AANA Journal[JOURNAL]
Sun
200 papers
Training Anesthesia Providers in Gastric Ultrasound Assessment: An Integrative Review.
Rafferty M, Turner A, Walch E … +1 more , Halstead A
AANA J · 2025 Oct · PMID 41056147 · Publisher ↗
Point-of-care ultrasound (POCUS) is an inexpensive and often readily available tool for anesthesia providers to utilize to assess gastric content, both qualitatively and quantitatively, in the perioperative arena. Gastri...
Point-of-care ultrasound (POCUS) is an inexpensive and often readily available tool for anesthesia providers to utilize to assess gastric content, both qualitatively and quantitatively, in the perioperative arena. Gastric POCUS requires the anesthesia provider to be trained and proficient in technique and interpretation of findings to accurately guide decision-making for patient care. The American Association of Nurse Anesthesiology, the American Society of Anesthesiologists, and the American Society of Regional Anesthesia have established guidelines supporting the use of gastric POCUS. This article aims to provide an integrative review of the literature surrounding current strategies in education and assessment of anesthesia provider competency in the perioperative utilization of gastric POCUS. Strict inclusion and exclusion criteria were used yielding eight articles in an effort to help determine feasible, efficient, reliable, and beneficial educational strategies to improve anesthesia provider competency. Findings suggest success with various educational strategies, including didactic, hands-on, electronic, and self-directed courses on gastric POCUS, supported by improved postintervention analyses of provider competency.
PrEP-ared for Surgery? A Comprehensive Narrative Review of Perioperative Recommendations for Anesthesia Providers.
Majumdar JR, Forrester JW, Haviland KS … +3 more , Massaro CD, Welch JC, Kelleher DC
AANA J · 2025 Oct · PMID 41056146 · Full text
The use of Pre-Exposure Prophylaxis (PrEP) for human immunodeficiency virus (HIV) prevention has increased significantly, with approximately 30% of eligible individuals in the U.S. receiving a prescription by 2021, up fr...
The use of Pre-Exposure Prophylaxis (PrEP) for human immunodeficiency virus (HIV) prevention has increased significantly, with approximately 30% of eligible individuals in the U.S. receiving a prescription by 2021, up from 13% in 2017. As more patients on PrEP undergo surgical procedures, understanding the perioperative implications of these medications is crucial for anesthesia providers. This review aims to summarize current literature on the perioperative considerations for patients on PrEP and provide anesthesia providers with key recommendations to optimize patient safety and outcomes. It examines the pharmacology, side effects, and perioperative considerations of current PrEP formulations: Truvada, Descovy, and Apretude. We conducted a broad literature search focusing on publications from 2013 through 2024. The review identifies potential nephrotoxicity with tenofovir-based formulations, particularly when combined with nephrotoxic agents such as nonsteroidal anti-inflammatory drugs. Emtricitabine/tenofovir alafenamide use is associated with an increased risk of hypertension and hypercholesterolemia. No specific anesthetic agents are contraindicated, but dose adjustments for renally excreted drugs may be necessary. Current evidence supports continuing PrEP throughout the perioperative period, with strategies provided for managing different formulations during surgery. As PrEP use expands, anesthesia providers must balance safe, effective care with contributing to HIV prevention efforts. Future research should focus on long-term anesthetic implications of PrEP and optimal perioperative management strategies. By implementing informed practices, anesthesia providers can significantly enhance the care of patients on PrEP and support broader public health goals in HIV prevention.
A National Survey Analysis of CRNAs' Perceived Ease of Use and Perceived Usefulness of Video Laryngoscopes for Difficult Airways.
Klemm U
AANA J · 2025 Oct · PMID 41056145 · Publisher ↗
Video laryngoscopes (VLs) offer benefits by improving visualization and first-attempt success and decreasing failed intubations. This study examined the perceived usefulness and perceived ease of using VLs by certified r...
Video laryngoscopes (VLs) offer benefits by improving visualization and first-attempt success and decreasing failed intubations. This study examined the perceived usefulness and perceived ease of using VLs by certified registered nurse anesthetists (CRNAs) utilizing the Technology Acceptance Model published by Fred Davis in 1989. The study further investigated the influence of patient airway types, provider characteristics (age, years of practice, intubation frequency), and clinical factors (hospital size and technology availability) on subsequent selection and usage. The cross-sectional design included a one-time national survey using a purposive 3,000-CRNA sample. Data analysis included univariate, bivariate, and multivariate methodologies with multiple linear and binary logistic regression models. Approximately 71% of CRNAs were extremely likely to find VLs useful and easy to use and approximately 60% reported their selection and use when confronting difficult airways. Additionally, CRNAs selecting VLs for routine airways 50% to 100% of the time reported 4.49 times greater odds of always using VLs (100%) for difficult airways compared with CRNAs using this technology infrequently. This study provides current usage data by CRNAs and represents a first-ever assessment exploring CRNA perceptions of usefulness and ease in utilizing VLs in the operating room setting.
Endotracheal Tube Replacement in the Prone Position With Intubating Laryngeal Mask Airway/Flexible Fiberoptic Scope Combination or Glidescope® Video Laryngoscope: A Manikin-Based Study.
Villareal A, de Somocurcio AR, Schauweker C … +2 more , Fisher R, Cornelius B
AANA J · 2025 Oct · PMID 41056144 · Publisher ↗
Placing patients in the prone position is required for many surgical procedures. However, once in this position, the endotracheal tube (ETT) is often inaccessible to providers and accidental removal in an anesthetized, s...
Placing patients in the prone position is required for many surgical procedures. However, once in this position, the endotracheal tube (ETT) is often inaccessible to providers and accidental removal in an anesthetized, surgical patient can pose a life-threatening emergency. This experimental study aimed to examine the effectiveness of endotracheal reintubation in the prone position using a video laryngoscope (Glidescope®) compared with an intubating laryngeal mask airway (LMA) with ETT placement assisted by fiberoptic scope on a manikin. This study was conducted using 30 anesthesia providers with varying degrees of experience. The median times to intubation were lower using the Glidescope (73.5 s vs 130 s; < .001). Moreover, the use of the Glidescope resulted in no esophageal intubations as well as fewer attempts than when using the LMA. Most anesthesia providers found that the Glidescope was the easiest technique to perform and learn. Despite these positive outcomes for the Glidescope, most of the participants reported the use of the LMA as a safer choice because of its capability to ventilate the manikin quickly (mean time to ventilation 12.13 s). The Glidescope method was found to be more likely to cause dental damage. The most important strategy is development of a plan prior to the emergent need.
Age Differences in Patients With Postoperative Pain and Their Relationships to Comorbid Conditions: Multivariate Logistic Regression Analysis.
Pruinelli L, Mathiason MA, Ma S … +5 more , Stalter N, Stone L, Fillingim RB, Setty S, Banik RK
AANA J · 2025 Oct · PMID 41056143 · Publisher ↗
This study analyzed the relationship between aging and reported pain during the acute postoperative period in a retrospective analysis of 2,600 adult patients who underwent abdominal surgeries. Data included demographics...
This study analyzed the relationship between aging and reported pain during the acute postoperative period in a retrospective analysis of 2,600 adult patients who underwent abdominal surgeries. Data included demographics, diagnoses, surgical, and pain assessments. Severe pain was defined as reported pain intensity ≥ 7 on the numeric rating score during the first 24 hours postsurgery. Patients were grouped into three different age categories: 18-44, 45-64, and ≥ 65 years. Comparisons among groups were performed using the Chi-square test. Multivariate logistic regression was used to estimate the likelihood of patients reporting pain intensity ≥ 7. The likelihood of reporting severe pain was significantly lower in older (> 65 years; OR, 0.48; CI, 0.39-0.60) and middle-aged (45-64 years; OR, 0.77; CI, 0.63-0.91) patients as compared with younger patients (18-44 years). Factors increasing the likelihood of reporting severe pain included female sex (OR, 1.34; CI, 1.13-1.58), history of chronic pain (OR, 2.03; CI, 1.58-2.60), and incidence of depression and/or anxiety (OR, 1.65; CI, 1.29-2.12). Findings suggest that patients ≥ 65 years are significantly less likely to experience severe acute postoperative pain following a major abdominal surgery. Nurse anesthetists' awareness of age-specific acute postoperative pain management can lead to better patient pain outcomes.
The Editor's Desk: The Critical Role of Peer Review: Ensuring Quality and Advancing Nurse Anesthesiology Scholarship.
Aroke EN
AANA J · 2025 Oct · PMID 41056142 · Publisher ↗
Abstract loading — click title to view on PubMed.
Course--Initiation and Anesthetic Management of ECMO in the Adult Noncardiac Surgical Patient.
Kiss R, Sopczneski S, Karaffa KM … +2 more , Gonzalez K, Szafranski M
AANA J · 2025 Aug · PMID 40742713 · Publisher ↗
The use of extracorporeal membrane oxygenation (ECMO) in surgical patients is increasing worldwide. Utilization of ECMO has nearly doubled in the past decade, enabling survival for 67% of patients in need of ECMO support...
The use of extracorporeal membrane oxygenation (ECMO) in surgical patients is increasing worldwide. Utilization of ECMO has nearly doubled in the past decade, enabling survival for 67% of patients in need of ECMO support. Induction and management of general anesthesia in the adult noncardiac surgical patient can present distinct challenges to the anesthesia practitioner's skill set. The need for alternative ventilatory and hemodynamic management strategies to support general anesthesia is indicated when challenges arise in the unstable surgical patient. ECMO support may be required to safely proceed with surgery in those instances. The rapid evolution of ECMO use in adult noncardiac surgical patients and a lack of updated clinical practice guidelines describing perioperative ECMO initiation and management create a knowledge gap among anesthesia practitioners. Resolving this knowledge deficit ensures efficacious care for this patient population at increased risk for perioperative complications and demise. This journal course will present evidence-based clinical practice recommendations to guide anesthesia practitioners on the initiation of elective preinduction and emergent ECMO support, and the considerations for intraoperative management of the adult noncardiac surgical patient on ECMO.
GRIT as a Predictor of Nurse Anesthesiology Student Success.
Collins S, Tracy A, Benson A … +3 more , Loughran S, Keaton J, Dehom S
AANA J · 2025 Aug · PMID 40742712 · Publisher ↗
Nurse anesthesiology programs continue to search for the best student traits and/or qualities to determine success in transitioning through a program of study and passing the National Certification Examination. These tra...
Nurse anesthesiology programs continue to search for the best student traits and/or qualities to determine success in transitioning through a program of study and passing the National Certification Examination. These traits are not always quantitative in nature, but qualitative. Students face many stressors in transitioning through a nurse anesthesiology training program, and how students cope with those stressors may clue in the nurse anesthesia educators as to what determines success. This pilot study aimed to determine whether grit, or perseverance toward meeting a long-term goal, was a trait worth considering in determining student success. To that end, this cross-sectional quantitative correlational pilot study conducted in two nurse anesthesiology programs found that one grit subscale--Perseverance of Effort--was statistically significant in determining student success as defined herein.
The Impact of Mandatory Substance Use Disorder Education on Peer Perception of Impairment in CRNAs.
O'Con KV
AANA J · 2025 Aug · PMID 40742711 · Publisher ↗
A gap exists in the literature examining peer perception of professional impairment among certified registered nurse anesthetists (CRNAs) with and without substance use disorder (SUD) education. In addition to SUD educat...
A gap exists in the literature examining peer perception of professional impairment among certified registered nurse anesthetists (CRNAs) with and without substance use disorder (SUD) education. In addition to SUD education, personal and professional factors influencing peer perceptions were also explored. An electronic survey was sent to American Association of Nurse Anesthesiology members, and 192 participants responded to a 55-item questionnaire. An independent t-test revealed that perceptions were more positive in CRNAs who received SUD education (M, 62.44; SD, 7.124) than those who did not (M, 64.17; SD, 6.919). Similarly, a multiple regression analysis was conducted to predict perceptions of nurse impairment from personal and professional factors. The model explained 5.4% of the variance in the perception of nurse impairment, although none of the five variables added statistical significance (F[6, 165] = 1.511; = .178; adj. R, .01). Recommendations for future studies include a qualitative study examining the lived experiences of CRNAs who suffer from SUD and sought treatment. This survey may offer the profession a unique perspective on the challenges impaired CRNAs face and the obstacles they must overcome to obtain treatment for their illness.
Trauma-Informed Care in Anesthesia for Women With a History of Sexual Assault: Investigating Provider Perceptions.
Petersen SR, Nguyen TE, Rollison S
AANA J · 2025 Aug · PMID 40742710 · Publisher ↗
According to the Centers for Disease Control and Prevention, one in four women in the United States has experienced attempted or completed rape, and over half have experienced a form of sexual violence in their lifetime....
According to the Centers for Disease Control and Prevention, one in four women in the United States has experienced attempted or completed rape, and over half have experienced a form of sexual violence in their lifetime. Despite this prevalence, there is currently no formal position statement regarding the role of trauma-informed care (TIC) in anesthesia. This study investigates provider knowledge and attitudes regarding TIC principles and specific applications to perioperative practices during the care of female-identifying patients. Interactive educational presentations were provided to perioperative staff in surgical centers across a large academic medical center in the Mid-Atlantic United States. Pre-post education surveys measured participant knowledge, attitudes, and practices surrounding TIC on a four-point Likert scale. Data were numerically coded and evaluated using independent t-test analysis. Results demonstrate that providers vastly underestimate the prevalence of sexual assault, do not regularly integrate TIC principles, desire additional TIC education, and are individually motivated to modify practices. Integrating universal TIC guidelines into the anesthesia care of this patient population can serve as a bridge to formal protocols, provider education, and practice integration.
Characterizing Periprocedural Care for Pediatric Patients With Williams Syndrome Undergoing General Anesthesia at a Tertiary Pediatric Hospital.
Andrews LK, Chamberlain RC, Silva S … +4 more , Hueckel R, Newberry D, Ames W, Funk EM
AANA J · 2025 Aug · PMID 40742709 · Publisher ↗
Williams syndrome is a rare congenital disorder affecting connective tissue and the cardiovascular and central nervous systems. Pediatric patients diagnosed with Williams syndrome face significant risk for cardiac collap...
Williams syndrome is a rare congenital disorder affecting connective tissue and the cardiovascular and central nervous systems. Pediatric patients diagnosed with Williams syndrome face significant risk for cardiac collapse and death when undergoing anesthesia. We sought to evaluate our institution's historical practices, evaluate individual risk stratification, and create detailed standardized perianesthesia guidelines for management of this population, particularly during noncardiac procedures. The study included a retrospective chart review of pediatric patients with Williams syndrome who received anesthesia over a 10-year period at a single institution. A total of 23 patients underwent 46 procedures. At time of procedure, median age was 5.8 years (range, 0.4-17.6 yr), and the majority (n = 19) had a "low" Williams syndrome risk category and required anesthesia for noncardiac procedures. Most (61%) had no cardiac involvement beyond mild supravalvar or branch pulmonary artery stenosis. No intraprocedure adverse cardiac events were identified. One patient experienced an adverse cardiac event approximately 60 minutes postanesthesia emergence which included ST segment depression and development of refractory ventricular fibrillation, necessitating deployment of venoarterial extracorporeal membrane oxygenation. This patient was eventually stabilized and was taken to the operating room 3 days later for definitive severe supravalvar aortic stenosis repair. Patients with Williams syndrome have a reported risk for sudden cardiac death that is 25 to 100 times greater than that of the age-matched general population. The incidence of adverse cardiac events in our cohort of patients with Williams syndrome undergoing anesthesia was lower compared with previous studies, which reported rates ranging from 4.2% to 11%. These findings support the idea that risk stratification and institutional practice guidelines can aid anesthesia providers in making informed decisions, and standardization of pre-, intra-, and postprocedural care according to existing guidelines may further reduce risks. Our review offers valuable insight into historical anesthesia management and contributes to a broader interdisciplinary understanding of care provision for this high-risk group.
Comparing the Ratios of Height-to-Thyromental Height and Height-to-Thyromental Distance as Pediatric Laryngoscopic Grade Predictors-- A Single-Center Cross-Sectional Study.
Lakshmana S, Dmello PG, Kanakalakshmi ST … +3 more , Kulkarni M, Shenoy L, KrishnaBhat RR
AANA J · 2025 Aug · PMID 40742708 · Publisher ↗
Multiple anatomic bedside screening tools are used in children to predict difficult laryngoscopy. Our study compared ratio of height-to-thyromental height (RHTMH) and height-to-thyromental distance (RHTMD) in forecasting...
Multiple anatomic bedside screening tools are used in children to predict difficult laryngoscopy. Our study compared ratio of height-to-thyromental height (RHTMH) and height-to-thyromental distance (RHTMD) in forecasting children's challenging laryngoscopy grades. This was a single-center, prospective, cross-sectional study in which children aged < 5 years undergoing elective surgery were included. Age, weight, height, body mass index (BMI), TMH, TMD, RHTMH, and RHTMD were documented; Cormack-Lehane grading with Cook's modification grade of laryngoscope view was noted. The primary and secondary outcomes were to determine sensitivity and specificity as well as to determine cut-off values for RHTMH and RHTMD with the highest sensitivity to predict difficult laryngoscopy. One hundred children with a mean age of 2.1 ± 1.6 years, height of 83.17 ± 16.54 cm, weight of 10.47 ± 4.04 kg, and BMI of 14.8 ± 2.68 kg/m were analyzed. Mean TMH, TMD, RHTMH and RHTMD were 4.43 ± 0.62 cm, 4.48 ± 0.66 cm, 18.75 ± 2.69, and 18.55 ± 2.51, respectively. At a cut-off of 19.56 (AUC, 0.714; P = .001), RHTMH showed 81.3% sensitivity and 41.2% specificity, while RHTMD had 84.4% sensitivity and 52.9 % specificity at a cut-off value of 19.14 (AUC, 0.724; = .001) to predict laryngoscopic Grade 2b and above. In children aged < 5 years, both RHTMH and RHTMD were good predictors of difficult laryngoscopy.
Practical Insights and Perspectives: Enhancing CRNA Practice Through Longitudinal Assessment.
Gill C, Berry K, Choudhry SA … +3 more , Ferris M, Muckle TJ, Preston JC
AANA J · 2025 Aug · PMID 40742707 · Publisher ↗
This narrative review examines the implications of longitudinal assessment (LA) for certified registered nurse anesthetists, proposing it as an innovative method to enhance continuous professional development and maintai...
This narrative review examines the implications of longitudinal assessment (LA) for certified registered nurse anesthetists, proposing it as an innovative method to enhance continuous professional development and maintain certification. Grounded in theoretical frameworks such as Miller's Pyramid of Clinical Competence and Moore's Expanded Outcomes Framework, this review explores how LA fosters lifelong learning in healthcare and synthesizes current evidence, detailing the integration of frequent, low-stakes assessments and targeted feedback to support knowledge retention and application. The principles of LA--flexibility, rigor, and relevance--are discussed with its potential to address the evolving demands of clinical practice, ensuring patient safety and competence. Key findings highlight the role of LA in reducing stress associated with traditional high-stakes testing while promoting engagement and critical thinking. This review highlights that LA represents a paradigm shift in healthcare education, aligning assessment methods with modern clinical and educational needs. By fostering continuous learning and adaptability, LA enhances clinician growth and improves patient outcomes. Further research is recommended to optimize LA implementation across diverse healthcare specialties.
Deficiencies of Informed Consent Among Anesthesia Providers: An Integrative Review.
Larsen S, Cova M, Chambers P … +2 more , Greenwood J, Anderson L
AANA J · 2025 Aug · PMID 40742706 · Publisher ↗
The purpose of this review was to identify omissions during the informed consent process by certified registered nurse anesthetists (CRNAs) and physician anesthesiologists that were identified in malpractice claims betwe...
The purpose of this review was to identify omissions during the informed consent process by certified registered nurse anesthetists (CRNAs) and physician anesthesiologists that were identified in malpractice claims between 1990-2022. Secondary aims included identification of injury, court ruling, and violations of patient rights and ethical principles. Abstracts of cases identified through systematic search on the Casetext database were screened for inclusion by the team's legal expert. Inclusion criteria were claims concluding between 1990-2022, failure to obtain informed consent as a primary or secondary claim, and an anesthesia provider as a defendant. Data from the included cases were extracted into a data matrix and presented in data tables to identify themes. Eighty-five cases were found on initial search, and 24 legal cases were included in the review. Defendants included CRNAs, anesthesiologists, employers of anesthesia providers, and anesthesia trainees. Risks associated with the delivery of anesthesia and failure to obtain informed consent before the delivery of anesthesia were the most frequent omissions by anesthesia providers. Patients' right to informed consent was violated in all cases, while the ethical principle of autonomy was violated in 17 cases. Anesthesia providers should consider reevaluating their communication process for informed consent because recent review of claims reveals adequate informed consent is frequently deficient.
The Editor's Desk: Evidenced-Based Practice and Quality Improvement Projects Can Improve Anesthesia Outcomes.
Griffis CA, O'Sullivan C, Aroke EN
AANA J · 2025 Aug · PMID 40742705
Abstract loading — click title to view on PubMed.
Anesthetic Considerations for Maternal-Fetal Interventions.
Twohig B, Walter C, Rachler R … +1 more , Cosgrove M
AANA J · 2025 Jun · PMID 40440201 · Publisher ↗
Advances in diagnosing and managing fetal anomalies have enabled the rapid evolution of maternal-fetal surgery (MFS). These surgeries are broadly categorized as minimally invasive, open, or ex utero intrapartum treatment...
Advances in diagnosing and managing fetal anomalies have enabled the rapid evolution of maternal-fetal surgery (MFS). These surgeries are broadly categorized as minimally invasive, open, or ex utero intrapartum treatment (EXIT) procedures. A multidisciplinary team is required for these techniques with the anesthesia provider playing a pivotal role. A unique aspect of MFS is the need to manage both mother and fetus. Successful delivery of anesthesia requires knowledge of the physiologic changes of pregnancy, fetal physiology, maintenance of uteroplacental blood flow, and mitigating risk of general anesthesia. Additionally, understanding the underlying condition of the fetus and its surgical correction can ensure optimal anesthetic care. Certified registered nurse anesthetists (CRNAs) may have limited experience with MFS, but knowledge of these considerations will enable safer delivery of anesthesia. The type of anesthesia for MFS is determined by the surgical procedure. Open surgeries and EXIT procedures commonly require general anesthesia with fetal immobility, management of uterine atony, and preparation for fetal resuscitation. Minimally invasive procedures are often performed with local anesthesia and maternal sedation. MFS is a growing subspecialty with specific anesthetic considerations that CRNAs should be familiar with. This journal course aims to increase knowledge to promote safe anesthetic care for MFS.
Emergency Surgical Front-of-Neck Airway Access: Effectiveness of a Didactic and Simulation-Based Training Intervention to Improve Performance and Self-Efficacy Among Resident Registered Nurse Anesthetists.
Allen D, Bulick H, Dalley CB … +3 more , Crowell N, Miller C, McAuliffe M
AANA J · 2025 Jun · PMID 40440200 · Publisher ↗
Simulation is a valuable tool for developing technical skills and self-efficacy for high-risk, low-frequency events such as cannot intubate, cannot oxygenate (CICO) scenario. There is a deficiency of evidence regarding C...
Simulation is a valuable tool for developing technical skills and self-efficacy for high-risk, low-frequency events such as cannot intubate, cannot oxygenate (CICO) scenario. There is a deficiency of evidence regarding CICO events and emergency front of neck access training for resident registered nurse anesthetists (RRNAs). This study explored whether a low-fidelity simulation training utilizing a 3D-printed cricothyrotomy task trainer and educational intervention increased self-efficacy, improved performance measures (performance time, performance checklist scores), and increased expert performance levels (performance time, performance checklist score, completion of critical performance checklist steps) regarding scalpel-bougie-tube surgical cricothyrotomy (SBT-SC) among RRNAs. This pilot study utilized a quasiexperimental pretest-posttest design. Ten RRNAs participated in the study. Statistical analysis with paired t-tests demonstrated statistically significant improvement in mean self-efficacy scores (3.13 to 4.5 out of 5, < .001), mean performance completion time (103.5 seconds (SD, 34.5) to 55.9 (SD, 17.9) seconds [ < .001]), mean performance checklist scores (5.5 to 9.1 out of 10, [ < .001]), and completion of critical checklist steps. Six participants completed the postintervention SBT-SC in under 60 seconds while completing all critical checklist steps. One participant met expert performance benchmark criteria following the intervention. This study supports low-fidelity simulation for SBT-SC education and training for RRNAs.
Adopting Transesophageal Echocardiography by CRNAs in Noncardiac Surgery: A Prospective Cohort Observational Study.
Swerdlow B, Osborne-Smith L
AANA J · 2025 Jun · PMID 40440199 · Publisher ↗
This study considered a cohort of 15 practicing certified registered nurse anesthetists (CRNAs) who completed a 1-day didactic and simulation-based workshop on focused transesophageal echocardiography (TEE) for noncardia...
This study considered a cohort of 15 practicing certified registered nurse anesthetists (CRNAs) who completed a 1-day didactic and simulation-based workshop on focused transesophageal echocardiography (TEE) for noncardiac surgery. Data were acquired by survey and knowledge-based testing immediately pre- and postworkshop, and after 3 months. The primary aims of the study were to determine the extent that workshop-trained CRNAs incorporated TEE into their noncardiac surgery practice soon after program completion and to identify perceived barriers to this process. The study also evaluated both initial acquisition and short-term retention of TEE knowledge. CRNA education in focused TEE to provide entry-level skills into practice via a 1-day workshop is feasible, acceptable, and has perceived utility. Preworkshop, 33% of the cohort utilized TEE during noncardiac surgery; 13% who had not previously utilized TEE incorporated it de novo into their practices within 3 months. The most common reason for failure to use TEE during noncardiac surgery postworkshop was lack of a TEE machine or an appropriate surgical patient. Other reasons included lack of a supervising anesthesiologist agreeable to doing so or lack of TEE privileges. As assessed by written evaluation, there was both significant knowledge acquisition and short-term retention associated with this workshop.
A Rare Event With High Acuity: A Case of Autonomic Dysreflexia.
Sullivan E, Husseini A, Easter L
AANA J · 2025 Jun · PMID 40440198 · Publisher ↗
Autonomic dysreflexia (AD) presents a unique circumstance that many learn about in school but seldomly see in clinical practice. In this case study, AD is identified in a higher-level spinal cord injury (SCI) than what i...
Autonomic dysreflexia (AD) presents a unique circumstance that many learn about in school but seldomly see in clinical practice. In this case study, AD is identified in a higher-level spinal cord injury (SCI) than what is typically imagined. In this case, physical and pharmacologic techniques are used to mitigate AD. Additionally, the procedure is still performed using various pharmacologic agents and collaborative efforts from the surgical and anesthesia team. A unique discussion on differentials and treatment options for AD is then presented. In conclusion, anesthesia providers must recognize AD such as triggers, understand signs/symptoms, and administer prompt treatment to ensure safety of SCI patients.
Maternal Health Equity Toolkit for Anesthesia Providers: A Content Validity Study.
Fierros J, Gillespie G, Clayton BA
AANA J · 2025 Jun · PMID 40440197 · Publisher ↗
The purpose of this toolkit is to minimize maternal health disparities by supplying obstetric anesthesia providers with evidence-based recommendations and resources that empower the provision of equitable analgesia and a...
The purpose of this toolkit is to minimize maternal health disparities by supplying obstetric anesthesia providers with evidence-based recommendations and resources that empower the provision of equitable analgesia and anesthesia. Toolkit development was accomplished through an extensive literature review and summary of evidence. The toolkit was critiqued by obstetric care experts for its relevancy, simplicity, clarity, and ambiguity. These data points were evaluated using a content validity index (CVI) process, yielding an overall CVI of 0.94. Three recommendations for improvement in obstetric analgesia and anesthesia care were identified. Recommendation 1 highlighted the need to proactively seek growth and improvement of care delivery through provider education, tracking anesthesia-specific parturient outcomes, and assessing parturient delivery experience. Recommendation 2 identified the need to strengthen parturient-provider relationships with communication, shared decision-making, and diversifying the anesthesia workforce. Recommendation 3 focused on multidisciplinary parturient management through rapid-response teams, performance of emergency drills, and implementation of crisis management checklists to standardize care. Overall, this validated toolkit offers obstetric anesthesia providers evidence-based recommendations and resources to support fair and effective pain relief and anesthesia.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe