On The Cover

While in the cardiovascular anesthesia rotation at Southern Arizona VA Health Care System, Tucson, Arizona, Capt Daniel Moore, RN, BSN, places a central line under the watchful eye of Kim Vinayak, CRNA. “Moore was a student nurse anesthetist at David Grant Medical Center, Travis AFB, California, the only United States Air Force clinical site for the US Army Graduate Program in Anesthesia Nursing,” said Lt Col Brian Koonce, CRNA, MSN, USAF, NC, who submitted the photo. Capt Daniel Moore, CRNA, MSN, USAF, NC, is now a staff nurse anesthetist and clinical instructor at David Grant Medical Center, Travis AFB, California.

Articles

  • Anesthetic Management of an Obstetric Patient With Charcot-Marie-Tooth Disease: A Case Study Charcot-Marie-Tooth disease (CMT) is categorized as an inherited peripheral neuropathic disease leading to distal muscle atrophy, sensory disturbances, and absent reflexes in the extremities. This case report describes the anesthetic management of an obstetric patient with CMT type 1A that used a combined spinal-epidural technique for labor. Previous similar case reports were reviewed and an extensive literature search was conducted to organize the limited body of research regarding use of regional anesthesia in patients with CMT.
    Keywords: Charcot-Marie-Tooth disease, epidural, obstetric, spinal.
    Version: 2009;77(5):335-337. Authors: Macy Brock, CRNA, MSN Cherry Guinn, RN, EdD Monica Jones, MD
  • Rescue Ventilation: Resolving a “Cannot Mask Ventilate, Cannot Intubate” Situation During Exchange of a Combitube for a Definitive Airway This case demonstrates the utility of the endotracheal Combitube as a rescue ventilation device for a patient with a large body mass index who is difficult or impossible to ventilate by bag-valve-mask ventilation and who also may initially be impossible to intubate. Additionally, it demonstrates the utility of having several options available for tracheal intubation to improve the success of establishing a definitive airway.
    Keywords: Airway exchange, Combitube, failed airway, failed intubation, rescue ventilation.
    Version: 2009;77(5):339-342. Authors: James M. Rich, CRNA, MA Andrew M. Mason, MB, BS, MRCS, LRCP H.A. Tillmann Hein, MD Michael Foreman, MD
  • Attitudes Toward Physician-Nurse Collaboration in Anesthesia When anesthesiologists and nurse anesthetists work together, the nature of their interactions has the potential to influence the patient care they provide. The purpose of this study was to compare the attitudes of anesthesiologists and nurse anesthetists toward collaboration with each other. The results of this study provide some divergent perspectives regarding collaboration previously demonstrated between physicians and nurses may also exist in the specialty field of anesthesia.
    Keywords: Anesthesiology, collaboration, delivery of healthcare, nurse anesthetist, physician-nurse relationship.
    Version: 2009;77(5):343-348. Authors: Cassandra L.Taylor, CRNA, DNP, DMP, CNE
  • Extended-release epidural morphine vs continuous peripheral nerve block for management of postoperative pain after orthopedic knee surgery: A retrospective study The authors of this study compare the efficacy and safety of extended-release epidural morphine and perineural infusion to control pain after total knee arthroplasty. The main end point of the study was pain scores up to 48 hours postoperatively, and the ancillary end points were supplemental opioid requirements and adverse effects. The results of the study showed no significant differences between the 2 groups for the levels of pain preoperatively, immediately postoperatively, and at 48 hours postoperatively.
    Keywords: Extended-release epidural morphine, peripheral nerve catheter, postoperative pain management.
    Version: 2009;77(5):349-354. Authors: Nicole R. Schmidt, CRNA, MSN Joseph A. Donofrio, CRNA, MSN David A. England, CRNA, MSN Leah B. McDonald, CRNA, MSN Carrie L. Motyka, PhD, APRN-BC Lisa A. Mileto, CRNA, MS
  • Intraosseous Infusion of Blood Products and Epinephrine in an Adult Patient in Hemorrhagic Shock In this case report, a properly placed intraosseous (IO) catheter was valuable in the resuscitation of a critically ill patient in hemorrhagic shock. The author concludes that IO infusion is an underutilized but clinically useful procedure in emergent situations where intravenous access is difficult or too time consuming to achieve. Anesthesia providers should seek education and training from those experienced in IO placement techniques and consider use of the IO route early in the resuscitative process.
    Keywords: Z-IO, hemorrhagic shock, intraosseous infusion, intraosseous transfusion.
    Version: 2009;77(5):359-363. Authors: James M. Burgert, CRNA, MSNA
  • AANA Journal Course: Update for Nurse Anesthetists—Part 4—Myocardial Infarction and Subsequent Death in a Patient Undergoing Robotic Prostatectomy In this case report, a properly placed intraosseous (IO) catheter was valuable in the resuscitation of a critically ill patient in hemorrhagic shock. The author concludes that IO infusion is an underutilized but clinically useful procedure in emergent situations where intravenous access is difficult or too time consuming to achieve. Anesthesia providers should seek education and training from those experienced in IO placement techniques and consider use
    Keywords: EZ-IO, hemorrhagic shock, intraosseous infusion, intraosseous transfusion.
    Version: 2009;77(5):359-363. Authors: James M. Burgert, CRNA, MSNA