October 2015 APSF Newsletter, The Official Journal of the Anesthesia Patient Safety Foundation


Monitoring of Neuromuscular Blockade

Large Anesthesia/Practice Management Groups

Expanding Our Influence

President’s Report

Safety of Neuromuscular Blockade

History of Sugammadex

Emergency Manual Workshop

FDA Issues Drug Safety Communication

NMB Reversal and Outcomes

Q&A:OR Power Failure

Dear SIRS: Incorrect Network Connection


Save the Date

Merck Support of APSF

NBCRNA Support of Grant

Medtronic Support of APSF


APSF Awards 2016 Grant Recipients

Procedure for Submitting 2017 Grant Applications

Letter to the Editor:

PACU Handoff


Archives of Past Issues
Sponsorship Opportunities
Corporate Donors
2016 Board and Committees
APSF Newsletter Guide for Authors

Editors' Note: This issue contains a series of articles regarding the safe use of nondepolarizing neuromuscular blocking drugs. All anesthesia professionals should understand the importance of appropriately monitoring and reversing neuromuscular blockade. We believe that these articles will increase awareness, provide important educational information, and improve patient safety.


—Featured Article—

Monitoring of Neuromuscular Blockade:
What Would You Expect If You Were the Patient?

The Anesthesia Patient Safety Foundation (APSF) believes that residual neuromuscular blockade in the postoperative period is a patient safety hazard that could be addressed partially by better and consistent use of our qualitative standard train-of-four (TOF) nerve stimulator monitors, but will ultimately require quantitative (objective TOF) monitoring along with traditional subjective observations to eliminate this problem completely.1-2 APSF and other anesthesia professionals believe that every patient receiving nondepolarizing neuromuscular blocking drugs (NMBDs) should have at least qualitative, and preferably quantitative monitoring of the intensity of neuromuscular blockade using a peripheral nerve stimulator during the intraoperative period and assessment of the pharmacologic antagonism of neuromuscular blockade and adequacy of neuromuscular function prior to tracheal extubation.1-10 [more]

Large Anesthesia/Practice Management Groups: How Can APSF Help Everyone Be Safer?


Dr. Stoelting moderates


Dr. Robert Stoelting, moderating.


On September 10, 2015, APSF invited representatives of large anesthesia and practice management groups to meet with members of the APSF executive committee to discuss mutually relevant anesthesia patient safety issues. The goal was to help APSF identify and implement patient safety initiatives of particular interest and value to the conference participants.
Thirty-six attendees representing 23 large anesthesia/practice management groups participated in the half-day session (Table 1). These 23 groups represented a wide geographical cross-section of the United States and a variety of practice models that included all categories of anesthesia professionals. The American Society of Anesthesiologists, which has a committee on Large Group Practice, was represented by Daniel J. Cole, MD, President Elect, and Paul Pomerantz, CEO...[more]



APSF Patient Safety Foundation
Announces the Procedure for Submitting Grant Applications

FEBRUARY 22, 2016 (5 PM EST)

Instructions for submitting a Letter of Intent can be found at:

...[see more]



The Official Journal of the Anesthesia Patient Safety Foundation

The Anesthesia Patient Safety Foundation Newsletter is the official publication of the nonprofit Anesthesia Patient Safety Foundation and is published three times per year in Wilmington, Delaware. Individual subscription–$100, Corporate–$500. Contri­butions to the Foundation are tax deduct­ible. ©Copyright, Anesthesia Patient Safety Foundation, 2016.

The opinions expressed in this Newsletter are not necessarily those of the Anesthesia Patient Safety Foundation. The APSF neither writes nor promulgates standards, and the opinions expressed herein should not be construed to constitute practice standards or practice parameters. Validity of opinions presented, drug dosages, accuracy, and completeness of content are not guaranteed by the APSF.

APSF Executive Committee:
Robert K. Stoelting, MD, President; Jeffrey B. Cooper, PhD, Executive Vice President; George A. Schapiro, Executive Vice President; Robert J. White, Vice President; Matthew B. Weinger, MD, Secretary; Casey D. Blitt, MD, Treasurer; Robert A. Caplan, MD; David M. Gaba, MD; Steven K. Howard, MD; Lorri A. Lee, MD; Robert C. Morell, MD; A. William Paulsen, PhD; Richard C. Prielipp, MD; Steven R. Sanford, JD; Maria A. van Pelt, PhD, CRNA; Mark A. Warner, MD. Consultants to the Executive Committee: John H. Eichhorn, MD; Bruce P. Hallbert, PhD.

Newsletter Editorial Board:

Robert C. Morell, MD, Co-Editor; Lorri A. Lee, MD, Co-Editor; Steven B. Greenberg, MD, Assistant Editor; Sorin J. Brull, MD; Joan Christie, MD; Jan Ehrenwerth, MD; John H. Eichhorn, MD; Glenn S. Murphy, MD; Wilson Somerville, PhD; Jeffery Vender, MD.

Address all general, contributor, and subscription correspondence to:

Administrator, Deanna Walker
Anesthesia Patient Safety Foundation
Building One, Suite Two
8007 South Meridian Street
Indianapolis, IN 46217-2922
e-mail address: walker@apsf.org

Address Newsletter editorial comments, questions, letters, and suggestions to:

Robert C. Morell, MD
Senior Co-Editor, APSF Newsletter

c/o Addie Larimore, Editorial Assistant
Department of Anesthesiology
Wake Forest University School of Medicine
9th Floor CSB
Medical Center Boulevard
Winston-Salem, NC 27157-1009
e-mail: apsfeditor@yahoo.com

Send contributions to:
Anesthesia Patient Safety Foundation
1061 American Lane
Schaumburg, IL 60167-4973
Or please donate online at www.apsf.org.