Anesthesia E-ssential

AANA Anesthesia E-ssential, August 30, 2018
 
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HealthCom Media Tapped to Lead Nurse Anesthetist Association’s Media Sales


The American Association of Nurse Anesthetists (AANA) has partnered with HealthCom Media (HCM), a leading information and content development company specializing in marketing and publishing solutions that complement traditional advertising programs. HCM will manage media sales for the AANA and offer the association’s industry partners innovative marketing channels to help them reach more than 52,000 Certified Registered Nurse Anesthetists (CRNAs) and student nurse anesthetists who are AANA members.

“HCM draws on more than two decades of marketing, content development, advertising, and publishing experience in the nursing and healthcare realm to create compelling content specifically for healthcare professionals,” said AANA CEO Randall Moore, DNP, MBA, CRNA. “Their unique abilities will enhance our industry partners’ efforts to inform our members and provide them with the resources they need to ensure our patients have access to safe, high-quality anesthesia care.”

The partnership between the AANA, which represents the nation’s first anesthesia professionals, and HCM will build upon the AANA’s commitment to evidenced-based practice standards, patient advocacy, and healthcare leadership, enduring qualities that will be bolstered by HCM’s content strategy.

“First and foremost, our approach to working with the AANA is to develop content that is consistent with the strategic goals of the association,” said HealthCom Media President Gregory Osborne. “Our HCM team will leverage years of experience in the healthcare publishing industry with market trends that directly correlate with the practice of nurse anesthesia.”

About the American Association of Nurse Anesthetists (AANA)
Founded in 1931 and located in Park Ridge, Ill., and Washington, D.C., the American Association of Nurse Anesthetists (AANA) is the professional organization representing more than 52,000 Certified Registered Nurse Anesthetists (CRNAs) and student registered nurse anesthetists across the United States. As advanced practice registered nurses, CRNAs are anesthesia experts who administer more than 43 million anesthetics to patients in the United States each year and are the primary providers of anesthesia care in rural America. In some states, CRNAs are the sole anesthesia professionals in nearly 100 percent of rural hospitals. For more information, visit https://www.aana.com and www.future-of-anesthesia-care-today.com.

About HealthCom Media
HealthCom Media, based in Doylestown, Pennsylvania, is an award-winning publisher and sales/marketing organization representing publications and promotional properties in the healthcare market. HCM currently publishes journals and educational projects delivered in both print and digital formats that target nurses and other healthcare professionals in a variety of specialties, as well as consumers and patients.

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Hot Topics


Business Meeting Materials Now Available on AANA Website


Important information for members attending the AANA Business Meeting on Saturday, September 22, at the AANA Annual Congress in Boston, is now available on the AANA website. Member login required.

The agenda for the meeting and the proposed resolution and bylaws amendments documents are available, along with other supporting documents. These documents will NOT be printed out or distributed at the Business Meeting, so if you are interested in having them to refer to in paper format, please print them from the website before you attend. These documents will be available on the AANA Meetings app during Annual Congress.

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Admitted vs. Non-Admitted Malpractice Insurance Companies: Do You Know the Difference?

There are significant differences between admitted and non-admitted malpractice insurance companies – and choosing the wrong company can put you, your reputation, and your personal assets at risk. Learn which questions to ask your insurance agent to ensure you have protection when you need it most.  See Will your assets be protected.

 

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NewsMaker: Beekeeping is CRNA's Sweet Hobby


Greg Cowling, MN, CRNA, has a honey of a hobby. In addition to being a CRNA, he is a beekeeper, having raised them for the past eight years.

"It was something I've had an interest in for a long time, and kind of kept putting it off," says Cowling.

Read more in The Augusta Chronicle.

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NewsMakers: Twin CRNAs, Also Authors, To Present Book Next Week


Twin CRNAs Shaletra Jordan, DNP, CRNA, and Shanetra Hodge-Hill, DNP, CRNA, who are also cancer survivors, will present their book to help surgical patients maintain a positive outlook while going through their own cancer treatments.

The book signing will take place during a Lunchbox Lecture from noon to 1 p.m. on Thursday, September 6, in the Murphy-Payne Community Rooms, M.P. Baker Library, Panola College, Carthage, Texas.

Read more in The Pony Express.

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AANA Member Benefits


Nationwide: How to Save Money on Groceries


If you're grocery shopping on a budget, use these 10 ways to help save money on groceries.


Learn how to save money on groceries

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Jobs


CRNACareers

Visit www.crnacareers.com to view or place job postings

 

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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.


Outpatient Dismissal with a Responsible Adult Compared with Structured Solo Dismissal

Investigators say short-acting medications, coupled with advance preparation and sound clinical judgment, make it safe for patients to be released alone following ambulatory anesthesia. Accepted practice has called for dismissal only into the charge of a responsible adult tasked with overseeing care for 24 hours post-procedure. Mayo Clinic researchers, however, theorized that patients discharged alone under a sedation dismissal process (SDP) are at no greater risk for adverse events than those handed over to a responsible adult. They tested their hypothesis in a sample of 2,441 SDP patients undergoing 2,703 outpatient procedures and 4,923 controls undergoing 5,133 procedures. The results revealed no between-group difference in complications or unplanned readmissions and emergency department visits over 24 or 96 hours, i.e., no clinical benefit to releasing outpatient anesthesia/sedation patients to a responsible adult escort. Adopting an SDP—which lines up alternatives such as medical transport service, hotel shuttle buses, and nurse's aides or patient care assistants—could reduce the burden on patients who are unable to arrange for a personal escort. In turn, that could mitigate delays that ambulatory facilities experience when patients arrive for a procedure without one.

From "Outpatient Dismissal with a Responsible Adult Compared with Structured Solo Dismissal"
Mayo Clinic Proceedings (09/18) Vol. 2, No. 3, P. 234 Martin, David P.; Warner, Mary E.; Johnson, Rebecca L.; et al.

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Laparoscopic Superior Hypogastric Blocks for Postoperative Pain Management in Hysterectomies

A prospective observational cohort study examined the effect of intraoperative superior hypogastric (SHP) blocks in managing post-surgical pain. The team from Kocaeli, Turkey, enrolled 60 elective laparoscopic hysterectomy patients in the trial. Half of the women received SHP using laparoscopic modified anterior approach, and half received usual treatment. The SHP patients used significantly fewer non-steroidal anti-inflammatory drugs and opioids in the post-anesthesia care unit and surgical ward, and they also went a longer period of time without rescue analgesia. Subsequently, the researchers found that intraoperative SHP block is preferred for postoperative pain relief in the setting of hysterectomy. For even better outcomes, they suggest using the approach in tandem with wound site local anesthetic infiltration or abdominal wall plane blocks.

From "Laparoscopic Superior Hypogastric Blocks for Postoperative Pain Management in Hysterectomies"
Journal of Minimally Invasive Gynecology (08/27/18) Aytuluk, Hande Gurbuz; Kale, Ahmet; Basol, Gulfem

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Transforaminal Epidural Steroid Injection Superior to Caudal in Lumbosacral Disk Herniation

The results of a new review, although not statistically significant, suggest that transforaminal epidural steroid injection (TFESI) may be a better choice than caudal epidural steroid injection (CESI) for patients with lumbosacral disk herniation (LDH). While CESI is effective, researchers believe TFESI can improve pain and functional limitation outcomes because of its direct delivery of steroid medications to the desired area. Investigators reached their conclusion after examining six published trials that compared TFESI against CESI for the treatment of LDH-associated leg pain and low back pain. Four of the studies deemed TFESI superior to CESI, one determined that the two techniques were equally effective, and one found CESI superior to TFESI. Imprecise results and inconsistency across the studies, however, weakened the quality of the evidence; and the researchers suspect that increasing the amount of injectate above conventional levels might even position CESI to achieve similar results to TFESI. For now, the authors report in The Spine Journal, “TFESI is preferred to CESI due to its target specificity, although discomfort during the needle approach occurs more frequently in TFESI. As a result, TFESI can be weakly recommended over CESI, even though controversy about the advantage of TFESI might still remain.”

From "Transforaminal Epidural Steroid Injection Superior to Caudal in Lumbosacral Disk Herniation"
Clinical Pain Advisor (08/23/18) Rothbard, Gary

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Pectoral I Block Does Not Improve Postoperative Analgesia After Breast Cancer Surgery

French and Canadian researchers conducted a randomized trial that assessed the effect of using first pectoral nerve block (Pecs I) to relieve pain after unilateral breast cancer surgery. All 128 participants received multimodal analgesia and local anesthetic infiltration. Ultrasound-guided Pecs I was administered with bupivacaine to 62 of the women and with saline to 65. Neither pain level 30 minutes after admission to the recovery unit nor morphine consumption was markedly different between the two groups. Based on the results, Pecs I does not appear to have an advantage over placebo in the setting of multimodal analgesia for breast cancer surgery. Additional investigation into the approach for major breast surgeries could be warranted, however, given that numerical pain scores differed on a statistically significant level for patients undergoing mastectomies or tumorectomies.

From "Pectoral I Block Does Not Improve Postoperative Analgesia After Breast Cancer Surgery"
Regional Anesthesia and Pain Medicine (08/18) Vol. 43, No. 6, P. 596 Cros, Jérôme; Sengès, Patrick; Kaprelian, Suzan; et al.

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6 Insights on How Artificial Intelligence Could Transform Anesthesia

John Alexander, MD, and Girish Joshi, MD—anesthesia providers at the University of Texas Southwestern Medical Center—point out various ways that artificial intelligence (AI) could ultimately play a role in the specialty. It remains to be seen if AI will ever be fully automated, they concede, because the current generation of robots lacks the dexterity to perform tracheal intubation, neural blockade, venous cannulation, and other delicate procedures. More likely, they say, AI will have a bigger impact on cognitive work through the development of innovative clinical decision support tools that draw on machine learning. A perioperative platform that uses an anesthesia information management system, automated medication management system, and digital preoperative assessment tool is already available, for example, to recommend therapies and provide patient risk profiles. By supporting some of the cognitive responsibility, Alexander and Joshi believe AI could foster "a renewed emphasis on the doctor-patient relationship."

From "6 Insights on How Artificial Intelligence Could Transform Anesthesia"
Becker's ASC Review (08/18) Stewart, Angie

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Self-Reported Functional Status Predicts Post-Operative Outcomes in Non-Cardiac Surgery Patients with Pulmonary Hypertension

Investigators explored whether self-reported exercise tolerance predicts outcomes in patients with pulmonary hypertension (PHTN), which is linked to morbidity and mortality after surgery and exposure to anesthesia. The University of Washington Medical Center led the retrospective cohort study, which encompassed a sample of 370 PHTN patients who underwent 550 non-cardiac, non-obstetric procedures. Functional status, defined in terms of metabolic equivalents of task, was assigned based on how many blocks patients estimated during a pre-anesthesia clinic that they could walk and how many flights of stairs they thought they could climb without experiencing symptomatic limitation. Those unable to walk four blocks and/or ascend two flights of stairs were categorized as having poor exercise tolerance—which, in turn, correlated with severe PTHN and predicted increased hospital length of stay (LOS) and post-procedure complications. Self-reported functional status represents an easy and cost-effective stratification tool for PHTN patients, the researchers conclude. The Pulmonary Hypertension Outcomes Risk Score (PHORS)—based on predictors of LOS longer than one week, including procedure duration and ASA class—can help flag higher-risk PHTN patients who may warrant further testing.

From "Self-Reported Functional Status Predicts Post-Operative Outcomes in Non-Cardiac Surgery Patients with Pulmonary Hypertension"
PLOS ONE (08/16/18) Shah, Aalap C.; Ma, Kevin; Faraoni, David; et al.

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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 Slack Incorporated at 800-257-8290.

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

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Phone: (855) 526-2262 (toll-free)/(847) 692-7050
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Attn: Cathy Hodson
E–ssential Editor
chodson@aana.com

August 30, 2018
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