October 2012

Direct vs. Videolarnygoscopy: Prioritization in Training

October 10, 2012

In My Opinion While attending a national anesthesiology conference 2 years ago, a colleague and his spouse strolled through the exhibit area and stopped at the booth sponsored by a...

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Swab All Vials With Alcohol

October 10, 2012

To the Editor The recent Letter to the Editor titled “Reader Raises Two Propofol Concerns” suggests that providers routinely swab propofol and Diprivan® vials prior to administration. A table was...

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Dental Emergencies Associated With Anesthesia Practice

October 10, 2012

Editor’s Note: The following is a summary of recommendations regarding the management of dental injuries during the perioperative period. Preoperative Evaluation, Consent, and Consultation Inform patient of potential trauma to...

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MRI-Compatible Handle and Blades

October 10, 2012

Dear Q&A, Would you consider having an MRI-compatible laryngoscope handle and blades necessary, or merely desirable, for safe administration of LMA anesthesia to children aged 2 to 12 years? Are...

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Reader Questions Why Some Anesthesia Machines Allow O2 Flow Below Basal Metabolic Needs

October 10, 2012

Dear SIRS: I am very curious why new machines have a flow that is below “basal metabolic needs.” Here are specifications for a number of different anesthesia machines to make...

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Communicating and Managing the Difficult Airway: One Health Care System’s Story

October 10, 2012

The Patient A middle-aged male was scheduled to undergo neurosurgery, but the procedure was aborted following an unrecognized difficult intubation with minor airway trauma. It was decided to postpone the...

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Hazards of Sedation for Interventional Pain Procedures

October 10, 2012

The ASA Committee on Pain Medicine, in their 2010 Statement on Anesthetic Care During Interventional Pain Procedures for Adults, wrote: “It is the opinion of the Committee that the majority...

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June 2012

Potential Hazards Created by Non-Standard Stopcock

June 10, 2012

To the Editor Standardization of the look and feel of supplies and equipment plays an important role in achieving a safe environment for patients. A supply substitution in our OR...

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Reader Raises Two Propofol Concerns

June 10, 2012

To the Editor Condensation was noted on the stopper of vials of propofol and inside the flip top cap which raised concerns about the drug’s potential sterility (Figures 1 and...

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Functional Test of the Ventilation and Breathing Circuits Will Detect Kinked Circuit

June 10, 2012

Editorial Reply The minimum anesthesia machine checkout between each case should include a functional test of the ventilation and breathing circuits. The automated machine checkout procedure really only looks for...

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Kinked Inspiratory Limb of Coaxial Circuit Mimics Bronchospasm

June 10, 2012

To the Editor A 68-year-old male was scheduled for a right knee arthroplasty after a previous distal femoral replacement became dislocated. Standard ASA monitors where placed and induction was performed...

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Converting an Anesthesia Circuit to Deliver and Titrate Supplemental Oxygen

June 10, 2012

To the Editor I read with great interest the recent lead article on fire safety in the OR,1 particularly the circumstances where a loose face mask is desired to provide...

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Should Inhalational Anesthesia Capability Be Required as Backup for TIVA?

June 10, 2012

Dear Q&A, From a patient safety perspective, do you consider it necessary to be able to switch to vaporizer-based inhalational anesthesia during TIVA, e.g., in case of an infusion line...

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Patient Safety Through Education: The Human Resources for Health in Rwanda Program

June 10, 2012

Anesthesiologists in Rwanda are truly one-in-a-million. There are currently 11 anesthesiologists in Rwanda to support a population of 11 million citizens. Most anesthetics are delivered by anesthesia technicians possessing little...

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Writing Standards to Improve Safety: How ASA’s Involvement Helped Make Dramatic Changes

June 10, 2012

For over 50 years a small group of ASA liaisons have represented anesthesiologists and our patients at various national and international standards-making organizations. In the United States, a standard is...

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Vasoplegic Syndrome and Renin-Angiotensin System Antagonists

June 10, 2012

Unexpected refractory hypotension under general anesthesia is an increasingly recognized perioperative issue. One cause for this type of hypotension is vasoplegic syndrome (VS). It is most commonly seen during cardiac...

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Take an Aspirin and I’ll (Safely) Put You On-Call to the OR in the Morning

June 10, 2012

Aspirin (acetylsalicylic acid, ASA) has a long, remarkable history in the development of useful drugs from herbal or vegetable sources. In ancient times, extracts of willow (Latin: salix) tree bark...

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A Checklist for Treating Local Anesthetic Systemic Toxicity

June 10, 2012

Within the world of anesthesia-related patient safety, the permutations of complication and treatment are constantly changing. Sometimes it is an old complication that never quite goes away; sometimes it is...

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Anesthesia Patient Safety Foundation (APSF) 2013 Grant Program

June 10, 2012

Funded Grant Applications (up to $150,000) scheduled to start January 1, 2013 will be announced on Saturday, October 13, 2012 at the Annual Meeting of the APSF Board of Directors...

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New Anticoagulants Present New Challenges

June 10, 2012

In the last decade, several new anticoagulation medications have become available on the market. Table 1 summarizes several of these new drugs as well as relevant pharmacologic data. Primarily these...

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