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AANA Journal

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https://www.readbyqxmd.com/read/28182855/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#1
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United states. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effot to reduce the incidence of surgical site infection...
February 6, 2017: AANA Journal
https://www.readbyqxmd.com/read/28235177/aana-journal-course-update-for-nurse-anesthetists-part-5-use-of-tranexamic-acid-in-preventing-postpartum-hemorrhage
#2
Derrick C Glymph, Tito D Tubog, Mariya Vedenikina
Postpartum hemorrhage (PPH) continues to be a serious complication in both developed and underdeveloped countries. It remains the leading cause of maternal mortality in underdeveloped countries. Implementation of the World Health Organization guidelines of PPH treatment has reduced mortality. In addition, the prophylactic administration of tranexamic acid with uterotonic agents may contribute to the reduction of PPH. This evidence-based literature review of tranexamic acid will examine its mechanism of action as well as its effectiveness in prevention of PPH and blood loss reduction in elective surgery, obstetrics, and trauma...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235176/laryngeal-mask-airway-and-valsalva-maneuver-during-ophthalmic-surgery-a-case-report
#3
Pamela Lovett, Rebecca Klingbeil, Ronald Reimer, Timothy Shine
The use of a supraglottic airway, also called laryngeal mask airway (LMA), is gaining in popularity for delivery of general anesthesia in certain situations and is shown to be safe. Use of infraglottic airways (tracheal tubes) allows for positive pressure ventilation and maneuvers, such as holding continuous positive pressure in the airway to check for pleural and dural leaks. We describe the successful use of the LMA (Teleflex Inc) for general anesthesia, in which continuous positive airway pressure of 15 cm H2O held for 20 seconds allowed the neurosurgeon to identify the site of a cerebrospinal fluid (CSF) leak and successfully repair the leak...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235175/laryngospasm-as-a-cause-of-unsuccessful-placement-of-laryngeal-mask-airway-proseal-a-case-report
#4
Geetanjali T Chilkoti, Medha Mohta, Sai Janani
Laryngospasm is a potential complication encountered during anesthesia using a laryngeal mask airway (LMA). We report a case in which laryngospasm resulted in unsuccessful placement of an LMA ProSeal Airway (Teleflex Inc), and we discuss the various causes of unsuccessful placement of this type of airway device. Laryngospasm causes increased resistance to gas flow by inducing closure of vocal cords, aryepiglottic fold, and periglottic tissue. In this case report, the laryngospasm-induced increased resistance to gas flow was manifested by exaggerated outward movement of the LMA ProSeal following its connection to gas flows and thus resulted in failed airway placement...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235174/low-dose-vasopressin-and-analogues-to-treat-intraoperative-refractory-hypotension-in-patients-prescribed-angiotensin-converting-enzyme-inhibitors-undergoing-general-anesthesia-a-systematic-review
#5
Kara F Hedman, Carrie L Mann, Cheryl Spulecki, Jessica Castner
This review assessed the utility of vasopressin and vasopressin analogues for the treatment of refractory hypotension associated with angiotensin-converting enzyme (ACE) inhibitors in the perioperative setting. A systematic review of the literature was conducted using MEDLINE, Embase, and ProQuest. Six randomized controlled trials met eligibility criteria. In the perioperative setting, continued use of ACE inhibitors within 24 hours before surgery remains controversial. Authors of the reviewed studies suggested that the morning dose of the ACE inhibitor be held, and those patients experienced decreased catecholamine use postoperatively and shorter duration of decreased mean arterial pressure...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235173/a-patient-safety-dilemma-obesity-in-the-surgical-patient
#6
Victoria Goode, Elayne Phillips, Pamela DeGuzman, Ivora Hinton, Virginia Rovnyak, Kenneth Scully, Elizabeth Merwin
Patient safety and the delivery of quality care are major concerns for healthcare in the United States. Special populations (eg, obese patients) need study in order to support patient safety, quantify risks, advance education for healthcare-workers, and establish healthcare policy. Obesity is a complex chronic disease and is considered the second leading cause of preventable death in the United States with approximately 300,000 deaths per year. Obesity is recognized by the Agency for Healthcare Research and Quality (AHRQ) as a comorbid condition...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235172/exploring-strategies-to-increase-and-sustain-membership-in-the-american-association-of-nurse-anesthetists
#7
Cynthia Ann Farina, Wanda Wilson, Kim FitzSimmons
The total numbers of Certified Registered Nurse Anesthetists (CRNAs) in the United States and members of the American Association of Nurse Anesthetists (AANA) have risen to an all-time high. However, the percentage of CRNAs who are AANA members has been slowly declining since 2006, particularly among newly certified nurse anesthetists. To develop new strategies to increase and sustain CRNA membership, the AANA conducted a translational research project that explored evidence-based determinants of individuals' decisions to join professional associations, current membership practices and patterns, results of a recent member needs survey, and socialization of student registered nurse anesthetists (SRNAs) into the AANA...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235171/the-editor-s-desk-science-and-clinical-potpourri-for-your-life-and-your-practice
#8
EDITORIAL
(no author information available yet)
No abstract text is available yet for this article.
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235170/legal-briefs-navigating-the-captain-of-the-ship-argument
#9
Mark J Silberman
No abstract text is available yet for this article.
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235169/letters-effect-of-ultrasound-guided-placement-of-difficult-to-place-peripheral-venous-catheters-a-prospective-study-of-a-training-program-for-nurse-anesthetists
#10
LETTER
https://www.readbyqxmd.com/read/28235168/guest-editorial-active-shooter-are-we-complacent
#11
EDITORIAL
Brenda Wands
No abstract text is available yet for this article.
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28366961/in-defense-of-p-values
#12
Brad Verhulst
P values have become the scapegoat for a wide variety of problems in science. P values are generally over-emphasized, often incorrectly applied, and in some cases even abused. However, alternative methods of hypothesis testing will likely fall victim to the same criticisms currently leveled at P values if more fundamental changes are not made in the research process. Increasing the general level of statistical literacy and enhancing training in statistical methods provide a potential avenue for identifying, correcting, and preventing erroneous conclusions from entering the academic literature and for improving the general quality of patient care...
October 2016: AANA Journal
https://www.readbyqxmd.com/read/27501656/tranexamic-acid-in-anesthetic-management-of-surgical-procedures
#13
Jessica Mayeux, Kathy Alwon, Shawn Collins, Ian Hewer
Blood loss during surgical procedures poses a grave risk to the patient, but transfusion is costly and associated with adverse outcomes. Antifibrinolytics, however, offer an economical and effective means of decreasing blood loss associated with surgical procedures. Tranexamic acid (TXA) is an antifibrinolytic that blocks lysine-binding sites of fibrinogen and fibrin, preventing the breakdown of existing clots. This journal course reviews extensive research demonstrating that antifibrinolytics such as TXA decrease blood loss and in some studies reduce allogeneic transfusion requirements...
June 2016: AANA Journal
https://www.readbyqxmd.com/read/27501655/unknown-pseudocholinesterase-deficiency-in-a-patient-undergoing-tiva-with-planned-motor-evoked-potential-monitoring-a-case-report
#14
Candace Binkley
Pseudocholinesterase abnormalities are a genetic cause of aberrant metabolism of the depolarizing muscle relaxant succinylcholine. This article examines a case where succinylcholine was chosen to facilitate intubation due to its ultra short duration and the request of the surgeon to monitor motor evoked potentials. Following succinylcholine administration the neurophysiologist was unable to obtain motor evoked potentials. This case study highlights the intraoperative and postoperative management of an elderly patient with an unknown pseudocholinesterase deficiency...
June 2016: AANA Journal
https://www.readbyqxmd.com/read/27501654/preventive-dorzolamide-timolol-for-rising-intraocular-pressure-during-steep-trendelenburg-position-surgery
#15
RANDOMIZED CONTROLLED TRIAL
Bonnie Lee Molloy, Xiamei Cong, Charles Watson
The study purpose was to evaluate preventive use of dorzolamide-timolol ophthalmic solution (Cosopt) during laparoscopic surgery with the patient in steep Trendelenburg (ST) position. Periorbital swelling, venous congestion, and elevated intraocular pressure (IOP) may produce low ocular perfusion. Prompt IOP reduction is important because 30- to 40-minute episodes of acute IOP elevations can result in retinal ganglion cell dysfunction. Dorzolamide-timolol ophthalmic drops reduce IOP and may ameliorate this effect...
June 2016: AANA Journal
https://www.readbyqxmd.com/read/27501653/anesthetic-considerations-of-stiff-person-syndrome-a-case-report
#16
REVIEW
Kristi Hylan, An-Duyen Nguyen Vu, Katherine Stammen
Stiff-person syndrome (SPS) is a neurologic disorder characterized by painful involuntary episodes of severe muscle rigidity affecting the axial muscles and extremities. Although the etiology of SPS is unknown, it is suspected to involve the synthesis of γ-aminobutyric acid (GABA). Symptoms of SPS are precipitated by sudden unexpected movements, noises, and stress. Additionally, SPS has been linked with various autoimmune disorders, including diabetes mellitus, thyroid disease, pernicious anemia, and certain cancers...
June 2016: AANA Journal
https://www.readbyqxmd.com/read/27501652/the-jehovah-s-witness-population-considerations-for-preoperative-optimization-of-hemoglobin
#17
Yasmine N Campbell, Melissa D Machan, Marquessa D Fisher
Most members of the Jehovah's Witness community refuse blood transfusions, and there are variations in what alternatives they will accept depending on their personal decisions. To provide culturally competent care, healthcare providers need to be knowledgeable about substitutions for blood administration as well as the risks and benefits of available alternatives so that they can inform their patients. It has been recognized in the literature that preoperative optimization of hemoglobin levels with alternative treatment modalities through a multidisciplinary approach can improve clinical outcomes in patients who refuse blood products...
June 2016: AANA Journal
https://www.readbyqxmd.com/read/27501651/venous-thromboembolism-prophylaxis-in-plastic-surgery-a-literature-review
#18
REVIEW
Sergio Hernandez, Jorge Valdes, Moises Salama
Venous thromboembolism (VTE) is a major health concern because it increases morbidity and mortality after a surgical procedure. A number of well-defined, evidence-based guidelines are available delineating suitable use of prophylaxis to prevent deep vein thrombosis and pulmonary embolism. Despite the available literature, there are clear gaps between recommendations and clinical practice, affecting the incidence of VTE. Plastic surgeons underuse the substantiated literature and risk stratification tools that are available to decrease the incidence of VTE in the office-based surgical setting because of fear of bleeding or hematoma complications postoperatively...
June 2016: AANA Journal
https://www.readbyqxmd.com/read/27501650/effects-of-a-30-ml-epidural-normal-saline-bolus-on-time-to-full-motor-recovery-in-parturients-who-received-patient-controlled-epidural-analgesia-with-0-125-bupivacaine-with-2-%C3%A2%C2%B5g-ml-of-fentanyl
#19
RANDOMIZED CONTROLLED TRIAL
Darren Couture, Lisa Osborne, Jeffery A Peterson, Sharon M Clements, Andrew Sanders, Julie A Spring, Dennis L Spence
Previous research suggests that an epidural bolus of 30 mL of normal saline after vaginal delivery may decrease the time for recovery from motor block. A double-blind, randomized controlled study was conducted in 46 parturients to determine if a 30-mL normal saline bolus or sham administered via epidural approach after delivery reduces the time to full motor recovery and the time to 2-dermatome regression. No significant difference was found in time to full motor recovery (saline group 83.18 ± 54 minutes vs control group 100...
June 2016: AANA Journal
https://www.readbyqxmd.com/read/27501649/hazardous-intraoperative-behaviors-what-s-at-risk
#20
LETTER
Joshua Philippon
No abstract text is available yet for this article.
June 2016: AANA Journal
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