Feasibility and Acceptability of a Low-Tech Simulation Using Local Resources in a Rural Community Hospital.

Simulation is an effective tool to learn or refresh skills and knowledge, but numerous barriers prevent the routine use of simulation. The purpose of this project was to assess the feasibility and acceptability of the use of a low-tech simulation kit by the hospital's personnel for overcoming those barriers. A phenomenological qualitative approach using semistructured interviews was conducted with a convenience sample of 5 Certified Registered Nurse Anesthetists (CRNAs) and a student registered nurse anesthetist at a rural community hospital.

Accuracy of Capillary and Arterial Whole Blood Glucose Measurements Using a Glucose Meter in Patients under General Anesthesia in the Operating Room.

Background: The aim of this study was to evaluate the use of a glucose meter with surgical patients under general anesthesia in the operating room.

Methods: Glucose measurements were performed intraoperatively on 368 paired capillary and arterial whole blood samples using a Nova StatStrip (Nova Biomedical, USA) glucose meter and compared with 368 reference arterial whole blood glucose measurements by blood gas analyzer in 196 patients. Primary outcomes were median bias (meter minus reference), percentage of glucose meter samples meeting accuracy criteria for subcutaneous insulin dosing as defined by Parkes error grid analysis for type 1 diabetes mellitus, and accuracy criteria for intravenous insulin infusion as defined by Clinical and Laboratory Standards Institute guidelines.

Does low-dose droperidol increase the risk of polymorphic ventricular tachycardia or death in the surgical patient?

Background: The Food and Drug Administration issued a black box warning regarding the use of droperidol and the potential for torsade de pointes.

Methods: The primary objective of this retrospective study was to determine if low-dose (0.625 mg) droperidol administration was associated with episodes of torsade de pointes in the general surgical population during the 3-yr period following the reinstitution of droperidol to our institutional formulary.

Tobacco intervention attitudes and practices among certified registered nurse anesthetists.

Background: The period before surgery represents an opportunity for perioperative nurses, including certified registered nurse anesthetists (CRNAs), to address the tobacco use of their patients.

Objective: To assess the current practices and attitudes of CRNAs toward tobacco interventions.

Methods: A survey assessing current attitudes, practices and beliefs, and respondent demographics was mailed to 1,000 practicing CRNAs randomly selected from the membership of the American Association of Nurse Anesthetists, with one follow-up reminder.

Does low-dose droperidol administration increase the risk of drug-induced QT prolongation and torsade de pointes in the general surgical population?

Background: The US Food and Drug Administration issued a black box warning regarding the use of droperidol and the potential for torsade de pointes (TdP).

Methods: The primary objective of this retrospective study was to determine whether low-dose droperidol administration increased the incidence of TdP in the general surgical population during a 3-yr time period before and after the Food and Drug Administration black box warning. A random sample of 150 surgical patients during each time interval was selected to estimate the droperidol use for each time period.

Anesthetic care of the trauma patient: development of a Web-based resource.

Adequate preparation by anesthesia providers promotes quality care and decreases the likelihood of morbidity and mortality. Unfortunately, many trauma cases occur after hours when support resources are less readily available. At a large midwest academic medical center, it was determined that a website on the institution's Intranet relating to anesthetic care of trauma patients would be a readily accessible, user-friendly resource for improved care.

A prospective study on anesthesia machine fault identification.

Background: Although few studies have been performed recently, several have suggested that some practitioners are not well able to detect preset anesthesia machine faults.

Methods: We performed a prospective study to determine whether there is a correlation between duration of anesthesia practice and the ability to detect anesthesia machine faults. Our hypothesis was that more anesthesia practice would increase the ability to detect anesthesia machine faults.

Update for nurse anesthetists--anesthetic considerations for patients with amyloidosis.

Amyloidosis is a rare disease process that results in the deposition of insoluble, fibrous amyloid proteins in extracellular spaces and tissues. Amyloid fibrils can be deposited locally or may involve every organ system of the body. Advancements in the treatment for amyloidosis allow longer survival, and patients are being seen in our operating rooms for diagnostic, interventional, and curative purposes.

Changing incidence, type, and natural history of conduction defects after coronary artery bypass grafting.

Background: Cardiac conduction defects occur after cardiac surgery. We hypothesized that population aging and increased use of beta-blockers would increase the incidence of new conduction defects after coronary surgery.

Methods: We examined the medical records of 800 coronary artery bypass grafting (CABG) patients (400 from 1991 and 400 from 2001).

Childhood airway manifestations of lymphangioma: a case report.

Lymphangioma is a congenital malformation of the lymphatic system, often involving areas of the head and neck. The involved structures may include enlarged tongue and lips, swelling of the floor of the mouth, and direct involvement of the upper respiratory tract. The definitive treatment for lymphangioma is surgery, often during the first years of life.