The Resurgence of Measles: A Rash From the Past.

Measles, or rubeola, remains a highly contagious infectious disease with a concerning resurgence in the United States. Despite previous control efforts, the number of reported cases continues to rise, surpassing the total for the previous year in just the first quarter of 2024 (CDC, 2024a). Emergency nurse practitioners and other emergency clinicians are likely to encounter patients presenting with concerns of or exposure to measles.

The Development and Validation of an Objective Assessment Tool for Performing Ultrasound-Guided Transversus Abdominis Plane Blocks.

The transversus abdominis plane (TAP) block is a regional anesthesia technique used as part of a multimodal pain management plan in patients undergoing abdominal surgery. There are numerous approaches and techniques described in the literature, resulting in a lack of consistency in block performance. This potentially reduces efficacy while increasing risk to the patient.

Implementation of a Power Down Initiative in 34 Operating Rooms.

Operating rooms (ORs) use energy-intensive equipment such as anesthesia gas machines, patient monitors, and lights. They are major contributors to an institution's carbon footprint; yet ORs are unoccupied 40% of the time. Implementing an initiative to power down electrical devices can reduce energy consumption, equipment failure, and financial outlay.

Implementation of Continuous Capnography Protocol in a Postanesthesia Care Unit for Adult Patients at High-risk of Postoperative Respiratory Depression.

Purpose: This project aimed to implement a continuous capnography protocol in the postanesthesia care unit (PACU) for postoperative adult patients who are at high risk for respiratory failure.

Design: A preintervention and postintervention quality improvement design with retrospective chart reviews evaluated patient demographics (age, weight, body mass index [BMI], perioperative fluid intake and output, use of intraoperative positive-end expiratory pressure), length of surgery, average length of PACU stay, incidence of respiratory events, and adherence to a PACU capnography protocol.

Methods: Preimplementation data were collected from retrospective chart reviews over a 3-month period.

Bilateral Erector Spinae Plane Blocks versus Bilateral Transversus Abdominis Plane Blocks in Patients Undergoing Abdominal Surgery: A Systematic Review and Meta-Analysis.

Postoperative pain associated with abdominal surgeries impairs physical function, delays recovery, and decreases quality of life. Regional anesthetic techniques such as transversus abdominis plane (TAP) block and erector spinae plane (ESP) block are used to improve patients' postoperative pain experiences. PubMed, CINAHL, Google Scholar, Cochrane Library, and gray literature were searched.

Quadratus Lumborum Block and Transversus Abdominis Plane Block in Non-emergency Cesarean Delivery: A Systematic Review and Meta-analysis.

Purpose: Investigate the analgesic efficacy of quadratus lumborum (QL) block versus transversus abdominis plane (TAP) block in postoperative pain management in nonemergent cesarean section.

Design: Systematic review with meta-analysis.

Methods: PubMed, Cochrane, CINAHL, Google Scholar, and gray literature were searched for evidence.

Atopic Dermatitis: A Common Pediatric Diagnosis That Is Not Just Another Rash.

Emergency nurse practitioners are expected to assess and manage a variety of patients. These patients may present with urgent care-type complaints to severe life-threatening illnesses or injuries. For some, dermatological problems can sometimes be just as challenging as a critically ill patient.

Intraoperative hypotension in ambulatory surgery centers.

Study Objectives: To measure the incidence of intraoperative hypotension (IOH) during surgery in ambulatory surgery centers (ASCs) and describe associated characteristics of patients and procedures.

Design: Retrospective analysis.

Setting: 20 ASCs.

Assessment Tools for the Evaluation of Simulation-Based Competency In Ultrasound-Guided Regional Anesthesia: An Integrative Review.

Ultrasound-guided regional anesthesia (UGRA) requires the interaction of technical skills, manual dexterity, and cognitive knowledge which many novice anesthesia providers find challenging. Although simulation improves clinical competency and enhances patient safety, there is no standard tool for assessing UGRA competency in the simulation setting. Therefore, this integrative review aims to determine the most accurate, reliable, and feasible method of evaluating UGRA competency in a simulation environment.

Efficacy and Safety of Buprenorphine in a Single-Shot Peripheral Nerve Block: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The purpose of this study was to evaluate the safety and efficacy of buprenorphine compared with placebo in prolonging the duration of analgesia in single-injection peripheral nerve block. The systematic review and meta-analysis were conducted following the PRISMA statement and Review Manager was used for meta-analysis. Outcomes were calculated using the mean difference (MD) with 95% confidence interval (CI) for continuous data.

Improved Technical Skill and Procedure Time With Central Venous Catheter Simulation.

Simulation manikins provide anesthetists a training modality to practice ultrasound-guided central venous catheter (CVC) insertion safely without the risk of patient harm. The goals of this quality improvement (QI) project were to increase technical skills and reduce procedure time among anesthesia providers during CVC placement by implementing an ultrasoundguided, simulated CVC insertion workshop. A primary benefit of simulation-based education is the provision of a safe learning environment-one in which learners and providers may practice and increase skillsets.

Improving Anesthesia Providers' Needle Cricothyrotomy Success With Ultrasound-Guidance: A Cadave Quality Improvement Project.

Difficult and failed airway management remains a significant cause of anesthesia-related morbidity and mortality. Failed airway management guidelines include performing a cricothyrotomy as a final step. Correct identification of the cricothyroid membrane (CTM) is essential for safe and accurate cricothyrotomy execution.

Incorporating Evidence-Based Ultrasound-Guided Vascular Access (USGVA) Standards Into the Nurse Anesthetist Armamentarium: A Quality Improvement Project.

Purpose: This quality improvement (QI) project developed and implemented a hybrid training program, that included online modules and hands-on training for experienced certified registered nurse anesthetists (CRNAs) to increase confidence, knowledge, and competency with ultrasound-guided vascular access (USGVA).

Design: This QI project used a pre-post design. Seventeen volunteer CRNAs participated in USGVA training and education, and a 90-day follow-up assessment was performed.

Assessing Provider Adherence To A Lung Protective Ventilation Protocol In Patients Undergoing Thoracic Surgery Using One-Lung Ventilation.

Patients undergoing one-lung ventilation (OLV) are at risk for lung injury leading to postoperative pulmonary complications (PPCs). Lung protective ventilation (LPV) challenges traditional anesthetic management by using lower tidal volumes, individualized positive end-expiratory pressure (PEEP), and recruitment maneuvers (RMs). LPV reduces driving pressure when properly applied, which reduces the incidence of PPCs.

Compliance With Opioid Disposal Following Opioid Disposal Education in Surgical Patients: A Systematic Review.

Purpose: The present opioid epidemic in the United States is a significant cause for concern in healthcare. In 1995, the concept of pain was introduced as the fifth vital sign. Since then, the sales of opioids have increased dramatically, as have the number of opioid deaths.

Surgical Patient Compliance With Healthcare Facility-Provided In-home Opioid Disposal Products: A Systematic Review.

Objective: The aim of this study was to review the literature regarding the use of an in-home opioid disposal product on unused opioids after surgery.

Background: The opioid epidemic in the United States is a major cause of concern for healthcare facilities. The misuse and diversion of retained opioids after a surgical procedure continues to contribute to this problem.

A New Rash Differential: CoVID-19.

The CoVID-19 pandemic has impacted all areas of health care, especially emergency medicine. Most commonly, CoVID-19 is associated with respiratory and typical viral presentations. However, nonrespiratory presentations are becoming more common.

Substance Abuse and Misuse Identification and Prevention: An Evidence-Based Protocol for CRNAs in the Workplace.

Healthcare providers are susceptible to substance abuse, and anesthesia personnel are some of the most vulnerable. Substance abuse is the principal cause of professional impairment for Certified Registered Nurse Anesthetists (CRNAs), with 1 of 10 experiencing addiction to drugs or alcohol. Despite this problem, there is no standardized screening protocol for the identification of substance abuse or misuse for CRNAs.

Effect of Simulation Training on Cognitive Performance Using Transesophageal Echocardiography.

Simulation is used in anesthesia training to reinforce didactic learning. The authors hypothesized that knowledge acquisition in the use of transesophageal echocardiography (TEE) could be accomplished better through the use of a simulator than with online or web-based learning. A total of 71 student registered nurse anesthetists were randomly assigned to either web-based or simulator-based TEE training.