Initial Impact of the COVID-19 Pandemic on Physician Assistant Education.

Purpose: The COVID-19 pandemic significantly impacted United States (US) health professions educational programs. Physician assistant (PA) programs were forced to respond to rapidly changing circumstances early in the pandemic. This study describes the impact that the early phase of the COVID-19 pandemic had on PA programs in the United States.

Utilization of Thromboelastography with Platelet Mapping to Predict Infection and Poor Wound Healing in Postoperative Vascular Patients.

Background: Postoperative infection and wound dehiscence rates are higher than expected in peripheral artery disease and contribute significantly to limb loss and mortality. Microvascular pathology characterized by microthrombi and increased platelet aggregation have been cited as contributing factors to poor wound healing and infection. The emergence of viscoelastic assays, such as thromboelastography with platelet mapping (TEG-PM), have been utilized to identify prothrombotic states and may provide insight into a patient's microvascular coagulation profile.

The Evolution of the Anesthesia Patient Safety Movement in America: Lessons Learned and Considerations to Promote Further Improvement in Patient Safety.

Ellison C. Pierce, Jr., M.

Pediatric hemispherectomy outcome: Adaptive functioning, intelligence, and memory.

Objective: Our purpose was to characterize neuropsychological evaluation (NP) outcome following functional hemispherectomy in a large, representative cohort of pediatric patients.

Methods: We evaluated seizure and NP outcomes and medical variables for all post-hemispherectomy patients from Seattle Children's Hospital epilepsy surgery program between 1996 and 2020. Neuropsychological evaluation outcome tests used were not available on all patients due to the diversity of patient ages and competency that is typical of a representative pediatric cohort; all patients had at least an adaptive functioning or intelligence measure, and a subgroup had memory testing.

Pulmonary Aspiration of Gastric Contents: A Closed Claims Analysis.

Background: Perioperative pulmonary aspiration of gastric contents has been associated with severe morbidity and death. The primary aim of this study was to identify outcomes and patient and process of care risk factors associated with gastric aspiration claims in the Anesthesia Closed Claims Project. The secondary aim was to assess these claims for appropriateness of care.

Perioperative Ulnar Neuropathy: A Contemporary Estimate of Incidence and Risk Factors.

Background: Retrospective and prospective studies 2 decades ago from the authors' institution reported the incidence of perioperative ulnar neuropathy persisting for at least several months in a noncardiac adult surgical population to be between 30 and 40 per 100,000 cases. The aim of this project was to assess the incidence and explore risk factors for perioperative ulnar neuropathy in a recent cohort of patients from the same institution using a similar definition for ulnar neuropathy.

Methods: We performed a retrospective incidence and case-control study of all adults (≥18 years) undergoing noncardiac procedures with anesthesia services between 2011 and 2015.

Postoperative nausea and vomiting after bariatric surgery and dexmedetomidine anesthetic: a propensity-weighted analysis.

Background: Patients undergoing laparoscopic bariatric surgery have high rates of postoperative nausea and vomiting (PONV). Dexmedetomidine based anesthetic could reduce PONV rates.

Objectives: To determine if PONV rates differ in patients undergoing laparoscopic bariatric surgery with anesthesia primarily based on dexmedetomidine or standard anesthetic management with inhalational agents and opioids.

Black Seed Oil and Perioperative Serotonin Syndrome: A Case Report.

Perioperative serotonin syndrome has been associated with a number of medications and herbal supplements. We report a patient who developed serotonin syndrome immediately after an endoscopic procedure in which the preoperative use of black seed oil appears to have played a role in stimulating the syndrome. Black seed oil has not been previously reported in association with perioperative serotonin syndrome.

Postoperative pulmonary complications in contemporary cohort of patients with pulmonary hypertension.

Patients with pulmonary hypertension are at increased risk for postoperative pulmonary complications (PPCs). Herein, we review PPCs in pulmonary hypertension patients undergoing non-cardiac procedures under general anesthesia. The medical records of pulmonary hypertension patients who underwent surgery with general anesthesia between 2010 and 2017 were reviewed for PPCs.

Respiratory Depression Following Ambulatory Urogynecologic Procedures: A Retrospective Analysis.

Objective: To assess the rate of postanesthesia respiratory depression (RD) and test for potential associations with clinical characteristics of patients undergoing urogynecologic procedures at ambulatory surgical centers (ASCs). Postanesthesia RD is poorly characterized for patients undergoing urogynecologic procedures in ASCs.

Patients And Methods: Health records of adult patients undergoing urogynecologic procedures at an ASC from July 1, 2010, through December 31, 2015, were abstracted.

Anesthesia recovery after ophthalmologic surgery at an ambulatory surgical center.

Purpose: To examine anesthesia recovery duration after ophthalmologic procedures performed at an ambulatory surgical center (ASC) and provide information that could be used to increase postanesthesia recovery unit efficiency.

Setting: Ambulatory surgical center at tertiary medical center, Rochester, Minnesota, USA.

Design: Retrospective case series.

A National Survey of Quality Improvement Education in Physician Assistant Programs.

Purpose: Quality improvement (QI) is emerging as a leadership and career track for physician assistants (PAs). Information on how PA programs teach QI is sparse. This study aimed to define how PA programs are providing education in QI through a national program survey.

Outpatient Dismissal With a Responsible Adult Compared With Structured Solo Dismissal: A Retrospective Case-Control Comparison of Safety Outcomes.

Objective: To test the hypothesis that patients dismissed alone in a sedation dismissal process (SDP) have no greater risk of adverse outcome compared with those who were dismissed with a responsible adult.

Patients And Methods: We compared 2441 SDP patients undergoing 2703 procedures with 4923 unique control patients who underwent 5133 procedures between June 1, 2012, and March 31, 2017.

Results: The rate of unplanned readmission related to the procedure was 0.

Safety of Sedation for Patients Undergoing Bone Marrow Biopsy and Aspiration While Febrile.

Objective: To determine the risks and outcomes of providing sedation to febrile patients scheduled for bone marrow aspiration or biopsy procedures.

Patients And Methods: During the 4-year period from January 1, 2013, through December 31, 2016, data from the periprocedural courses of 12,134 consecutive patients in an outpatient procedure center at a large tertiary medical center were collected retrospectively and analyzed to determine whether febrile patients undergoing bone marrow aspiration and/or biopsy with propofol sedation present a unique patient safety risk.

Results: Eighty-four patients (0.

Scheduling the nonoperating room anesthesia suite.

Purpose Of Review: Nonoperating room anesthesia (NORA) and procedural services often are associated with dispersed geographic settings and small volumes of cases. These lead to scheduling challenges that, if not managed well, result in decreased patient and healthcare team satisfaction and reduced efficiency. This review describes recent studies and provides examples on how NORA scheduling issues have been addressed.

Anesthetic Considerations for Angelman Syndrome: Case Series and Review of the Literature.

Background: Angelman syndrome is a rare neurodevelopmental disorder characterized by intellectual disability, severe speech impairment, ataxia, seizures, happy demeanor, distinctive craniofacial features, high vagal tone, and gamma-amino butyric acid receptor abnormalities. The aim of this report is to review our experience of patients with Angelman syndrome undergoing anesthetic management.

Methods: We retrospectively reviewed perioperative course of patients with Angelman syndrome who underwent procedures under anesthesia from 2000 to 2016.

Same-Day Cancellation in Ambulatory Surgery: A Retrospective Review at a Large Academic Tertiary Referral Center.

Although ambulatory surgery offers patients convenience and reduced costs, same-day cancellation of ambulatory surgery negatively affects patient experiences and operational efficiency. We conducted a retrospective analysis to determine the frequency and reasons for same-day cancellations in an outpatient surgery center at a large academic tertiary referral center. Of 41 389 ambulatory surgical procedures performed, same-day cancellations occurred at a rate of 0.

Patients with glycogen storage diseases undergoing anesthesia: a case series.

Background: Glycogen storage diseases are rare genetic disorders of glycogen synthesis, degradation, or metabolism regulation. When these patients are subjected to anesthesia, perioperative complications can develop, including hypoglycemia, rhabdomyolysis, myoglobinuria, acute renal failure, and postoperative fatigue. The objective of this study was to describe the perioperative course of a cohort of patients with glycogen storage diseases.