October 2020

Our Founders and Their Gift of Core Principles

October 1, 2020

Thirty-five years ago, leaders from the American Society of Anesthesiologists (ASA) and corporations that provided key technologies and pharmaceuticals for anesthesia practices joined forces through the establishment of the Anesthesia...

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The International APSF Newsletter Community Continues to Grow

October 1, 2020

When the APSF was founded in 1985, safety issues in anesthesia in Japan were more of a personal nature involving ethics and discipline. The importance of keeping direct physical contact...

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ASA 1986 Monitoring Standards Launched New Era of Care, Improved Patient Safety

October 1, 2020

Anesthesia professionals who trained after the late 1980s have never known a time without “routine ASA monitors,” often represented on the anesthesia record by a check box indicating...

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“What Then?” and “What Now?” 35th Anniversary Edition of the APSF Newsletter

October 1, 2020

Ten years ago, the APSF Newsletter celebrated its 25th year “Silver” Anniversary. In that commemorative edition, John Eichhorn, MD recapped the creation of the APSF and...

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June 2020

Ketamine: A Review of an Established Yet Often Underappreciated Medication

June 1, 2020

The Origin of Ketamine Since its synthesis in a Detroit laboratory nearly six decades ago, ketamine has proven to be a complex medication with unusual properties, heterogeneous, interconnected mechanisms, and...

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Successful Evidence-Based International Emergency Manual Implementation Strategy

June 1, 2020

It has been suggested that increasing access to resources and decreasing reliance on rote memory are two potential methods to combat medical errors;1 both of which can be achieved through...

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Safety and Utility of Nitrous Oxide for Labor Analgesia

June 1, 2020

This article pertains to non-COVID-19 patient care. There is currently insufficient information about the cleaning, filtering, and potential for aerosolization associated with use of nitrous oxide for labor analgesia in...

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The Anesthesia Professional’s Role in Opioid Stewardship

June 1, 2020

Introduction Health care professional-prescribed opioids have played a significant role in the growing opioid epidemic. In 2017, more than 70,000 drug-related deaths occurred in the United States with over 47,000...

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Educating the Next Generation: A Curriculum for Providing Safe Anesthesia in Office-Based Surgery

June 1, 2020

Introduction In 1979, fewer than 10% of all surgeries were performed as outpatient procedures. In just about 25 years, approximately 70% of operative procedures have evolved beyond the walls of...

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Malignant Hyperthermia Preparedness: Stocking, Drilling, and Offsite Considerations

June 1, 2020

Introduction This July marks the 60th anniversary of the publication of a Letter to the Editor describing the inherited condition, now known as Malignant Hyperthermia (MH), in a young man...

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Gas Embolism Events in GI Endoscopy: What We Know Now and How We Can Mitigate Them Through the Routine Use of CO2 Insufflating Gas Instead of Air

June 1, 2020

There is an accumulating pulmonary and/or cardiac adverse event case experience arising out of gastroenterology (GI) endoscopy suites. High morbidity and mortality embolic events have been reported when the insufflating...

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Cardiopulmonary Sentinel Event During Endoscopic Retrograde Cholangiopancreatography (ERCP): Oversedation or Gas Embolism?

June 1, 2020

Introduction Gas embolism occurring during endoscopy procedures such as endoscopic retrograde cholangiopancreatography (ERCP), where a mucosal membrane is breached is a rare, but potentially devastating complication that can cause permanent...

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When Medical Equipment Standards Fail to Protect Patients

June 1, 2020

Standards applied to the design of medical equipment have a variety of purposes, with patient safety being paramount. In this issue of the APSF Newsletter, we have two examples where...

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Drug Swaps and Compressed Medical Gases

June 1, 2020

Introduction Safety standards for compressed medical gases and their labelling and delivery have improved over the last several decades. But despite efforts to strengthen standards for labeling and administration of...

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Misfilling the Exhausted Vaporizer

June 1, 2020

A 61-year-old male was urgently taken to the operating room for removal of infected pelvic hardware. Shortly after induction, both isoflurane and sevoflurane appeared on the display (Figure 1), despite...

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Effective Leadership and Patient Safety Culture

June 1, 2020

Effective leadership is necessary in medicine to foster an organizational climate that promotes patient safety. Leadership is the cornerstone of success to any project or business. Effective leaders lead by...

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Postoperative Recurarization After Sugammadex Administration Due to the Lack of Appropriate Neuromuscular Monitoring: The Japanese Experience

June 1, 2020

Sugammadex rapidly reverses neuromuscular blockade via selective encapsulation of rocuronium and other nondepolarizing aminosteroid muscle relaxants. Since its 2010 launch in Japan, sugammadex has been administered to an estimated...

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An Update on the Perioperative Considerations for COVID-19 Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)

June 1, 2020

The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) continues to have a profound impact on life across the globe and has placed an enormous strain on...

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April 2020

COVID-19 Pandemic—Decontamination of Respirators and Masks for the General Public, Health Care Workers, and Hospital Environments

April 27, 2020

There is a serious shortage of respirators and masks that are essential for the protection of frontline healthcare workers and for the mitigation of community transmission during...

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February 2020

Perils and Pitfalls With the Rapid Infusion Catheter (RIC)

February 1, 2020

Dear Rapid Response: Introduction The rapid infusion catheter (RIC) is a device used to convert standard peripheral intravenous (PIV) access into a large-volume resuscitation portal.1 The placement of this large-bore...

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