and strategies are presented.
    Version: 2017;85(3):166-170. Authors: Kathryn Staker, CRNA, Brian Schloss, MD, Joseph D. Tobias, MD
  • Bilateral Tension Pneumothoraces During Colonoscopy: A Case Report and Review of Literature The purpose of this case report and review of the literature is to increase awareness of pneumothorax as an extremely rare but severe and often life-threatening complication of colonoscopy among anesthesia care providers. The mechanisms of pneumothorax development are also discussed.
    Keywords: Colonic perforation, colonoscopy, subcutaneous emphysema, tension pneumothorax.
    Version: 2017;85(3):171-177 Authors: Hideyo Tsumura, DNP, MSN, CRNA
  • Ventilatory Management During Intraoperative Airway Obstruction due to Endotracheal Tube Kinking The authors present a case of polyvinyl chloride (PVC) endotracheal (ET) tube kinking and discuss the airway pressure changes, implications, and ventilation-based methods to functionally remedy the situation. The kink developed in the intraoral portion of an 8.5-cm PVC ET tube in a patient undergoing T3-T5 laminectomy in the prone position
    Keywords: Anesthesia, endotracheal tube, kinking, ventilation, ventilatory management.
    Version: 2017;85(3):178-180. Authors: B. S. Deepti, MD, PDF, Venkatapura J. Ramesh, MD, Dhritiman Chakrabarti, MD, Nitin Manohar, MD, DNB
  • Intravenous Acetaminophen for Perioperative Pain Control in Adult Elective Neurospine Surgical Patients: A Retrospective Case-Control Study This descriptive pilot study investigated the analgesic effect of a single dose of IV acetaminophen administered intraoperatively as routine practice for perioperative pain management for adults undergoing elective spine surgery. Future prospective studies are needed to assess the analgesic effects of IV acetaminophen for spine surgery cases.
    Keywords: Acute surgical pain, intravenous acetaminophen, perioperative pain, multimodal analgesia, spinal surgery.
    Version: 2017;85(3):181-188 Authors: Fengyan Deng, DNP, CRNA, Susan D. Horn, PhD, Randall J. Smout, MS, MT(ASCP), Joanne V. Hickey, PhD, RN, APRN, ACNP-BC, FAAN, FCCM, Joseph J. Naples, MD
  • Intravenous Dexamethasone for Prolonged Duration of Axillary Nerve Blockade A 61-year-old woman presented for an open reduction and internal fixation of bilateral distal radius fractures. The patient underwent general anesthesia and received bilateral axillary nerve blocks. A single 8-mg dose of dexamethasone was given intravenously to prolong the analgesic effect of the axillary nerve blocks. This case study supports previous findings suggesting that dexamethasone, 8 mg, administered intravenously prolongs the duration of analgesia when used in conjunction with bupivacaine in a peripheral nerve block.
    Keywords: Analgesics, anti-inflammatory, dexamethasone, regional anesthesia, steroid.
    Version: 2017;85(3):189-194. Authors: Dorothy Lim, CRNA, Michele Gold, PhD, CRNA
  • Literature Searching for Practice Research For CRNA professionals and students who may not be able to work directly with a librarian, this article aims to provide useful strategies for thoroughly searching relevant literature in support of a high-quality DNP/DNAP project and research that a practicing CRNA may conduct.
    Keywords: Capstone project, doctor of nurse anesthesia practice/doctor of nursing practice literature review, database search, nurse anesthesia doctoral education.
    Version: 2017;85(3):195-204. Authors: Dana Gerberi, MLIS, Mary Shirk Marienau, PhD, CRNA, APRN
  • Self-Efficacy and Graduate Education in a Nurse Anesthesia Program: A Pilot Study A descriptive correlational pilot study was conducted to examine the relationship between self-efficacy and demographic and outcome variables (age, gender, academic or clinical year, years of experience as a critical care nurse, number of clinical cases, call hours, and years since attending an academic program).
    Keywords: Academic success, clinical education, motivation, self-efficacy.
    Version: 2017;85(3):205-216. Authors: F. Scott Imus, MSN, CRNA, Shari Burns, EdD, CRNA, Donna M. Weglarz, MS
  • Workforce Initiative for Current Predictors of CRNA Employment in the State of Florida The challenging Florida anesthesia workforce has 3 different types of anesthesia providers competing in the same market and a growing population ranked number 2 in the United States. This study attempted to forecast changes in supply and demand of nurse anesthetists in Florida between 2014 and 2018.
    Keywords: Certified Registered Nurse Anesthetist workforce, Florida, predicted staffing, workforce.
    Version: 2017;85(3):217-221. Authors: Linda L. Wunder, PhD, CRNA, ARNP, Derrick C. Glymph, DNAP, CRNA, Lori Schirle, PhD, CRNA, Jorge A. Valdes, DNP, CRNA
  • AANA Journal Course: Update for Nurse Anesthetists—Part 2—A Review of Dental Anatomy and Dental Injury Associated With Anesthesia Dental injury during airway management is a common complication encountered during the administration of general anesthesia. This article gives an overview of the frequency of dental injuries, dental anatomy, conditions that increase the risk of dental injury, and mechanism of injury, as well as discusses injury management and avoidance of dental trauma.
    Keywords: Adverse anesthetic events, difficult intubation, perioperative dental injury.
    Version: 2017;85(3):222-230. Authors: Kyle M. Stein, DDS, FACS, John Aker, DNAP, CRNA