Anesthesia E-ssential

AANA Anesthesia E-ssential, April 9, 2020
 
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Vital Signs


AANA Continues to Support CRNAs During the COVID-19 Pandemic

The United States now leads all countries in the most confirmed COVID-19 cases. The AANA is here to support all CRNAs caring for COVID-19 patients or preparing for a surge in cases.

Anesthesia Workstations as Ventilators
Hospitals continue to plan for the increased need of ventilators amidst a nationwide shortage due to the COVID-19 pandemic. In an AANA Journal online exclusive, Michael Dosch, PhD, CRNA, provides technical considerations for using an anesthesia workstation as a ventilator for critically ill patients. Dosch affirms that "anesthesia providers should set up, check, and manage the anesthesia workstation." Additional resources regarding use of anesthesia machines as ventilators can also be found on the AANA Critical Care Resources webpage.

Drug Shortages
AANA is increasingly concerned about the drug shortages occurring due to the COVID-19 pandemic. If your facility is experiencing a drug shortage, inform us through the COVID-19 online submission form. Additionally, CRNAs can report to the FDA CDER Drug Shortage Staff directly at drugshortages@fda.hhs.gov.

CRNAs in Critical Care Roles
In addition to several position statements reinforcing CRNAs' critical roles as advanced care providers to expand the critical care workforce in this time of crisis, AANA has developed two infographics to support our members: Updated Website
AANA's COVID-19 Resources webpage has been expanded to include up-to-date?clinical practice, critical care, state advocacy, employment, Medicare, well-being, and student and educator resources. This page is continuously updated with the most relevant research and information.

Missed the Tele-Town Hall?
For a replay of the April 2, 2020, tele-town hall, visit AANA's COVID-19 Resources webpage and listen to our experts answer hot topic questions.

CRNA Well-Being
The AANA reminds CRNAs to care for yourselves during this stressful time. Visit the COVID-19 Well-being webpage for resources to help maintain a healthy work-life balance, manage stress, and support CRNA mental and emotional well-being.

The AANA is committed to supporting CRNAs, who are on the front lines of care during this unprecedented crisis. Please submit any questions not currently addressed in our resources through the COVID-19 online submission form.
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Mid-Year Assembly is Now Virtual and Free

Join us April 19 live online for webinars covering the most current healthcare policy updates and successful advocacy tips straight from esteemed political pundits. While we understand some of you may be unable to attend, we want to be sure everyone who had registered for the 2020 Mid-Year Assembly was made aware of this alternate opportunity.

Your registration is free. Seats are limited.

Earn 6 Class A CE Credits with these Virtual Event Sessions
  • Advocacy Training for Beginners — Christopher Kush
  • Advanced Lobbying Strategy: Meeting Hostile Offices, etc. — Amy Showalter
  • The Art & Science of Storytelling to Achieve Your Advocacy — Nancy Bocskor
  • How to Build Relationships with Lawmakers in Changing Times — Bradford Fitch
  • Get Political: 2020 Election Update — Charlie Cook
  • A View from Capitol Hill — Ralph Kohl
Learn more or Register now!

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Quality Payment Program Response to COVID-19

The Centers for Medicare & Medicaid Services (CMS) is providing relief to Merit-Based Incentive Payment System (MIPS)-eligible clinicians who cannot submit 2019 MIPS data by the April 30, 2020 deadline due to the COVID-19 pandemic. The national emergency was identified as a triggering event for the MIPS Automatic Extreme and Uncontrollable Circumstances Policy. Eligible CRNAs who are not able to submit MIPS data by the deadline will automatically qualify, so an application is not required. According to the policy, clinicians will receive a neutral payment adjustment for the 2021 payment year.
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Acute Respiratory Distress Syndrome (ARDS): What You Need to Know Today

A free webinar on Acute Respiratory Distress Syndrome (ARDS) management webinar will discuss recent findings related to ARDS and the current COVID-19 pandemic. The webinar will be held Tuesday, April 14, 2020, at 6 p.m. CT and good for 1.0 Class A CE Credit.

Speakers John J. Gallagher, DNP, FN, CCNS, CCRN-K, TCRN, RRT, and Andrew Rice, MSN, CRNA, APRN, ACNP-BC, will review the current literature, physiology, patient profiles, and at-risk groups. The webinar also will cover COVID-19 and how it can tie into sepsis, and it will identify critical diagnosis, therapies and best practices for treatment.

Learning Outcomes:
  1. Identify current trends in the clinical management of ARDS during the COVID-19 Pandemic.
  2. Make recommendations for caring for patients with ARDS during the COVID-19 Pandemic.
Register today to reserve your spot!
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Hot Topics


New: Five Things You Need to Know About CRNA Malpractice Insurance

Malpractice insurance can be complicated. Gain a basic understanding of CRNA Malpractice Insurance with AANA Insurance Service’s new Five Things You Need to Know resource: Learn more.
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Last Call for Abstracts! Don’t Miss Out on a Chance to Speak at 2021 ADCE and the ADCE Portion at the 2021 Annual Congress

You are invited to submit an abstract for consideration to present at the 2021 Assembly of Didactic and Clinical Educators (ADCE) and the ADCE portion at the 2021 Annual Congress. Present your idea to hundreds of CRNA faculty, clinical preceptors, program directors, and students, and help shape the future of nurse anesthesia education.

Topics
Submissions should include educational topics that will develop the effectiveness of CRNAs in their roles as program administrators, didactic educators, and clinical educators in diverse settings.

AANA will accept up to two submissions per presenter.

Submission Deadline
April 14, 2020 – Visit the abstract submissions page for more information.
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Nominate an SRNA for the Education Committee Student Excellence Award

One student will receive the Education Committee Student Excellence Award at the 2020 AANA Annual Congress. The winner will be recognized at the Student Luncheon. The submission deadline is April 20, 2020.

The award will be presented to a student in good academic standing who demonstrates:
  • Outstanding leadership and professionalism during their nurse anesthesia program,
  • Participates in activities that foster a positive public image of nursing,
  • Participates in activities that foster high-quality healthcare to consumers, or
  • Engages in volunteer activities of community service or support of healthcare.
The student must be nominated by their program administrator or the program administrator’s faculty designee. All SRNAs who are a student at the time of the submission deadline are eligible.

Please visit the AANA website for complete details under Opportunities for Educators.
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Education Committee Student Writing Contest

Submissions are now being accepted for the annual Student Writing Contest. SRNAs must submit an essay of no more than 1,500 words (including references) on a topic pertinent to education, professional practice and development, wellness, healthcare, or health policy.

Potential essay topics include, but are not limited to: leadership; case reports; health policy; professional development; quality improvement; student wellness; diversity; interprofessional collaboration; community service; work-life balance; simulation; innovative use of technology in education; ethics; and generational issues. Citations must follow AMA format. The submission deadline is April 20, 2020.

The winner will be recognized during the Student Luncheon at the 2020 AANA Annual Congress. There also is an opportunity for the winning essay to be published in the AANA NewsBulletin as a Student News column.

Please visit the AANA website for complete details under Education Opportunities for Students
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Students and CRNAs Needed for the Anesthesia College Bowl!

The spirited Anesthesia College Bowl will be held at the 2020 AANA Annual Congress on Monday, August 17, 2020. Six teams of students play each other, answering questions about anesthesia that have been submitted by nurse anesthesia program directors. The winning student team faces off against a team of six CRNAs to determine the ultimate winner of the College Bowl. The winners hold bragging rights until the following year! Applications for both students and CRNAs are due May 4, 2020.

Students wishing to play must inform their program administrator, who can submit a maximum of two students to participate. CRNAs must submit the Challenge Team sign-up form. Please visit the AANA website for complete details under CE & Education > Education > Opportunities for Educators
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Accepting Applications: Student Representative to the Education Committee

The AANA Education Committee supports the professional development of nurse anesthesia didactic and clinical educators and students. The committee includes a student representative, elected annually, who serves for one year. This student functions as an information source for students and enhances communication between the student body and the committee. In addition to participating in the above activities, the student representative facilitates the AANA Connect SRNA Community, contributes content to the AANA for SRNAs Facebook page, and writes the Student News column for the AANA NewsBulletin.

The student representative is elected by the students attending the AANA Annual Congress. The student representative participates in Education Committee meetings and conference calls. Please visit the AANA website for complete details under CE & Education > Education > Opportunities for Students. Note that your expected graduation date must be August 2021 or thereafter. The deadline for submission is May 4, 2020.

Primary activities of the Education committee include planning the Assembly of Didactic and Clinical Educators (ADCE) meetings and the Student Session at Annual Congress. The committee also hosts the Student Luncheon and Anesthesia College Bowl at Annual Congress.

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War Stories: Recording the Contributions of CRNAs In Service of Our Country

The American Association of Nurse Anesthetists (AANA) seeks to record the histories of our Certified Registered Nurse Anesthetists (CRNAs) who served in any of the United States' military operations and maneuvers of the 20th or 21st centuries (World War I, World War II, Korean War, Vietnam, The Invasion of Grenada, Gulf War, Iraq War). The AANA is interested in preserving your experiences as a matter of historical record. The AANA hopes to share these experiences with our membership, legislators, and the general public as a means of enlightening, healing, and reaching back into history so that the many accomplishments and sacrifices of CRNAs are not forgotten.

Submission guidelines are provided on the War Stories and Vietnam Voices pages. If you have any questions, or would like assistance in crafting your narrative, please contact Cathy Hodson, managing editor, digital publications and public relations.
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Foundation and Research


AANA Foundation: Grant Applications – Due May 1, 2020

The mission of the AANA Foundation is to advance the science of anesthesia through education and research. Grants are awarded to CRNAs only and the applicant must be an AANA member. The AANA Foundation sets a broad research agenda that includes healthcare policy, science of anesthesia, education, practice/clinical, and leadership. Visit the AANA Foundation website to learn more and apply. Grant applications are due May 1, 2020.
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AANA Foundation: ‘State of the Science’ Oral and General Poster Sessions Application Now Available – Due May 1, 2020

The ‘State of the Science’ Oral and General Poster Sessions offer CRNAs and SRNAs an opportunity to present their research findings and innovative educational approaches at the AANA Annual Congress in San Diego, Calif., August 14-18, 2020. Research, literature reviews, and innovative, creative techniques in anesthesia are appropriate topics. Access the applications on the AANA Foundation website. Apply today!
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AANA Member Benefits


Explore Resources for Respiratory Compromise, Ventilation, Brain Health Monitoring

AANA Corporate Partner Medtronic has a vast library of tools and resources available for clinicians needing information on ventilators and other devices supporting respiratory compromise and brain health monitoring. They are here to support you as you take on patient care at this unprecedented time. Check out these resources:

Ventilator resources

Monitoring resources

Newsletter – Get the latest news, bulletins, and product information directly from Medtronic (Opt-in required).
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Jobs



CRNACareers

CRNACareers.com - What are your next steps?

Whether you’re graduating soon and researching employers, are a seasoned professional interested in advancing your career or looking to supplement your work with locum tenens options, CRNACareers.com is the place to help get you started:

  • Search and apply to locum tenens or permanent positions at industry-leading facilities.
  • Upload your resume anonymously and allow employers to contact you.
  • Set up job alerts to receive notifications on new openings.
  • Access free career resources to assist with resume and interview preparation.

Learn more today!

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Certified Registered Nurse Anesthetist: Memorial Health System, Illinois

Our CRNAs administer general, regional, and MAC anesthesia to patients of all ages and any ASA status. The CRNAs work in a collaborative team environment with 50 CRNAs, 21 Anesthesiologists and 12 Anesthesia Techs to assist with room turnover and stocking. The CRNAs serve as Clinical Instructors for SIUE and Millikin/Decatur Nurse Anesthesia programs.

Due to our continued growth, Memorial Medical Center has multiple needs for Certified Registered Nurse Anesthetists. Positions are available full time in the Main OR, CVOR or as a split 50/50 between Main OR and CVOR.
  • Deliver more than 29,000 anesthetics annually across 23 Main ORs, 4 CVORs, 6 Ambulatory surgery ORs, and multiple off-site locations including OB, ECT, GI, IR, and Cath Lab.
  • Level 1 Trauma Center.
  • Diverse case mix.
  • Newest technology available with standardized equipment throughout the health system.
  • Robust EHR (Cerner).
  • Hospital employed; competitive salary and benefits package.
  • Reimbursement for continuing education with educational leave time.
  • Financial assistance of up to $30,000 available while pursuing anesthesia education.
  • Sign-on bonus of up to $30,000 for New Grad and $60,000 for Experienced.
  • Relocation assistance available.
Learn more.
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CRNA: Quincy Anesthesia Associates, Illinois

Quincy Anesthesia Associates, based out of Quincy, IL, is expanding our group due to added surgical volumes and CRNA shifts.

QAA is offering earnings that eclipse the 90th percentile for compensation as measured by the 2019 AANA salary survey
.

QAA is seeking additional CRNAs to increase the staff to a 27-provider practice that serves the Blessing Hospital operating rooms and the surgical center.

QAA offers:
  • A collegial environment with outstanding surgeons and staff.
  • A comprehensive benefit plan valued at $50,000 which includes Family health insurance, employer contribution to retirement, and all insurances.
  • Some CRNAs in our group exceed the 90th Percentile for income because of our paid call compensation plan.
  • Our CRNAs enjoy 40 days off combined vacation and holidays.
  • Quincy, IL, has been twice selected as an “All American City” and a Forbes top 10 small city based upon quality of life considerations: schools, low crime rates and low cost of living.
We invite you to investigate the rewards of working and living in Quincy.

Our family-oriented city offers recreational activities for all, including sports, dance, fine arts, museums, and all types of outdoor fun! Education in Quincy is highly valued and we have 2 collegiate opportunities in town, including a nursing school.

For additional information on this outstanding career opportunity, please contact our practice consultant, Mr. Gene Corbett at 636-288-4003 or by email at Gene.Corbett@iCloud.com. Learn more.
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Cardiac CRNA, Memorial Health System, Illinois

Our Cardiac Certified Registered Nurse Anesthetist administers anesthesia for all cardiac and vascular procedures employing a variety of techniques to render persons insensible to pain during a variety of surgical, dental, obstetric, and diagnostic procedures. Evaluating the effectiveness of interventions and assist in identification of alternative strategies. Demonstrate knowledge of the principles of growth and development for patients of adult age through geriatrics. Assess and interpret data reflective of the patient's status and provide care relative to their age-specific needs in accordance with the department's policies, procedures, and standards of care.

They are directed by an Anesthesiologist and work in a collaborative team approach to improve quality, safety, and control costs. Serve as clinical mentor for Student Registered Nurse Anesthetists.

Due to our continued growth, Memorial Medical Center has multiple needs for Certified Registered Nurse Anesthetists. Positions are available full time in the Main OR, CVOR or as a split 50/50 between Main OR and CVOR.
  • Level 1 Trauma Center.
  • Diverse case mix.
  • Newest technology available with standardized equipment throughout the health system.
  • Robust EHR (Cerner).
  • Hospital employed; competitive salary and benefits package.
  • Reimbursement for continuing education with educational leave time.
  • Financial assistance of up to $30,000 available while pursuing anesthesia education.
  • Sign-on bonus of up to $30,000 for New Grad and $60,000 for Experienced.
  • Relocation assistance available.
Learn more.
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Advanced Practice Nurse/CRNA, Ann & Robert H. Lurie Children’s Hospital, Illinois

Why join our world-class team?

Because at Ann & Robert H. Lurie Children's Hospital, we're committed to providing superior pediatric care with the most advanced innovations in medical technology, where we offer cutting-edge research, education for physicians, nurses, and allied health professionals; and a family-friendly environment.

Some amazing kids are counting on you!

Lurie Children's Hospital is expanding the CRNA team! We have an extraordinary team of 12 that continues to grow each year. Located in the heart of downtown, Lurie Children's Hospital is a 360-bed, freestanding pediatric hospital serving the children and families of Chicago. Lurie Children's Division of Anesthesiology administers more than 15,000 anesthetics a year to treat children with all types of conditions. The division provides safe and state-of-the art sedation, pain management, critical care and surgical anesthesia for procedures using the highest standards in medicine; recognized by ChildKind for our exceptional commitment and treatment of children's pain. CRNAs function in a multidisciplinary team with anesthesiologists, surgeons, proceduralists, radiologists, and nurses. We have a close-knit collaborative team and are looking for CRNAs with a passion for pediatrics.

Responsibilities:
  • Assessing, planning, implementing and evaluating the peri-procedural care and anesthetic plan for pediatric procedural and surgical patients.
  • Monitoring and managing the patient physiologic response to anesthesia, sedation, and procedures and communicating changes to the anesthesiologist.
  • Prescribing pharmacologic and non-pharmacologic interventions and performing other therapeutic or corrective measures to treat pre-anesthesia illness and improve health status.
Credentials:
  • Master's degree from an accredited school of nursing appropriate for pre-certification as an advanced practice/certified nurse anesthetist required; doctoral-related degree preferred.
  • Licensure in the state of Illinois as an APN, certification by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA), and experience as delineated in clinical privileges through the Medical Staff office essential.
  • BLS certification required; PALS certification required in some specialty areas; experience in pediatrics preferred.
Competitive salary, flexible scheduling options, and an excellent benefits package as well as relocation assistance available! Learn more.
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Certified Registered Nurse Anesthetist: UPMC Pinnacle, Pennsylvania

Join UPMC Pinnacle — a growing, multisite health system with seven acute care hospitals — as a Certified Registered Nurse Anesthetist, an essential member of the UPMC Pinnacle health care team who is responsible for assessing, planning, implementing, evaluating, and coordinating the total anesthesia care of patients. Through collaboration with all members of the anesthesia care team, the nurse anesthetist diagnoses and treats the human response of the patient and family to the anesthesia process, continuously monitoring, analyzing, and improving the performance of clinical activities. The nurse anesthetist is self-directed, empowered, and accountable for the direct supervision of all team members delivering care to assigned patients.

Multiple opportunities are available including UPMC Pinnacle Harrisburg, Community Osteopathic, and West Shore hospitals.

CRNAs practice includes various case types including General, Pediatric, Vascular, ENT, GI, GU, GYN, EP, Robotics, Thoracic, Orthopaedics, OB, Transplant, and IR.

Job Opportunity:
  • Enjoy flexible schedule, generous time off, excellent work-life balance, and overtime opportunities.
  • Be part of a supportive and family-oriented team within a department that offers a strong, supportive culture.
  • Practice in an environment that is safe, medically directed, and affords CRNAs the opportunity to practice in a high functioning capacity that is very collegial and collaborative.

Job Requirements:
  • Graduate from an approved school of nursing and hold current Pennsylvania RN licensure.
  • Graduate from a Council on Accreditation of Nurse Anesthesia Educational Programs (COA)-accredited nurse anesthesia program.
  • Successful completion of the certification examination or board eligible as defined by the AANA.
  • Comply with criteria for recertification as defined by the NBCRNA.
Benefits:
  • Health, life, and disability insurance.
  • Medical malpractice insurance.
  • Defined contribution plan; 403(b) plan with employer match.
  • Professional dues and CME allowance.
Learn more.
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Healthcare Headlines

Healthcare Headlines is for informational purposes, and its content should not be interpreted as endorsements, standards of care, or position statements of the American Association of Nurse Anesthetists.

PPE-Associated Headaches Increase Among Health Care Workers Amid COVID-19

Research out of Singapore examined the relationship between prolonged use of personal protective equipment (PPE) during the coronavirus pandemic and headache among health care professionals. The single-site HAPPE study surveyed 158 nurses, doctors, and paramedical personnel who wore goggles and N95 masks for an average of six hours per day. More than 80 percent of them reported de novo PPE-associated headache, with nearly a quarter experiencing migraine-like symptoms including nausea, vomiting, photophobia, phonophobia, movement sensitivity, and neck discomfort. The pain generally started within an hour of donning PPE and typically dissipated within an hour of removing it. Most study participants shunned acute analgesic treatment, with the exception of health care workers with a history of headaches. These respondents were more likely to suffer de novo PPE-associated headache, which combined with sleep deprivation, stress, and other factors to exacerbate their background headaches. The National University Hospital researchers determined that the main cause of PPE-associated headaches was pressure on the head and tractional forces from masks and goggles. "The magnitude of this condition is clinically significant and might worsen if the current outbreak spreads widely and stays for a longer time, affecting the work performance of health care workers," they report in Headache. "Perhaps, better strategies are needed for designing various personal protective equipment and reducing their exposure time by health care workers.”

From "PPE-Associated Headaches Increase Among Health Care Workers Amid COVID-19"
Healio (04/07/2020) Cimberle, Michela

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IV Esketamine, Ketamine Equally Effective for Resistant Depression

A noninferiority study done in Brazil compared intravenous (IV) esketamine with IV ketamine in the setting of treatment-resistant depression. The randomized controlled trial included 63 patients, who received a single subanesthetic dose of either racemic ketamine or esketamine for 40 minutes. The findings, published in the Journal of Affective Disorders, indicate that both options were safe and well tolerated. Efficacy was comparable, too, with 24.1 percent of the ketamine patients and 29.4 percent of the esketamine patients achieving remission of major depressive disorder at 24 hours after treatment infusion. "Our findings bring a greater basis for practitioners from locations where intravenous esketamine is more easily obtainable than ketamine to use it as an affordable option for treating depressive patients," said senior investigator Lucas Quarantini, MD, of the Federal University of Bahia. The study's other key result was that the number of therapeutic treatment failures—but not the number of suicide attempts or degree of disassociative behavior—effectively predicted remission of depressive symptoms. "Identifying remission predictors may contribute to selecting more suitable candidates for the intervention and result in more individualized and effective patient management," the researchers concluded.

From "IV Esketamine, Ketamine Equally Effective for Resistant Depression"
Medscape (04/06/20) Melville, Nancy A.

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Researchers Create Algorithm to Protect Surgical Team Members From COVID-19

Stanford University researchers have developed a best practice guideline, published in the Journal of the American College of Surgeons ahead of print, to protect operating teams from COVID-19 during emergency operations. Besides preventing transmission of the virus, the goal of the algorithm is to rationally conserve the personal protective equipment (PPE) used by team members. In line with the American College of Surgeons' April 1 statement on PPE shortages, the Stanford algorithm considers the urgency of the procedure, the likelihood of aerosolization and release of viral droplets at the surgical site, and the risk that the patient may have coronavirus. In the absence of a negative test, the algorithm assumes that a patient could indeed be infected; and it allows that the procedure may be delayed for testing if a patient presents with unexplained fever or other viral symptoms. When proceeding with surgery on someone with confirmed or suspected COVID-19, operating room personnel must wear an N-95 respirator, gloves, eye protection, and a gown. Anesthesia providers, who are positioned at the head of the bed, must don N-95 masks and droplet-protective PPE. "You never know what's going to happen, and it's better to be prepared and use the right PPE at the right time and be careful not to waste PPE," says Joseph Forrester, MD, lead author of the algorithm article.

From "Researchers Create Algorithm to Protect Surgical Team Members From COVID-19"
News-Medical (04/06/20)

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Effects of Benzydamine Hydrochloride on Postoperative Sore Throat After Extubation in Children

Nearly 150 children participated in a study to see if benzydamine hydrochloride (BH) spray reduces postoperative sore throat (POST) after intubation during general anesthesia. The enrollees, aged 6 to 12 years old, were randomly divided into two treatment arms. After induction of anesthesia, direct laryngoscope was placed and BH spray was applied to the upper trachea and vocal cord of kids in the intervention group; and intubation was performed using a cuffed tube lubricated with normal saline. Children in the control group underwent the same intubation process, but without the spray intervention. Following extubation, they were evaluated in the post-anesthesia care unit for the presence of POST and any adverse events. The observations indicated no benefit from using BH spray in the oropharyngeal space. Children who received the intervention shared similar incidence of POST as the controls as well as comparable postoperative pain, coughing, laryngospasm, and other complications. Despite the disappointing results from this study, the researchers at Seoul National University Hospital say more work is needed to determine if better results can be had using different application methods for BH in this setting.

From "Effects of Benzydamine Hydrochloride on Postoperative Sore Throat After Extubation in Children"
BMC Anesthesiology (04/02/20) Vol. 20, No. 77 Yhim, Hyung-Been; Yoon, Soo-Hyuk; Jang, Young-Eun; et al.

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Etomidate Imposes Pro-Inflammatory Effect with Respiratory Consequences

Researchers are cautioning anesthesia providers about using etomidate, a GABA-A receptor agonist, as an induction agent in patients with trauma. While the drug is often preferred in this setting due to a short half-life and few hemodynamic adverse effects, there is new evidence that it also increases inflammatory response and impairs respiratory function in this patient population. The data comes from a planned secondary analysis of the PROPPR (Pragmatic Randomized Optimal Platelet and Plasma Ratios) randomized clinical trial, which included 195 trauma patients who were induced with etomidate and 370 patients who received other induction anesthetics. The investigators observed elevated levels of proinflammatory cytokine interleukin (IL)-6, eotaxin, and vascular endothelial growth factor along with lower levels of anti-inflammatory cytokines IL-10 and IL-9 in the etomidate group. While clinical outcomes, including 24-hour mortality and rate of complications, were similar regardless of induction agent, those receiving etomidate also were more likely to develop acute respiratory distress syndrome.

From "Etomidate Imposes Pro-Inflammatory Effect with Respiratory Consequences"
Anesthesiology News (03/30/20) Vlessides, Michael

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Essential Drug Supplies for Virus Patients Are Running Low

As U.S. hospitals confront a surge in coronavirus cases, they are also beginning to report shortages of critical medications—especially those needed to ease the disease's assault on patients’ respiratory systems. Drugs used to keep patients’ airways open, antibiotics, antivirals, and sedatives are among the most commonly reported areas of shortage. Demand for these products significantly increased in March as the pandemic took hold in the United States. Orders for antibiotics like azithromycin and antiviral medicines like ribavirin nearly tripled. Medicines used for sedation and pain management—including fentanyl, midazolam, and propofol—increased by 100 percent, 70 percent, and 60 percent, respectively. Demand for the asthma inhaler medication albuterol has also risen significantly due to its importance in easing the breathing of patients with severe infection. At the same time, the rate at which these prescriptions are filled and shipped to hospitals has declined by one-half to more than three-fourths in the last month, according to data collected by Premier Inc.

From "Essential Drug Supplies for Virus Patients Are Running Low"
New York Times (04/03/20) Sheikh, Knvul

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News summaries © copyright 2020 SmithBucklin



Anesthesia E-ssential is an executive summary of noteworthy articles of interest to nurse anesthetists. It is distributed weekly to AANA members.

Anesthesia E-ssential is for informational purposes, and its contents should not be interpreted as endorsements, standards of care, or position statements of the American Association of Nurse Anesthetists.

If you are interested in advertising in Anesthesia E-ssential contact HealthCom Media at 215-489-7000.

For more information on AANA and Anesthesia E-ssential, contact:

AANA
222 S. Prospect Avenue
Park Ridge, IL 60068
Phone: (855) 526-2262 (toll-free)/(847) 692-7050
Fax: (847) 692-6968

Attn: Cathy Hodson
E–ssential Editor
chodson@aana.com
April 9, 2020