Setting up for obstetric fistula repair surgery in Kigali, Rwanda, Jobina Ruiz, BSN, a Northeastern University student registered nurse anesthetist, fills the halothane vaporizer and checks airway equipment. Ms Ruiz participated in a global anesthesia immersion experience with the International Organization for Women and Development. Photo by Sundeep Mathur.
Breaking Through the Economic Barriers of Anesthesia Information Management SystemsAnesthesia information management systems (AIMS) are being increasingly used to assist the delivery and documentation of anesthesia services. The major benefits of AIMS: to (1) reduce costs, (2) facilitate quality assurance and quality improvement processes, (3) increase the accuracy and completeness of the anesthesia record, and (4) improve adherence to recommended guidelines. The major drawback is cost. This article identifies 2 of the main elements of AIMS that exist in IT and data systems already present in a hospital. This project showed that it is possible to achieve 2 of the major benefits of an AIMS without the cost of purchasing one.
Apneic Oxygenation: A Method to Prolong the Period of Safe ApneaA difficult intubation poses one of the most challenging tasks for anesthesia professionals. Unanticipated difficult
mask ventilation and intubation may result in serious complications. Nine articles were selected for appraisal: 6 randomized control trials, 2 prospective studies, and 1 retrospective study. Multiple apneic oxygenation techniques demonstrated effectiveness at delaying the onset of hypoxemia during the apnea period. Prolonging the apneic window changes the nature of airway management in patients at high risk of desaturation and when an unanticipated difficult airway arises.
Factors Influencing Patient Safety During Postoperative HandoverPatient safety continues to be a major concern for healthcare providers and organizations. Handovers, also called handoffs, serve as the transfer of postoperative care from the anesthesia provider to the postanesthesia care unit provider. Ineffective handovers result in gaps in care and potential harm to the patient. This scoping review demonstrates a multilevel analysis of factors affecting handovers and patient safety.
Keywords: Anesthesia, communication, handovers, patient safety, postanesthesia care unit.
Version: 2016;84(5):329-338. Authors: Monica Rose, MSN, CRNA
Susan D. Newman, PhD, RN, CRRN
Postoperative Supplemental Oxygen Is Unnecessary in Low-Risk Cesarean Delivery Parturients Under Spinal Anesthesia: An Observational StudyThe incidence of maternal oxygen desaturation after cesarean delivery in the postanesthesia care unit (PACU) has not been thoroughly reported. The purpose of this study was to evaluate the incidence of desaturation and to describe the frequency of supplemental oxygen administration in
patients being monitored in the PACU. The incidence of postoperative oxygen desaturation in healthy parturients
undergoing elective cesarean delivery under spinal anesthesia was uncommon. Routine administration of supplemental oxygen in the PACU is therefore unnecessary.
Keywords: Cesarean delivery, desaturation, healthy parturient, postanesthesia care unit, spinal block.
AANA Journal Course: Update for Nurse Anesthetists—Part 4—Perioperative Vision Loss: Considerations and ManagementPerioperative vision loss (POVL) associated with routine surgical procedures is a rare but catastrophic event. Although no clear direct cause of POVL has been determined, it is theorized that decreased ocular perfusion pressure of the optic nerve is responsible for POVL. This AANA Journal course article will investigate theories as to why POVL occurs, risk factors associated with POVL, anatomy related to POVL, preventive measures that may help to reduce risk of POVL, and interventions that the anesthesia provider can implement.