Emergency Operable Traumatic Pulmonary Injury at a Level 1 Trauma Center: A Retrospective Descriptive Study.

Introduction: Despite the use of body armor, emergency operable pulmonary trauma (EOPT) remains a major cause of battlefield morbidity and mortality. While EOPT during military conflicts has some features that distinguish it from EOPT in civilian settings, the 2 occurrences demonstrate overall parallel findings related to presentation, management, and outcome. The goals of the present study were to provide a descriptive analysis of the nature of EOPT and its management at a level 1 trauma center and to determine the associations between EOPT patient demographics and/or patient management and outcome in order to better understand battlefield EOPT.

Design of a Workshop for Focused Transesophageal Echocardiography During Noncardiac Surgery in Nurse Anesthesia Education.

Objective: The use of transesophageal echocardiography (TEE) by certified registered nurse anesthetists (CRNAs) during noncardiac surgery is relatively uncommon despite its unique potential to diagnose causes of hemodynamic instability. To address this problem, educational endeavors designed to provide practical TEE skills to CRNAs are needed. The aim of the current study was to evaluate the feasibility, acceptability, efficacy, and utility of a 2-day focused TEE workshop in nurse anesthesia education that employed a protocol involving a limited number of views and used goal-directed, qualitative assessments of critical physiologic parameters.

Cognitive Competence and Curriculum Development in Nurse Anesthesia Education: A Pilot Study.

Background: Advanced practice nursing in the United States is shifting toward doctoral certification, most commonly a Doctor of Nursing Practice degree. However, there is limited evidence that this transition improves clinical competence.

Purpose: The aim of this study was to determine whether modifications in a nurse anesthesia curriculum that transitioned from a Master of Nursing to a Doctor of Nursing Practice program were associated with improved cognitive performance using an oral examination.

A Cognitive Template for Management of Perioperative Adverse Events.

Perioperative crisis management commonly involves both rapid generic responses and slower abstract reasoning for the successful management of adverse events. A metacognitive approach to this process offers the potential for minimizing errors and thereby improving outcomes. One such metacognitive technique uses templates that guide dynamic decisionmaking.

Sugammadex: Pharmacometrics, Clinical Utility, and Adverse Effects.

Sugammadex has been used clinically since 2008, and it represents the only cyclodextrin neuromuscular blocking reversal agent currently available for patient care. Sugammadex's unique mechanism of action allows it to reverse the effects of aminosteroid neuromuscular blockade rapidly, and pharmacodynamically predictable doses are selected based on quantitative neuromuscular monitoring. The drug has several potential adverse effects, predominantly related to immediate hypersensitivity reactions and bradyarrhythmias, and it can be costly.

Synchronous Screen-Based Simulation in Anesthesia Distance Education.

Purpose: The aim of the present study was to evaluate the feasibility, acceptability, and utility of synchronous online screen-based simulation (SBS) in anesthesia education.

Methods: The investigational cohort consisted of 12 second-year nurse anesthesia students enrolled in a Doctor of Nursing Practice (DNP) program. Pairs of students worked with a single instructor online using the same SBS employing a cloud-based peer-to-peer platform and high-fidelity software involving a graphical avatar.

Mock Oral Board Examination in Nurse Anesthesia Education.

Background: Despite its widespread use in anesthesia residency training, mock oral board examinations (MOBEs) are not included in the pedagogy of most nurse anesthesia programs (NAPs). A small-scale study was conducted to assess the use of MOBEs in this setting.

Method: The investigational cohort consisted of 10 second-year students in a master's program in nurse anesthesia.

Anesthesiologists Have an Important Role in Preclinical Nurse Anesthesia Education.

Anesthesiologists do not participate regularly in the preclinical portion of nurse anesthesia training programs (NAPs). This practice is predicated on a historical separation of the early educational tracks of physicians and advanced practice nurses whose professions ultimately came to occupy overlapping niches within the field of anesthesia. The state of affairs has been bolstered by territorial friction between professional organizations, and by the lack of a perceived need for anesthesiologists to become involved at an early stage of nurse anesthesia education given the large number of qualified certified registered nurse anesthesia instructors available to perform this role.

Distance Education in Anesthesia Using Screen-Based Simulation - A Brief Integrative Review.

Screen-based simulation (SBS) using digital technology has been demonstrated to improve the cognitive and psychomotor skills of anesthesia trainees. As a method of education and evaluation, this form of simulation offers multiple advantages related to cost, availability, simplicity, repeatability, and scorability. Online use of SBS with software employing standard cloud-based peer-to-peer platforms allows for instruction at a distance of important anesthesia-related critical thinking skills including crisis management.

Surgical smoke and the anesthesia provider.

Surgical smoke generated by use of electrosurgical units (ESUs), lasers, and ultrasonic scalpels constitutes a physical, chemical, and biological hazard for anesthesia personnel. Inhalation of particulate matter with inflammatory consequences, pulmonary injury from products of tissue pyrolysis, exposure to mutagens and carcinogens, and the transmission of human papillomavirus (HPV) and possibly other pathogens represent a spectrum of adverse effects associated with the occupational exposure to surgical plume. While adequate operating room ventilation and use of high filtration-efficiency masks offer some protection from these conditions, the most effective method of safeguarding against surgical smoke involves its removal with a dedicated smoke evacuation device (SED).