Clinical Updates

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  • TEE for Non-Cardiac Surgery

    5/13/2013 Transesophageal echocardiography (TEE) is increasingly becoming an important monitoring tool for noncardiac surgery. Although there are well-established guidelines for cardiac surgery, there is some controversy among clinicians regarding those for noncardiac surgery.

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  • Sugammadex May Be Getting New Life

    3/26/2013 When looking at closed claims data for anesthesia, one particular area where we still struggle is post operative respiratory compromise, and many of the cases are directly related to residual neuromuscular blockade.

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  • Meningitis Outbreak: Confirmed cases increase

    1/25/2013 The national meningitis outbreak has impacted 75 facilities in 23 states, including two facilities in Pennsylvania. Read how this developed and learn the best course of action for patients exposed to suspect lots.

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  • New: CME Journal Articles Available for PSA Members

    8/30/2012

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  • The History of Modern Anesthesia

    5/7/2012 As anesthesiologists, CRNAs, hospital administrators, and health policy experts debate and consider scope of practice and supervision issues for non-physician anesthetists, those supporting a broad scope of practice often point out that nurses, not anesthesiologists, were the first modern anesthesia providers. Most of these historical references are accurate. The question is, what is the significance of this history?

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  • Strategies to Detect Drug- Induced Respiratory Depression

    3/6/2012 APSF believes that clinically significant drug-induced respiratory depression (oxygenation and/or ventilation) in the postoperative period remains a serious patient safety risk that continues to be associated with significant morbidity and mortality since it was first addressed by APSF in 2006.

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  • Airway Fire: Risk and Management

    11/15/2011 The incidence of operating room fires has decreased over the past 100 years as less flammable anesthetic agents are being used. However, it still remains a constant threat to patient safety. It is imperative that all staff not only collaborate to prevent these fires but also understand how to manage them when they do occur.

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  • Peri-operative Diabetes Management for Dummies: Just Check the Sugar!

    9/7/2011 What do we know about peri-operative glucose control? We know that infection rate, length of hospital stay, overall cost for the hospitalization, and morbidity and mortality are directly proportional to peri-operative blood glucose levels. We also know that there are numerous studies demonstrating improved overall outcomes with improved glucose control.

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  • Perioperative Management of Patients with Cardiac Rhythm Management Devices

    8/15/2011 Patients presenting to the operating room or procedure room with a cardiac implantable electronic device (CIED) have become increasingly commonplace, and their devices have become increasingly sophisticated. There is an implicit understanding that patients with a CIED bring with them a complex medical history; a complete understanding of that history is paramount to preparing a skilled anesthesia plan.

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  • Anesthesia Induction Agents

    7/11/2011 Induction of anesthesia is most often achieved using intravenous agents. Inhalational agents can also be used and are particularly useful in children. Propofol, thiopental, etomidate, and ketamine are the most commonly used intravenous agents. While opioids and benzodiazepines can also be used for induction, their use is less common and discussion of these agents is beyond the scope of this clinical review.

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  • Prolonged QT Syndrome: Drug Induced

    6/24/2011 Long QT Syndrome (LQTS) is a disorder of myocardial repolarization that is displayed by a prolonged QT interval on electrocardiogram (EKG). The syndrome can be either congenital or acquired.

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  • Perioperative Cardiovascular Medicine Management

    6/24/2011 As the current population ages and the anesthetic and surgical techniques become safer, we can only expect that the surgical patient population will be presenting at older ages and with more co-morbid conditions. Of the 27 million patients in the United States who are given anesthesia for surgical procedures each year, approximately 8 million have known coronary artery disease or coronary risk factors.1An estimated 50,000 patients who are scheduled to undergo noncardiac surgery will have a perioperative myocardial infarction, and an estimated 1 million patients will have a perioperative cardiac complication.2

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  • Perioperative Corneal Abrasions: Etiology, Prevention, and Management

    1/10/2011 Corneal abrasions are the most frequent ocular complications following general anesthesia, and are a painful burden to the recovering postoperative patient. The most recent (1992) ASA closed claim analysis showed that eye injury occurred in 3 percent of all claims in the database. Of these claims, 35 percent represented corneal abrasions with a 16 percent incidence of permanent eye injury.

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  • Guidelines on Regional Anesthesia in Patients on Antithrombotic Therapy

    3/31/2010 The third edition ASRA guidelines for neuraxial and regional anesthesia in patients on drugs that alter hemostasis were recently published. The authors presented a thorough review of the pharmacologic and scientific data available for several drugs combined with neuraxial anesthesia.

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  • Perioperative Visual Loss

    3/17/2010 The American Society of Anesthesiologists (ASA) established the Postoperative Visual Loss (POVL) Registry in 1999 because of increasing reports of perioperative visual deficits. Debate has ensued that questions whether the incidence of the problem is actually increasing or if increased awareness has resulted in more frequent recognition and reporting. Although uncommon, POVL is devastating for the patient who awakens with visual deficits not present before surgery.

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Anesthesiologists

Physicians Protecting Patients